Cosnautas - Online medical dictionary | Fernando Navarro's medical dictionary.

Preface to the fourth edition

Fernando A. Navarro

In 2000, the last year of the 20^th century, a book came hot off the press (yes, at that time most dictionaries were still made of paper), the Dictionary of Doubts and Difficulties in English-Spanish Medical Translation, and it quickly became the top terminological book for medical translators working into Spanish. Five years later in 2005, the second edition of the dictionary came out in a revised, improved and much expanded version, now with a pan-Hispanic perspective, but still in hard copy only.

I had to wait for eight more years–and within that time for none other than the ground-breaking Dictionary of Medical Terms (2011) from the Royal Academy of Medicine in Spain–to produce the Libro rojo and take the leap from paper to cyberspace. The third edition of the dictionary, and first on the Cosnautas website, had a new name: Dictionary of Doubts and Difficulties in English-Spanish Medical Translation (2013), now only in electronic version for online research.

Since then, I have updated the work every six months, and thus over these nine years, 18 updates have marked the progressive improvement and expansion of the Libro rojo. But only now, with the deadly Covid-19 pandemic about to pass into history, have I decided to publish, at last, a fourth edition of the dictionary. The newly revised Dictionary of Doubts and Difficulties in English-Spanish Medical Translation (2022) will provide the basis and the model for a version in Portuguese already being prepared by the Brazilian doctor and translator Carla Vorsatz, and we hope to release it on the Cosnautas platform in its preliminary version this year.

The internal structure of the work has hardly changed in all this time. The lexicographical structure of the dictionary continues to be essentially identical to that of the first edition in hard copy, which as I mentioned above was originally published in 2000. There is also no substantial change with respect to the Cosnautas edition from 2013 mentioned in the prologue to the third edition.

So, what has changed since the third edition of the dictionary (version 3.01, July 2013) in this new fourth edition (version 4.01, March 2022)?

Mainly, it is the magnitude of the work. Libro rojo has gone from 47,344 terms in version 3.01 to 60,757 entries in version 4.01. In other words, almost 13,500 new entries corresponding to neologisms, technisms and expressions that are misleading or difficult to translate from nearly every biomedical field and other areas of knowledge. History rolls on, with medical breakthroughs taking place non-stop: the continuous discovery of new monoclonal antibodies, Obama's healthcare reform, the publication of the 23rd edition (2014) of the Dictionary of the Royal Spanish Academy and its 23.1 (December 2017), 23.2 (December 2018), 23.3 (November 2019), 23.4 (November 2020), and 23.5 (December 2021) updates, robotic surgery and telemedicine, new chemical elements approved by IUPAC in 2016, the revolutionary CRISPR technique and Brexit for those of us in Spain in January 2020, the first coronaviruses, the Zika virus, the pandemic of Covid-19 and the new ARNm vaccines–all these things have left their mark on the Libro rojo. For those who are curious to know the type of terms that were added to the dictionary and when exactly, you will see in table 1 a list of 600 new entries in the Libro rojo between January 2015 and March 2022. It is only a small selection of the 13,000 new entries in the fourth edition, but it may help to show the overall vision of the work.

Have you ever wondered how new terms get into the Libro rojo? Where did the 13,000 new entries of the fourth edition come from? Many of them arose from my own doubts. I have been working in medical translation for 35 years, and I rarely spend a day without translating or reading a medical text in English. It is also quite rare for me to spend a day without encountering some uncertainty or difficulty in translation, and when it happens, I always try–regardless of my deadline–to find the time to document it and add it to the Libro rojo. I am now an expert in uncertainties and difficulties in translation, though this is not to say I am an expert in resolving them! I am only an expert in having doubts.

As with the second and third editions of my dictionary, I also continue to collect knowledge from out in cyberspace where my fellow translator colleagues go with their queries: the MedTrad and Tremédica discussion threads, of course, but also–for this fourth edition–the main social media channels (Facebook, LinkedIn and, above all, Twitter).

Apart from this, I would like to highlight two other abundant resources that my dictionary, and mine alone, benefits from. They are two places of query that would have delighted the lexicographers of previous generations. Ever since the Libro rojo was published in Cosnautas, the interactive and collaborative model of Cos has allowed me to tap into the enquiring minds of the cosnauts themselves on a daily basis. In the nine years in which the third, now extinct, edition of Libro rojo (versions 3.01 to 3.18, July 2013 to February 2022) was active, more than 300 cosnauts contributed on several occasions with ideas for improvement: some who wrote me simply to correct a small errata (always an important task, to rid the text of "rats"); others, essentially, who wrote to propose an interesting new entry I probably would not have encountered on my own. In table 2 you will see a hundred additions that reached me this way with the name of the cosnaut who threw me down the lexicographical gauntlet. There were several hundred more just like them.

Even more wonderful still, though unforeseen, was another resource that I only discovered once my dictionary appeared on Cos. All users of Cosnautas, merely by consulting the Libro rojo, were already actively collaborating in the process of revision and improvement of the work. I was able to know, with just a few clicks, the most consulted entries in the dictionary, but also–and even more interestingly–which unsuccessful searches were most frequent. If many medical translation professionals are all looking for a term that does not appear in a dictionary of doubts like mine, it must be a recurring problem that perhaps would have to be addressed in the Libro rojo, though it had not been apparent it to me. A meticulous review of the list of unsuccessful searches in each version of the dictionary allowed me to open up the work to a multitude of interesting terms that until then had been ignored, including blueprint, drusen, fibroscan, MedDRA, narrative, ookinete, orthotist and VEGF. Hundreds of the most frequent searches typed in by cosnauts that had once come up empty now show results in this fourth edition. Table 3 shows more than 300, but in fact there were many more. Among them, there are terms that at a certain point became trendy; during the 2020-2022 pandemic, for example, many of us spent the two years translating texts on epidemiology, the coronavirus, preventative measures, covid vaccines and new antiviral medications. The Libro rojo was enriched by the questions that emerged in my translations and reading, and with others that arose during the compilation of the English-Spanish Covid-19 Glossary for Cosnautas and Tremédica. But until I reviewed the list of unsuccessful searches from version 3.15 (1 March to 31 August 2020) I did not realize that I had ignored queries as common as CPAP, ECMO, facemask, lockdown, paucisymptomatic, PPE and sanitisation. In this last case, by the way, the Libro rojo actually contained the entry to sanitise, but hundreds of cosnauts did not arrive at it when typing in sanitisation. Many of the queries that produce unsuccessful searches were in fact are due to simple variants (such is the case, for example, in words like hayfever, lightheaded, stenting and tophi, which were unfruitful even though they were listed in the dictionary as hay fever, lightheadedness, stent and tophus), or even frequent errata or incorrect variants (in the dictionary we had balloon and proprietary, but hundreds of cosnauts did not find them when typing ballon or baloon in the first case, and propietary in the second). Unbeknownst to the cosnauts making these failed searches, all their actions were extremely useful to me in improving my work.

The combination of electronic lexicography with the participative model of Cosnautas has been key to achieving both the quantitative and qualitative jump between the third and fourth editions of the Libro rojo. It is thus closer than ever to reaching its goal of becoming the best bilingual dictionary in history.

Preface to the third edition (2013)

Fernando A. Navarro

Back in 1999, when I first talked to McGraw-Hill Interamericana about my project for a critical dictionary of English-Spanish medical doubts, I mentioned how useful it would be to publish the dictionary in compact disc format too, because electronic reference resources had already become an essential part of a language professional’s toolkit. However, the publishers decided to put an electronic edition on hold because of the uncontrollable risk of pirated copies, a risk that is still as real today as it was back then. And thus, for far too many years, my dictionary was relegated to being a well-thumbed tome on a bookshelf.

Fourteen years on, I am delighted to be able to offer doctors, specialised translators, scientific writers and translation students this new edition of my dictionary, in an online format at long last. Online access not only offers the well-known benefits of electronic formats (fast searches, cross-referencing, two-way Spanish and English translation, traceability of the full content of every entry, etc.), it also means that the dictionary can be accessed from anywhere with an internet connection, and it becomes a living resource, through an ongoing updating process.

The leap from paper to cloud was so big that I realised that a new name was warranted. For the first two editions, the libro rojo was called Diccionario crítico de dudas inglés-español de medicina (2000 and 2005). For this third edition, I have renamed it Diccionario de dudas y dificultades de traducción del inglés médico (2013). Despite this rechristening, the internal structure of the dictionary has not undergone substantial change: two versions later, the lexicographical design remains largely identical. Proof of this is that the introduction for first-time Cosnautas users (see below), is a simple copy-paste of the original version from the first edition, with very few changes at all. If you are familiar with either of the first two editions of the Diccionario crítico de dudas, you will be able to start using this third edition immediately, without having to learn the meanings of any new symbols or typographical conventions.

You will, however, notice some other changes. For example, before, you looked up terms in alphabetical order and leafed backwards or forwards to locate cross references. Now, simply type a term in the search box and click on the links that take you to the cross references.

You will also notice that colours have been added to indicate headwords, numbered meanings, cross references and comments’ symbols. This has freed up formatting types. Now, the most relevant translations are emphasised in bold, and different degrees of contraindication or error are *encased in asterisks* or marked with a ~~strikethrough~~ effect (in the latter case, following the example of Diccionario de términos médicos [2011] published by the Real Academia Nacional de Medicina).

In this third edition, I have continued my efforts to reduce the dogmatic tone of the dictionary. This is no easy task, because in my pursuit of concision, I have to solve translation dilemmas in a question of lines rather than pages, and this inevitably entails the risk of dogmatism. When my dictionary was still at an embryonic stage, I followed the wise counsel of Ortega y Gasset: “whenever you teach, teach also to question what you teach”. Therefore, I set out my preferred translation solutions, while trying to explain the academic criteria behind them, common usage in medical practice, recommendations from standardised nomenclatures, terminology traditions in the Spanish language, relevant etymological criteria and analogies with similar terms. This strategy has a clear goal: to enable you to make an informed decision - your own decision, not mine - on the most suitable option for a translation, depending on your specific text and personal context. I look on my dictionary, above all, as a medium between two translators, a pointer in the right direction, an informal chat between colleagues. And my comments are written safe in the knowledge that all translators, both new and old, will be using the dictionary in the valuable company of their intelligence and common sense, which are the most powerful work tools of all. I do not seek to convince anyone of anything. With this dictionary, I simply wish to share my knowledge and experience with my medical and translation colleagues, to help them improve professionally and enjoy the legitimate satisfaction of a scientific translation well done.

This electronic version of the Diccionario de dudas y dificultades de traducción del inglés médico is a new, revised, improved and hugely extended edition. I have added thousands of new entries since the second edition, such as acid-fast, add-on therapy, amplatzer, anisakis, annulation, appy, attending, bareback sex, Big Pharma, binge drinking, biogeneric, blunt, breathalyzer, BTC drug, carry over, chaperone, chemical pregnancy, chemonaive, club, concierge medicine, didactic, disease mongering, droptainer, drug-eluting stent, echolocation, ex novo, expanded access, first-hour quintet, forest plot, gamification, ghrelin, grant, grommet, hamstring, high-ceiling diuretics, hot flush, human medicine, junk food, lab-on-a-chip, lap, leakage, locavore, lost to follow-up, luer lock, machine, mindfulness, mourning, multiple, to need, nonvertebral fracture, orthorexia, patch clamp, perfusate, pouch, pregnancy loss, premetabolic syndrome, rare disease, readability, recall, Red Crystal, resurfacing, ritalin, schedule, sexting, sibship, signaling, small molecule, smokeless tobacco, spa, spike, spot, standard drink, statutory, subcentimeter, surrogate mother, system organ class, targeted, tiger mosquito, toddler, tooth numbering, trainee, translational research, transthyretin, to tube-feed, vocational training, wear, webinar, wilderness medicine, workup and yellow flag . I am proud to announce that a large number of these terms are making their very first appearance in a Spanish dictionary; in fact, it will be a first for many of them in international specialist lexicography.

The extended content is not limited to the addition of new entries or sections, however. I have expanded the comments in many sections that already existed in the second edition of the dictionary. To see what I mean, compare, for example, the sections devoted to the following terms in the second and third editions: aggressive, auditory nerve, bar chart, bay, BC, biologicals, blood alcohol, breath alcohol test, °C, capture, carrier, charge, chart, chikungunya, clavus, clinical pathology, counseling, criminal, -cytic, death, dipping, district nurse, driving while intoxicated, to empower, ex-, finally, foul, height, hematinic, ICH, international normalized ratio, intestinal obstruction, to irradiate, judgment, kinky, local, mg%, -olimus, operator, PD, pulp, pump, to qualify, smart drugs, social worker, to socialize, ST, survival, three Rs, toilet water and veil.

The 15,000 or so cross references in the first edition have now grown to more than 52,000 clickable links embedded in the dictionary, helping you make full use of the dictionary as a whole, while maximising the educational and professional yield of each search. As a result, you will also perceive the internal coherence and uniform criteria that can only be achieved by a single author in projects of this size and characteristics.

And this brings me to the unavoidable issue of geographical variation in the Spanish language. When I published the first edition of the libro rojo, I had never set foot in Latin America; the United States of America was the only part of the New Continent that I knew. It is not surprising, therefore, that the first edition focused heavily on the differences between UK and US English, but as far as the Spanish was concerned, I relied almost exclusively on the medical language used in faculties, hospitals and clinics in Spain. In my opinion, this was one of the biggest oversights in my dictionary, and it was also one that Latin American users repeatedly pointed out.

The second edition marked a clear change in this aspect. It was still obvious that the dictionary had been written in Spain, by an author whose native language was European Spanish, who viewed the Spanish-speaking medical community as a whole. However, peach-flavored tablets were no longer simply tablets with sabor a melocotón, but also sabor a durazno. The animalario now lived side by side with the bioterio; placas de Petri with cajas de Petri; frigorífico with refrigeradora and heladera; datos fiables with datos confiables; biberón with mamadera; hormigón with concreto, and accidentes de tráfico with accidentes de tránsito. The second edition showed that basic language units and their geographical variants are quite compatible, as acknowledged in socorrista and salvavidas, beber and tomar, conducir and manejar, recuento and conteo, inversor and inversionista, mantequilla de cacahuete and manteca de maní.

In the third edition, this greater focus on American variants of Spanish became much more patent. To check this out yourself, take a look at entries such as band-aid, bikini, bleach, booties, brassiere, breast pump, capitation, cartoon, chance, computer, concrete, constipation, contact lens, cost, cream, croissant, cutter, decimal point, dental technician, denture, diesel, donut, dummy, dynamo, earrings, elevator, epidural anesthesia, GDP, grocery, Guinea pig, hair-band, hangover, heel, highchair, hot flush, icon, insulin pen, intensive care unit, jersey, juice, junk food, lemon, lifeguard, lollipop, mammagraphy, marijuana, marker, mask, mat, medical device, mosquito net, notifiable disease, number sign, oxygen tank, pacifier, panties, panty liner, parole, peanut, pertussis, Petri dish, petrol, plaster, prescription, pus, pyjamas, refrigerator, sanitary towel, sauna, -scopy, soya, spectacles, stapler, stethoscope, teether, tin loaf, tongue depressor, traffic, truant, tub, umpteen, unemployment, varicose veins, VAT, white coat and zipper. I trust my Latin American colleagues will notice a considerable difference in this aspect since the first edition.

Three main factors influenced this major change in my approach between the first and third editions: a) from 2001 onwards, I started travelling frequently to different Latin American countries (including five trips to Argentina), and everywhere I went, people asked me to please, oh please, give more weight to regional and national language variants in the second edition; b) the spectacular development of Google with geographical filters in search settings that gave reliable results, and c) e-mail exchanges and forum debates with medical translators and users of my dictionary in different Latin American countries.

Introduction

Fernando A. Navarro

There is no doubt that in the world of general and specialised dictionaries, translators are spoilt for choice. Considering the sheer number of monolingual, bilingual and multilingual dictionaries, I am sure that many readers will be surprised and somewhat sceptical about the publication of this Diccionario crítico de dudas inglés-español de medicina^†:

“What? Not another dictionary! And what a weird title!“

In the course of this introduction, I hope to convince you that a dictionary of this nature is not only necessary - I can almost hear the critics saying “it fills a gap in the bibliography” - but also that it simply has to have this title. However strange and exotic it initially sounds, the title is certainly not the result of a rash decision or fleeting fancy. Let us dissect the title, word by word.

* This Introduction is a literal copy of the original version published in the first edition, with some very minor changes to adapt to the new typography and format of the third edition.

^† This was the title for the first two editions (Madrid: McGraw·Hill-Interamericana, 2000 and 2005); for this electronic Cosnautas edition (2013), I decided to rename it Diccionario de dudas y dificultades de traducción del inglés médico, which is the title I will use from now on in this introduction.

Why yet another dictionary?

You will find shelf-fuls of dictionaries of all shapes and sizes in a bookshop. Many of them, and specialised medical ones in particular, are heavy tomes, packed with information, often with over a hundred thousand entries.

In fact, the first thing that novel medical translators notice is the extraordinarily rich vocabulary that a medical text employs. Probably no other specialised field of translation uses so many new words. On every page of every text, there will be half a dozen terms and expressions that even well-educated people will not be familiar with: antiparkinsonian, glomerulonephritis, hepatocystoduodenostomy, hexachlorocyclohexane, keratoconjunctivitis, leukoerythroblastosis, onychotillomania, pneumoencephalography, pyelonephrolithotomy, sphenopalatine, thrombocytoagglutination, uteroenteroanastomosis. However, medical language, and indeed every scientific language, strives to be essentially universal, which is ideal for translators. As we know, many medical terms originate from Latin and Greek, and as the field grows, neologisms are created from classical roots, prefixes and suffixes. This is true of all the main European languages. In the case of the tortuous words quoted above, new medical translators with just a minimum grounding will be able to translate them straight off into Spanish (or other target language), even if they have never heard of them before: antiparkinsoniano, glomerulonefritis, hepatocistoduodenostomía, hexaclorociclohexano, queratoconjuntivitis, leucoeritroblastosis, onicotilomanía, neumoencefalografía, pielonefrolitotomía, esfenopalatino, trombocitoaglutinación and uteroenteroanastomosis. Doctor and translators, in fact, do not need to look up these words in a dictionary. Nobody turns to a bilingual dictionary to translate electrocardiogram. Yet, surprisingly, today’s medical dictionaries are bursting at the seams with such words. They contain tens of thousands of technical terms, which, despite their undeniable apparent complexity, do not ever have to be researched in a dictionary. However, when translators find an English word that entails a tiny challenge, they turn to the same dictionaries and discover that it is not there at all, is incorrectly translated or is missing some of its many possible translations.

Why a dictionary of doubts?

To answer this question, simply ask a translator to look at this sentence: Anthrax is an infectious animal disease that is transmitted to veterinarians by contact with animals. Translators will be aware that medical language is largely universal and that much of it stems from Latin and Greek. So, based on this premise, they might well presume that anthrax, in English, translates to ántrax in Spanish, even if they have never heard of these words before and do not know what they mean. Bilingual medical dictionaries will confirm this presumption, when, in fact, the truth is just the opposite. What English-speaking doctors call anthrax, we call carbunco and, vice versa, what they call carbuncle, we call ántrax. Both are infectious diseases that cause skin lesions and they share a similar etymological origin (one comes from the Greek ἄνθραξ, ‘coal’, and the other from the Latin carbunculus, ‘small coal’), but they differ significantly in the causal bacteria (Bacillus anthracis in the case of anthrax and staphylococcus in the case of carbuncle) and also in their treatment and prognosis.

The Diccionario de dudas y dificultades aims to resolve these sorts of paradoxes. Here is the entry for anthrax, which I will use to describe a typical entry structure in this dictionary:

The opening headword is immediately followed by an abbreviation in square brackets to denote the specific field. In the above example, the field is ‘microbiology, parasitology and infectious diseases’ (see the key to these abbreviations). The main body then gives the correct translation and there is a brief comment on the difference between ántrax and carbunco. The symbol ◘ denotes an English sentence that illustrates the use and meaning of the commented word in a wider context. The symbol ● is followed by complex expressions that contain the headword and are misleading or challenging to translate. They appear in alphabetical order. Finally, the symbol ►► precedes comments on the usage of anthrax and its translation. All expressions that contain the headword have their own entry in the dictionary, to make it easier to locate them. Thus, if you search for inhalational anthrax, you will be taken to this entry:

The symbol → denotes a cross reference to the entry for anthrax, and there, the symbol ● will contain the desired expression: inhalational anthrax (carbuncosis pulmonar). The same cross reference symbol → followed by a word in turquoise is also used to show that the translation of a word is explained in a completely different entry. For example, virilizing → masculinization, means that the translation problems inherent to the English word virilizing are commented on in the entry for masculinization.

The doubts to which I refer in the dictionary title are not only those that stem from false friends, which are words that are spelt identically or very similarly in two languages, but have different meanings, such as physic (which is not física, but medicina), plague (not plaga, but peste bubónica), labor (not labor, but parto) and matron (not matrona, but directora de enfermería). Translators also have gnawing doubts about Anglicisms such as rash, odds ratio, immunoblot, piercing, stent, distress and by-pass, because it appears they have no equivalent in Spanish.

Furthermore, in translation, the visual impact of the source text sometimes leads to an expression being used in the target language that is not exactly an error, but sounds unnatural because it simply is not in common usage. Take, for example, a general, non-medical expression: What would you think if you saw information technology or computer science translated as tecnología de la información or ciencia de las computadoras? These translations are not wrong, of course, but the fact is that in Spain, everyone (except Google Translate) uses the term informática, not ciencia de las computadoras. The same also applies to the field of medicine, with expressions such as human milk (leche materna rather than leche humana), weight loss (adelgazamiento rather than pérdida de peso), high blood pressure (hipertensión arterial rather than presión sanguínea alta) and liver cell (hepatocito rather than célula hepática).

Another problem, leading on from the above paragraph, is the complexity of polysemic words in English. Since many such words have a similar equivalent in Spanish, translators use the same translation time and time again, without realising that while it may absolutely correct for one particular meaning, it is actually wrong in all the other cases. For example, knife may mean cuchillo, but in the operating theatre it usually means bisturí. Worse still, words such as abuse and examination can have very different meanings indeed: child abuse (malos tratos a menores), spousal abuse (violencia conyugal), alcohol abuse (alcoholismo), heroin abuser (heroinómano), self-abuse (automutilación, autolesión or masturbación, depending on the context); clinical examination (exploración física), fundus examination (oftalmoscopia), pelvic examination (tacto vaginal), postmortem examination (necropsia, autopsia), ultrasound examination (ecografía). In these cases, the dictionary displays the different meanings in a single entry using a turquoise numbered list, as follows: