Combining root terms

Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

William S. Halsted, MD
(1852 – 1922)

American anatomist, teacher, and surgeon, William Stewart Halsted was born in New York City, USA to a wealthy family of English origin. His father was involved in charitable work and Governor and trustee to a city hospital. Not a brilliant student initially, Halsted took an undergraduate in Liberal Arts in Yale, CT., after which he entered the Medical College of Physicians at the Columbia College, where he excelled.

As a second-year medical student Halsted applied and obtained a position in surgery at a local hospital. In here he learned about Lister’s antiseptic technique and became an adamant proponent of it to reduce infection. In 1877 Halsted obtained his MD. After a short time as House Physician at the New York Hospital, Halsted traveled to Europe to further his education studying for two years at the Universities of Vienna, Leipzig, and W?rzburg.

Besides being at the forefront of surgical and antiseptic techniques (introducing the use of rubber gloves in surgery), Halsted was extremely concerned with the way medical students were taught in the US. He pioneered bedside clinical round discussions with the medical students after two years of basic sciences studies. Halsted developed the idea of a patient chart; he also developed the residency program for medical students in use today.

Halsted is probably the most influential researcher and surgeon at the turn of the century. He dedicated time to the study of intestinal anastomoses and the use of silk as a suture material. His experimental work in 1887 proved that the inclusion of the submucosa layer in an anastomosis was mandatory, as well that a single layered anastomosis was enough to attain closure. Perhaps Halsted’s most important contribution was the application and use of the scientific method to surgical questions. Halsted’s principles, also known as "Halsted's Rules of Surgery", set the standards used today in surgical suturing and surgical stapling.

He also pioneered the development and surgical techniques for radical mastectomy as a treatment for breast cancer.

As a side effect of this studied in anesthesia and the use of cocaine for anesthesia, Halsted became addicted to this substance, a problem that followed him through the years. Without impairing his capacity as a researcher and a surgeon, Halsted eventually recovered. He died in Baltimore in 1922 as a complication to surgery.

Sources:
1. Dubay, A. D., & Franz, G. M. (2003). Acute Wound Healing: The Biology of Acute Wound Failure. Surg Clin NA, 83, 463-481.
2. Halsted, W. S. (1887). Circular Suture of the Intestine - An Experimental Study. Am J Med Sci, 436-461.
3. “William Stewart Halsted: his life and contributions to surgery” Osborne, P. Lancet Oncol 2007; 8: 256–65
4. “William Stewart Halsted: Surgical pioneer” Burress, P Endoc Today (2010), 8: (2) 22
5. “William Stewart Halsted (1852–1922) Neurological stamp” Haas, LF J Neurol Neurosurg Psych 2000;69:641
Original image courtesy of "Images from the History of Medicine" at www.nih.gov

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Details: Published: December 26, 2014

GIF image of combining root terms

Most medical words have only one root term and do not require combination as in the word [colectomy]. The situation arises when there is more than one organ or structure that is influenced by the suffix and the prefix (when present), such as [coloproctectomy]. Following are the basic rules for root terms combination:

- Place an [-o-] between the root terms being combined. The combining vowel [o] means "and". The word [gastroenterology] means "study of the stomach and the small intestine"
- Organize the root terms using their proximal to distal relationship. For a better explanation, click here
- If the first root term ends in a vowel, the combining vowel [-o-] is not needed. An example are the root terms [-chole-], meaning "bile or gall". and [cyst], meaning "bladder or sac". The word [chole-cyst-ectomy] does not have an [-o-] between the root terms
- If the proximal to distal relationship does not apply, then the words should be ordered in a way that is euphonic
- The only time a hyphen should be used is the rare case when using an [o] is not possible. Based on this rule, the word [salpingooophorectomy] is correct, the word [salpingo-oophorectomy] is not. An example of this is the word [cross-section].

An example of rule #5 is the word co-author. Since adding an [o] as a combining vowel would give us the word cooauthor (which is not correct), a hyphen must be used.

In the case of the word [coloproctectomy] the word can be divided into these components" The first root term [-col-], meaning "colon", the combining vowel [-o-], meaning "and", the second root term [-proct-], meaning "rectum", and the suffix [-ectomy], meaning "removal of". Properly read, the word means "removal of colon and rectum]. The proper term is [coloproctectomy], please do not use the terms [proctocolectomy] or worse, [protocolectomy], because they are incorrect usage of medical terminology.

For information on how to read medical words, click here.

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Combining root terms

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