Lietuviško anatomijos vardyno istorijos metmenys

Gintautas ČESNYS Vilniaus universitetas THE LITHUANIAN ANATOMICAL NOMENCLATURE HISTORICAL OUTLINE The foundation of international anatomical nomenclature consists of Latin and Latinized Greek words, inherited historically or newly created in the spirit of the classical languages. Names of Arabic and other origins are rare exceptions. The nomenclature comprises nouns (ren) and their derivatives with suffixes and prefixes (renalis, retrorenalis); hybrids are formed less often, for example, from a Greek and a Latin word (lymph nodus). The semantics of Latin terms records the properties of the objects named at a particular stage of knowledge; moreover, the system must remain open to accumulating future scientific experience. Owing to its stability and precision, Latin was the international language of science for centuries. Although its importance declined somewhat in the twentieth century, it nevertheless remained the core of medical nomenclature, continually supplemented and refined. On the other hand, an object or phenomenon, its essence, is better understood only once it has been named in one’s native language. Traditions of national nomenclatures differ greatly. The simplest course is not to bother creating one’s own nomenclature, but to use Latin, as the Turks, for example, do. Unfortunately, in this case the semantic information contained in Latin word combinations is lost, information that makes it possible to understand the content of the object described and is necessary for grasping the logical structure of terms. A second possibility is to adapt Latin terms to the grammar, spelling, and pronunciation of the native language. This is what peoples whose languages contain many words of Latin origin do (Italians, French, English). In this case, pronunciation diverges greatly from the Latin original, and such a deformed term is more difficult for speakers of other languages to understand. A third option is to create an original system of names in the native language, usually by translating from Latin but drawing on folk-language traditions. This is what our closest neighbors—the Latvians, Russians, Poles, and Germans—do. National anatomical nomenclatures ensure a conscious understanding of Latin words. In addition, they are a great asset, a contribution to the native language and to the general culture of the nation as a whole. 55 Lietuviško anatomijos vardyno ištakomis reikia laikyti Konstantino Sirvydo (1579–1631) trikalbį (lenkų–lotynų–lietuvių) žodyną, kurio pirmasis leidimas išėjo apie 1620 m. (žinomas tik defektuotas egzempliorius be antraštinio lapo), fotografuotinis – 1997 m., o labiausiai paplitęs trečiasis Dictionarium trium linguarum – 1642 m., fotografuotinis – 1979 m. Jame užfiksuota gausi paveldėtoji lietuvių kalbos leksika, tarnybes, archaizmai, paties K. Sirvydo naujadarai, tarp jų ir iš medicinos, pvz.: negyvagimis, žinia paraikymo sąnarių (anatomija), karštinė (drugys). The Latin text of the dictionary makes it possible to build a bridge between the age of K. Sirvydas and our own, and to assess which medical, and especially anatomical, names are the oldest, coming from the depths of time, and which are products of later periods (Butrimaitė 2000). Three groups of words used by K. Sirvydas can be distinguished. The first group consists of names that have taken root in anatomical nomenclature and are still in use: the whole body (kūnas), its individual parts (galva, kaklas, krūtinė, nugara, pilvas, šonas, ranka, koja), regions of the head (veidas, smakras, kakta, momuo, pakaušis), parts of the limbs (kirkšnis, šlaunis, blauzda, kelis, petys, alkūnė, delnas, pirštas, nykštys), and systems and organs (oda, nagas, plaukas, ausis, burna, lūpa, dantis, gomurys, kaulas, sąnarys, širdis, inkstas, krūtis, bamba). The second group comprises words whose meanings have narrowed, broadened, or changed over time (plaštaka – dabar ne palma, o manus; smegenys – tik medulla, bet ne gingivae). The third group consists of such good words that did not take root in anatomical nomenclature as nugarkaulis (the term that took root is slankstelis), bruvis (– antakis), kiaušas (– kaukolė), rietas (– šlaunis), stomuo (– ūgis), jeknos (– kepenys), gysla (– nervas). Pirmuosiuose profesionalios medicininės publicistikos bandymuose Vincas Kudirka (1858–1899) vartojo jau įsišaknijusius anatomijos pavadinimus (plaučiai, krūtinė, burna, dantys, žarnos, širdis, gysla (– vena), inkstai, smegenys, sąnariai), taip pat terminus (skilvis), gal ir savo sugalvotus, kurie vėliau neprigijo (dirksniai, driksniai, sunkė (– arterija), sunkinis kraujas, gyslinis kraujas ir kt.). Vincas Kudirka (Kudirka 1889, 1895) pirmasis mėgino pavadinti audinius žodžiu au-da, atkakliai ieškojo gleivinės, plėvės, dangalo lietuviškų terminų, tačiau ne visai vykusiai visus juos bendrino žodžiu plonė – smegenų plonės, pilvo slidplonė, pilvaplonė, plonės aplink širdį, jungplonė (– jun- 56 ginė), a thin palate. He also struggled with the names for the pharynx, larynx, liver, and pancreas, continuing to confuse them. The search for an equivalent for gland, which never took root, is interesting: a little lump of saliva, sweat or a little lump. The undisputed pioneer of professional anatomical nomenclature as a system of names was Jonas Basanavičius (1851–1927). The Manuscript Collection of the Institute of Lithuanian Literature and Folklore preserves his handwritten “Materials for an Anatomical and Medical Nomenclature,” which contains about 270 anatomical names in Russian, Latin, and Lithuanian, as well as some equivalents in German and Polish. He used some Russian medical terminology dictionary, drew on words he had heard from people in his native region (Pilviškiai, Skiriaudžiai, Marijampolė), and consulted F. Kuršaitis’s (1806–1884) dictionary (1870, 1883, 1894). The materials were probably collected after Jonas Basanavičius had returned to Lithuania (about 1908–1912). The dictionary drafts contain names for almost the entire body, its parts, and organs, already widespread since the time of K. Sirvydas. Among new Lithuanian words of this kind, we may mention those used by J. Basanavičius: build, side, nape, viscera, popliteal region. Names for general features of the locomotor apparatus were apt (skeleton, periosteum, cartilage, muscle, tendon), as were terms relating to bone relief and joints (groove, crest,?t, suture, fontanelle, vault), some bones (rib, scapula, vomer, incus), objects of splanchnology (internal organs) (fold, portal, nostrils, lungs, tongue, uvula, esophagus, gallbladder, rectum, omentum, umbilical cord, vagina, penis), and some body fluids (sweat, saliva, bile, semen). The use of atrium, carotid artery, vestibule of the ear, and tympanic membrane probably also began with J. Basanavičius. Interestingly, alongside the names of the sexual organs, synonyms are also given that now sound vulgar. His efforts to create neurological terminology deserve separate mention. The terms he used—ganglion, nucleus, gyrus, brain, medulla oblongata, cerebellum—remain in use today; on the other hand, of the names for nerves (accessory, facial, lingual and nas-al, hypoglossal, oculomotor, olfactory, optic, trigeminal, vagus), only some took root, and even those in altered forms. Names proposed by J. Basanavičius that came very close to current usage include eye socket,?terpietis, seminal vesicles, hymen, small intestine, semicircular canal, peritoneum, pericardium, sacrum. Among interesting terms that failed to take root are: gyvyslė (arte- 57 Fig. 1. Facsimile of J. Basanavičius’s manuscript ria), small brain vessel (nervus), ligament (ligamentum), lumbar vertebra (columna vertebrarum), stump, coccyx (os coccygis), kneecap (patella), arch (clavicula), clitoris (clitoris), scrotum (scrotum), diaphragm (diaphragma), lingual frenulum (frenulum linguae). Also worth mentioning are outgrowth (processus) and nerve plexus (plexus), probably more accurate than the currently used appendage and plexus. J. Basanavičius had difficulty choosing names for parts of the foot and hand, the pelvic bone, and the meninges; the term for the throat was still unclear, the spleen and pancreas were confused, and much thought was given to Lithuanian equivalents for the parts of the eye (the terms for sclera, cornea, retina, choroid, lens, iris, conjunctiva were not yet known). J. Basanavičius could not translate cellula, cochlea, concha, ovarium, ductus ejaculatorius, epiglottis and other terms. 58 Fig. 2. Example of word formation by J. Basanavičius Latin words. He made a great effort to translate glandula, proposing at least several translation options (gelaža, grumulus, žirnukas, virukas), while he thought liauka (‘gland’) to exist only in pigs. Later, it was precisely this last name that caught on. J. Basanavičius’s principles of term formation emerge from the outlines of his dictionary. First, he did not overuse adjectives with the suffix -inis, often using the genitive of a noun instead: facial nerve, reproductive organs, parotid gland, sublingual gland, carotid artery. Second, he promoted derivatives of nouns formed with prefixes: neck – nape, knee – popliteal region, heart – atrium, tooth – interdental space, and so on. Finally, J. Basanavičius retained some Latin terms that had apparently become very well established and were difficult to translate, as is also the case in today’s anatomical nomenclature: aorta, artery, nerve, organ, prostate, myology, osteology, syndesmology, splanchnology. By the way, having considered the names of four branches of anatomy, he also translated them quite successfully (the study of muscles, bones, joints, and viscera). J. Basanavičius did not include the now-established term fascia, proposing muscle membrane in its place. 59 Thus J. Basanavičius seemed to crown that epoch in the development of our anatomical nomenclature when Lithuania had no medical institution of higher education and terminology was the concern of individual enthusiasts. The vigorous development of Lithuanian anatomical nomenclature, as of medical nomenclature generally, began with the establishment of the University of Lithuania in Kaunas. At first, medical students studied from German and Russian textbooks, so there arose a need to prepare textbooks in their native language and, consequently, to seek Lithuanian medical terms, especially anatomical ones. These were created not only by anatomists but also by physiologists, pathologists, clinicians, and natural scientists. During this period, the achievements of our most renowned ophthalmologist, Petras Avižonis (1875–1939), stand out exceptionally. Having loved his native language from childhood, associated with Jonas Jablonskis (1860–1930) and other linguists, written two short grammars, edited and translated texts, P. Avižonis created an impeccable nomenclature for the eye, of which Pranas Skardžius (1899–1975) wrote: “It can be confidently asserted that he organized the medical terminology of his field better than that of any other medical field. He was the only physician who, one might say, was passionately devoted to matters of language” (Skardžius 1939: 114). The distinguished eye specialist had been a member of the Terminology Commission since 1920, often consulting with its chair Jonas Jablonskis and the linguist Juozas Balčikonis (1885–1969), which ensured the impeccable language of his writings (Puzinas 1979). Two stages can be distinguished in the creation of the anatomical nomenclature of the eye: in the article Senatviškieji akių pakitimai (1929), P. Avižonis established the terms sclera, cornea, iris, pupil, vitreous body, choroid, while in his famous Akių ligų vadovas (1940), published after the author’s death, he used knob-shaped body, retina, lens, eyelids, lacrimal lake, lacrimal sac, orbit. All these words caught on remarkably quickly; their perfect formation remains a model for all who care about Lithuanian terminology, now and in the future. Kaip nurodė Salezijus Pavilonis (1919–1998), reikšmingiausią vaidmenį tada atliko Jurgis Žilinskas (1885–1957), padedant Anatomijos instituto bendradarbiams (Pavilonis 1993). Jis dalimis paskelbė anatomijos vadovėlio metmenis (Neurologijos paskaitos, 1923; Osteologija ir sindesmologija, 1932; Splanchnologija, 1934). Pirmoje dalyje dar randame tik lotyniškus terminus, o kitose – jau ir lietuviškus, tokius, kurių dauguma vartojama iki šiol. Pažymėtina griežta J. Ži- 60 linsko and colleagues’ word-formation system. For example, bones were most often named using compound nouns (wedge bone, heel bone, etc.); the formation of terms for serous membranes was likewise uniform and based on the same principle (peritoneum, pleura, pericardium). Teeth (incisors, canines, premolars, molars) and tissues (connective, epithelial, etc.) were aptly named; adjectives formed with the suffix -inis were used for many complex names, and the digestive and respiratory systems were named analogously. Names for internal organs and their parts, laryngeal cartilages, glands, and the lining membranes of tubular organs became firmly established in usage. Noteworthy apt nouns include mucosa, muscular layer, as well as the carefully considered division of the intestine. Nevertheless, the first teaching aids for anatomy did not manage to cover the entire nomenclature. Syndesmology, myology, and neurology remained almost untouched, and even splanchnology, which had already advanced considerably, still had gaps: inconsistencies were unavoidable (sometimes only Latin terms were given – isthmus faucium, tunica fibrosa pharyngis, etc.); adjectives were used too often instead of the genitive of nouns (palatine arches); there were such awkward translations as entrance into the stomach, exit from the stomach (i.e., cardia, pylorus), the descending (i.e., descending) part of the duodenum. According to S. Pavilonis, the preference given to kepenims over jėknas was unwarranted; in the genital regions, gėda. J. Žilinskas rendered cellula as narveliu, o lastėle, a term later introduced by the biologist Jurgis Elisonas (1889–1964), who wrote several zoology textbooks during the interwar period. The natural science and medical authorities at Vytautas Magnus University did not adopt J. Žilinskas’s proposed terms uniformly. The physiologist Vladas Lašas (1892–1966) and the pathologist Janina Mackevičaitė-Lašienė (1897–1993) continued to name bones with two words (frontal, occipital, temporal bone), called the stomach a skilvis, coined their own names for muscles, and disputed some organ names (e.g., liver). The biologist Pranciškus Šivickis (1882–1968), who completed his studies in the United States, used Latin names adapted to Lithuanian grammar, following the Anglo-Saxon model, although native-language equivalents already existed (faringas, laringas, duodenas, uteras, even ekskrecijos duktai, deferentinis duktas, etc.). It is hardly surprising that these foreignisms did not take hold, since, as we can see, they clearly ran counter to the Lithuanian terminology and its tradition of creation (Pavilonis 1993). 61 After the Second World War, Lithuanian teaching materials were scarce, and there was not enough capacity to prepare them quickly, so efforts were made to translate a respectable textbook by Vladimir Tonkov (1872–1954) from Russian (Tonkovas 1957, 1958). Its principal translators—Salezijus Pavilonis and Artūras Jurgutis (1909–1967)—began a new phase in the fundamental revision of anatomical terminology according to the Basel Nomina Anatomica (B.N.A.). The translators replaced or corrected some of J. Žilinskas’s terms (replacing stuburkaulis with slankstelis, bevardis kaulas with dubenkaulis, gėdikaulis with gaktikaulis, and pleištikaulis and kulnikaulis with pleištakaulis and kulnakaulis), coined new Lithuanian names for joints and ligaments, and created muscle terminology according to a single principle. Most of the latter terms were fairly precise translations of the Latin names, though in rare cases they acquired a different meaning (e.g., galvos sukamasis raumuo – m. sternocleidomastoideus, dvilypis blauzdos r. – m. gastrocnemius, plekšninis r. – m. soleus, etc.). Drawing on the experience of the Kaunas anatomist Jadvyga Dobrovolskaitė-Tiknienė, other myological terms were also newly prepared; kraujo indai was replaced by krauja gyslės, proposed by the physiologist Jonas Šopauskas (1900–1968); and names for parts, nuclei, and nerves of the brain were coined or refined (Pavilonis 1993). When work began in the late 1950s to compile a dictionary of Lithuanian medical terms, anatomical terminology was also revisited. S. Pavilonis and A. Vaitilavičius published an article (Pavilonis, Vaitilavičius 1959) inviting not only anatomists but also linguists and the entire medical community to critically assess some of the names proposed up to that point. These efforts apparently later established, both in textbooks and in the terminology presented today, terms such as smegenų gumburas, antgumburis, pagumburis, ausies būgnelis, as well as skiltelė, nugaros (not stuburo) smegenys, sėklidė, tarpupplautis, tarpietė, dvylykapištės žarnos ir smegenų sturmuo (bulbus), pėda (not letena), antkaulis (not apykau-lis), žiedinis skydo raumuo, etc. The authors also raised several contentious questions that remain unanswered to this day. First, the use of the prefixes pa- and po-. Drawing on analogies with pažastis, pakinkis, pasmakrė, papilvė, the authors insistently advocated translating Latin sub- as pa- rather than po-, as linguists had proposed and continue to propose. Perhaps that is why adjectives with the prefix pa- later predominated in the original Lithuanian textbook: paakinis, pasąnarinis, 62 pasmegeninis, pamentinis, paodinis, and many others. Later, a compromise was sought, and in most cases the prefix po-, specialized in new formations to express the meaning ‘underneath’, was retained. Second, variation in the attributive function between active and passive participles, and between the latter and the noun genitive: jungiančioji ar jungiamoji artery, kylančioji ar kylamoji aorta, perveriančiosios ar perveriamosios, arteries maitinančios ar blauzdikaulio maitinamosios the tibia, uodžiamasis ar uoslės nerve, kramtomasis ar kramtymo muscle, virškinamasis ar virškinimo system, etc. Third, the authors did not dare to insist on slėsna and slėsnokauliai instead of the inaccurate and ambiguous padas and padikauliai, perhaps explaining why the latter terms later became established. Some names supported by S. Pavilonis and A. Vaitilavičius did not catch on. For example, the authors proposed translating plica as klostė, and reserving raukšlė for age-related facial changes and abnormal mucosal formations. However, raukšlė took hold, while klostė somehow came to refer only to formations of the synovial lining of the joint capsule. Valvula semilunaris was proposed to be translated as delčinis vožtuvas, but pusmėnulinis vožtuvėlis is now used. The authors proposed išangė for anus, but it remained only as a synonym for išeinamoji anga. Integumentum commune was apparently rendered in the Lithuanian textbook, through the authors’ efforts, as bendroji kūno danga, whereas the current tendency is toward kūno dangalas. The attempted term perdanga has now been abandoned (perhaps unnecessarily?), while the international term diafragma has been retained. The still-consolidating anatomical terminology was adapted to the Paris Nomina Anatomica (P.N.A.) in A. Jurgutis’s Osteologija (1965) and in the textbook for secondary medical schools by A. Jurgutis et al., Žmogaus anatomija (1967). A further step in refining the terminology was taken in preparing a Lithuanian textbook (Pavilonis et al. 1972, 1984), authored by the leading Lithuanian anatomists of the time: Salezijus Pavilonis, Rimvydas Stropus (born 1936), Kazimieras Tamašauskas (1936–1998), and Adolfas Urbonas (1922–1995). Vytautas Gavelis (born 1927) and Regina Mikėnienė (born 1931) joined the preparation of the second edition (1984). Terminological work drew on the Paris (1955) nomenclature, with the New York (1960) and Wiesbaden (1965) amendments; the second edition also took account of the Tokyo (1975) amendments. The most important anatomical terms were included in the Medicinos terminų žodynas (Astrauskas et al., 1980), whose preparation also involved many lingu- 63 …makers. A great advantage of the dictionary is that it is accented. Unfortunately, it too contains regrettable inaccuracies, ambiguities, and debatable terms. A new Latin–Lithuanian anatomical nomenclature, based on the 1998 edition of Terminologia Anatomica, has been prepared for publication; many terms in it have been standardized and refined. Only the younger generation of lecturers and students will be able to assess the success of this work. Anatomists in the 21st century will also have plenty to do, since there is no limit to how much anything can be improved. LITERATŪRA A s t r a u s k a s V. ir kt. 1980: Medicinos terminų žodynas, Vilnius. A v i ž o n i s P. 1929: Senatviškieji akių pakitimai. – Kosmos 1. A v i ž o n i s P. 1940: Akių ligų vadovas, Kaunas. B a s a n a v i č i u s J. Anatomijos ir medicinos vardyno medžiaga (rankraštis), Lietuvių literatūros ir tautosakos instituto rankraštynas, P–2–628. B u t r i m a i t ė I. 2000: Sirvydo žodynas – lietuviškos anatominės terminologijos šaltinis. – Vilniaus universiteto Medicinos fakulteto Studentų mokslinės draugijos LII konferencija, 2000 m. gegužės 8–12 d. Programa ir pranešimų santraukos, Vilnius. J u r g u t i s A. 1965: Osteologija, Vilnius. J u r g u t i s A. ir kt. 1967: Žmogaus anatomija, Vilnius. K u d i r k a V. 1889, 1895: Hygiena: I. Arbata. II. Kava. III. Tabakas. IV. Alkogolis ir alkogolizmas. – Varpas, 1889, 1–3, 8–11; 1895, 9–11. P a v i l o n i s S. 1993: Lietuviškosios anatomijos terminologijos evoliucijos apybraiža. – Acta musei historiae medicinae et pharmaciae Lithuaniae 1. P a v i l o n i s S., V a i t i l a v i č i u s A. 1959, 1960: Kai kurių lietuviškų medicinos terminų kritinė apžvalga. – Sveikatos apsauga, 1959, 3; 1960, 10. P a v i l o n i s ir kt. 1972, 1984: Žmogaus anatomija, Vilnius. Pirmasis lietuvių kalbos žodynas. Konstantinas S i r v y d a s 1979: Dictionarium trium linguarum, Vilnius. P u z i n a s J. P. 1979: Avižonio rūpinimasis medicinos terminija. – P u z i n a s J. Profesorius medicinos daktaras Petras Avižonis, Čikaga. S k a r d ž i u s P. 1939: Avižonis. – Gimtoji kalba 8. T o n k o v a s V. N. 1957, 1958: Normaliosios žmogaus anatomijos vadovėlis 1, 2, Vilnius. 64 AN ESSAY ON THE HISTORY OF LITHUANIAN ANATOMICAL TERMINOLOGY Summary The history of Lithuanian anatomical terminology begins in 1620, when a Polish-Latin-Lithuanian dictionary by Konstantinas Sirvydas (1579–1631) was published. In the first publicistic writings in medicine, Vincas Kudirka (1858–1899) used some anatomical terms that have survived until now. Jonas Basanavičius (1851–1927) started the creation of Lithuanian medical nomenclature as a system. Between the two world wars, Jurgis Žilinskas (1885–1957) and his colleagues tried to unify the system, and Petras Avižonis (1875–1939) quite successfully created terms in eye structure and ophthalmology in general. After the Second World war, Lithuanian anatomical terminology developed when translating Russian hand-books and preparing an authentic Lithuanian text-book of anatomy for university students (1972, 1984), as well as by working on the Dictionary of medical terminology (1988). Salezijus Pavilonis (1919–1998) and Kazimieras Tamašauskas (1936–1998) distinguished themselves especially. Nevertheless, Lithuanian anatomical terminology is far from perfect and future generations of anatomists will have much to do. Gintautas ČESNYS Gauta 2002-06-06 Vilniaus universitetas, Medicinos fakultetas M. K. Čiurlionio g. 21, LT-2009 Vilnius E. paštas [email protected] 65