George Christopher
Michigan, United States

Samuel Johnson (1709–1784) was a prominent eighteenth-century writer whose compositions include literary reviews of the works of Shakespeare, Addison, Dryden, Milton, Pope, and other major authors; scathing commentaries on moral and political issues such as the institution of slavery and the mistreatment of indigenous Americans; brief biographies; poems; a tragic play; and his landmark work A Dictionary of the English Language (1755).^1,2 His writing style is notorious for prolonged sentences featuring complex syntax incorporating numerous subordinate clauses and phrases, and especially for the use of long words.

A rationale for using lengthy terminology is that each long word may replace multiple shorter words, paradoxically improving conciseness. Medical parlance, colloquially referred to as “medspeak,” uses such an approach; for example, the term aplastic anemia is more concise than decreased circulating red blood cell mass due to inadequate erythrocyte production in the bone marrow. Hematogenous metastasis is more succinct than the spread of disease from an initial focus to another anatomic site via the bloodstream. Medspeak terms are often derived from either Greek, Latin, French, German, or other linguistic word roots, and frequently combine word roots from the same language (e.g., superinfection, an infection that complicates a preceding infection, such as bacterial pneumonia complicating influenza. Both super and infection are derived from Latin: super [above, added] + infectionem [to corrupt], while endocardial [pertaining to the endocardium, the inner lining of the heart chambers] is derived from two Greek words, ἔνδον [endon, within] and καρδία [kardia, heart]). Medspeak often combines word roots from several languages into single terms (e.g., hypertension; Greek ὑπέρ [hyper, above or excessive]; Latin tensio, tension). Although medspeak facilitates communication among health professionals, it can be counterproductive during interactions with patients. Because the well-being of our patients is the ultimate goal of all medical interventions, communication with patients must be shared in language that all can understand.³

Johnson’s Dictionary contains numerous medical terms.² Some, with or without minor spelling revisions, carry the same (or highly similar) connotations that they have today. These include but are not limited to abscess, agalaxy (agalactia), artery, asthma, atrophy, cardiack, carious, caseous, cephalagy (cephalgia), coma, cachexy (cachexia), chancre, chirgeon (surgeon), dentifrice, epidermis, eructation, exomphalos, exsudation, febrile, fever, gangrene, genital, gustation, hemorrhage, hemorrhoids, hospital, infection, jaundice, lithotomy, lymphatick, marasmus, microscope, myopy (myopia), narcotick, odontalgick (odontalgia), palsy (this definition also describes hemiplegia and paraplegia, although they are not given separate entries), phlebotomy, physick (physical, physician, or medical), prognostick, prophylactick, quarantine, quotidian, scalpel, spasm, sternutation, suffusion, tumour, ulceration, and veterinarian.

Given the contemporary state of the medical art, definitions of diseases are descriptive rather than etiologic. These include elephantiasis, epilepsy, gonorrhea, gout,megrim (migraine), pleurisy, quinsy, and sarcocoele. Terms that are used today but with different meanings include autopsy (“Ocular demonstration; seeing a thing one’s self” rather than postmortem examination). The definition of cataract (“A suffusion of the eye…the pupil of the eye is either wholly, or in part, covered, and shut up with a little thin skin, so that the light has no admittance”) seems to denote pseudomembranous conjunctivitis, while the definition of glaucoma (“A fault in the eye, which changes the crystalline humour into a greyish color, without detriment of sight…”) suggests asymptomatic cataracts; the definition closes with a quote from Samuel Sharp, a noted surgeon, that “The glaucoma is no other disease than the cataract.” Johnson used the contemporary but now archaic term crystalline humour for the lens; its definition under its own entry correctly notes its anatomy and more solid consistency compared to the aqueous and “glassy” (vitreous) humors, and ends with “The parts of the eye are made convex, especially the crystalline humour, which is of a lenticular figure, convex on both sides.” Infarction is described as “Stuffing, constipation.” The definition ofleprosy (“A loathsome distemper, which covers the body with a kind of white scales”) could apply to several hyperkeratotic dermatoses, especially psoriasis and eczema.

Non-medical words in the Dictionary that gave rise to modern medical terms include botryoid (“Having the form of a bunch of grapes”), as used today in botryomycosis, a chronic bacterial infection that causes clustered grape-like cutaneous nodules,⁴ bruit (“To report; to noise abroad; to rumor,” comparable to its current medical usage as an auscultative finding associated with turbulent vascular flow), and hamated (“Hooked; set with hooks”), used to name the hook-shaped hamate bone of the wrist).

Johnsonian medical terms no longer used today include ablactate (“To wean from the breast”), androtomy (“The practice of cutting human bodies” [dissection in today’s lexicon]), terms for blind (bisson) or blindness (ablepsy, cecity), crinigerous (“Hairy, overgrown with hair” [hypertrichotic]), febricitate (“To be in a fever”), pockhole (“Pit or scar made by the smallpox”), and ptysmagogue (“A medicine which discharges spittle” [expectorant]). Several definitions reflect the medical theories of the time, such as those of humours (“The different kind of moisture in man’s body, reckoned by the old physicians to be phlegm, blood, choler, and melancholy, which, as they predominated, were supposed to determine the temper of mind”), blood-let (To bleed; to open a vein medicinally”), and miasm (“Such particles or atoms as are supposed to arise from distempered, putrefying, or poisonous bodies, and to affect people at a distance”).

Scrofula (“A deprivation of the humours of the body, which breaks out in sores commonly called the king’s evil”) is now understood as tuberculous lymphadenitis, usually involving cervical and/or supraclavicular nodes. Complications may include rupture onto the overlying skin, drainage, and fistulization. This definition is of special interest because Johnson developed scrofula during childhood. After failing to respond to the laying on of hands by Queen Anne, he was treated with incisional lymph node drainage, which left him with facial scars. He eventually developed multiple chronic illnesses that may have included Tourette’s syndrome, depression, obesity, gout, asthma, and finally cerebrovascular and cardiovascular disease.^5-7 He died at age seventy-five, probably of congestive heart failure that was refractory to medical therapy and lancing of the lower extremities, which was intended to facilitate drainage of peripheral edema. The latter procedure was performed by both physicians and the patient himself. Johnson also self-treated (drained) a cystocele that developed during his terminal course. Postmortem findings included cardiomegaly, aortic disease, and what was probably pulmonary emphysema.⁷ Yet throughout his productive years, poor health did not dampen his capacities for mentorship, friendship, engaging conversation, and superb writing, as described by his close friend James Boswell in his biographical masterpiece The Life of Samuel Johnson (1791).

Brilliant examples of self-deprecating humor are found in Johnson’s preface to the Dictionary,² in which he laments that:

It is the fate of those who toil at the lower employments of life, to be rather driven by the fear of evil, than attracted by the prospect of good; to be exposed to censure, without hope of praise, to be disgraced by miscarriage, or punished for neglect, where success would have been without applause, and diligence without reward.

Among these unhappy mortals is the writer of dictionaries…doomed only to remove rubbish and clear obstructions from the paths of Learning and Genius, who press forward to conquest and glory, without bestowing a smile on the humble drudge that facilitates their progress. Every other author may aspire to praise; the lexicographer can only hope to escape reproach, and even this negative recompense has been granted to very few.

And in his definition of lexicographer:

A writer of dictionaries; a harmless drudge, that busies himself in tracing the original, and detailing the signification of words.

When encountering lengthy medical terminology in textbooks, journals, or case presentations during rounds, we can bestow a belated smile on the humble drudge and remember the contributions of Samuel Johnson, that prolific proponent of prodigious polysyllabic palaver who, in the words of Oliver Goldsmith, could make minnows speak like whales.

References

1. Samuel Johnson. The Major Works, Ed. Donald Greene. New York: Oxford University Press Inc.; 1984.
2. Johnson, Samuel. A Dictionary of the English Language. 1755, 1773. Edited by Beth Rapp Young, Jack Lynch, William Dorner, Amy Larner Giroux, Carmen Faye Mathes, and Abigail Moreshead. 2021. https://johnsonsdictionaryonline.com. Accessed April 29–May 5, 2026.
3. Killian L, Coletti M. The role of universal health literacy precautions in minimizing “Medspeak” and promoting shared decision making. AMA J Ethics. 2017;19(3):296-303. doi:10.1001/journalofethics.2017.19.3.pfor1-1703.
4. Devi B, Behera B, Dash M, Puhan M, Pattnaik S, Patro S. Botryomycosis. Indian J Dermatol. 2013;58(5):406. doi:10.4103/0019-5154.117322.
5. Samuel Johnson: Medical. Hek Int. 2025;17(3): Literary Essays. https://hekint.org/2025/09/05/samuel-johnson-medical/. Accessed May 1, 2026.
6. JMS Pearce. Samuel Johnson: “The great convulsionary.” Hek Int. 2022;14(1): Literary Essays. https://hekint.org/2022/02/23/samuel-johnson-the-great-convulsionary/. Accessed May 1, 2026.
7. Dunea G. Doctor Johnson and his ailments. Hek Int. 2020;12(4): Literary Essays. https://hekint.org/2020/08/07/doctor-johnson-and-his-ailments/. Accessed May 1, 2026.