Tuesday, July 21, 2020

Infectious diseases, Part 24: Tuberculosis

[This entry comes from a section of the chapter "Words about infectious diseases" in Part II of the open-source textbook Spanish-English Cognates: An Unconventional Introduction to Spanish Linguistics.]


The English word tuberculosis and its Spanish cognate tuberculosis refer to an infectious disease typically caused by the bacteria Mycobacterium tuberculosis (MTB), though there are four other mycobacteria that can cause, M. bovis, M. africanum, M. canetti, and M. microti. Tuberculosis, often abbreviated to TB in English, primarily affects the lungs, but it may affect other parts of the body as well. The cause of this disease was found by German physician and microbiologist Robert Koch in 1882, when he discovered the tuberculosis bacillus, for which he received the Nobel Prize in physiology and medicine in 1905. The pulmonary form of the disease had already been described in 1689 by English physician Richard Morton. who described the tubercles or nodular lesions in the lungs of affected patients. It was not until the 1820’s, however, that tuberculosis was found to be a single disease and it received its current name in 1839 (see below).

About 90% of all tuberculosis infections result in no symptoms and thus the bacteria is said to be latent (and non-contagious). In the remaining 10%, the disease becomes active and about half of those patients will die if not treated. Currently, about a quarter of the world population has the latent form of the disease. Active TB can be diagnosed by means of X-Rays and cultures of bodily fluids and latent TB (LTBI), by means of the tuberculin skin test (TST) or blood tests. There is a preventive vaccine for TB and the disease can now be treated by means of multiple antibiotics administered during a long period of time, though antibiotic resistance is an increasing problem.

The word tuberculosis

The name tuberculosis is a New Latin noun created in the 1839 by German professor of medicine Johann Lukas Schönlein. Interestingly, Dr. Schönlein was also one of the first German medical professors to lecture in German rather than in Latin. From German, the name tuberculosis spread to other European languages, including English tuberculosis [tə.ˌbɜɹ.kjə.ˈloʊ̯s.əs], French tuberculose [ty.bɛr.ky.ˈloz], and Spanish tuberculosis [tu.βeɾ.ku.ˈlo.sis].

This New Latin word was formed from the stem tūbercŭl‑ of the classical Latin noun tūbĕrcŭlum ‘a small swelling, bump, or protuberance; a boil, pimple, tubercle’ (L&S), a diminutive of the third declension noun tūber (gen. tūbĕr‑is) that meant primarily ‘a hump, bump, swelling, tumor, protuberance on animal bodies, whether natural or caused by disease’ (L&S) (cf. tūbĕr‑cŭl‑um, with the diminutive suffix ‑cŭl‑). To this stem, the scientific New Latin suffix ‑osis was added, which adds the meaning ‘diseased or abnormal condition’ (AHD). The source of this suffix is the Greek ending -ωσις (-ōsis) ‘state, abnormal condition, or action’, from ‑όω (-óō) stem of causative verbs, and the noun-forming ending ‑σις (-sis). The reason for the name is the tubercules (lumps) in the lungs that result from the disease.

English and Spanish have also borrowed the Latin source words from which the word tuberculosis is derived, directly from written Latin. Spanish has the word tubérculo, from Lat. tūbercŭlum, and English has both tuber, from Lat. tūber, and tubercle, from Lat. tūbercŭlum. Eng. tuber (first attested in the mid-15th century) means ‘a round swollen part on the stem of some plants, such as the potato, that grows below the ground and from which new plants grow’ (LDCE). The English word tubercle (first attested in the mid-16th century) is mostly a technical one used in anatomy, zoology, botany, and medicine (pathology). In the latter of these fields, it has the meaning ‘a small nodular lesion in the lungs or other tissues, characteristic of tuberculosis’ (COED) and in the former ones, ‘a small rounded projection or protuberance, especially on a bone or on the surface of an animal or plant’ (COED). The word tuber can also be used with the last of these meanings of the word tubercle, namely for ‘a rounded swelling or protuberance; a tuberosity; a tubercle’ (RHWU). The Spanish equivalent of both of these English words is tubérculo, since Spanish never borrowed the Latin word tuber.

From the noun tuber, Latin derived an adjective and from it, another noun, both of which have made it into English and Spanish. The adjective was tūbĕrōsus/a, formed with the first/second adjective-forming suffix ‑ōs‑, which meant ‘full of humps, lumps, or protuberances’ (L&S). From this, we get the synonymous English adjectives tuberous and tuberose that mean ‘producing or bearing tubers’ or ‘being or resembling a tuber’ (AHD). Spanish has also borrowed this noun as tuberoso/a. From this adjective and the abstract-noun-forming suffix ‑ĭ‑tāt‑, Latin could form the noun tūbĕrōsĭtāt‑, which English has borrowed as tuberosity, which refers to ‘the quality or condition of being tuberous’ but can also mean ‘a projection or protuberance, especially one at the end of a bone for the attachment of a muscle or tendon’ (AHD). The Spanish cognate of this word is tuberosidad.

There may be another pair words in English and Spanish that are derived ultimately from Lat. tūber, namely the cognate words (paronyms, not full cognates) Eng. truffle and Sp. trufa. These words are good friends semantically and they have two rather different meanings in each of these modern languages, namely (1) ‘a strong-smelling underground fungus that resembles a rough-skinned potato, considered a culinary delicacy. [Family Tuberaceae.]’; and (2) ‘a soft sweet made of a chocolate mixture’ (COED). The second sense of these words is derived from the first one, in the 20th century and it is based on the visual similarity between the fungus and the chocolate confection. Both of these words have been hypothesized to come from Old Provençal trufa, a descendant of a vulgar Latin tufera, with metathesis of the r, a descendant of the neuter plural wordform tūbĕra of the noun tūber ‘edible root’. French would have borrowed the term from Occitan at the end of the 14th century, cf. Mod. Fr. truffe [ˈtʀyf]. Spanish and French both borrowed the word from Occitan and English borrowed it from French to which it later added the suffix ‑le (OED). (The English word without the suffix did exist in English as truff, but it is now obsolete, OED.) The Spanish word trufa has another sense in colloquial dialectal Spanish, namely ‘lie, hoax, jest’, a meaning that is quite old and exists also in the French word (Sp. ‘mentira, patraña, embuste, engaño’; cf. Cat. trufa ‘joke, kidding’). Actually, the ‘trick, jest’ meaning of this French word precedes the ‘edible fungus’ one. The former is found already in the 13th century, whereas the latter is not found until the 15th century.

Earlier names in English

The traditional name for the tuberculosis disease in English before its modern name was borrowed from German was consumption [kənˈsʌmpʃən]. English borrowed this word in the 14th century from Old French consumpcion or consumption (Modern French consomption [kɔ̃sɔ̃psjɔ̃]), where it meant ‘wasting of the body’, ‘destruction’ and, eventually, ‘wasting disease, especially pulmonary tuberculosis’ (OED). The word consumption to refer to tuberculosis is now ‘dated’ (COED), ‘old-fashioned’ (MWALD), and ‘no longer in scientific use’ (AHD).

The original source of this word was classical Latin cōnsūmptiōn-, a noun meaning ‘the process of consuming or wearing away’ in classical Latin, and in post-classical Latin also ‘destruction’, ‘death’, and ‘a disease in which the body wastes away’ (for the most part, what we now know as tuberculosis). This noun was derived from the participial stem cōnsūmpt‑ of the passive participle cōnsūmptus of the verb cōnsūmĕre (principal parts: consūmo, consūmĕre, consumpsi, consumptus). The original meaning of this Latin verb was ‘to take wholly or completely’ (L&S), from which other meanings derived over time such as ‘to consume, devour’, ‘to waste, squander, annihilate’, ‘to kill, destroy’ and ‘to eat’. This Latin verb is, of course, the source of the cognates Eng. consume ~ Sp. consumir, which are close friends semantically in the modern languages.

The 3rd conjugation Latin verb cōnsūmĕre was derived from the verb sūmĕre ‘to take, take up, take in hand, etc.’ by means of the prefix con‑ ‘with, together; completely’ (con+sūmĕre; principal parts: sūmo, sūmĕre, sumpsi, sumptus). This verb was passed on to Spanish as sumir, a fancy word today that means primarily ‘to sink, plunge, submerge’, used mostly in a figurative sense, e.g. Al caer al río el anillo, se sumió con rapidez ‘As the ring fell into the river, it quickly sank’, La guerra sumió a muchas personas en el hambre ‘The war plunged many people into hunger’ (both examples from Larousse). Other verbs derived from this Latin verb by prefixation were: (1) assūmĕre ‘to take up, receive, adopt or accept’, source of (partial friends) Eng. assume and Sp. asumir, from ad ‘to’ + sūmĕre); (2) praessūmĕre ‘to take first; to take for granted, etc.’, source of (partial friends) Eng. presume ~ Sp. presumir, from prae‑ ‘before’ + sūmĕre; and (3) īnsūmere ‘to take for any thing; hence to apply to, expend upon’ (L&S), source of the rare cognate verbs Eng. insume ~ Sp. insumir both meaning ‘to take in, absorb’ (from in‑ ‘in’+sūmĕre). Interestingly, Spanish has adopted a noun derived from the rare verb insumir, namely insumo, as the most common way to translate the very common English word input. Medieval Latin has also created a verb subsūmĕre ‘to take under’ from which comes Eng. subsume, a verb not borrowed by Spanish (the Spanish translations of Eng. subsume are englobar and incluir).

In the early 16th century, English borrowed another name for this disease that had been used in Late Latin, namely phthisis. Although rare, this word is still used in English for ‘pulmonary tuberculosis or a similar progressive wasting disease’ (COED). The Late Latin word phthisis was a loanword from Greek φθῐ́σῐς (phthísis), the name for tuberculosis and tuberculosis-like wasting diseases in this language, though this noun had a more basic original meaning, namely ‘decline, decay, wasting away’, since it was derived from the verb φαίνειν (phaínein) ‘to decay, waste away’ by means of the noun-forming suffix ‑σις (‑sis). The English word phthisis, typically pronounced [ˈθ̯sɪs] or [ˈ̯sɪs], among other possible spelling pronunciations, was never a common one in English, but rather a medical one and most dictionaries classify it as archaic or rare today, though not obsolete. As we will see below, its Spanish cognate was quite a bit more common.

Two adjectives were derived from the noun phthisis in English, namely phthisic and phthisical. The former is a loanword through Old French tisike or phtisique ‘consumptive’ (11th century), which comes from the Latin adjective phthĭsĭcus/a ‘consumptive, related to consumption’, a loanword from Gk. φθισικός (phthisikós) ‘consumptive, phthisical’, both containing cognate adjective-forming suffixes, namely Grk ‑ικ‑ and Lat. ĭc (phthĭs‑is + ‑ĭc‑ = phthĭsĭcus). The adjective phthisical was created in English from the earlier phthisic by the addition of the Latinate adjectival suffix ‑al, a common addition to Latinate adjectives ending in ‑ic in this language (cf. Eng. physical vs. Sp. físico/a, Eng. logical vs. Sp. lógico/a). Interestingly, English borrowed the adjective phthisic even earlier than the noun phthisis, in the late 14th century. (As we will see, Spanish did too.)

Not only that but the adjective phthisic was also used as a noun to refer the disease, as a variant of the noun phthisis (AHD). Actually, it wasn’t just tuberculosis that the name phthisic and/or phthsis referred too, for at the time these diseases were not properly understood. The dictionary tells us that the noun phthisic was used in English not just for tuberculosis but also for ‘any illness of the lungs or throat, such as asthma or a cough’ (AHD). The same thing is true of the name consumption, which could refer to any wasting disease, of which tuberculosis was the most common. It is thus not surprising that the newly-coined word tuberculosis was so readily adopted once the cause of the disease was discovered in the 19th century.

Earlier names in Spanish

The two English words for this disease that we just discussed have cognates in Spanish, which were also used to refer to the disease in this language. The earliest name for the disease in Spanish was consunción, a semi-learned word that comes from the same Latin source as Eng. consumption, with simplification of the Latin consonant cluster (cf. Part I, Chapter 10). This word is rare in Modern Spanish and dictionaries do not give it as another name for tuberculosis but rather define it more vaguely as, first, ‘deterioration and extinction of something, generally by combustion, evaporation or wear’ and, secondly, in medicine, as the ‘progressive physical deterioration of a person or animal, accompanied by a visible loss of weight and energy’ (Vox).[1]

The connection of this noun to the modern Spanish verb consumir is obvious but the semantic connection is only partial. The verb consumir is polysemous since it has between 5 and 7 senses, depending on the dictionary. According to the DLE, which gives 7 senses for consumir, some quite rare, the two main ones are ‘to destroy, extinguish’ and ‘using groceries or other goods to satisfy needs or wants’.[2] María Moliner’s dictionary, which only gives 5 senses for this verb, does give one that the DLE does not, perhaps because it is archaic, namely ‘to make someone skinny or weak’, which is relevant to us since this is the sense that relates to the Spanish noun consunción.[3]

Note that Spanish has created other nouns from the verb consumir that relate to the main senses of the verb consumir, namely consumo and consumición, both meaning ‘consumption, the act of consuming’. The noun consumición can also be used in some dialects, such as in Spain, to refer to what one consumes at establishments such as bars, coffeeshops, or discotheques, the word being very common in that context, e.g. Cuesta mil pesetas la entrada con consumición ‘The cost of entrance and a drink (etc.) is one thousand pesetas’ (María Moliner).

Before tuberculosis became the normal name for this disease in Spanish in the 19th century, the more common name was no longer consunción but rather tisis, which is an adaptation of Lat. phthisis (see above). This word is somewhat archaic now in Spanish, but it is still found in dictionaries, which tell us that the word is still used in medicine as a synonym of tuberculosis, but also to refer to any ‘disease in which there is gradual and slow consumption, hectic fever and ulceration in some organ’ (DLE). In other words, tisis was the word that was used for tuberculosis and similar diseases that resulted in patients wasting away before the causes of these diseases was known and the diseases were given unambiguous names.

An even earlier word for the tuberculosis disease in Spanish, now obsolete, is tísica, a noun derived from the adjective tísico/a used to refer to people with the disease, much like the noun física ‘physics’, the name of the branch of science, is derived from the feminine form of the adjective físico/a ‘physical’. As we saw, English also used a cognate of this word, namely phthisic, to refer to the disease in the 14th century, even before it borrowed the noun phthisis. Nebrija’s 1495 dictionary gives tísica as the name for the disease, but not tisis, which was obviously not in use at the time. Nebrija also mentions the noun tísico/a as the name for someone who suffers from the disease (DCEH), much like Sp. físico/a ‘physicist’ is used to refer to someone who practices physics.

It seems that Old French did use early on the word tesie or tisie derived from the Latin name phthisis, which in the mid-16th century came to be spelled phtisie, its current form. It is very likely that Sp. tisis and Eng. phthisis were adopted under the joint influence of the cognate Latin and French words after the words Sp. tísica ~ Eng. phthisic were already in use as names for the disease.

Names for tuberculosis sufferers

Since we just mentioned that tísico/a was used to refer to a sufferer of this disease, we should ask if there are any other names for such sufferers. In English, there is no single word for them today and thus the only options are tuberculosis sufferer or tuberculosis patient. Spanish, on the other hand, uses the noun tuberculoso/a for such a meaning. This noun is derived by conversion from the identical adjective formed with the adjective-forming suffix ‑oso/a. The Spanish adjective tuberculoso/a translates into English as tuberous in Botany and as tubercular or tuberculous in Medicine. But the English cognate of the adjective tuberculoso/a, namely tuberculous, cannot be used as a noun in English. Actually, this is not surprising since this is something applicable to all adjectives containing the cognate suffix that descends from Lat. ‑ōs‑. In Spanish, adjectives formed with the ending ‑­oso/a that describe people are often used as nouns too, as in this case, but not so their English cognates, e.g. Sp. avaricioso/a ‘avaricious; avaricious person’ ~ Eng. avaricious, Sp. goloso/a ‘sweet-toothed (person)’, Sp. cauteloso/a ‘cautious (person)’.

As we saw above, in Spanish, the adjective tísico/a could also be used as a noun in earlier times to refer to a person affected by tuberculosis, a ‘sufferer of phthisis’. In English, the word consumptive was used to refer to someone suffering from consumption. Eng. consumptive was primarily an adjective meaning ‘of, relating to, or afflicted with consumption’, but in earlier times, since around the middle of the 17th century, it was also used as a noun for ‘a person afflicted with consumption’ (AHD). Some dictionaries warn us that the noun consumptive is today ‘old-fashioned’ to refer to a person afflicted with consumption, but other dictionaries do not give any such usage warnings.[4]

[1] In Spanish: ‘Deterioro y extinción de algo, generalmente por combustión, evaporación o desgaste’ and ‘Deterioro físico progresivo de una persona o animal, acompañado de una pérdida visible de peso y energía’.

[2] In Spanish: ‘tr. Destruir, extinguir. U. t. c. prnl’ and ‘Utilizar comestibles u otros bienes para satisfacer necesidades o deseos’.

[3] In Spanish: ‘tr. Poner *flaco o *débil a ↘alguien.’

[4] It is The Longman Dictionary of Contemporary English that tells us that this use is ‘old-fashioned’ today.

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