Libro Rojo

1 Preface to the fourth edition (2022)

Fernando A. Navarro

In 2000, the last year of the 20th century, the Diccionario crítico de dudas inglés-español de medicina came off the press (yes, in those days most dictionaries were still printed on paper) and quickly became the standard terminological reference work for medical translators working into Spanish (women and men alike, of course). Five years later, in 2005, the second edition of the dictionary was published: revised, improved, greatly expanded and now with a pan-Hispanic perspective, but still on paper.

I had to wait another eight years – with nothing less than the groundbreaking Diccionario de términos médicos (2011) of the Real Academia Nacional de Medicina de España in between – before taking the Libro Rojo from paper to cyberspace. The third edition of the dictionary, the first on Cosnautas, came with a change of name: Diccionario de dudas y dificultades de traducción del inglés médico (2013), now available only as an online electronic version.

Since then, I have been updating the work every six months: nine years and eighteen updates that have marked the gradual improvement and expansion of the Libro Rojo. But only now, with the deadly COVID-19 pandemic about to pass into history, have I finally decided to publish a new edition of the dictionary, the fourth. This renewed Diccionario de dudas y dificultades de traducción del inglés médico (2022) will serve as the basis and model for the Portuguese-language version already being prepared by the Brazilian physician and translator Carla Vorsatz, which we hope to launch on Cosnautas – in a preliminary version – later this year.

The internal structure of the work has barely changed in all this time: the lexicographical design of the dictionary remains essentially identical to that of the first print edition, which I explain in the original Introduction of 2000. And there are no substantial changes with respect to the 2013 Cosnautas edition, discussed in the Preface to the third edition.

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

Essentially, the size of the work: the Libro Rojo has grown from 47,344 headwords in version 3.01 to 60,757 entries in version 4.01. In other words, almost thirteen thousand five hundred more entries, covering neologisms, technical terms and expressions that are difficult or deceptive to translate, drawn from almost every biomedical discipline and from other fields of knowledge. History runs its course and medical advances keep coming without pause: the continual discovery of new monoclonal antibodies; Obama’s healthcare reform; the publication of the twenty-third edition (2014) of the Diccionario of the Real Academia Española and its updates 23.1 (December 2017), 23.2 (December 2018), 23.3 (November 2019), 23.4 (November 2020) and 23.5 (December 2021); robotic surgery and telemedicine; the new chemical elements named by IUPAC in 2016; the revolution brought about by the CRISPR technique; Brexit or Corte Inglés (“English cut”) of January 2020; the first coronaviruses, Zika virus, the COVID-19 pandemic and the new mRNA vaccines: all of this has left its mark on the Libro Rojo. For those curious to know what kind of terms were entering the dictionary and exactly when, Box 1 lists some six hundred entries added to the Libro Rojo between January 2015 and March 2022. They are only a small selection of the more than thirteen thousand added in the fourth edition, but they may help to give an overall picture.

Have you ever wondered how the Libro Rojo gets its new material? Where do the thirteen thousand new entries in the fourth edition come from? Many of them arise from my own doubts. I have been working in medical translation for thirty-five years, and rarely do I go to bed without having translated or read some medical text in English. Rarely, too, does a day go by without my coming across some translation doubt or difficulty; and when that happens, I always – however pressed I am by deadlines – try to find a moment to document it and add it to the Libro Rojo. I have become quite an expert in translation doubts and difficulties; not, mind you, an expert in resolving or solving them, but an expert in doubts and an expert in doubting.

As with the second and third editions of my dictionary, I also continue to glean rich pickings from the corners of cyberspace where my fellow translators go to ask their questions: the MedTrad and Tremédica discussion lists, of course, but also – for this fourth edition – the main social networks (Facebook, LinkedIn and, above all, Twitter).

Separately, I would like to highlight two abundant sources on which my dictionary – and no other – draws in particular. Two sources of doubts that would have delighted the lexicographers of earlier generations. Ever since the Libro Rojo was published on Cosnautas, Cos’s interactive and collaborative model has allowed me to take the pulse of the cosnautas’ own concerns on a daily basis. During the nine years in which the now-defunct third edition of the Libro Rojo was active (versions 3.01 to 3.18; July 2013 to February 2022), more than three hundred cosnautas repeatedly sent in suggestions for improvement: some write to me simply to point out a small typo (an essential task, this business of ridding the text of those wretched typo gremlins); others – and this is my point – propose interesting new entries that would probably never have occurred to me on my own. Box 2 contains a hundred or so additions that reached me in this way, with the name of the cosnauta who threw down the lexicographical gauntlet. And there were several hundred more like them.

Even more wonderful, because so unexpected, was another extremely valuable source of doubts that I discovered only when my dictionary landed on Cos. Every Cosnautas user, simply by consulting the Libro Rojo, is already actively contributing to the process of renewing and improving the work. This is because, with just a couple of clicks, I can see which entries in the dictionary are consulted most often; but also – and this is of even greater interest – which unsuccessful searches are typed most frequently. If many professional medical translators all search for a term that is not recorded in a dictionary of doubts like mine, it means that it is a recurrent doubt and should perhaps be included in the Libro Rojo, even if it did not seem so to me at first. A meticulous review of the list of unsuccessful searches for each version of the dictionary enables me to bring into the work a host of interesting terms that I had previously overlooked, such as blueprint, drusen, fibroscan, MedDRA, narrative, ookinete, orthotist and VEGF. Hundreds of the searches most often typed by cosnautas, which at the time returned no results, are now recorded in this fourth edition. Box 3 lists more than three hundred of them, but there were in fact a good many more. They include terms that became fashionable at a given moment; during the 2020–2022 pandemic, for example, many of us spent two solid years translating texts on epidemiology, coronaviruses, preventive measures, COVID-19 vaccines and new antiviral drugs. The Libro Rojo was enriched with the doubts I came across in my own translations and reading, and with many others that arose during the compilation of the English–Spanish Dictionary of COVID-19 for Cosnautas and Tremédica; but it was not until I went through the list of unsuccessful searches for version 3.15 (1 March to 31 August 2020) that I realised I had overlooked such frequent doubts as CPAP, ECMO, facemask, lockdown, paucisymptomatic, PPE and sanitization. On the subject of the last of these, incidentally, the Libro Rojo already contained the entry to sanitize, but hundreds of cosnautas failed to reach it when they typed sanitization. Many of the doubts brought to light by unsuccessful searches are in fact simple variations (as is the case, for example, of words such as hayfever, lightheaded, stenting and tophi, which returned no results even though the dictionary did record hay fever, lightheadedness, stent and tophus), or even common typos or incorrect variants (the dictionary had balloon and proprietary, but hundreds of cosnautas failed to reach them because they typed ballon or baloon in the first case and propietary in the second). All of this, as I say, happened indirectly, without the cosnautas who typed those unsuccessful searches being aware that what they were doing was proving extremely useful to me in improving my work.

The combination of electronic lexicography with Cosnautas’s participatory model has been key to the twofold leap, in both quantity and quality, between the third and fourth editions of the Libro Rojo. It is thus ever closer to achieving its stated aim of becoming the best bilingual dictionary in history.

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.

2 Preface to the third edition (2013)

Fernando A. Navarro

3 Introduction (2000)

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 reproduced verbatim from the first edition, with a few minimal changes to adapt it to the typographical and formatting changes of the third edition.

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

4 Why yet another dictionary?

5 Why a dictionary of doubts?

Just ask any translator faced with the following sentence: Anthrax is an infectious animal disease that is transmitted to veterinarians by contact with animals. Knowing full well that medical language is essentially international and draws heavily on the classical languages, our hypothetical translator will suspect from the outset that the English anthrax may well correspond to the Spanish ‘ántrax’, even without ever having heard either of these technical terms or knowing what they mean. Bilingual medical dictionaries will confirm that assumption, yet nothing could be further from the truth: what English-speaking doctors call anthrax is what we call ‘carbunco’ and, conversely, our ‘ántrax’ is the English carbuncle. Both infectious diseases cause skin lesions and have similar etymological origins (the former from the Greek ἄνθραξ, ‘coal’; the latter from the Latin carbunculus, ‘small coal’), but they differ considerably both in the causative bacteria (Bacillus anthracis in the case of carbunco; staphylococci in the case of ántrax) and in their prognosis and treatment.

Situations like this are precisely what this Diccionario de dudas y dificultades sets out to resolve. If we look up the entry for anthrax, which will serve to illustrate a typical entry in this dictionary, we find the following:

Immediately after the headword that opens the entry we find, in square brackets, an abbreviation indicating the specific field concerned; in this case, “microbiology, parasitology and infectious diseases” (the meaning of these abbreviations is explained in the corresponding key). Next, the body of the entry gives the correct translation and adds a brief comment on the difference between ‘ántrax’ and ‘carbunco’. The symbol ◘ marks an English sentence that illustrates the use and meaning of the word under discussion in a broader context. The symbol ● introduces a series of multi-word expressions containing the headword that are difficult or misleading to translate, listed in alphabetical order. Finally, the symbol ►► introduces various usage notes on the translation of anthrax. To make every expression easy to find in the dictionary, phrases containing the headword have their own entry; so anyone searching the dictionary for, say, the correct translation of inhalational anthrax will find the following:

The symbol → refers the reader to the entry anthrax, where the expression sought will be found after the symbol ●: inhalational anthrax (carbuncosis pulmonar). This same cross-reference symbol → followed by a word in turquoise is also used to indicate that the translation of a word is explained in an entirely different entry, as in the case of virilizing → masculinization, which indicates that the translation problems posed by the English word virilizing are discussed in the entry for masculinization.

But the doubts referred to in the title of my dictionary are not limited to what translators call ‘treacherous words’ or ‘false friends’ (faux amis); that is, words spelt very similarly or identically in English and Spanish but with different meanings in the two languages, such as physic (which is not ‘física’ but ‘medicina’), plague (not ‘plaga’ but ‘peste bubónica’), labor (not ‘labor’ but ‘parto’) or matron (not ‘matrona’ but ‘directora de enfermería’). Another constant source of doubt for translators is Anglicisms such as rash, odds ratio, immunoblot, piercing, stent, distress or by-pass, for which there is supposedly no Spanish equivalent.

In translation, the pull of the original printed text may also lead us to use an expression in Spanish that, while not strictly incorrect, is jarring because it is so unusual. Let us look at an example from everyday language: what would we think if someone translated information technology or computer science as ‘tecnología de la información’ or ‘ciencia de las computadoras’? These expressions are clearly not incorrect, but it is equally clear that in Spain, outside careless translations, everyone calls the science of computers ‘informática’. The same is true in medicine of 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’) or liver cell (hepatocito, rather than ‘célula hepática’).

A problem related in some ways to the one discussed in the previous paragraph is posed by polysemous English words. Since many of them have a similar equivalent in Spanish, translators reach for it time and again, without realising that it may be perfectly correct for one of the word’s senses but not for all the others. Thus, the English knife can mean ‘cuchillo’, but in surgery it is mainly used in the sense of ‘bisturí’; and matters become more complicated with words such as abuse or examination, which can be found with very different meanings: 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 such cases, the dictionary distinguishes the different senses within a single entry with the numbers 1, 2, 3, etc. in turquoise, as in the following example:

Incidentally, we can see once again that the simplistic translation ‘ligamento anular’ found in the usual medical dictionaries may well be very convenient, but it falls frankly short for the medical translator.

Here, I would like to clarify that the concept of ‘doubt’ in this dictionary does not coincide with its meaning in everyday language. This dictionary does not, of course, set out to cover every doubt that medical translators may encounter in the course of their work. When faced with an English medical text, translators may well not know the meaning of a huge number of words. However, I do not believe that these words pose a major danger, because their very apparent difficulty will prompt translators to consult specialised dictionaries and reference books to clarify their meaning. The biggest danger lies in the English words or expressions that seem easy and are therefore translated literally, which often leads to incorrect, uncertain, problematic or less-than-ideal translations in Spanish. Those are the ‘doubts’ discussed in this dictionary.

6 Why a critical dictionary?

7 Why an English–Spanish dictionary?

For almost half a century, English has been the indisputable global language of medicine. I feel I could almost skip this section of the introduction because it is so obvious that nowadays, a medical translator absolutely has to understand English. Not only is English the source language of most translations; it is also the lingua franca of the main text books and cutting-edge journals in every field of medicine. In other words, medical translators who do not understand English may well find it impossible to solve doubts that arise when translating a medical text in French, German or any other modern language.

And this, of course, will be in addition to the multitude of doubts and misleading or challenging words that they will have to decipher when translating a medical text from French or German. However, I thought it was particularly urgent to publish, at long last, the dictionary of English–Spanish doubts that medical translators had been clamouring for for years, without which I can now hardly imagine translating effectively.

Since I am referring to medical translators as the natural beneficiaries of this dictionary, I would like to point out that my definition of this professional function is all-embracing. Translation is not included in a medical student’s training, and few doctors have become medical translators, as I have. However, most Spanish and Latin American doctors have done many informal translations during their training and later on in their career. It is an undeniable fact that the majority of today’s medical publications in Spanish are the outcome of texts that were originally written in English. Not only am I referring to medical text books edited in Spanish-speaking countries, a quarter of which are translations of foreign works. I am also particularly referring to the fact that more than 80% of the references of articles published in specialised Spanish medical journals are in English. We should acknowledge, therefore, that in countries like ours, where science plays a supporting role to the main English-speaking actors, every medical author also has to be a translator to a great extent. And, in my opinion, it is not too far-fetched to think that in a few years’ time – as was the case one generation ago with the history of medicine – medical translation and writing might be duly recognised as medical specialties in their own right.

I would also like to answer another question that I am sure many of you will be asking by now:

“OK, an English–Spanish dictionary, but which flavours of English and Spanish?”

My decision, like many others I have made with this dictionary, was largely determined by my personal circumstances. As a medical translator with broad experience working with multinational pharmaceutical companies and international organisations, I am only too familiar with having to tackle words that have different meanings, depending on which side of the Atlantic they hail from.

As you probably know, the word billion means a million million in England, but only a thousand million in the United States; pants are underpants for an English lord, but long trousers for a Californian; a gallon is equal to 4.55 litres in Britain, but only 3.79 litres in America; a nursing-home is a private clinic in England, but a residential home for the elderly in the United States; MD is a doctoral qualification at Oxford, but a bachelor’s degree at Harvard; and a US Surgeon General is the chief medical officer of the public health service, while his English namesake is the most senior medical officer of the Navy.

You will also be aware of spelling differences between British and American English. In general, translators need not worry that doctors in London write tumour and haematology, while their colleagues in New York use tumor and hematology. These trivialities rarely matter when you are translating into Spanish. But sometimes they do. A British anaesthetist, for example, has the same training as his or her Spanish counterpart (in other words, they are doctors specialised in anaesthesia), while an American anesthetist is a professional individual, but not a qualified doctor, who is registered to administer anaesthesia to patients. (A US doctor specialised in anaesthesia would be called an anesthesiologist.)

These and other differences in meanings between American (and usually Canadian) English and British English (which is also used in many other countries in the world) are included in this dictionary, preceded by their respective abbreviations [US] and [GB].

However, with regard to Spanish differences on either side of the Atlantic, in the first edition of this dictionary, I used just the opposite approach. Since I was born and bred in Spain, and undertook my medical training at the University of Salamanca and at the Marqués de Valdecilla Hospital in Santander, it was logical for my dictionary to weigh heavily towards the medical language used in Spanish faculties, hospitals and clinics, scientific journals and text books. Thirteen years later, my personal knowledge of the geographical variants of Spanish has increased exponentially, and, as a result, I have paid much more attention to variants in this edition of Diccionario de dudas y dificultades, as explained in more detail at the end of the “Preface to the third edition” (see above).

8 Why a medical dictionary?

While it is perfectly reasonable for a reader to ask this question, in my opinion it is unnecessary to do so. As a medical specialist by training and a medical translator by career, it would have been quite illogical for me to write a dictionary on heraldry, beekeeping, plumbing or Etruscan art (with all due respect, of course, for the experts in these fields).

Unfortunately, writing a medical dictionary is not that simple, because it has to include a host of common but misleading words found in medical texts that do not strictly belong to the medical sphere. Examples of such words are actual (real), American (estadounidense), library (biblioteca), vegetables (verduras) and November (noviembre), which medical translators will find time and time again in their texts. And, for the same reason, you will find thousands of entries that do not belong to the field of medicine itself but to many other similar or complementary sciences, such as pharmacy, chemistry, biostatistics, zoology, botany, genetics, molecular biology, history of medicine, bibliology, law, etc.

Some readers may think that, in that case, it would have been more correct to call this dictionary a “biomedical dictionary”, a “dictionary of health sciences” or similar fashionable title. I deliberately chose not to. When you become familiar with this dictionary, you will realise – I hope – that one of its flagship features is its condemnation of unnecessary or deliberately misconstrued euphemisms. I do not agree with the advertising tactics of pharmaceutical companies, which have stopped using ‘medicine’ (replacing it with ‘health’ to avoid any negative connotation with illness or pain) and ‘chemistry’ (to avoid any subconscious association with carcinogenic E numbers or pollution). Nor do I like the process by which big pharma, later followed by the rest of the international medical community, has gradually replaced ‘toxicity’, a term that was used to denote a medicinal product’s ability to produce toxic effects, initially coming up with ‘tolerability’, a word with less negative connotations, and finally arriving at ‘safety’, a word with a clearly positive ring to it.

Personally, as a doctor, I have often consulted dictionaries on botany, biochemistry, genetics or pharmacy to expand my knowledge. Therefore, I hope that my colleagues in other fields will welcome a new medical dictionary, in the broadest sense of the term. I have every confidence that this medical English dictionary will be exceptionally useful, not only for doctors and medical students, but also for biologists, pharmacists, chemists and, above all, specialised translators and scientific writers.

9 Conventions on grammatical gender

In Spanish, unlike in English, grammatical gender is a vital syntactic function that expresses agreement among nouns, adjectives, some pronouns, articles and certain participles used as adjectives. Grammatical gender poses major challenges for lexicographers, particularly with regard to nouns that name persons.

      In a bilingual dictionary, it is fairly easy to denote the grammatical gender of inanimate nouns, since most objects have a single form and explicit gender: biopsia, for example, is always feminine; quirófano is always masculine. In a bilingual dictionary, it is therefore easy to state that “biopsy is biopsia” and “operation room is quirófano”.

      However, in the case of nouns that name persons, most have a double gender form in Spanish (e.g., el cardiólogo and la cardióloga, el bioquímico and la bioquímica) or they are invariant with an implicit gender (e.g., el dentista and la dentista, el psiquiatra and la psiquiatra). Very few nouns that are invariant with explicit gender can be used for both biological sexes without changing the grammatical gender. This is true of masculine (e.g., bebé, cadáver, personaje, ser) and feminine nouns alike (e.g., criatura, familia, gente, persona, víctima).

      Nouns naming persons that undergo gender-related changes are a major problem for bilingual dictionaries. Some dictionaries opt to use an inclusive masculine form. This strategy is very common in general spoken language when referring to a person whose sex is not yet known (e.g., “espero que en este hospital haya un ginecólogo de guardia”). These dictionaries state, for example, that “neurologist is neurólogo”, running the risk that their strategy may be misinterpreted as gender bias against women. Other dictionaries, on the other hand, prefer to expand the double forms and state that “neurologist is neurólogo o neuróloga” or they opt for a double abbreviated form, “neurologist is neurólogo/-ga”.

      These two alternatives for solving Spanish gender variance work quite well in monolingual dictionaries (where they are used as isolated headwords) and in simple bilingual dictionaries (where direct equivalents are usually given in the form of one- or two-word entries). However, in complex bilingual dictionaries that provide a range of compound expressions, these strategies become cumbersome and confusing. For example, a good surgeon becomes un buen cirujano, una buena cirujana (not to mention un/a buen/a cirujano/­na!). Even more long-winded and convoluted are explanatory sentences with nouns, adjectives and articles that all express gender agreement. A sentence such as “Además del médico adjunto y el auxiliar administrativo, solamente pueden estar presentes el paciente ingresado y un amigo íntimo o un familiar cercano“ should reflect all its variants: ”Además de la médica adjunta y el auxiliar administrativo, solamente pueden estar presentes la paciente ingresada y un amigo íntimo o una familiar cercana“, ”Además del médico adjunto y la auxiliar administrativa, solamente pueden estar presentes el paciente ingresado y una amiga íntima o un familiar cercano“, ”Además de la médica adjunta y la auxiliar administrativa, solamente pueden estar presentes la paciente ingresada y un amigo o amiga íntimos o una familiar cercana“ and scores of other possibilities that the Spanish language contemplates. Instead of increasing the reader’s understanding, these strategies actually further confuse the issue. Worse still would be a double expanded option (“Además del médico adjunto o la médica adjunta y el auxiliar administrativo o la auxiliar administrativa, solamente pueden estar presentes el paciente ingresado o la paciente ingresada y un amigo íntimo o una amiga íntima o un familiar cercano o una familiar cercana“) or a double abbreviated option (”Además del/de la médico/­ca adjunto/­ta y el/la auxiliar administrativo/-va, solamente pueden estar presentes el/la paciente ingresado/-da y un/a amigo/-ga íntimo/-ma o un/a familiar cercano/-na“).

      The options for nouns that name persons also apply to all English adjectives for persons and things, but with an even greater degree of complexity. This is because adjectives have gender and number in Spanish, but not in English. An adjective such as white, for example, would be blanca in white skirt (falda blanca), but blancos in white trousers (pantalones blancos). So, in an exhaustive bilingual dictionary, it would no longer suffice to say that white means blanco, as is usually the case, but white means blanco, blanca, blancos or blancas or, in the abbreviated form, white means blanco(s)/-ca(s). Again, this is extremely cumbersome and confusing, which is just what a dictionary seeks to avoid.

      Therefore, the time-honoured practice in the history of lexicography is to tend towards simplicity and clarity over exhaustiveness. Everyone who regularly uses a monolingual dictionary will know, for example, that bisturíes has to be searched for as bisturí, because it does not have its own entry. Likewise, soy, eras, fue, seremos and serían have to be searched for as ser; librito as libro; dificilísimo as difícil, and so on and so forth.

      I have never heard anyone suggest that searching for different verb forms using the infinitive shows bias against past, present, future or imperative conjugations. And no one contends that finding Spanish plurals only by searching for singulars implies a number bias that might empower the individualistic nature of our modern capitalist society against the plurality and sense of community that is defended by the social revolution of Christianity or anarchism. Everyone readily understands that these are mere conventions of usage, designed to simplify dictionary searches, with an eminently practical purpose. So it should not be hard to interpret grammatical gender conventions the same way, as simple grammatical conventions designed for practicality.

      In the Dictionary of Doubts and Difficulties in English Medical Translation, I have sought to avoid the long-windedness of expanding each and every Spanish grammatical gender variant of an English term or phrase. I have therefore opted to apply the following conventions:

1. For headwords and compound expressions (denoted by the symbol ●), I have given the Spanish equivalent in an inclusive or generic single gender form. In line with general Spanish usage, the inclusive gender is usually masculine, except for a few cases in which the inclusive feminine form is used in general speech to represent both grammatical genders. Therefore, the equivalent terms rheumatologist (reumatólogo) and obstetric nurse (comadrona), should be interpreted in the standard, underlying sense of rheumatologist (reumatólogo or reumatóloga, depending on the context) and obstetric nurse (comadrona or comadrón, depending on the context), respectively.

2. In the case of example sentences (denoted by the symbol ◘), however, I have used the inclusive masculine form only (or, more rarely, the inclusive feminine form) when the example refers to a group of men and women or a person of indeterminate or unknown sex. In all other cases, I have tried to alternate examples in which an English noun has a standard, underlying Spanish masculine equivalent with others that have a feminine one, so that the reader is constantly aware that the transformation from English to Spanish involves an inherent grammatical gender decision. Therefore, with words such as child and doctor, the reader will encounter example sentences such as My child is badly injured (mi hijo está gravemente herido) and The doctor ordered complete rest (la médica le prescribió reposo absoluto) together with other examples such as She was often ill as a child (de pequeña se ponía enferma con frecuencia) and The doctor put the patient out for surgery (el médico anestesió a la paciente para la intervención quirúrgica).

      Notwithstanding the above, for some entries where I feel it would be useful for the reader to have access to more detailed comments, I have discussed specific problems encountered when translating English – a language with almost no traces of grammatical gender – to Spanish, where this feature is ever present. Take, for example, the first comment on usage (denoted by the symbol ►►) in the entry for Dr. or the comment on usage (denoted by the symbol ►) in meaning one, sub-meaning a), in the entry for nurse.

10 Acknowledgements

To Lydia, Antonio, Álvaro, Isabel and Miguel.

Many of the hours that I spent compiling this dictionary

– and I can assure you there were many indeed  – were in fact theirs.

Many friends and translators have sent in suggestions and comments to improve the dictionary, and have helped solve terminology doubts in person, by phone, post and email. In this respect, the following colleagues have made the biggest or most assiduous contributions to this third edition of my dictionary of doubts: José Rafael Blengio Pinto (Querétaro), Guido Castañeda Macchiavello (Barcelona), M. Gonzalo Claros Díaz (Malaga), Fernando Contreras Blanco (Madrid), Xavier Fuentes Arderiu (Barcelona), Betty Galiano (Rosario), Carlos Gancedo (Madrid), Isabel García Acha (Salamanca), Carlos Garrido (Vigo), Javier Hellín (Madrid), Antonio Hernández Rolón (Mexico), José María Izquierdo (Cordova), Pablo Mugüerza (Valladolid), Laura Munoa (Madrid), Ignacio Navascués (Madrid), Emilia Picazo (Mexico), Rafael Rivera (Miami), Julio Rodríguez-Villanueva García (Soto del Real), Gustavo A. Silva (Washington and Geneva), Sandro Tomasi (New York), Manuel Talens (Valencia), Damián Vázquez (Buenos Aires and Washington) and Elisa Vilaret (Barcelona), as well as, in particular, Guillermo Murillo Godínez (Querétaro) and, especially, Juan Manuel Martín Arias (Madrid)[*].

My colleagues, numbering almost three hundred, on the mailing list servers MedTrad <www.rediris.es/list/info/medtrad.html> (since September 1999) and Tremédica <tremedica.org> (since February 2008) have been extremely helpful. This treasure trove – over one hundred thousand archived messages of which I am proud to say I have read each and every one – has been without doubt my most valuable source of information over these long years of work, fine tuning this third edition of the dictionary of doubts. In fact, in my opinion, the MedTrad and Tremédica lists have been so valuable that they should be acknowledged as the collective co-authors of this reference work. I exaggerate not.

Since launching the third edition of the Libro Rojo on Cosnautas, I have received proposals for additions and corrections from many colleagues. Their suggestions have greatly improved this fourth edition, which is currently available online, and I would like to publicly thank the following cosnautas for their contributions:

Version 4.10  Inés Arjona, Ana Atienza, Andrea Baltanás Palomar, Lida Barbetti Vros, Alejandro Barra Bastías, Guido Castañeda Macchiavello, Constanza Cervino, M. Gonzalo Claros, Pilar Comín Sebastián, José Antonio de la Riva Fort, Analía de León, Antonella Dolce, Rosa María Domínguez Borad, Sierra Essex, Jorge Esteban Casas, Alicia Fernández de Peñaranda, Alba Férriz, Betty Galiano, Amy Gazzard, Irene Gigli, William Giller, Jesús M. Giménez, Paz Gómez Polledo, Paula González Fernández, María J. Hernández Weigand, Mar Jiménez Quesada, Júlia Llàcer Adell, María López García, Laura López Sicilia, Eva Losa Rodríguez-Brusco, Agustina Luján de la Torre, Emilia Madrigal Palacio, Javier Mallo Martínez, Elisa Manzanal, Aida Mateos Fuentes, Marina Mediano, Aníbal J. Morillo Zárate, Paola Núñez, Anthony Palomo, Aina Pellicer Cueves, Raquel Peris Sánchez, Emilia Picazo Guadarrama, Mariluz Ponce, Fernando Presumido, Antonio M. Regueiro, María Romero Carrasco, Julia Salas, Almudena Santos Moya, María Victoria Sormani, Lucía Straneo Cal, Noelia Tolosa Navarro, Teresa Triana, Arantxa Ubieta, Clarisa Vega, Carolina Vergara Palomares, Oriana Vidal de la Torre, Marta Vita, Javier Wasserzug.

Version 4.09  Ana Atienza, Lida Barbetti Vros, Claudia Bayá Crapuchett, Ayla Carazo, Guido Castañeda Macchiavello, Constanza Cervino, Mario Chávez, Jesús Clemente, Fernando Contreras Blanco, José Antonio de la Riva Fort, Jorge Esteban Casas, Betty Galiano, Sara García, Marta Gil Rojo, William Giller, Emma Goldsmith, Raquel Gómez Casares, María J. Hernández Weigand, Mar Jiménez Quesada, Juan Diego López García, Aida Mateos Fuentes, Andre Moskowitz, Alfonso Nevado Caballero, Omar Osorio Juárez, Emilia Picazo Guadarrama, Cristina Río López, Elías Rivas Fromherz, Ana Paula Rodríguez, Virginia Rubio, Lorenzo Serrahima, Antonio Sanguino Yturriaga, María Victoria Sormani.

Version 4.08  Ana Atienza, Lida Barbetti Vros, Claudia Bayá Crapuchett, Natalia Caicedo, Francisco Calderón Pérez, Suyapa Carías, Daniel Carrión de Gómez, Guido Castañeda Macchiavello, Mario Chávez, Fernando Contreras Blanco, José Antonio de la Riva Fort, Macarena Dueñas Martín, Jorge Esteban Casas, Nur Ferrante Morales, Mary Fons i Fleming, Natàlia Fusté Hussain, Betty Galiano, Maria Gené Gil, William Giller, Rocío Gómez Zamora, Alexandra Guevara Salcedo, Monika Hachiya, María Paula Irigoyen, Daniel Mañanet, Juan Manuel Martín Arias, Marta Martín Delmo, Aida Mateos Fuentes, Gabriela Mattoni, Pablo Mugüerza, María Luisa Ortega Hernández, Omar Osorio Juárez, Isabel Pachiarotti, Emilia Picazo Guadarrama, Liliana Rodríguez, Ismael Roldán Hernando, M.ª Verónica Saladrigas, Noelia Sibilla Casanovas, María Victoria Sormani, Arantxa Ubieta, Jonathan Van Cauwenberge Muñoz, Mariano Vitetta, Néstor Zumaya.

Version 4.07  Sarah Jane Aberasturi, Leticia Arcos, Ana Atienza, Lida Barbetti Vros, Claudia Bayá Crapuchett, Yvonne Becker, Heidy Blanco, Esperanza Blog-Case, Laura Bocco, Marina Borrás Ferrá, Francisco Calderón Pérez, Guido Castañeda Macchiavello, Mario Chávez, Jorge Colomo Grech, Noemí Contartese, Fernando Contreras Blanco, José Antonio de la Riva Fort, María de la Rubia Gómez-Morán, Rosa María Domínguez Borad, Jorge Esteban Casas, Mary Fons i Fleming, Betty Galiano, Sara García, Rebeca García Corrales, Alicia García Espinosa, William Giller, María J. Hernández Weigand, Daniel Hinostroza, Diego Ibáñez Rivera, Mar Jiménez Quesada, Matt Leedham, Juan Diego López García, Javier Mallo Martínez, Isabel M. Martos, Javier Mas, Gabriela Mattoni, Teresa Miret Mestre, Miriam M. Mora Mau, Nuria Morales, María Cristina Morinaga, Pablo Mugüerza, Alfonso Nevado Caballero, Andrés Paredes Jiménez, Emilia Picazo Guadarrama, M.ª Fernanda Pignataro, Antonio M. Regueiro, Ana Paula Rodríguez, Victoria Romero Moreno, M.ª Verónica Saladrigas, Antonio Sanguino Yturriaga, Xiomara Smith, María Victoria Sormani, Karol Tapia de Moya, Teresa Triana, Verónica Visgarra, Javier Wasserzug, Néstor Zumaya.

Version 4.06  Mónica Adler, Marta Altimira Cabré, Ana Atienza, Lida Barbetti Vros, Claudia Bayá Crapuchett, Valeriy Belykh, Míriam Bernal Montoro, Heidy Blanco, Esperanza Blog-Case, José Bocic, Iria Carballo, Daniel Carrión de Gómez, Guido Castañeda Macchiavello, Constanza Cervino, Alfonso Cigarrán, M. Gonzalo Claros, Noemí Contartese, Fernando Contreras Blanco, Jorge Esteban Casas, Mary Fons i Fleming, Sandra Frisancho Herrera, Belén Fuentes García, Betty Galiano, Olga Gallegos, William Giller, Emma Goldsmith, Silvia Gómez de Antonio, Paz Gómez Polledo, Rocío Gómez Zamora, Nuria González Martínez, Manuela Goñi, Mariana Guiadanes Figueiras, María J. Hernández Weigand, Daniel Hinostroza, Juan Manuel Igea, Anna Jené Palat, Mar Jiménez Quesada, Lilian Jiménez-Ramsey, Becky Katz, Juan Diego López García, Valentina Luridiana, Monica Madel, Javier Mallo Martínez, Elisa Manzanal, Carlos Martínez Mesa, Ovidia Martínez Sánchez, María Laura Mazza, María Millán García, Teresa Miret Mestre, Pablo Mugüerza, Alfonso Nevado Caballero, Ana Gloria Otero Álvarez, Mercedes Pacheco Ruiz, José Sergio Pajares Nievas, Anthony Palomo, Elena Pérez Hernández, María Pineda, Paula Porcar Llorens, Héctor Quiñones Tapia, Antonio M. Regueiro, Cristina Río López, Mar Rodríguez Vázquez, Mireia Ros García, Diego Sansone, Lourdes Serna Chávez, María Victoria Sormani, Luciana Sosa, Ainhoa Tallón Ruiz, Paula Torres López, Sara Varela García, Javier Wasserzug.

Version 4.05  Mónica Adler, Ana Atienza, Lida Barbetti Vros, Francisco Bautista Becerro, Claudia Bayá Crapuchett, Yvonne Becker, Laura Bocco, Marina Borrás Ferrá, Liliana Bryant, Natalia Caicedo, Ayla Carazo, Iria Carballo, Constanza Cervino, M. Gonzalo Claros, Noemí Contartese, Fernando Contreras Blanco, José Antonio de la Riva Fort, María de la Rubia Gómez-Morán, Silvia Escobar, Jorge Esteban Casas, Marta Fernández Seoane, Luisa Fernández Sierra, Nur Ferrante Morales, Mary Fons i Fleming, Betty Galiano, Sara Galindo Álvarez, Ana Elisa Gil Vodermayer, William Giller, Paz Gómez Polledo, Myra Guzmán-Teare, María J. Hernández Weigand, José A. Huarancca Sánchez, Mar Jiménez Quesada, Vanesa Jorge Sostoa, María Kurtz, Núria Llorens, Juan Diego López García, Ileana Luque, Valentina Luridiana, Javier Mallo Martínez, Elisa Manzanal, Eva Martínez Fornos, Álvaro Medina Muñoz, Miriam M. Mora Mau, Pablo Mugüerza, María José Nägler, Julieta Olivero, José Sergio Pajares Nievas, Anthony Palomo, Blanca Paniagua Marco, Emilia Picazo Guadarrama, M.ª Fernanda Pignataro, María Pineda, Patricia Posadas Suquía, Fernando Presumido, Héctor Quiñones Tapia, Daniela Ramírez, Antonio M. Regueiro, María Requena Castañol, Cristina Río López, Mar Rodríguez Vázquez, Rodrigo Rosales Sosa, Manuel Rubio Máñez, M.ª Verónica Saladrigas, Giselle Saldaña, Antonio Sanguino Yturriaga, Gemma Sanza Porcar, María Victoria Sormani, Karol Tapia de Moya, Andrea Valero Mathieu, Javier Wasserzug.

Version 4.04  Mónica Adler, Ana Atienza, Maite Babío Galán, Lida Barbetti Vros, Claudia Bayá Crapuchett, Natalia Caicedo, Susana Campos, Constanza Cervino, M. Gonzalo Claros, Rossella Cordone, José Antonio de la Riva Fort, María de la Rubia Gómez-Morán, Verónica Escobar, Jorge Esteban Casas, Mary Fons i Fleming, Pedro Juan Galán Martín, Betty Galiano, Sara Galindo Álvarez, Lorenzo Gallego Borghini, Mercedes García-Briones Teglia, Emma Goldsmith, Rocío Gómez Zamora, María J. Hernández Weigand, Diego Ibáñez Rivera, Celina Iñones, Mar Jiménez Quesada, Becky Katz, Germán Londoño, Valentina Luridiana, Monica Madel, Elisa Manzanal, Antoni C. Maroto, Valentina Marta Rodríguez, María Laura Mazza, Álvaro Medina Muñoz, Eva Molina-De Vilbiss, José María Montero Vázquez, Miriam M. Mora Mau, Pablo Mugüerza, Laura Munoa, Alfonso Nevado Caballero, José Sergio Pajares Nievas, Anthony Palomo, Andrés Paredes Jiménez, Emilia Picazo Guadarrama, M.ª Fernanda Pignataro, Fernando Presumido, Héctor Quiñones Tapia, Antonio M. Regueiro, María Requena Castañol, Gloria M. Rivera, Mar Rodríguez Vázquez, Rodrigo Rosales Sosa, María Victoria Sormani, Paula Steiner, Javier Wasserzug.

Version 4.02  Meritxell Almarza Bosch, Lida Barbetti Vros, Claudia Bayá Crapuchett, Luis Ángel Becerra Andrade, Míriam Bernal Montoro, Marina Borrás Ferrá, David Bravo Blanco, Fernando Campos Leza, Federico Carroli, Guido Castañeda Macchiavello, Constanza Cervino, Edurne Chopeitia, M. Gonzalo Claros, Fernando Contreras Blanco, Rossella Cordone, Agustina Cossia Golagioia, José Antonio de la Riva Fort, Alejandra Durán Paiz, Fiorella Farfán, Mary Fons i Fleming, Pedro Juan Galán Martín, Betty Galiano, Sara Galindo Álvarez, Lorenzo Gallego Borghini, Luis A. García Nevares, Pilar García Valdecasas, William Giller, Paz Gómez Polledo, Rocío Gómez Zamora, María J. Hernández Weigand, Daniel Hinostroza, José A. Huarancca Sánchez, Juan Manuel Igea, Valentina Luridiana, W. Christopher Marquardt, Blanca Leticia Merlin Jarquin, Eva Molina-De Vilbiss, Pablo Mones, José María Montero Vázquez, Pablo Mugüerza, Jaume Mullol García, Alfonso Nevado Caballero, Anthony Palomo, Marisa Parzenczewski, Emilia Picazo Guadarrama, Héctor Quiñones Tapia, Antonio M. Regueiro, Cristina Río López, Gloria M. Rivera, Mar Rodríguez Vázquez, Virginia Rubio, M.ª Verónica Saladrigas, Antonio Sanguino Yturriaga, María Victoria Sormani, María Taibo, Karol Tapia de Moya, Eñaut Urrestarazu Aizpurua, Carla Vorsatz.

Version 4.02  Meritxell Almarza Bosch, Lida Barbetti Vros, Claudia Bayá Crapuchett, Luis Ángel Becerra Andrade, Míriam Bernal Montoro, Marina Borrás Ferrá, David Bravo Blanco, Fernando Campos Leza, Federico Carroli, Guido Castañeda Macchiavello, Constanza Cervino, Edurne Chopeitia, M. Gonzalo Claros, Fernando Contreras Blanco, Rossella Cordone, Agustina Cossia Golagioia, José Antonio de la Riva Fort, Alejandra Durán Paiz, Fiorella Farfán, Mary Fons i Fleming, Pedro Juan Galán Martín, Betty Galiano, Sara Galindo Álvarez, Lorenzo Gallego Borghini, Luis A. García Nevares, Pilar García Valdecasas, William Giller, Paz Gómez Polledo, Rocío Gómez Zamora, María J. Hernández Weigand, Daniel Hinostroza, José A. Huarancca Sánchez, Juan Manuel Igea, Valentina Luridiana, W. Christopher Marquardt, Blanca Leticia Merlin Jarquin, Eva Molina-De Vilbiss, Pablo Mones, José María Montero Vázquez, Pablo Mugüerza, Jaume Mullol García, Alfonso Nevado Caballero, Anthony Palomo, Marisa Parzenczewski, Emilia Picazo Guadarrama, Héctor Quiñones Tapia, Antonio M. Regueiro, Cristina Río López, Gloria M. Rivera, Mar Rodríguez Vázquez, Virginia Rubio, M.ª Verónica Saladrigas, Antonio Sanguino Yturriaga, María Victoria Sormani, María Taibo, Karol Tapia de Moya, Eñaut Urrestarazu Aizpurua, Carla Vorsatz.

[*]     Without neglecting those who were so generous with their help in the first two editions: Enrique Alcaraz Varó [†] (Alicante), José María Álvarez Blanco (Madrid), Cristina Andrade (Madrid), José Rafael Blengio Pinto (Querétaro), M.ª del Pilar Calbet Rebollo (Barcelona), M.ª Jesús del Sol Jaquotot (Madrid), María Claudia Filgueira (Paris), Xavier Fuentes Arderiu (Barcelona), Betty Galiano (Rosario), Pilar García Menéndez (Madrid), Valentín García Yebra [†] (Madrid), Carlos Garrido (Vigo), Paz Gómez Polledo (Madrid), Luis González (Brussels), Francisco Hernández (Basel), Martin Kuhn (Freiburg im Breisgau), Juan Manuel Martín Arias (Madrid), Ernesto Martín-Jacod (Buenos Aires), Juan Antonio Navarro González (Badajoz), Ignacio Navascués (Madrid), Luis Pestana (Washington and Geneva), Emilia Picazo (Mexico), Héctor J. Quiñones (Madrid), Federico Romero [†] (Madrid), M.ª Verónica Saladrigas (Basel), Joaquín Segura (New York), David Shea (Las Palmas), Gustavo A. Silva (Washington), Pepe Tapia (New York and Ann Arbor), Elisa Vilaret (Barcelona) and Mariano Zomeño (Madrid).

I also implemented suggestions made by doctors, translators and terminologists in their reviews of this dictionary in Actas Dermo-Sifiliográficas (Madrid), Apuntes (New York), Excélsior (Mexico), Hexagon (Basel), Lebende Sprachen (Berlin), Medicina (Buenos Aires), Medicina Clínica (Barcelona), Médico Interamericano (New York), Panace@ (Madrid), Puntoycoma (Brussels), Quark: Ciencia, Medicina, Comunicación y Cultura (Barcelona), Revista Española de Cardiología (Madrid), Revista Española de Enfermedades Metabólicas Óseas (Madrid), Revista Panamericana de Salud Pública (Washington), Terminologie & Traduction (Brussels), Terminology (Amsterdam), Trans: Revista de Traductología (Malaga).

11 Bibliography