AJR 2002; 178:1101-1107
© American Roentgen Ray Society
Etymology of Selected Medical Terms Used in Radiology
The Mythologic Connection
Christos S. Georgiades1
1 Department of Radiology, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore,
MD 21287.
Received October 4, 2001;
accepted after revision November 12, 2001.
Address correspondence to C. S. Georgiades.
The origin of much of the nomenclature used in radiology is rarely
researched. In some cases, a specific disease is named after the scientist who
first described it (Hodgkin's lymphoma, 1832) or after the patient in whom it
was first described (Lou Gerhig's disease). Rarely, such as with Trousseau's
syndrome, are the scientist and patient the same person. Commonly, disease
names are more descriptive, such as familial polyposis coli. The origin of
certain terms, however, is not intuitive nor does it fit into any of these
categories. During my search to uncover the meaning and origin of some of
these more mysterious terms, I uncovered delightful narratives, a selection of
which follows.
Caput Medusae
Medusa, a beautiful woman, is bedded with Poseidon, the god of the sea, in
one of Athena's temples. Poseidon desecrated Athena's temple by lying in it
with Medusa, to spite his fellow deity with whom he maintained a long rivalry.
Medusa, on the other hand, was a mere mortal and left vulnerable to Athena's
rage. The angered goddess promptly turned Medusa's golden wavy hair into
living snakes (Fig. 1A). The
serpentine appearance of the dilated paraumbilical veins
(Fig. 1B), occasionally seen in
patients with portal hypertension (Cruveilhier-Baumgarten syndrome),
[1] resembles Medusa's (Greek)
head (caput, Latin) after her unfortunate transformation. Athena went further,
cursing Medusa so that anyone who looked her straight in the eyes would turn
into stone. Perseus, under the protection of Athena, eventually killed Medusa
by using a polished shield as a mirror to avoid looking directly into her
eyes. In one of his later duels, Perseus used Medusa's head, still functional,
to defeat a sea monster by turning her head into stone. The sea monster was
sent by Poseidon to kill Andromeda, princess of Ethiopia
(Fig. 1C), who was later
immortalized as a constellation by Athena
[2].
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Fig. 1A. —Caput Medusae. Head of Medusa by Michelangelo da
Merisi, otherwise known as Caravaggio (oil on canvas, 1590, Galleria Uffizi,
Florence, Italy), shows live reptiles that replaced the gorgon's hair. Blood
can be seen gushing from Medusa's severed neck after Perseus, with Athena's
help, beheaded her.
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Fig. 1B. —Caput Medusae. Axial contrast-enhanced CT scan of abdomen
shows dilated serpentine paraumbilical veins in 55-year-old woman with
cirrhosis and portal hypertension. Physical examination found patient to have
caput medusae sign.
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Fig. 1C. —Caput Medusae. Perseus and Andromeda by Joachim
Wtewael (oil on canvas, 1611, Musee de Louvre, Paris, France) shows Perseus,
in this postrenaissance rendition of the fable of Medusa, on his flying horse
holding Medusa's head in his left hand and preparing to save a chained
Andromeda from the sea monster who was sent by Poseidon, god of the sea and
Athena's arch rival, who, in turn, was Perseus' protector.
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Cyclopia
According to the ancient Greeks, Mother Earth first gave birth to a
semihuman race, which included the Cyclopes (Greek, ring-eyed). This race of
master-smith giants owed their name to the fact that they possessed only one
eye centered above the nose
[3]. The congenital presence of
one eye is thus referred to as cyclopia
[4]
(Fig. 2A) and is associated
with a multitude of midline cranial defects
(Fig. 2B). One of these
Cyclopes, Polyphemus (Fig. 2C),
was the keeper of an island on which Odysseus and his companions landed on
their way back to Ithaca after sacking Troy. Polyphemus decided to make dinner
out of Odysseus's party. Odysseus offered wine to the giant who soon fell into
a drunken stupor. He then sharpened a branch from an olive tree, drove it into
the Cyclops's only eye, and escaped with his men
[3]. The race of the Cyclopes
was eventually exterminated by Apollo, and their souls were cast into the
volcanic depths of Aetna
[2].
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Fig. 2A. —Cyclopia. Photograph of gross specimen of stillborn male
fetus shows midline fused orbits (cyclopic deformity), arhinia (Greek,
congenital absence of nose), and proboscis (Greek, trunk).
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Fig. 2C. —Cyclopia. Polyphem by Johan Heinrich Wilhelm
Tischbein (1862, Landesmuseum, Oldenburg, Germany) shows single midline eye
characteristic of the race of the Cyclopes. This particular Cyclops,
Polyphemus, was blinded by Odysseus and his men during their long journey home
from Troy.
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Galactocele
Gala (Greek, milk) and cele (Greek, pouch) form this word
that refers to a cystic collection of milk in the breast as a result of ductal
obstruction (Fig. 3A)
[5]. According to Greek
mythology, Pygmalion, the king of Cyprus, who was disappointed that he could
not find a woman to suit him, commissioned a statue of the perfect woman. The
marble statue was so exquisite that Pygmalion fell in love with it. He named
it Galatea (Greek, milky white) (Fig.
3B), fitting the color of polished marble used in the sculpture.
Aphrodite (the goddess of love and beauty who, according to Homer, was also
born in Cyprus [Fig. 3C]) took
pity on Pygmalion and brought the statue to life
[2].
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Fig. 3B. —Galactocele. Pygmalion and Galatea by Francois
Boucher (oil on canvas, ca. 1750) shows the milky white marble statue of
Galatea coming to life as Pygmalion, the sculptor, watches in awe. Pygmalion
fell in love with his statue, which, in his mind, was the image of the perfect
woman. The goddess Aphrodite (next to the statue) took pity on Pygmalion and
breathed life into the statue.
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Fig. 3C. —Galactocele. Birth of Aphrodite by Alessandro di
Mariano Filipepi, also known as Sandro Botticelli (tempera on canvas, 1480,
Galleria degli Uffizi, Florence, Italy), shows the gods of winds (left) and a
nymph welcome Aphrodite and shower her with roses as she is born from the
sea.
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Hippocampus
The hippocampus is part of the limbic cortex and is located in the
inferomedial portion of the temporal lobes
[6]. On cross-sectional images,
the hippocampus appears as two interlocking C's reminiscent of a sea horse.
The hippocampi (Greek; hippos, horse; campia, wormlike) were
the sea horses that pulled Poseidon's (Greek god of the sea) chariot
(Fig. 4A) through the depth of
the oceans [2]. Atrophy of the
hippocampus (Fig. 4B) is
referred to as mesial temporal sclerosis and has been implicated in causing
seizures.
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Fig. 4A. —Hippocampus. Poseidon and His Sea Horses by Leonardo
da Vinci (ca. 1511, Windsor Royal Library, London, England) depicts the sea
horses (Greek, hippocampi) as horses with fish tails instead of hind legs. The
spiral appearance of their tails gave the name to the well-known sea horses
and to the hippocampus, part of the human limbic system.
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Fig. 4B. —Hippocampus. Coronal T2-weighted MR image obtained through
hippocampi of 14-year-old boy who presented with seizure disorder shows
malacia of left hippocampus (arrow) indicative of mesial temporal
sclerosis.
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Labyrinthitis
When King Minos ascended to the throne of the island of Crete, he pledged
an annual sacrifice to Poseidon. Once he took office, King Minos forgot his
promise. Unfortunately for King Minos, Poseidon's memory was not as short, and
to avenge the mortal, he sent a white bull with whom Minos' wife mated. The
result of that unnatural union was a son named Minotaur (Greek;
tauros, bull) who had the head of a bull. Embarrassed, Minos' wife
asked the master engineer, Daedalus, to build a maze (Greek, labyrinth) from
which the imprisoned Minotaur could never escape
[2,
3]. Labyrinthitis thus refers
to the inflammation of the cochlea
[7]
(Fig. 5A), which has a
mazelike form on cross-sectional images. Eventually, Minotaur was killed by
Theseus, the young Athenian hero, with whom Ariadne (Minotaur's half sister)
fell in love (Fig. 5B).
Ariadne gave the secret of the labyrinth to Theseus who promised to take her
back to Athens and marry her. Completing the cycle of betrayal, Theseus
abandoned Ariadne on the island of Naxos for the favors of another woman.
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Fig. 5A. —Labyrinthitis. Axial gadolinium-enhanced T1-weighted MR image
of 42-year-old woman who presented with acute onset vertigo shows increased
signal in left cochlea (arrow) and horizontal semicircular canal,
compatible with labyrinthitis. (Courtesy of Yousem D, Baltimore, MD)
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Fig. 5B. —Labyrinthitis. Theseus Slaying the Minotaur (detail
by Capana Cassone, sixteenth century, oil on canvas, Avignon Museum, France),
in which artist uses medieval themes to depict Theseus wearing armor and
slaying the Minotaur. Ariadne, who helped Theseus find his way through the
maze, is seen in the left foreground.
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Omphalocele
The legendary hero Heracles (Greek name for Hercules), eager to marry Iole,
visited her father seeking his approval. Eurytus, however, refused, and
Heracles, insulted, swore vengeance. He invited Eurytus's son for dinner, and
after luring him to the tower, Heracles hurled him to his death. This action
constituted a serious violation of hospitality rules, and even though he was a
demigod, Heracles was sentenced to be sold as a slave for 1 year to be rid of
his sin. He was bought by Omphale, the Queen of Lydia with whom he eventually
fathered four sons, including one of the ancestors of the famous King of
Lydia, Croisus. Heracles was fond of Omphale and claimed that the part he
liked the most about her was her navel
(Fig. 6A)
[2]. Omphalos thus came to mean
navel in Greek and omphalocele (Fig.
6B), a hernia through the navel
[8].
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Fig. 6A. —Omphalocele. Omphale and Hercules by Francois
Lemoyne (oil on canvas, 1724, Musee de Louvre, Paris, France) shows Hercules
(Latin name for Heracles) and Omphale, the Queen of Lydia, depicted in a
romantic scene with a cupid by their side. Hercules was especially fond of
Omphale's navel. Not surprisingly, the Greek word for navel is omphalus.
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Fig. 6B. —Omphalocele. Sonogram of male fetus shows thin membrane
(long arrow) surrounding partially herniated echogenic liver.
Umbilical cord (short arrow) is seen inserting in midline of
membrane, which is indicative of omphalocele.
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Phrygian Cap
Midas, King of Phrygia, found himself a witness to a musical competition
between Apollo, god of music, and Pan, god of goat-herds and shepherds, as
they were playing the lyre and pipes, respectively. Apollow was declared the
winner, but Midas unwisely expressed his disagreement with the outcome. An
enraged Apollo transformed Midas' ears into those of an ass
(Fig. 7A) as punishment.
Humbled, Midas spent the rest of his life wearing a long, baggy cap, called a
phrygian cap (Fig. 7B) to hide
his hideous ears [2]. A baggy,
folded gallbladder on sonography or CT is thus referred to as a phrygian cap
(Fig. 7C), which can
occasionally be confused with a septated gallbladder or gallstones
[9]. Marsyas, a satyr from
Phrygia, also lost a musical contest to Apollo. Apollo was not in a merciful
mood this time, and after winning the contest, he flayed Marsyas alive (Figs.
7A and
7D)
[2].
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Fig. 7A. —Phrygian cap. Punishment of Midas by Hendrick de
Clerck (1620, Rijkmuseum, Amsterdam, The Netherlands) shows Apollo busy
flaying Marsyas as the frightened Midas, King of Phrygia, is watching in the
background. King Midas is seen wearing ass's ears, his punishment for
insulting Apollo. A violin (modern equivalent to the ancient lyre) and a set
of pan pipes are also seen in the foreground.
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Fig. 7B. —Phrygian cap. Priapus (unknown artist, House of the
Vettii, Pompeii, Italy) shows "the pruner" wearing so-called
phrygian cap (what King Midas wore to hide his ass's ears) and holding a
pruning knife. He was cursed to carry large genitalia by the mother of gods,
Hera, who wanted to punish Aphrodite (Priapus's mother) for her
promiscuity.
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Fig. 7C. —Phrygian cap. Sonogram of right upper quadrant in 36-year-old
man shows an apparently septate gallbladder. Further examination revealed this
to be only folded gallbladder without a septum, compatible with phrygian cap
deformity.
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Fig. 7D. —Phrygian cap. Flaying of Marsyas by Tiziano
Vecellio, better known as Titian (Kromeriz, State Museum, Czech Republic),
shows Marsyas hanging upside down as Apollo's accomplices flay him. Apollo is
seen in the left background playing music. One of his accomplices, standing to
the left of Apollo, is sporting a phrygian cap.
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Sirenomelia
The Sirens, originally described in The Odyssey by Homer, were a
group of mythic beasts with the head of a woman and the body of a bird, whose
irresistible melodies were the downfall of many a Greek sailor
[2]. In the epic poem, The
Odyssey, Odysseus plugged the ears of his sailors with wax and had then
tie him on the mast (Fig. 8A).
Thus they managed to escape the realm of the Sirens without losing any of
their comrades. Later on, especially during the Renaissance, the Sirens took a
different, more romantic, and mermaid-like from in art, being transformed by
the artist into half women, half fish
(Fig. 8B). The Greek suffix
-melia refers to limbs and sirenomelia to the mermaidlike congenital
fusion of the lower extremities (Figs.
8C and
8D)
[10].
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Fig. 8A. —Sirenomelia. Stamnos of Odysseus and the Sirens
(unknown artist, Greece, 460 B.C.; British Museum, London, England) shows
Odysseus, tied to the center mast, surrounded by the Sirens (half women, half
birds), whose melodious songs drew many Greek sailors to their drowning death.
His comrades, with their wax-plugged ears, managed to row past the Sirens'
realm.
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Fig. 8B. —Sirenomelia. Ulysses and the Sirens by Herbert James
Draper (1909, Ferens Art Gallery, Hull, England) shows Odysseus' encounter
with the Sirens. The latter have taken a more appealing, mermaidlike form.
(Reprinted with permission from Ferens Art Gallery)
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Syringomyelia
Syringomyelia is a composite from the Greek words syrinx and
myelos, the latter referring to the spinal cord. Syrinx was a young
maiden in ancient Greece who was unlucky enough to catch the eye of Pan, a
lesser god not formally inducted among the Olympian twelve. Half goat, half
man, Pan scared his enemies away with a terrifying cry that caused panic,
hence the origin of the word "panic." Syrinx grew desperate from
Pan's relentless pursuit and, at the banks of the river Ladon, begged the gods
to save her (Fig. 9A). The
gods took pity on Syrinx and transformed her into a clump of reeds
[2]. A hollow cylinder was
henceforth known as syrinx and became the root for words such as syringomyelia
(Fig. 9B) and syringe. Pan,
determined to have Syrinx one way or another, cut down the reeds and fashioned
from them his well-known pan pipes.
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Fig. 9A. —Syrinx. Pan and Syrinx by Jean-Francois de Troy (oil
on canvas, 1733) shows Syrinx being comforted by a god, while Pan, her
pursuer, appears through a clump of reeds, symbolic of Syrinx's later
transformation.
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Conclusion
These myths provide us with an interesting insight into the mind of the
early scientists and their first impressions of these diseases. We hope the
knowledge they provide will enhance the learning process and enliven the job
of radiology educators.
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B. D. Nguyen and C. S. Georgiades
Greek Mythologic Etymology in Radiology
Am. J. Roentgenol.,
November 1, 2002;
179(5):
1347 - 1347.
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