Passion, carminative as wine

On the label … it was described as being in the highest sense carminative … It seemed so wonderfully to describe that sensation of internal warmth … which followed the drinking of cinnamon … “And passion carminative as wine” was what I wrote … And then suddenly it occurred to me that I had never actually looked up the word in a dictionary … A small English-German dictionary was all I had at hand … There it was “Carminative: Windtreiband”

From Crome Yellow by Aldous Huxley

As small children we have to learn to speak without the aid of a dictionary. We work out the meaning of words from hearing them in context. It is a fascinating process, and I have found it very entertaining listening to small children talking to themselves and trying out words that they have just discovered. I remember watching a toddler going round a room, examining everything and trying to work out what material it was:

This is made of wood. This is made of plastic. This is made of metal. This is made of wood and metal. This is made of Hong Kong...”

Then on to the next step. Testing the new words out on their parents:

Mummy, why do spiders spide?

Or suddenly finding themselves in a situation where they are not quite sure what is appropriate and they have to guess:

Angry father after young daugther has insisted on swinging on the coat rack one more time and accidentally pulled it off the wall:

“I told you not to do that. Now, what do you say to Daddy?”

Long pause while the child picks herself up from the heap of coats and racks her brains to think what an adult would say here…

“Oh shit!”

We continue to encounter new words throughout our lives, and most of the time it is reasonably clear what the speaker is trying to say without us having to understand every single word. Some of them nevertheless filter through into our vocabulary. I used to love thumbing through Chambers 20th Century Dictionary, looking up words I had heard or read, or just browsing new ones, and getting out the magnifying glass in order find definitions of more unusual words in the condensed edition of the Oxford English Dictionary, photographically compressed into two volumes with microscopic type. Nowadays there are any number of dictionaries available through our smartphones. This makes the process easier but maybe not quite so much fun.

I suspect most of us are happy to start using a new word without really knowing what it means, and if enough people do this the meaning itself changes. This can enrich language, but it can also impoverish it when the original meanings are lost, particularly when there are no alternatives that express them so well. There are a few that particularly come to mind.


A few months ago I found myself watching the TV show QI. They were showing a clip of two people being winched up into a helicopter, and one of the panellists referred to “the one who is akimbo”. I wasn’t sure which one he meant, since neither of the chaps dangling in the air were akimbo. I have also hear people use the phrase “legs akimbo”, generally in the context of being sprawled on the ground in a rather undigified way. However, I don’t think even a professional contortionist skilled in dislocating their joints could manage to lie with their legs akimbo.

On the other hand, when I was still working as an oncologist, if somebody needed radiotherapy for a tumour in the humerus (the bone of the upper arm) we used to treat them akimbo, as an easy and reliable method of immobilising the limb in a reproducible posititon.

Akimbo means having your hands on your hips. Apparently this comes from Old Norse, in kenebow, kene being keen or sharp and bow being bowed or arched, so referring to the elbow jutting out when you are in this position.


I think everybody is familiar with the phrase “it was a bit of a damp squib”, meaning that something (or someone) turned out to be rather disappointing. J K Rowling gave us a new meaning to the word in the Harry Potter books as being a non-magical person of magical parents, certainly a disappointment to all concerned. The word itself sounds a bit like squid, and conjures up something damp, fishy and unexciting, along the lines of a wet towel.

An actual squib, however, is rather the opposite of this, being a small hissing firework. Definitely a disappointment, though, if you haven’t kept it dry.


I thought I would put in a few more medical words here, this time used by obstetricians. How about delivery, the process that results in a baby? Strictly speaking, the midwife delivers the mother, not the child. Delivery in this sense refers to the safe conclusion of a hazardous process, as in the Lord’s Prayer “Deliver us from evil”. I think the confusion arises from the tradition of storks bringing babies, (storks being what Amazon used before drones were available).


Sticking with the theme of early childhood, people commonly talk of weaning a child off milk (and doctors use wean in a similar sense when they are trying to get a patient off a drug, such as morphine, or off life support). However, wean comes from a Germanic root meaning accustom, prepare, habituate or something along those lines, so you don’t wean an infant off milk, you wean them onto solids.


And she brought forth her firstborn son, and wrapped him in swaddling clothes, and laid him in a manger

Luke Chapter 2 verse 7, King James Bible

These days most people probably encounter these words only during a Christmas Carol service, and might naturally conclude that Mary had done what any mother would do, wrapping her child up safe and warm. According to more recent translations of the Bible that is more-or-less what she did: “She wrapped him in cloths” (New International Version, New American Standard Bible and Good News Translation), “She dressed him in baby clothes” (Contemporary English Version).

What she was really doing was trying to protect his health. Travellers to the Indian sub-continent and the Middle East will be familiar with the sight of people walking around (or limping, rather) with distorted, bowed legs from rickets. We now know the cause to be a deficiency of vitamin D, but vitamins hadn’t been identified 2,000 years ago, and it was commonly believed that this deformity, resulting from walking on calcium-starved bones that are too soft to take the body’s weight without gradually bending, could be prevented by splinting the limbs of an infant. Swaddling does this using strips of cloth to bind the child’s limbs tightly, with the legs straight and the arms by their side, so that they can’t move at all. More like Egyptian mummy than yummy mummy.

Nowadays it would be considered child abuse, and the next person to tell me that they have swaddled their baby can expect a visit from Social Services.

Disinterested / uninterested

Surely these are alternative opposites of interested? Well, not exactly, any more than disgruntled is the opposite of gruntled, unless you are Bertie Wooster (the gruntle is the snout of a pig, and being disgruntled is the state of having your snout pushed out of the feeding trough by a bigger pig; you can imagine how that makes you feel).

The familiar meaning of interested is curious, absorbed, noticing, paying attention etc. and uninterested is the opposite of this. But it is also used extensively in the financial world, and not just interest on a savings account or on a loan. If you have an interest in something you have a stake in it. If you don’t you are disinterested. Impartial.

You always want your doctor to be interested in you, but you also want him to be disinterested, otherwise he is going to prioritise meeting his targets over your welfare (NHS) or refer you for an unnecessary scan because he owns a share in the clinic (private sector).

Mitigate / militate

“What factors mitigate against a fistula healing?”

Young surgeon teaching on a ward round at my medical school

Militate isn’t a word that I have ever had cause to use. It comes from the Latin miles (soldier) from which we get militia and military, and it means applying a strong pressure to cause something, or more often to prevent it, as though the force of an army were involved, or at least some soldiers at a checkpoint.

Lack of funds militates against an exotic holiday this year.

Mitigate is simply to lessen the effect of something, alleviate, lighten, weaken, ease.

Aspirin mitigates the aching muscles of a virus infection.

Factors militating against a fistula healing include infection, malignancy and the presence of a foreign body, a fistula being an abnormal connection between two epithelial surfaces, epithelium (parietal or visceral) being… Oh! Look it up yourself!

Less / fewer (number / amount)

This is simple. If you can count something then you can have a large number of them, and if you take some away then you have fewer. If you have to measure rather than count them then you can have a large amount, and when you take some away you have less.

There are a large number of people here, but fewer over there.

There is a large amount of food on this table, but less on that one.

Heart attack

There are a lot of words that have crossed over from medical terminology into plain English, and have lost their precise technical meaning on the way. Heart attack isn’t one of them, however, because it doesn’t really mean anything at all. To some people it might suggest sudden damage to the heart from blockage of a coronary artery (myocardial infarction) or even stoppage of the heart altogether (cardiac arrest). To those prone to rhythm disturbances it might be a sudden speeding up (tachycardia) or slowing down (bradycardia, both arrhythmias and if they are sudden and temporary they are paroxysmal). Cardiac pain brought on by exercise might also be described as a heart attack (angina of effort). But I think it is best to avoid a term that means so many different things to different people.

Heart Failure

This is a term I hear bandied around quite regularly, and from the context I think people probably mean cardiac arrest (“he died from sudden heart failure”), or what medics might refer to as asystole, which means that the heart is not pumping, (systole is contraction of the heart as it pumps, and the relaxation between beats when it fills again is diastole; blood pressure is usually quoted (as the height in millimetres of a column of mercury exerting the same pressure due to its weight) using two figures representing these two stages of the heartbeat, e.g. 125/80 mmHg). Quite commonly the heart can respond to lack of oxygen or other stresses by very active contractions of the individual fibres but in an unco-ordinated way, which we refer to as ventricular fibrillation; the ECG shows a rather chaotic up-and-down trace and the heart is unable to pump blood, so this is rapidly fatal unless the fibres can be co-ordinated again by an electric shock from a defibrillator. But this is not heart failure.

To a medic, heart failure means something rather different, namely the failure of the heart muscle to pump adequately. It is still beating, but can’t really keep up with the demands of the body. Very often the situation is compounded when strategies we have evolved to cope with blood loss start to come into play. The main result here is retention of fluid, which makes the situation worse as there is now a greater volume of blood for the heart to pump, more work to supply the muscles trying to move a heavy, bloated body around and less oxygen absorbed through the waterlogged lungs. So heart failure is a chronic condition, and treatment is aimed at maximising the efficiency of a worn-out system.


The late Les Dawson used to complain “I’m a martyr to piles”, usually when dressed as a Manchester housewife. Everybody knows that it refers to a problem “down there” but most don’t feel that it is very genteel to inquire too closely. So when somebody tells me they have piles I’m not quite sure whether they are telling me that they have internal or external haemorrhoids, whether they are prolapsing or thrombosed, bleeding or painful, grade 1, 2 or 3, or something else entirely such as fissures, warts or pinworms.

Still, when you tell people that you have piles they probably feel that you are over-sharing already even without you going into further details.

And if you have wind as well, then you will just need to ask the chemist for something suitable. Something in the highest sense carminative.

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