On the problem of nomination and synonymy of the term "glaucoma"

Kripak Anna Valentinovna ORCID: 0000-0002-9117-828X Postgraduate student of the Department of Russian Language and General Linguistics of the Buryat State University named after Dorji Banzarov 664003, Russia, Irkutsk region, Irkutsk, 4th Sovetskaya str., 102, sq. 46 anna_kripak@mail.ru Other publications by this author

Kharanutova Darima Shagdurovna ORCID: 0000-0001-5692-5393 Doctor of Philology Associate Professor of the Department of Russian Language and General Linguistics, Buryat State University named after Dorji Banzarov 670000, Russia, Republic of Buryatia, Ulan-Ude, Smolina str., 24a dkharanutova@mail.ru

The increasing role of terminology, the need for its unification and standardization necessitate the analysis of specialized terminology systems. A fairly large number of linguistic studies devoted to the development of the theory of nomination and understanding the linguistic picture of the world as a whole confirm the relevance of this area.

The ophthalmological terminological system, being a subsystem of the medical terminological system, has gone a long way in becoming and can be considered established, which is confirmed by the works of domestic and foreign researchers ^[1-4]. Meanwhile, the issue of synonymy of the ophthalmological terminology system remains to be fully disclosed. Functioning in speech, in addition to the nomenclatural approved name, the term often acquires duplicate names. At the same time, some researchers consider this phenomenon to be positive and natural, which arose in parallel with the development of science and the expansion of scientific knowledge ^[5-7]. Others insist that this is an extremely negative phenomenon that violates the integrity of the terminological system, making it difficult for it to function ^{[8, 9]}. However, both recognize the existence of terminological synonymy, which cannot be disguised, just as it is impossible to prohibit the use of duplicate names ^[10], some of which are defined as "terminological synonyms", others as "terminological doublets", and others as terminological variations.

The term, being a scientific concept, has a number of conceptual features: conceptual, figurative component, background knowledge. Investigating ophthalmological terminology, we have discovered the existence of a double and triple series of duplicate names of terms: nomenclature names, professional jargonisms, folk terms that characterize different areas of experience and represent different aspects of knowledge. At the same time, if a sufficient number of works are devoted to the study of nomenclatural terms, then fewer linguists are engaged in the study of professional jargonisms and "folk terminology". However, they all agree that medical jargonisms are not designed for widespread use and are effective only at the specialist-specialist level ^{[11, p. 66]}. An even smaller number of researchers are involved in the nomination of medical folk terminology, and many of them suggest linking its etymology with knowledge and aspects of traditional medicine and healing ^{[12, p. 56]}. However, in addition to the practical activities that influence the emergence of folk terms, there are other factors that contribute to the emergence of a new nomination. When getting acquainted with a phenomenon, a person notices one of the many signs of a given subject that seems characteristic to him, and uses it to nominate a new subject. Perceiving a new phenomenon, sharing feelings with other participants in communication, a person creates a new "folk" term that functions at the patient-patient level.

At the same time, both the "folk term" and the professional jargon are not synonymous with the nomenclature term, they are not identical and not interchangeable. In a previous study, we proved that they can be considered quasi-synonyms ^{[13, p. 26]}.

From the point of view of the theory of the concept, the structure of the triple row of an ophthalmological term may look like this: the nomenclature name, which is the conceptual core, in the nuclear zone there are professionalisms-jargonisms that convey background knowledge, and on the periphery there are folk terms that convey perceptual-associative knowledge (Fig.).

Fig. The structure of the ophthalmological concept

For an adequate interpretation of the conceptual core, special knowledge of ophthalmology is required. The term nuclear zone can only be interpreted by a communicant from a professional community, because it includes background knowledge, in our case, an ophthalmologist or a nursing staff. The peripheral level of the ophthalmological concept has an associative component, which can only be represented by communicants who do not have special knowledge, but who experience certain emotions and perceive the nomenclature term through personal perception and attitude to their own health. At the same time, our previous research showed that not all ophthalmological terms have a triple or double row of quasi-synonyms. There are terms that do not have duplicate names. The question naturally arises, why is this happening?

This work represents the next stage of an earlier study, the subject of which is ophthalmological terminology.

The purpose of the work is to explain the nature of the appearance of the term "glaucoma" from the moment of its origin to becoming a nomenclatural generally accepted term and to find possible quasi-synonyms for this term.

To achieve this goal, historical medical sources were developed, including those in foreign languages ^[14-16]. A unidirectional experiment was also conducted to identify possible quasi-synonyms for the term "glaucoma".

The history of the term "glaucoma"

The disease, classified today as "glaucoma," appeared a long time ago. At first, the term "glaucoma" was used to refer to a general group of eye diseases without differences that led to blindness. It was only a little later that signs began to appear indicating a disease similar to glaucoma, in the form in which it is now known ^{[14, p. 1563]}.

However, there is still some disagreement about the true origin of the term. "Glaucosis" was first mentioned in the writings of Hippocrates as a disease leading to blindness, most often found in the elderly ^{[16, p. 1603]}. The sources mention that "as soon as the pupil turns the color of the sea, vision is destroyed, and often the other eye is also blind." It has been suggested that the word "glaucoma" comes from the ancient Greek word γλαύvξ – γλαύvκος (glaukos), a noun and adjective derived from the verb "γλαύvσσω" (glausso), meaning "to shine" or "to shine", which possibly refers to the "hot" eye in acute glaucoma. If we talk about color, then this word also means "blue-white" or "blue-green", ophthalmologically these are eyes that have a light blue or marine hue. Arab scholars have also translated glaukos as zarqaa, a term meaning "blue" ^{[15, p. 28]}. To this day, glaucoma is called "blue water" in Arabic. The addition of "water" to the term may be due to the belief that the discoloration was caused by edema (which is actually true). There is another version, the Greek word "glaukos" also means an owl, which is believed to have been named so because of its ferocious, large and luminous eyes. In addition, it is known that congenital glaucoma was recognized already in ancient times and was characterized by large ophthalmic eyes (bulbous eyes) that looked like the eyes of an owl. There is also evidence that the ancient Greek goddess Athena and the city named after her (Athens) were called glaucomati in Greek, which means "having the eyes of an owl" ^{[3, 14]}. This probably reflects the fact that she was as wise as an owl. Thus, the ornithological concept reinforces the debate concerning the exact origin of the term "glaucoma".

Since studying the history of the term "glaucoma" does not provide an unambiguous answer to the question of the etymology of the word, we suggested that the term's nomination may be related to patients' perception of their disease. In the experimental part of this study, we attempted to find out how patients understand their diagnosed glaucoma disease, or in other words, how patients "see" glaucoma with their own eyes.

Participants in a unidirectional experiment

The study included patients who applied to the glaucoma service of a large ophthalmological clinic in Irkutsk in the period from January 2024 to June 2024. All patients underwent a complete ophthalmological examination. Patients with a diagnosis of primary open-angle glaucoma of various stages of the disease were recommended to participate in the experiment (110 people). Of these, 6 patients had a far-advanced stage of glaucoma in which visual acuity is minimal, these patients were excluded from the study, 7 patients had other concomitant pathologies and, for the purity of the experiment, they were also excluded from the study, 4 people refused to participate in the study. All the remaining 93 patients signed written voluntary consent to participate in the study. The characteristics of the participants in the experiment are presented in Table 1.

Table 1. Characteristics of the participants in the experiment

The questionnaire

For the experiment, a questionnaire was developed based on the most specific symptoms previously mentioned by patients and recorded by the doctors of the institution. The questionnaire included 12 questions that require answers: "yes", "no", and one additional question that requires a detailed answer (Table 2).

Table 2. Questionnaire "What do glaucoma patients see"

On the recommendation of the attending physicians and taking into account the severity of the pathology, questions were asked orally to each participant in the experiment and recorded in writing. To eliminate discrepancies in the answers and confirm the accuracy of the results, the survey was conducted twice (the second time the same questions were asked 15 minutes after the first survey).

Experimental results

The study ended in June 2024, when 93 study participants were interviewed and their responses recorded and analyzed. All 93 patients were divided into 2 groups depending on the stage of glaucoma (initial stage and advanced stage). It was important to do this, since the patient's visual acuity and field of vision are different at each stage, and it is likely that the patient will also determine his condition differently. According to medical sources, at the initial stage of glaucoma, patients experience an increase in the size of the blind spot, the boundaries on the nasal side narrow by 5 degrees, and at the advanced stage of glaucoma, the boundaries on the nasal side narrow to 15 degrees.

The answers to the open question were deciphered in order to search for visual symptoms of the disease and later to identify signs indicating the connection of the symptom with the etymology of the term "glaucoma". Words such as "fuzzy" and "fuzziness" were considered to be of the same root, derived from a single feature – "fuzziness". Descriptors such as "hazy", "blurred", and "smoky" were considered different. Table 3 shows the symptoms described by the patients.

Table 3. The most common symptoms of glaucoma

In patients with initial or advanced glaucoma, the most common symptoms were: the need for more light (73.6% and 88.8%), darkening of the eyes in the group with the initial stage of glaucoma was observed by 33% of patients and 83% in the group with advanced stage of glaucoma, in addition, 83% of patients in the same group saw grain and veil in front of my eyes. The patients were asked an open-ended question: "Please describe in one or two words how you see this world?" Since patients with early-stage glaucoma see the world practically through the eyes of a healthy person, almost 100% of patients in this group said they did not see any changes in their perception of the picture. The most common response in the group with advanced glaucoma was "turbidity" (45%), the second most common was "dullness" (26%), and the third was "blurred" (10%). Despite the fact that all the patients' comments are similar, we have identified two that differ from the others, but are of interest to our study, as they relate to historical findings concerning the origin of the term "glaucoma". So, one respondent said, "The world seems more blurry. It's just not quite clear. Everything used to be clearer." Another patient described his condition as: "Now I'm looking through murky greenish water." There were also responses characterizing vision changes: "blurred" (6%), "hazy" (3%), "clouding" (5%), "unclean" (4%) and "unclear" (1%). It should be noted that not a single patient from the group with advanced glaucoma complained of "tunnel vision", which experts say is a symptom of glaucoma development, narrowing of the visual field was confirmed only by instruments.

Discussion

Glaucoma (glaukos, Greek, glaucoma, English) is a chronic eye pathology characterized by increased intraocular pressure, the development of optical neuropathy and visual impairment ^{[17, p. 16]}. The question of the etymology of the ophthalmological term "glaucoma" still remains controversial and open. Appearing at the beginning of 400 BC, the term "glaucoma" was universal, denoting a complex disease leading to blindness. A study of historical sources has not given a clear answer as to whether the word "glaukos" was first used as a verb (to shine), as an adjective (blue-green), or as a noun (owl).

In this study, we attempted to explain whether the etymology of the term is related to patients' perception of their disease, as well as to find out whether the term "glaucoma" has quasi-synonyms.

The experiment made it possible to determine the range of descriptors most often used by patients to determine their condition. The most popular among them were: "turbidity", "dimness", "haze". Less popular are "fuzziness" and "hazeiness".

The detailed responses of the patients were of particular interest to our study. One of the patients' characterization of his condition as "looking through cloudy greenish water" allows us to say that the etymology of the term "glaucoma" may be related to the use of the adjective (cloudy blue-green) in ancient times. In addition, during the experiment, we refuted the popular opinion of the medical community that a narrowing of the visual field leads to a patient with advanced glaucoma seeing the world "through a cocktail tube" or "keyhole". None of the 93 patients described their condition in this way.

Despite the fact that in previous work we pointed out the presence of a high percentage of quasi-synonyms in the ophthalmological terminology system ^{[13, p. 24]}, the results of the presented experiment did not reveal duplicate names for the term "glaucoma". Most likely, the nomination of the term "glaucoma" is historically motivated by a number of factors: 1. Etymological factor - external similarity to the object (owl with big eyes); 2. Identity factor - similarity to the symptoms of the disease (cloudy green water); 3. Euphony factor – ease of memorization, pronunciation, as a result - uniform sound in all languages.

A mistake.

The ophthalmological terminology system is well-established, but insufficiently studied from the point of view of synonymy. Using the term "glaucoma" as an example, this study made it possible to explain why some ophthalmological terms have neither doublets nor quasi-synonyms. The absence of duplicate names was influenced by the etymological factor, the factor of identity and the factor of euphony, which is confirmed by the results of the experiment. "Glaucoma" is firmly embedded in the language of both professionals and laypeople, and this term does not require an alternative as a synonym, doublet, or quasi-synonym. In the future, it is necessary to develop criteria for the distribution of duplicate names into three groups: nomenclature terms, professional jargonisms, and "folk" terms.