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The document provides information on the 10th edition of 'Medical Terminology: A Programmed Systems Approach' by Dennerll, along with links to various related medical terminology ebooks. It includes details about the structure of the textbook, including units, case studies, and professional profiles. Additionally, it emphasizes copyright information and electronic rights restrictions.

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Medical Terminology A Programmed Systems Approach 10th Edition 10th Ed Dennerll instant download

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This is an electronic version of the print textbook. Due to electronic rights
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CONTENTS
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
List of Illustrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv
About This Programmed System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
How to Use Studyware™. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi
Section A How to Work the Program—Directions for Use of Programmed Learning. . . . . . . . . . . . . . . . . . . . . . . . xxv
UNIT 1 FRAMES 1.1–1.98 The Word-Building System—Introduction to Word Parts
Including Word Roots, Suffixes, Prefixes, Parts of Speech,
and Plural Formation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CASE STUDY INVESTIGATION (CSI): Shingles. Varicella zoster virus (VZV).
Herpes zoster. Postherpetic neuralgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
PROFESSIONAL PROFILE: Dermatologist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
CASE STUDY INVESTIGATION (CSI): Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

UNIT 2 FRAMES 2.1–2.137 Surgical Suffixes, Hematology, and Diagnostic

Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
CASE STUDY INVESTIGATION (CSI): Castleman’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
PROFESSIONAL PROFILE: Registered Radiologic Technologist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
CASE STUDY INVESTIGATION (CSI): Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
PROFESSIONAL PROFILE: Cytotechnologist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
CASE STUDY: Discharge Summary—Acute Chest Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

UNIT 3 FRAMES 3.1–3.143 Oncology and the Central Nervous System . . . . . . . . . . . . . . . . . . . . . . .73
CASE STUDY INVESTIGATION (CSI): Malignant Melanoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
PROFESSIONAL PROFILE: Medical Technologist (MT [ASCP]), Medical
Laboratory Technician (MLT), Certified Laboratory Assistant (CLA) . . . . . . . . . . . . . . . . . . . . . 88
CASE STUDY INVESTIGATION (CSI): Ovarian Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
PROFESSIONAL PROFILE: Radiation Therapists (RT[T]). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
PROFESSIONAL PROFILE: Electroneurodiagnostic (END) Technologist . . . . . . . . . . . . . . . . . . . . . . 97
CASE STUDY INVESTIGATION (CSI): West Nile Virus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

UNIT 4 FRAMES 4.1–4.157 Orthopedics, Osteopathy, and Body Regions. . . . . . . . . . . . . . . . . . . . 114

CASE STUDY INVESTIGATION (CSI): Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
PROFESSIONAL PROFILE: Doctor of Osteopathy (DO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
CASE STUDY INVESTIGATION (CSI): Post-Polio Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120
CASE STUDY: Report Summary—Septic Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156

UNIT 5 FRAMES 5.1–5.165 Pathology, Otorhinolaryngology, and Prefixes dys-,

brady-, tachy-, poly-, syn- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
CASE STUDY INVESTIGATION (CSI): E. Coli Infection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
CASE STUDY INVESTIGATION (CSI): Otitis Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
PROFESSIONAL PROFILE: Audiologist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
CASE STUDY: Operative Report—Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200

UNIT 6 FRAMES 6.1–6.131 Urology and Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204

CASE STUDY INVESTIGATION (CSI): Interval History and Physical Exam . . . . . . . . . . . . . . . . . . . . . . .226
CASE STUDY INVESTIGATION (CSI): Intestinal Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229
CASE STUDY: Discharge Summary—Transurethral Resection of the Prostate . . . . . . . . . . . .244
UNIT 7 FRAMES 7.1–7.102 Gastroenterology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
CASE STUDY INVESTIGATION (CSI): Paraesophageal Hernia
with Perforated Duodenal Ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256
CASE STUDY INVESTIGATION (CSI): HIV with Hepatitis B and C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .266
CASE STUDY: Endoscopy Report—Gastrointestinal Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . .280

iii

38892_00_frontmatter_pi-xxviii.indd iii 9/25/09 8:20:23 PM

iv CONTENTS

UNIT 8 FRAMES 8.1–8.144 Neurology, Psychology, Anesthesiology,

and Vascular Terminology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
PROFESSIONAL PROFILE: Registered Pharmacist (R.Ph), Pharmacy Technician. . . . . . . . . . . . . .297
CASE STUDY INVESTIGATION (CSI): Endovenous Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .305
PROFESSIONAL PROFILE: Certified Registered Nurse Anesthetist (CRNA) . . . . . . . . . . . . . . . . . . .310
PROFESSIONAL PROFILE: Physical Therapist (PT), Physical Therapy Assistant . . . . . . . . . . . . . . .318
CASE STUDY: Summary—Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .327

UNIT 9 FRAMES 9.1–9.125 Anatomic Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332

CASE STUDY: Consultation Note—Hypoventilation Syndrome,
Diabetes Mellitus Type 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367
UNIT 10 FRAMES 10.1–10.167 Surgery, Diabetes, Immunology, Lesions,
and Prefixes of Numbers and Direction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
CASE STUDY INVESTIGATION (CSI): Laparoscopic Procedure Description. . . . . . . . . . . . . . . . . . . . .373
PROFESSIONAL PROFILE: Certified Surgical Technologist (CST ) . . . . . . . . . . . . . . . . . . . . . . . . . . . .375
CASE STUDY INVESTIGATION (CSI): Autopsy (Postmortem Exam) . . . . . . . . . . . . . . . . . . . . . . . . . . . .404
CASE STUDY: Mastectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .416

UNIT 11 FRAMES 11.1–11.94 Descriptive Prefixes, Asepsis, and Pharmacology . . . . . . . . . . . . . . . 422

PROFESSIONAL PROFILE: Registered Diagnostic Medical Sonographer (RDMS) . . . . . . . . . . . .438
CASE STUDY INVESTIGATION (CSI): Unintentional Drug Overdose Death. . . . . . . . . . . . . . . . . . . . .443
CASE STUDY: Neurology Operative Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .453

UNIT 12 FRAMES 12.1–12.96 Prefixes of Location and Medication Administration. . . . . . . . . . . . 457

CASE STUDY INVESTIGATION (CSI): Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .464
PROFESSIONAL PROFILE: Nurse, LPN, RN, NP, CRNA, Clinical Nurse
Specialist, MSN, PhD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .477
CASE STUDY: Operative Report—Bilateral Adnexal Masses, Endometriosis. . . . . . . . . . . . . . .485

UNIT 13 FRAMES 13.1–13.99 Respiratory System and Pulmonology . . . . . . . . . . . . . . . . . . . . . . . . . 489

CASE STUDY INVESTIGATION (CSI): COPD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .497
PROFESSIONAL PROFILE: Respiratory Therapist (RRT or CRT ). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .505
PROFESSIONAL PROFILE: Registered Health Information Administrator (RHIA)
and Registered Health Information Technician (RHIT ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .510
CASE STUDY: Postop Visit—Status Asthmaticas, Viral Syndrome. . . . . . . . . . . . . . . . . . . . . . . . .518

UNIT 14 FRAMES 14.1–14.115 Word Parts for Night, Sleep, Split, Skeletal System,
and Orthopedics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522
PROFESSIONAL PROFILE: Registered Occupational Therapist (OTR) . . . . . . . . . . . . . . . . . . . . . . . .525
CASE STUDY INVESTIGATION (CSI): Cervical Radiology Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .537
CASE STUDY: Operative Report—Open Reduction Fractured Elbow. . . . . . . . . . . . . . . . . . . . .554

UNIT 15 FRAMES 15.1–15.158 Ophthalmology, Endocrinology, and Medical

Specialties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 558
PROFESSIONAL PROFILE: Certified Ophthalmic Assistant (COA),
Technician (COT ), and Medical Technologist (COMT ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .560
CASE STUDY INVESTIGATION (CSI): Thyroidectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .580
PROFESSIONAL PROFILE: Emergency Medical Technician (EMT ), Paramedic (EMT-P) . . . . . . .583
CASE STUDY: Phacoemulsification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .594

APPENDIX A ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations . . . . . . . 599
APPENDIX B Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602
Weights and Measures 602
Chemical Symbols 603
Diagnoses 604
Procedures 607
Health Professions and Groups 610
Charting Abbreviations 612
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

38892_00_frontmatter_pi-xxviii.indd iv 9/25/09 8:20:51 PM

CONTENTS v

APPENDIX C Additional Word Parts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616

APPENDIX D Glossary of Proper Names of Diseases and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . 618
APPENDIX E Answers to Unit Review Activities and Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 620
APPENDIX F Puzzle Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 630
Index of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .646
Index of Word Parts Learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .657

38892_00_frontmatter_pi-xxviii.indd v 9/25/09 8:20:51 PM

PREFACE
Medical Terminology: A Programmed Systems Approach, Tenth Edition, is a medical
terminology textbook that teaches a word-building system using a programmed
learning format. Thousands of medical words may be built by learning the Latin and
Greek prefixes, suffixes, and word roots from which our English medical terms originate.
Genevieve Smith and Phyllis Davis were the first to apply programmed learning to the
teaching of medical terminology when they designed this textbook over 38 years ago.
This system continues with the tenth edition to refine the process as well as to enhance
this system using current educational technology.
Medical Terminology: A Programmed Systems Approach, Tenth Edition, is designed to
provide a comprehensive entry-level study of medical language for health career
learners with little or no previous experience. During 30 years of teaching medical
terminology, I have been amazed by course assessment statistics showing positive
results using this textbook. Instructor and student reviews also express their satisfaction
and enthusiasm for using the materials in this textbook and its supplemental package.

ABBREVIATION USE WARNING

Use of correct medical abbreviations allows the healthcare provider to communicate
concisely and quickly. However, use of incorrect, poorly written, confusing, and
made-up abbreviations are dangerous. Poor quality care may result from errors made
misusing medical abbreviations. The Joint Commission has issued an official “do not use”
list of abbreviations and symbols. Visit the http://www.jointcommission.org Web site
and search for “do not use list” to view the list. In addition to the Joint Commission list,
the Institute for Safe Medication Practices (ISMP) has published “ISMP’s List of Error-Prone
Abbreviations, Symbols, and Dosage Designations”; refer to Appendix A.
Medical Terminology: A Programmed Systems Approach, Tenth Edition will continue to
include medical abbreviations as part of each unit. The rationale for this decision is that
even though abbreviation use is being discouraged, its use continues in printed and
electronic records and past medical records. It would be irresponsible for this text to
exclude abbreviations from study. By continuing their presentation, this text hopes to
increase the learner’s awareness of correct use of abbreviations, the need for caution,
and safe practices.
ORGANIZATION
This book contains fifteen units progressively organized by word-building subject
matter and body systems that may be easily organized for semester assignments.
The programmed learning, word-building system format presents and reinforces word
parts and word building with over 2,000 frames—more than any other programmed
medical terminology textbook. This format requires active participation through reading,
writing, answering questions, labeling, repetition, and providing immediate feedback.
Various types of tables offer word part summaries, medical report data, and additional
information about subjects that may not be included in the frames. Abbreviation
tables that appear at the end of each unit include correct medical abbreviations.
Abbreviation lists are included in Appendix B and organized by subjects including
weights and measures, chemical symbols, diagnoses, procedures, health professions
and organizations, and charting.

vii

38892_00_frontmatter_pi-xxviii.indd vii 9/25/09 8:20:51 PM

viii PREFACE

Several special features in each unit enhance the learning of medical terminology. See
“About This Programmed System” on pages xvii–xix for a detailed description of each
feature.

LEARNING SUPPLEMENTS
The following supplements are included with your textbook to provide even more help
as you study.
• Flashcards. Improve your knowledge and test your mastery by using the flashcards
created from the cards provided in the last section of the book. Remove these
perforated pages carefully and then separate the cards. Flashcards are an effective
study aid for use even when you only have a small amount of time.
• StudyWARE™ CD-ROM. This interactive software packaged with the book offers an
exciting way to gain additional practice (while having fun) through exercises, game
activities, and audio for each chapter. See “How to Use StudyWARE™ ” on page xxi for
details.
CHANGES TO THE TENTH EDITION
• Extensive technical accuracy reviews were performed on every aspect of the
textbook and directly-linked ancillaries to ensure correctness of all terminology
content and answers.
• Over 50 NEW images and line art illustrations were added to enhance your
understanding of the content.
• NEW diagnostic imaging modalities; surgical techniques; and anatomy, physiology,
and disease terminology updates can be found throughout the text.
• NEW StudyWARE™ Connection feature directs you to additional learning
opportunities such as practice quizzes, animations, image labeling, and other
interactive games included on the accompanying CD-ROM.
• NEW Case Study Investigation (CSI) in each unit features excerpts from actual
medical records, and a vocabulary challenge provides “real-world” experience with
analyzing medical terms, breaking down terms into their respective word parts,
defining word parts, and defining abbreviations.
• NEW Flashcards in the back of the book are a convenient and portable study aide to
help you master the important terms from each unit.
• NEW Images for Professional Profiles provide a visual with the description of the
function and credentials of various allied health professions. These vignettes and
photos provide information about possible career paths.
• NEW Icons for feature frames help you easily identify these special frames
that point out interesting facts to help with retention, spelling tips and tricks, and
dictionary exercises.
• EXPANDED Glossaries in each unit ensure you have all the latest terminology you’ll
need for the workplace.
• Revised Review Activities provide you with a variety of exercises to reinforce terms
learned within the frames.
• NEW appendix lists error-prone abbreviations, symbols, and dose designations.
• NEW Mobile Downloads including audio for iPods, MP3 players, and cell phones
allow you to study anywhere and at any time.
• NEW instructor slides created in PowerPoint® include images and animations
and are designed to aid instructors in planning class lectures.

38892_00_frontmatter_pi-xxviii.indd viii 9/25/09 8:20:54 PM

PREFACE ix

• REVISED Audio CDs provide practice for learning the definitions and proper pronun-
ciation of 3500 word parts and terms and is presented with corresponding textbook
frame references.
• REVISED Instructor’s Manual in electronic format has numerous resources to help
instructors prepare for class, including sample syllabi; course schedules; lesson plans;
quizzes; exams; and word part activity sheets for each unit.
SPECIAL RESOURCES TO ACCOMPANY THE BOOK
Audio CDs ISBN: 1-4354-3893-0
Audio CDs to accompany Medical Terminology: A Programmed Systems Approach, Tenth
Edition, includes specific frame references and pronunciation of most terms, presented
in unit order. The Audio CDs are designed to allow learners to listen to the term,
pronounce it aloud, and in many cases hear the term used in context or defined. The
Audio CDs may also be used as dictation by listening to the term, writing the word, and
then checking the spelling of the terms in the textbook.
Also Available: Text/Audio CDs Value Package ISBN: 1-1110-8036-4

Instructor Resources ISBN 1-4354-3890-6

The Instructor Resources is a robust computerized tool for all instructional needs!
A must-have for all instructors, this comprehensive and convenient CD-ROM contains
the following:
• The Instructor’s Manual features a correlation guide from the ninth to tenth
edition, sample syllabi for 10-week and 16-week courses, quizzes for each unit,
midterm exam, and comprehensive final exam. In addition, suggestions for course
design, class activities, games, and unit word part lists are also included.
• ExamView® Computerized Testbank contains over 1,400 questions with answers
organized according to the fifteen units in the textbook. This CD-ROM testbank assists
in creating personalized unit, midterm, and final examinations.
Features include:
• An interview mode or wizard, to guide instructors through the steps of creating
a test in less than 5 minutes
• The capability to edit questions or to add an unlimited number of questions
• Online (Internet-based) testing capability
• Online (computer-based) testing capability
• A sophisticated word processor
• Numerous test layout and printing options
• Link groups of questions to common narratives
• Instructor slides created in PowerPoint® include images and animations and are
designed to aid in planning class lectures.
WebTUTOR™ Advantage
Designed to complement the text, WebTUTOR™ is a content-rich, Web-based teaching
and learning aid that reinforces and clarifies complex concepts. Animations enhance
learning and retention of material. The WebCT™ and Blackboard™ platforms also provide
rich communication tools to instructors and learners, including a course calendar, chat,
email, and threaded discussions.

38892_00_frontmatter_pi-xxviii.indd ix 9/25/09 8:20:54 PM

x PREFACE

WebTUTOR™ Advantage on WebCT™ (ISBN: 1-4354-3892-2)

Text Bundled with WebTUTOR™ Advantage on WebCT™ (ISBN: 1-4354-3089-1)
Text Bundled with WebTUTOR™ Advantage on WebCT™ and Audio CDs
(ISBN: 1-1110-8038-0)
WebTUTOR™ Advantage on Blackboard™ (ISBN: 1-4354-3891-4)
Text Bundled with WebTUTOR™ Advantage on Blackboard™ (ISBN: 1-4354-3097-2)
Text Bundled with WebTUTOR™ Advantage on Blackboard™ and Audio CDs
(ISBN: 1-1110-8037-2)
Mobile Downloads
Expand your knowledge with Delmar/Cengage Learning mobile downloads including
audio for iPods, MP3 players, and cell phones! Now you can study anywhere, anytime
and make learning fun! Visit http://www.podcasts.cengage.com/healthcare.

ADDITIONAL RESOURCES
Delmar/Cengage Learning’s Medical Terminology Audio Library
This extensive audio library of medical terminology includes four audio CDs with
over 3,600 terms pronounced, and a software CD-ROM. The CD-ROM presents terms
organized by body system, medical specialty, and general medical term categories. The
user can search for a specific term by typing in the term or key words, or clicking on a
category to view an alphabetical list of all terms within the category. Hear the correct
pronunciation of one term or listen to each term on the list pronounced automatically.
Definitions can be viewed after hearing the pronunciation of terms.
Institutional Version ISBN: 1-4018-3223-7
Individual Version ISBN: 1-4018-3222-9

Complete Medical Terminology Online Course

Designed as a stand-alone course, there is no need for a separate book. Everything
is online! Content is presented in four major sections: study, practice, tests, and
reports.
The study section includes the content from the text, along with
graphics and audio links. The practice section includes exercises and
games to reinforce learning. The test section includes tests with a
variety of question types for each unit. A midterm and final exam
are also available. The report section features student and instructor
reports.
Individual Course ISBN: 0-7668-2754-2
Educational Course ISBN: 0-7668-2753-4

Delmar/Cengage Learning’s Medical Terminology Student Theater:

An Interactive Video Program ISBN: 1-4283-1863-1
Organized by body system, this CD-ROM is invaluable to learners
trying to master the complex world of medical terminology. The
program is designed for allied health and nursing students who
are enrolled in medical terminology courses. A series of video
clips leads learners through the various concepts, interspersing
lectures with illustrations to emphasize key points. Quizzes and
games allow learners to assess their understanding of the video
content.

38892_00_frontmatter_pi-xxviii.indd x 9/25/09 8:20:54 PM

PREFACE xi

Delmar/Cengage Learning’s Medical Terminology CD-ROM Institutional

Version ISBN: 0-7668-0979-X
This exciting interactive reference, practice, and assessment tool is
designed to complement any medical terminology program. Features
include the extensive use of multimedia—animations, video, graphics,
and activities—to present terms and word-building features. The difficult
functions, processes, and procedures help learners to more effectively
learn from a textbook.

Delmar/Cengage Learning’s Medical Terminology Video Series

This series of fourteen medical terminology videotapes is designed
for allied health and nursing students who are enrolled in medical
terminology courses. The videos may be used in class to supplement a
lecture or in a resource lab by users who want additional reinforcement.
The series can also be used in distance learning programs as a
telecourse. The videos simulate a typical medical terminology class, and
are organized by body system. The on-camera “instructor” leads students
through the various concepts, interspersing lectures with graphics, video
clips, and illustrations to emphasize points. This comprehensive series
is invaluable to students trying to master the complex world of medical
terminology.
Complete Set of Videos ISBN 0-7668-0976-5 (Videos can also be
purchased individually.)
Delmar/Cengage Learning’s Medical Terminology Flash!: Computerized
Flashcards ISBN: 0-7668-4320-3
Learn and review over 1,500 medical terms using this unique electronic
flashcard program. Flash! is a computerized flashcard-type question and
answer association program designed to provide learners with correct
spellings, definitions, and pronunciations. The use of graphics and audio clips
make it a fun and easy way for users to learn and test their knowledge of
medical terminology.

Delmar/Cengage Learning’s Anatomy and Physiology Image Library

CD-ROM, Third Edition ISBN: 1-4180-3928-4
This CD-ROM includes over 1,050 graphic files. These files can be
incorporated into a PowerPoint®, Microsoft® Word presentation, used
directly from the CD-ROM in a classroom presentation, or used to make
color transparencies. The Image Library is organized around body systems
and medical specialties. The library includes various anatomy, physiology,
and pathology graphics of different levels of complexity. Instructors can
search and select the graphics that best apply to their teaching situation.
This is an ideal resource to enhance your teaching presentation of
medical terminology or anatomy and physiology.
It is our intent that Medical Terminology: A Programmed Systems Approach,
Tenth Edition, Delmar/Cengage Learning, be the best edition yet and
continues to serve the needs of the learners and teachers who use it. We
maintain our commitment to the original philosophy and integrity of this
classic textbook.

38892_00_frontmatter_pi-xxviii.indd xi 9/25/09 8:21:02 PM

ACKNOWLEDGMENTS
Medical Terminology: A Programmed Systems Approach, Tenth Edition, would not have
been possible without many people contributing their expert observations, testing,
evaluation, and skills. I would like to first thank the following team members from
Delmar/Cengage Learning whose dedicated professional publishing skills maintain the
quality and integrity of this work.
Acquisitions Editor: Matthew Seeley
Senior Product Manager: Debra Myette-Flis
Editorial Assistant: Samantha Zullo
Content Project Manager: Thomas Heffernan
Senior Art Director: Jack Pendleton
Technology Project Manager: Patricia Allen
For many years I have been able to count on a number of healthcare practitioners and
experienced medical terminology instructors in the community of Jackson, Michigan,
who have made content contributions to this and previous editions. I extend my
continued thanks to:
Billie Jean Buda, CMA, Medical Assistant Instructor
Lynne Schreiber MA, RT(R), RDMS
Ann Wentworth, BS, RT(R), RDMS, Medical Terminology Instructor
Marina Martinez-Kratz, MSN, Nursing Instructor
Grant Brown, Pharm D, Brown’s Option Care
Andrew J. Krapohl, MD, Retired Obstetrician and Gynecologist
Patricia Krapohl, RN, MPH
Chip Smith, EMT-P
Denise Brzozowski, AAS, COT
Ann Blaxton, CCC-A, Professional Hearing Services
Sharon Rooney-Gandy, DO, General Surgery Board Certified
Paul H. Ernest, MD, TLC Eye Care PC
Shawn McKinney, COMT, American College of Ophthalmic Technology
Noreen Calus, MS, RHIA (posthumous)
Allegiance Healthcare, Jackson, MI
Faculty and staff of Jackson Community College, Jackson, MI
I would like to express thanks to the reviewers who continue to be a valuable resource
through their comments, suggestions, and attention to detail.

Dominica Austin
Academic Dean, Lincoln College of Technology, Marietta, Georgia

Bradley S. Bowden, PhD

Professor of Biology Emeritus, Alfred University, Alfred, New York

Leah A. Grebner, MS, RHIA, CCS, FAHIMA

Director of Health Information Technology, Midstate College, Peoria, Illinois

Anne M. Loochtan, PhD, RRT

Associate Dean of Health and Public Safety, Adjunct Faculty Member, Cincinnati
State Technical and Community College, Cincinnati, Ohio
xiii

38892_00_frontmatter_pi-xxviii.indd xiii 9/25/09 8:21:07 PM

xiv ACKNOWLEDGMENTS

Additionally, I am particularly grateful to the following technical accuracy reviewers

who were instrumental in assisting in my commitment to creating quality materials for
learners and instructors.

Ellen Anderson, MAdEd, RHIA, CCS

Associate Professor, College of Lake County, Grayslake, Illinois

Bradley S. Bowden, PhD

Professor of Biology Emeritus, Alfred University, Alfred, New York

Lisa M. Carrigan, RN
Instructor, Health Sciences, Medical Terminology, Applied Technology Center and
South Carolina Virtual School Program, Rock Hill, South Carolina

Anne M. Loochtan, PhD, RRT

Associate Dean of Health and Public Safety, Adjunct Faculty Member, Cincinnati
State Technical and Community College, Cincinnati, Ohio

Susan L. Nawrot, MT, CSR

Instructor, Jackson Community College, Allied Health Department, Adrian,
Michigan

Karen R. Smith, RN, BSN

Health Science Consultant, Kentucky Department of Education, Division of Career
and Technical Education, Frankfort, Kentucky

I would also like to acknowledge the contribution that 30 years of medical terminology
students have made at Jackson Community College in Jackson, Michigan, and other
students from around the world. Through direct comments, letters, and emails, they remind
me what it is like to be a beginning medical terminology student, what improvements are
needed in the textbook to enhance learning, and what details must be addressed.
Finally, I am grateful for the continued support and understanding of my husband and
computer technician, Timothy J. Dennerll, PhD; my daughter, Diane; my son, Raymond;
and my mother, Helen Stamcos Tannis. You are my inspiration.
Sincerely,
Jean M. Tannis Dennerll BS CMA (AAMA)

38892_00_frontmatter_pi-xxviii.indd xiv 9/25/09 8:21:08 PM

LIST OF ILLUSTRATIONS
Illustration Page Arthroplasty 122
Microscope 3 Arthroscope—internal view 123
Herpes zoster 6 Arthroscopy 124
Chickenpox 6 Hyperplasia, hypertrophy, dysplasia 124
Injectable forms of medication 12 Bone density scan 126
Sperm and ovum 14 Rib cage 127
Acromegaly 20 Knee 128
Contact dermatitis 21 Teeth 130
Lesions 22 Braces 131
Gastrotomy 33 Orthotic device 133
Gastroduodenostomy 35 Regions of the abdomen 134
Computed tomography 38 Vertebral column 136
MRI 39 Abduction/adduction 139
CT scan 39 Quadrants of the abdomen 140
CAT scan 39 Amniocentesis 141
PET scan 39 Cystoscopy 142
SPECT 39 Body cavities 143
CT planes 41 Hydrocele 145
Heart and EKG 42 Disease producing organisms 161
EKG tracings 42 Streptococcus 162
12 Lead ECG tracings 44 Staphylococcus 162
EKG machine 45 Impetigo 163
Fracture radiograph 45 Diplobacillus 163
Echocardiogram 46 Acne pustule 165
Radiographer 46 Mouth 167
Skin 48 Otoscope 169
Acrocyanosis 50 Ear 169
Cytotechnologist 54 Audiologist 172
Blood cells 55 Hearing aid 174
Wright’s stained blood smear 55 Cholelithiasis 175
Lymphatic system 57 Trichomonas vaginalis 176
Cytometer 57 Cholecystography 178
Four tissue types 75 Bradycardia/tachycardia 180
Tissue specimen 76 Thermometer 183
Hypotrophy/hypertrophy 77 Microsurgery 186
Blood pressure screening 78 Syndactylism 189
Melanoma 81 Cranial sutures 189
Squamous cell carcinoma 83 Urinalysis—reagent strip 205
Kaposi’s sarcoma 85 Urinalysis—automated 206
Medical technologist 88 Polycystic kidneys 207
Radiation therapist 90 Urinary system 208
Anterior view of cavities 90 IVP 211
Structures of the head 93 Sutures 213
Encephalocele 95 Testis 215
Sagittal section of the brain 96 Male reproductive system 216
Electroneurodiagnostic technologist 97 Prostate disease 219
Cranium 97 Female reproductive system 221
Lateral brain 99 External genitalia—female 223
Meningocele, myelomeningocele 101 Hysterectomy 228
Muscles and tendons 115 Hysteroptosis 230
Osteoporosis 117 Conization 232
Osteopathic physician 119 Vasectomy 234
Meningomyelocele 121 Digestive system 250
xv

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xvi LIST OF ILLUSTRATIONS

Oral cavity 253 Physical exam instruments 402

Hernias 258 Percussion 402
Colostomy sites 261 Symmetry/asymmetry 426
Diverticulosis 261 Direction prefixes 429
Sigmoidoscope 263 Meninges 430
Accessory digestive organs 265 Hematomas 432
ERCP 268 Mammography 433
Neurosurgeon 286 Bones—hand 436
Superficial veins of the arm 288 Catheterization 437
Arteries of the arm 288 Sonographer 438
Motor pathways 289 Fetal ultrasound 438
Spinal cord and nerves 290 Asepsis 439
Prescription psychotropic medication 296 Culture and sensitivity 441
Pharmacists 297 TURP 445
Arterial disease 300 IV 459
Hemangioma 303 Instillation—eye drops 460
Phlebotomy 306 Anorexia 463
Angioplasty 308 Biceps/triceps 465
Stenting 308 Vessels—head and neck 466
Nurse anesthetist 310 Down syndrome 471
Autonomic nervous system 314 Curvature of the spine 471
Muscle tissue 317 Prescription 475
Muscular system 318 Nurse 477
Physical therapist 318 Angles of injection 478
Anatomic position 333 Respiratory system 491
Radiographic projection positions 335 Chest x-ray 491
Electrocardiogram electrode Heart—veins and arteries 495
placement 336 Radiograph 499
Common terms for body areas 338 Pharyngitis 500
Computed tomography (CT) Respiratory therapist 505
planes 339 Podiatrist 508
Peritoneal dialysis 342 Pediatrician 509
Hemodialysis 342 Health information technician 510
Water aerobics 343 Skeletal system 523
Gonorrhea (Neisseria gonorrhoeae) 344 Bones—left hand 524
Hemostats 348 Bones—foot 526
Syphilitic chancre 349 Fractures 527
Ventral cavity membranes 352 Femur fracture 528
Pleural membranes 352 Bones—pelvis 531
Ectopic pregnancy 356 Abdominal incisions 533
Uterine displacement 358 Spinal column 535
Laparoscopy 374 Vertebra—herniated disk 539
Surgical technologist 375 Cleft palate 544
GTT 377 Eye—external structures 559
Immunization schedule 381 Ophthalmic technician 560
Pregnant woman 385 Myopia/hyperopia 561
Twins 386 Esotropia/exotropia 565
Adduction/abduction 389 Eyeball 566
Skin injuries 390 Nail conditions: paronychia,
Deciduous teeth 392 onychomycosis, onychocryptosis,
Extension/flexion 394 onychophagy 576
Tonicity 395 Alopecia 577
Circumduction 398 Endocrine system 579
Skin lesions 399 EMT 583

38892_00_frontmatter_pi-xxviii.indd xvi 9/25/09 8:21:11 PM

ABOUT THIS
PROGRAMMED SYSTEM
Medical Terminology: A Programmed Systems Approach, Tenth Edition, is
carefully designed to help you learn medical terminology.

OBJECTIVES OF THE LEARNING SYSTEM

Upon completion of this system, the learner should be able to:
1. Build literally thousands of medical words from Greek and Latin
prefixes, suffixes, word roots, and combining forms.
2. Define medical words by analyzing their Greek and Latin parts.
3. Spell medical words correctly.
4. Use a medical dictionary.
5. Pronounce medical words correctly.
6. Recall acceptable medical abbreviations that represent phrases
and terms.
To maximize the benefits of this learning system, familiarize yourself
with the following features.

UNIT 2
Surgical Suffi
PROGRAMMED LEARNING FORMAT xe
and Diagnost s, Hematology,
ic Imaging
Information is presented and learned in
small numbered sections called frames.
You will have an active part in learning ANSWER C
OLUMN

medical terminology using this successful INFO RMAT ION

2.1
Surgery is an impo
rtant medical treat
FRAM E incision, excision, ment tool. Surg
repair, replaceme ical procedures
programmed approach. The right column introduction, or
surgical procedur
surgical cutting.
dilation. Througho
e terms. As a begin
nt, destruction,
ut the next few
ablation, caute
units you will be
ning, let us study
may include:
rization,
learning many
some terms relate

contains a statement and an answer 2.2

Consider the follow
d to

WOR D ing word parts

.
blank; the left column provides the ORIG INS
Word Part
tomos
Origin
Meaning
Greek
ex (ec) cut
answer. Cover the answer column with os
stoma
Latin/Greek
Latin
Greek
out of, away, from
opening like a
mouth
in opening like a
mouth
a bookmark (two are provided as part of cis (incisio)
Greek
Latin
inside, into
cut, cut with a
knife

the back cover). Read the right column 2.3

From the Gree
k word tomos we
cutting procedur build many of
es. the suffixes repre

of the frame and write your answer in

senting surgical
-tome
instrument used
-tomy to cut slices
cut into, incise
-ectomy , incision
the blank. Pull down the bookmark to -ostomy
cut out, remove,
cut a new surgi
excise, excision
cal opening

reveal the answer and confirm your 32

response. Then move on to the next 38892_02_unit

02
02_p03
p0322-072.in
072 i dd 32

frame. Learning one bit of information 9/14/09 3:23:20

at a time is part of programmed learning. Another part is continual

reinforcement of word parts and terms throughout the book.

WORD-BUILDING SYSTEM WORD

AND WORD PARTS BUILDING MICR + O = MICR/O
■■■■■ word root vowel combining form
Word roots, combining forms, prefixes, and
suffixes are important building blocks in the
word-building system. Combining forms are highlighted in bold, prefixes in blue with
a hyphen after each, and suffixes in pink with a hyphen preceding each.

xvii

38892_00_frontmatter_pi-xxviii.indd xvii 9/25/09 8:21:11 PM

xviii ABOUT THIS PROGRAMMED SYSTEM

1.9
FEATURES FRAMES
Adding a vowel (a, e, i, o, u, or y) to a word root to create a combining form
INFORMATION
FRAME
allows two or more word roots to be joined to form a compound word. It also Information—present interesting facts to help retention
allows a word root to be joined with a suffix (ending of a word) to form a word.
In addition, the vowel assists by making the term easier to pronounce. “O” is the
most commonly used combining vowel.

4.117
Spell Check—clues and special notes on troublesome
In the spelling of the combining form for abdomen, the “e” changes to
SPELL
CHECK
“i”—abdomin/o. spelling
EXAMPLE: The abdominal incision was made in the RLQ of the abdomen.

4.118
Take a Closer Look—analyzes similar terms
Abdomin/al is an adjective that means
TAKE A * .
CLOSER LOOK
NOTE: For descriptive reference the abdomen may be divided into four quadrants
including the right upper quadrant (RUQ), the left upper quadrant (LUQ), the right
pertaining to the lower quadrant (RLQ), and the left lower quadrant (LLQ).
abdomen
38892_01_unit01_p001-031.indd 2 9/16/09 8:47:44 PM

38892_04_unit04_p114-159.indd 139
5.151
9/16/09 8:37:42 PM
Word Origins—encourages memory retention
WORD drom/o comes from the Greek word for run. A hippodrome was an open air stadium
ORIGINS built for racing horses or chariots in ancient Greece. Drom/o/mania is an insane through fascinating references using Greek and Roman
impulse to wander or roam. You usually use drom with the prefixes syn- and pro-.
mythology, legends, and etymology

4.21 Dictionary Exercise—provides learners with practice

Find the word myeloblast in your dictionary. Write the meaning here.
DICTIONARY * using a medical dictionary
EXERCISE

bone marrow germ cell The combining form of myel is / .

myel/o

St r u c t u r e s o f t h e h e a d Crani/o (skull)
FULL-COLOR ART
Delmar/Cengage Learning
Cranial cavity
Encephal/o (brain)
Even more full-color illustrations and photos are included
Cephal/o (head)
in this edition. Art and photos are placed near their
reference—not in a separate color section. A complete
list of all art is on pages xv–xvi.

PR O FESSIO N A L PROFESSIONAL PROFILES

PR O FIL E Vignettes and photos describing the function and
Doctor of Osteopathy (DO): Osteopathic phy- credentials of many allied health professions are placed
sicians are fully licensed to practice medicine,
performing the same duties as a medical doctor throughout the text. These profiles give information
(MD, allopathic doctor). Because of the original
philosophy of osteopathic medicine, founded about various professions and possible career paths as
by Dr. Andrew Still in 1874, they identify the
musculoskeletal framework as a key element to well as reinforce the importance of medical terminology
health. They also believe that the body has a
natural ability to heal itself given a favorable for all health professionals.
environment and good nutrition and so act as
teachers to help patients take a responsible
role in their own well-being and to change
unhealthy patterns. In addition, osteopathic
manipulative therapy (OMT) is incorporated in
the training and practice of osteopathic phy-
38892_04_unit04_p114-159.indd 121
sicians. Although
38892_05_unit05_p160-203.indd 190 60% practice primary care, O s t e o p a t h i c p hy s i c a n p e r f o r m i n g a n 9/16/09 8:37:06 PM
9/17/09 9:16:22 PM
e x a m Delmar/Cengage Learning
osteopathic physicians may specialize in surgery,

CASE STUDY I N V E S T I G A T I O N ( C S I ) CASE STUDY INVESTIGATION (CSI)

The Case Study Investigation (CSI) features excerpts from
Spleen
Pathology Report: Gross examination of a spleen actual medical records and a vocabulary challenge that
An entire spleen, weighing 127 grams and measuring 13.0 × 4.1 × 9.2 cm. The encourages you to apply what you’ve learned in the
external surface is smooth, leathery, homogeneous, and dark purplish-brown.
There are no defects in the capsule. The blood vessels of the hilum of the spleen are
chapter through analyzing medical terms from the case
patent, with no thrombi or other abnormalities. The hilar soft tissues contain a study, breaking down terms into their respective word
single, ovoid, 1.2-cm lymph node with a dark grey cut surface and no focal lesions.
Source: By Edward O. Uthman, MD. ([email protected]). Diplomate, American Board
parts, defining word parts, and defining abbreviations.
of Pathology.

38892_00_frontmatter_pi-xxviii.indd xviii 9/25/09 8:21:33 PM

ABOUT THIS PROGRAMMED SYSTEM xix

Abbreviation Meaning ABBREVIATIONS

AAD American Academy of Dermatology Abbreviations are covered many ways. Several frames
ALL acute lymphocytic leukemia work abbreviations, a list of abbreviations and meanings
ARDMS American Registry for Diagnostic Medical Sonography
ARRT American Registry of Radiologic Technologists is included in each unit, and activities specifically
ASRT American Society of Radiologic Technologists identify and test abbreviations. Appendix B includes a
CABG coronary artery bypass graft
CAT Scan computed axial tomography
comprehensive list of abbreviations.
CBC complete blood count
CCU cardiac care unit (critical care unit)
CE cardiac enlargement (cardiomegaly)
CT Computed Tomography
cTnI and cTnT Troponin I and Troponin T (serum cardiac proteins
indicating myocardial injury)
Diff differential white blood cell count
DMS diagnostic medical sonography

To complete your study of this unit, work the Review Activities on the
AUDIO CDS
following pages. Also, listen to the Audio CD that accompanies Medical After completing each unit, you may want to listen to
Terminology: A Programmed Systems Approach, 10th edition, and practice
your pronunciation. the Audio CDs that accompany the text. You can use
the Audio CDs to listen to each term and repeat the
term aloud for pronunciation practice. You may also
38892_01_unit01_p001-031.indd 23
write the term and its definition to check spelling and
9/16/09 8:48:27 PM

meaning comprehension.

GLOSSARY GLOSSARY
blastocyte immature cell etiology the study of the origin of the Unit end glossaries summarize terms and definitions in
cause of disease
cardialgia heart pain
gastralgia stomach pain
a frame-type format for easy study and review.
cardiologist physician specialist in heart
disease gastrectomy excision of the stomach

cardiomegaly enlarged heart gastric pertaining to the stomach (adj.)

cyanoderma blueness of the skin gastroduodenostomy making a new opening

between the stomach and
cyanosis condition of blueness duodenum
cytologist a technologist who studies gastromegaly enlarged stomach
cellular disease
gastrostomy making a new opening in the
cytology the science of studying cells stomach
cytometer instrument used to count cells histoblast immature tissue cells
cytometry process of using a cytometer histology the science of studying tissues
dermatology the science of studying the skin hypodermic pertaining to below the dermis

REVIEW ACTIVITIES REVIEW ACTIVITIES

SELECT AND CONSTRUCT

Select the correct word parts (some may be used more than once) from the following list and construct medical Activities include a variety of exercises to reinforce
terms that represent the given meaning.
-ac acro -al -algia -blast cardi(o) terms learned within the frames. Also included are case
chlor cyano cyt(e)(o) derm(a)o dermato duodeno
echo ectomy electro -emia -er erythro study excerpts from actual medical records featuring
_p032-072.indd 63 gastr/o(ia) -gram -graph -graphy -ia -ic 9/14/09 3:24:39 PM
-itis leuko -logy mania megal(o)(y) melano medical terms in context along with questions to test
osis -ostomy paralysis -pathy penia radio
sono thrombo tom(e)(o) -tomy um xantho and reinforce spelling and definitions. Crossword puzzles
1. excision of the stomach
provide definition to term review in an easy, fun format.
2. make a new opening (connection) between the stomach and the duodenum

3. blueness of the skin

4. disease condition of the skin

5. red blood cell

6. embryonic dark pigmented cell

38892_02_unit02_p032-072.indd 71 9/14/09 3:24:41 PM

38892_00_frontmatter_pi-xxviii.indd xix 9/25/09 8:21:47 PM

HOW TO USE
STUDYWARE™
to Accompany Medical Terminology:
A Programmed Systems Approach, Tenth Edition

MINIMUM SYSTEM REQUIREMENTS

Operating systems: Windows XP w/SP 3, Windows Vista w/ SP 1
Processor: Minimum required by Operating System
Memory: Minimum required by Operating System
Hard Drive Space: 200 MB
Screen resolution: 1024 × 768 pixels
CD-ROM drive
Sound card and listening device required for audio features
Flash Player 10. The Adobe Flash Player is free, and can be
downloaded from http://www.adobe.com/products/flashplayer/.
Adobe Reader

SETUP INSTRUCTIONS
1. Insert disc into CD-ROM drive. The StudyWARE™ installation program should start
automatically. If it does not, go to step 2.
2. From My Computer, double-click the icon for the CD drive.
3. Double-click the setup.exe file to start the program.

TECHNICAL SUPPORT
Telephone: 1-800-648-7450
Monday–Friday
8:30 A.M.–6:30 P.M. EST
E-mail: [email protected]
StudyWARE™ is a trademark used herein under license.
Microsoft® and Windows® are registered trademarks of the Microsoft Corporation.
Pentium® is a registered trademark of the Intel Corporation.

GETTING STARTED
The StudyWARE™ software helps you learn terms and concepts in Medical Terminology:
A Programmed Systems Approach, Tenth Edition. As you study each chapter in the text,
be sure to explore the activities in the corresponding chapter in the software. Use
StudyWARE™ as your own private tutor to help you learn the material in your Medical
Terminology: A Programmed Systems Approach, Tenth Edition textbook.
Getting started is easy. Install the software by inserting the CD-ROM into your
computer’s CD-ROM drive and following the on-screen instructions. When you
open the software, enter your first and last name so the software can store your quiz
results. Then choose a chapter from the menu to take a quiz or explore one of the
activities.

xxi

38892_00_frontmatter_pi-xxviii.indd xxi 9/25/09 8:21:50 PM

xxii HOW TO USE STUDYWARE™

MENUS
You can access the menus from wherever you are in
the program. The menus include Quizzes and other
Activities.

Quizzes. Quizzes include multiple choice and

fill-in questions. You can take the quizzes in
both practice mode and quiz mode. Use practice
mode to improve your mastery of the material.
You have multiple tries to get the answers
correct. Instant feedback tells you whether
you’re right or wrong and helps you learn quickly
by explaining why an answer was correct or
incorrect. Use quiz mode when you are ready to
test yourself and keep a record of your scores.
In quiz mode, you have one try to get the
answers right, but you can take each quiz as
many times as you want.

Scores. You can view your last scores for each quiz
and print your results to hand in to your instructor.

38892_00_frontmatter_pi-xxviii.indd xxii 9/25/09 8:21:55 PM

HOW TO USE STUDYWARE™ xxiii

Activities. Activities include image labeling,

hangman, concentration, crossword puzzle, spelling
bee, and championship. Have fun while increasing
your knowledge!

Animations. Animations expand your learning by

helping you visualize concepts related to anatomy and
physiology.

38892_00_frontmatter_pi-xxviii.indd xxiii 9/25/09 8:22:14 PM

SECTION A
How to Work the Program—
Directions for Use of
Programmed Learning

ANSWER COLUMN

A.1
Directions: Tear off the bookmark from the back cover and use it to cover the
answer column.
A frame is a piece of information, plus a blank (_______________) in which you
frame write. All this material following the number A.1 is a _______________.
Now go on to Frame A.2 Check your answer by sliding down your bookmark.

A.2
By checking your answer immediately, you know if you are correct. This
immediate knowledge helps you to learn only what is (choose one)
correct _______________ (correct/incorrect).
Now go on to Frame A.3 Check your answer by sliding down your bookmark.

A.3
Programmed learning is a way of learning that gives you immediate feedback and
allows you to work at your own speed. When you work a series of frames and are
program certain that you know the terms, you are learning using a ____________________.
Check your answer by sliding down your bookmark.

A.4
check Always _______________ your answers immediately. _______________ your
Write answers in the blank or on a separate paper.
The first time you read the frames you may want to just think of the answer.
Then read the frames a second time and write the answer on the blank provided
or on a separate sheet of paper and check your answer again.

xxv

38892_00_frontmatter_pi-xxviii.indd xxv 9/25/09 8:22:36 PM

xxvi
xxvi INDEX
SECTION A

ANSWER COLUMN

A.5
When you write a new word and check your answer, you will usually find the
INFORMATION pronunciation given. Pronounce the word aloud and listen to what you are saying.
FRAME Practice proper pronunciation by listening to the Audio CDs prepared to accompany
Medical Terminology: A Programmed Systems Approach, Tenth Edition. Pronouncing
words correctly assists in spelling correctly, speaking medical phrases correctly, and
understanding medical terms when you hear them pronounced (as in dictation).

A.6
pró nun sē ā, shun The front inside cover presents a pronunciation key to vowel and consonant
sounds and the phonetic system used in this text. The syllable with the major
accent is highlighted in bold print.

A.7
aloud Practice saying each new medical word _______________ several times.
Practicing pronunciation helps you to focus on each syllable so you do not miss
any part of the word as you read. Pronunciation will also help you see each letter
of the word and improve your spelling.

A.8
When you see a blank space (_______________) your answer will need only one
medical word. In the sentence, “This is a program in _______________ terminology,” you
one know to use _______________ word.

A.9
A single blank (_______________) contains a clue. It is proportional to the length
of the word needed. A short blank (_______) means one short word.
long A long blank (_______________________) means one _______________ word.

A.10
When you see an asterisk and a blank (*_______________), your answer will
require more than one word. In the sentence, “This is a programmed course in
medical terminology *______________________________________________________________ ,”
more than one word your answer requires *_____________________________________________.

A.11
When you see (*_______________) there is no clue to the length of the words.
The important thing to remember is that an asterisk and a blank means
more than one word *__________________________________________________.

A.12
Use the pronunciation key on the inside front cover to aid in proper practice
aloud when saying words _______________.

A.13
spelling Saying each term aloud will also improve your _______________.

38892_00_frontmatter_pi-xxviii.indd xxvi 9/25/09 8:22:38 PM

HOW TO WORK THE PROGRAM xxvii

ANSWER COLUMN

A.14
anything from interesting When you see a double asterisk and a blank (**___________________),
to dull (if you did not use your own words. In the sentence, “I think a programmed course in
answer this one, medical terminology will be **___________________,” you are expected to
it doesn’t matter) **___________________.
use your own words

A.15
When working a program, never look ahead. The information presented in the
frames is in a special order, so do not skip around and
never look ahead *______________________________.

A.16
Now summarize what you have learned so far.
one A single blank means _______________ word.
length A single blank gives a clue about the _______________ of the word.
more than one A single asterisk means *___________________ word.
use your own A double asterisk means *___________________ words.
aloud Practice saying each term _______________.
never look ahead The frames are in a special order so *___________________.

A.17
Saying, listening, seeing, writing, and thinking will do much for your learning. On
the following drawing, find the parts of the brain used when saying, listening,
seeing, writing, and thinking.
1. thinking area
2. hearing area
3. saying area
4. seeing area
5. writing area

A.18
If you have five parts of the brain working for you at the same time, you will learn
INFORMATION much faster. This is efficient learning. It makes sense to say a word, listen to it, look
FRAME at it, write it, and think about it in one operation.

A.19
This programmed learning, word-building system encourages you to read (look
and understand) about medical terms, say them aloud correctly, listen to them on
Audio CD, write the terms as answers in the blanks and review activities, and think
about the terms as you use them to complete statements. Doing this uses at least
five _______________ areas of your brain and helps you learn more efficiently.

See how efficiently you You are now ready to move on to an introduction of the word-building system
are learning! and learning your first medical terms.

38892_00_frontmatter_pi-xxviii.indd xxvii 9/25/09 8:22:38 PM

UNIT 1
The Word-Building System—
Introduction to Word Parts
Including Word Roots,
Suffixes, Prefixes, Parts of
Speech, and Plural Formation

ANSWER COLUMN
1.1
Welcome to your study of medical terminology using both this unique method of
programmed learning and the word-building system. By combining programmed
learning and the word-building system, you will soon be learning hundreds, even
medical thousands, of terms.

1.2
It would be impossible to simply memorize thousands of medical terms and
remember them for very long. The word-building system teaches word parts
including word roots, combining forms, prefixes, and suffixes as well as rules
about grammar usage and spelling. In a short time you will be easily using the
word-building system * .

1.3
All words are built using word roots. Word roots come from their language of
origin. In English medical terminology most word roots originate from Greek
and Latin. Greek and Roman physicians studied anatomy and were responsible
for naming body structures and identifying early diseases. This formed the basis
for the development of western medical language. Medical terms are built
word roots using * .

1.4
The word root is the foundation of a word. Trans/port, ex/port, im/port, and
word root sup/port have port as their * .

1.5

word root Suf/fix, pre/fix, af/fix, and fix/ation have fix as their * .

38892_01_unit01_p001-031.indd 1 10/10/09 7:23:27 AM

2 UNIT 1

ANSWER COLUMN

1.6
The word root for stomach in gastr/itis, gastr/ectomy, and gastr/ic is
gastr .

NOTE: Notice that when a combining form is presented by itself it is printed in

bold text.

EXAMPLE: gastr/o is the combining form meaning stomach.

1.7

word root The foundation of the word is the * .

NOTE: A slash mark (diagonal) “/” is used to divide words into their word parts.

EXAMPLE:

gastr/ o/ duoden/ -ostomy

word root combining vowel word root suffix

1.8
A combining form is a word root plus a vowel. In the word therm/o/meter,
combining form therm/o is the * .

WORD
BUILDING MICR + O = MICR/O
■■■■■ word root vowel combining form

1.9
Adding a vowel (a, e, i, o, u, or y) to a word root to create a combining form
INFORMATION allows two or more word roots to be joined to form a compound word. It also
FRAME allows a word root to be joined with a suffix (ending of a word) to form a word.
In addition, the vowel assists by making the term easier to pronounce. “O” is the
most commonly used combining vowel.

1.10
In the word cyt/o/meter (instrument used to measure [count] cells), the
vowel or letter o * allows cyt to be joined to meter.

1.11
In the words micr/o/scope, micr/o/film, and micr/o/be, micr/o is a
combining form * and micr is a * .
word root

38892_01_unit01_p001-031.indd 2 10/10/09 7:23:57 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 3

ANSWER COLUMN

1.12
COMBINING FORM RULE: Use a combining form when adding a word root to
SPELL another word root or suffix that begins with a consonant (for example b, d,
CHECK m, p, s, t, v). When building a word from “acr” and the suffix “-megaly”, use the
combining form “acr/o” to form the correctly spelled term “acromegaly”. Try
this for yourself.
Build words from the following parts:
gastr and duoden and –scopy
gastr/o/duoden/o/scopy / / / /
gas’ trō doo’ ō den os’ ko pē

micr and -scope

micr/o/scope / /
mī‘ krō skōp

WORD
BUILDING GASTR/O + DUODEN/O + SCOPY = GASTRODUODENOSCOPY
■■■■■ combining form combining form suffix compound word

Compound microscope
Delmar/Cengage Learning
Oculars
(Eyepieces)
Binocular
observation
tube

Turrat
Arm

Objectives
Stage Clips
Stage

In-base
illuminator
Coarse/ with filters
Fine Focus
Adjustment

Base

38892_01_unit01_p001-031.indd 3 10/10/09 7:23:58 AM

4 UNIT 1

ANSWER COLUMN

1.13

would You (choose one) (would/would not) use a combining

neur/o/spasm form to join the word roots neur and spasm to form
/ / .

1.14
WORD ROOT RULE: Use a word root when joining a word root to another
SPELL word root or suffix that begins with a vowel (a, e, i, o, u, y). When building a
CHECK word using “aden” and “-itis” use the word root “aden” to create aden/itis.
Aden(o)itis is an incorrect spelling. Try this for yourself.
Build a word using:
lymph and –oma (lymphatic tumor)
lymph/oma /
limf ō‘ mә
ot and –algia (ear pain)
ot/algia /
ō tal‘ gē ә
Good job.

WORD
BUILDING DERMAT + ITIS = DERMATITIS
■■■■■ word root suffix word

1.15

would not You (choose one) (would/would not) use a

combining form to join the words “lymph” and “adenopathy” to form
lymph/aden/o/pathy / / / .
limf ad en op‘ ә thē

1.16
Combining forms are never used as a suffix. They require an ending to complete a
SPELL word. There are many exceptions to the rules about combining form usage stated
CHECK above. Always consult your medical dictionary for correct spelling of new terms.
That way you will know if the new word you created is actually a medical word.

1.17
Compound words can be formed when two or more word roots are used to
build the word. Even in ordinary English, two or more word roots are used to form
compound words * (for example, shorthand or download).

38892_01_unit01_p001-031.indd 4 10/10/09 7:24:02 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 5

ANSWER COLUMN

1.18
Sometimes word roots are whole words. Two or more words combined form a
compound word compound word. Chickenpox is a * .

WORD
BUILDING CHICKEN + POX = CHICKENPOX
■■■■■ word root word root compound word
(word) (word)

1.19
Form a compound word using the word roots under and age.
underage

1.20
Form a compound word from the words “brain” and “stem.”
brainstem .

1.21
Because they are formed by joining two or more word roots, therm/o/
meter, cyt/o/meter, micr/o/scope, and micr/o/surgery are all
compound words * .

1.22
Compound words can also be formed from a combining form and a whole word.
Thermometer is a compound word built from a combining form and a word. In
combining form the word therm/o/meter, therm/o is the * ,
whole word (suffix) meter is the * .

1.23
Micr/o means small.
Build a compound word using the combining form micr/o plus
-scope
micr/o/scope micr/o/ (instrument used to see small things);
mī‘ krō skōp
-surgery
micr/o/surgery micr/o/ (surgery using a microscope);
mī krō ser‘ jer ē
-meter
micr/o/meter micr/o (device used to measure small things).
mī kro’ me ter
Remember to practice pronouncing the terms aloud as well.

38892_01_unit01_p001-031.indd 5 10/10/09 7:24:03 AM

6 UNIT 1

CASE STUDY I N V E S T I G A T I O N ( C S I )
Shingles. Varicella zoster virus (VZV). Herpes zoster.
Postherpetic neuralgia.
Mrs. S, a 75-year-old female, presented with a her-
petic blister-like rash on the face and back. She
stated that the rash areas burned and were very
painful. The shooting pain followed nerve lines and
postherpetic neuralgia was suspected. The pain
was level 8 “very painful and difficult to tolerate.”
Mrs. S has a history of childhood chickenpox and
had not received a herpes zoster immunization
(Zostervax). She was diagnosed with breast cancer
two months ago and recently completed radiation
Herpes zoster Courtesy of Robert A.
therapy and chemotherapy treatments. The blis- Silverman, MD, Pediatric Dermatology,
ters were examined and a viral culture ordered. The Georgetown University
culture results confirmed that varicella zoster virus
(VZV) was responsible for the lesions and the patient
had shingles. An anti-viral medication and cream were
prescribed along with an analgesic medication. Mrs. S
experienced remission and recurrence of symptoms for
about four months before finally being rash- and pain-
free.

CSI Vocabulary Challenge

From what you have learned about the word building
system and with assistance from your medical diction-
ary, answer questions about the following terms taken
from the case. Va r i c e l l a — c h i c ke n p ox
1. A herpetic lesion is a herpes viral blister. In the Courtesy of Robert A. Silverman, MD,
Pediatric Dermatology, Georgetown
term post/herpet/ic post- is a University
(word part) indicating pertaining to after the
development of herpetic lesions.
2. Chickenpox is a word for the disease also known as
Varicella.
3. Zostervax is a type of that may help prevent those
with a history of childhood chickenpox from developing shingles
after age 60.
4. The combining form chem/o was used to build the term chem/o/therapy
because the word therapy begins with a .
5. Indicate the part of speech of the term analgesic as used in this case study.

6. Write the term that means: condition of nerve pain.

7. The adjective viral means pertaining to a .

38892_01_unit01_p001-031.indd 6 10/10/09 7:24:03 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 7

ANSWER COLUMN

1.24
Hydr/o means water.
Build a compound word using the combining form hydr/o plus
-phobia
hydr/o/phobia hydr/o/ (fear of water);
hī drō fō‘ bē ә
-cele
hydr/o/cele hydr/o/ (water a saclike cavity);
hī‘ drō sēl
-therapy
hydr/o/therapy hydr/o/ (treatment using water).
hī drō thair‘ ә pē

1.25
-ic is an adjective suffix. In medical terminology, compound words are usually
built from a combining form, a word root, and a suffix. In the word micr/o/scop/ic,
micr/o is the combining form;
scop is the word root;
suffix -ic is the .

1.26
In medical terminology, compound words are usually built in the following
order: combining form + word root + suffix. The word part coming first
combining form is usually a * . The word part that comes last
suffix is the .

NOTE: The suffixes are highlighted in [pink] print throughout this textbook for
easy identification.

1.27
In the word therm/o/metr/ic,
therm/o is the combining form;
word root metr is the * ;
suffix -ic is the .

1.28
Build a word from the combining form radi/o and the suffix
radi/o/grapher -grapher. / /
rā dē og‘ raf er

1.29
Build a word from the combining form acr/o; the word root dermat; and the
acr/o/dermat/itis suffix -itis. / / /
a‘ krō der‘ ma ti‘ tis

38892_01_unit01_p001-031.indd 7 10/10/09 7:24:06 AM

8 UNIT 1

ANSWER COLUMN

1.30
When a definition is stated, the suffix is usually described first, for example:
SPELL (1) Definition: pertaining to electricity
CHECK suffix (–ic), word root (electr) = electr/ic
(2) Definition: inflammation of the bladder
suffix (-itis), word root (cyst) = cyst/itis

1.31
The ending that follows a word root or combining form is called a suffix. You can
change the meaning of a word by putting another part after it. This other part is
suffix called a (highlighted in pink).

1.32
The suffix -er means one who or one which. The word root port (to carry) is
changed by putting -er after it. In the word port/er (one who carries), -er is a
suffix .

1.33

one who A medical practition/er is * practices medicine.

1.34
In the word inject/able, -able changes the meaning of inject.
suffix -able is a .

WORD
BUILDING ANEM + IA = ANEMIA
■■■■■ word root suffix noun

ANEM + IC = ANEMIC
word root suffix adjective

1.35
Let’s review some basic grammar. Suffixes may change the part of speech
INFORMATION of a word. A noun is a word that names or labels a person, place, or thing. In
FRAME medical terms a person’s name may become the name a of a disease and would
be a proper noun. Here are some examples of proper noun diagnoses: Down
syndrome; West Nile virus. Names of diseases that are not capitalized, such as
appendicitis or carcinoma, are common nouns. In medical terminology nouns are
also labels or names for body parts, instruments, and medical procedures.

38892_01_unit01_p001-031.indd 8 10/10/09 7:24:06 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 9

ANSWER COLUMN

1.36
Adjectives describe or modify the meaning of a noun. In the phrase “small cell,”
INFORMATION small is an adjective describing the size of the cell (noun). In a medical phrase an
FRAME adjective may describe size, amount, shape, color, level of severity, and quality.
In the following phrases the adjectives are underlined:
chronic cough
reddened skin
duodenal ulcer
triple bypass

1.37
A noun may become an adjective by changing the suffix. Each noun form has a
SPELL specific adjectival form that comes from the language of origin of the word. You
CHECK cannot just switch adjective suffixes to make any noun an adjective. Study the
following table showing nouns and their suffixes and how they are changed into
adjectives.

Noun Suffix Adjective Suffix

cyanosis -osis cyanotic -otic
anemia -ia anemic -ic
mucus -us mucous -ous
ilium -um iliac -ac
condyle -e condylar -ar
carpus -us carpal -al
emesis -sis emetic -tic

1.38
In the words cyan/osis, anem/ia, and ili/um, the noun suffixes
-osis are ,
-ia ,
-um and .

1.39
By now you may be curious about the meanings of several of these medical
DICTIONARY terms. Look up the following words in your medical dictionary, then write the
EXERCISE meaning below.
Word Meaning
cyanosis
condyle
anemia
emetic
Good work.

38892_01_unit01_p001-031.indd 9 10/10/09 7:24:07 AM

10 UNIT 1

ANSWER COLUMN

1.40
List the suffixes that make the following nouns adjectives.

Adjective Nouns
-ac ili/ac ilium
-otic cyan/otic cyanosis
-ic anem/ic anemia
-al duoden/al duodenum
-ous vomit/ous vomit
-ar condyl/ar condyle
-iac man/iac mania
-itic arthr/itic arthritis
-tic eme/tic emesis

Read and study this table. Then move on to the next frame.

Noun Suffixes Examples

-ism—condition, state, or theory hyperthyroidism
-tion—condition contraction, relaxation
-ist—specialist psychiatrist
-er—one who radiographer
-ity—quality sensitivity

Adjectival Suffixes Examples

-ous—possessing, having, full of nervous, mucous
-able injectable
-ible }
—ability
edible

1.41

condition or state Hyper/thyroid/ism is a of too much secretion by the thyroid gland.

1.42
Darwin/ism presents a theory of evolution. Mendel/ism presents a
theory of heredity.

1.43

condition Contrac/tion is a of muscle shortening. Relax/a/tion is the

condition of diminished tension.

1.44

nouns Contrac/tion and relax/a/tion are (choose one)

(nouns/adjectives) because they name a condition.

38892_01_unit01_p001-031.indd 10 10/10/09 7:24:07 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 11

ANSWER COLUMN

1.45

a specialist A psychiatr/ist is * who practices psychiatry.

one who A medical practition/er is * practices medicine.

1.46

noun The word practitioner is a (choose one) (noun/adjective).

1.47

quality -ity indicates a quality. Conductiv/ity expresses the

of conducting nerve and muscle impulses. Sensitiv/ity expresses the
quality of nervous tissue excitability related to receiving stimuli.

1.48

noun Irritabil/ity is a (choose one) (noun/adjective).

1.49
Mucus, a noun, is a watery secretion. Muc/ous, an adjective, refers to the nature
having a material of * secreted by
(substance) the mucous membrane.

having, possessing Ser/ous refers to the nature of material lining

closed body cavities such as the abdomen.

1.50

having, possessing Nerv/ous refers to too much stress, or

nerve having a type of tissue made of cells.

1.51

adjectives Words ending in -ous are (choose one) (nouns/adjectives).

1.52
-ible and -able indicate ability. To say a food is digestible is to say it has the
ability to be digested. To say a fracture is reducible is to say that it
ability has the to be reduced.

STUDY WARETM C O N N E C T I O N

After completing this unit, you can play a hangman or other interactive game on your
StudyWARE™ CD-ROM that will help you learn the content in this chapter.

38892_01_unit01_p001-031.indd 11 10/10/09 7:24:07 AM

12 UNIT 1

ANSWER COLUMN

1.53

ability To say that lungs are inflatable is to say that they have the
to inflate.

1.54

adjectives Words ending in -ible or -able are (choose one)

(nouns/adjectives).

1.55
Verbs are words that represent action or a state of being.
INFORMATION
EXAMPLE: incise, ambulate, love.
FRAME
Verbs also have “tense,” which tells you when the action is happening: past,
present or future.

1.56
The suffixes -ed or -ing added to the verb vomit alter the tense of this word
(when the action takes place). Create the past tense by adding -ed to
vomited vomit: , and the present participle by adding -ing to
vomiting vomit: .

1.57
Use the suffixes -ed and -ing with the word inject.
injected past tense;
injecting present participle.

Injectable forms
o f m e d i c a t i o n:
(A) a m p u l e,
(B) c a r t r i d g e,
(C ) m u l t i d o s e v i a l
Delmar/Cengage Learning

(B)
(A) (C)

38892_01_unit01_p001-031.indd 12 10/10/09 7:24:07 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 13

ANSWER COLUMN

1.58
Helping verbs are also used to indicate the tense of a verb. The helping verbs and
INFORMATION verbs are identified in the following phrases below.
FRAME Future tense:
The nurse will (helping verb) inject (verb) the medication.
Present tense:
Dr. Jones is (helping verb) performing (verb) the biopsy today.
Past tense:
Sam was (helping verb) transferred (verb) from the ER to CCU.

1.59
Since most medical terms in English come from Greek or Latin words, the rules for
WORD forming plurals from singular nouns also often come from the Greek and Latin
ORIGINS languages. We typically use “s” and “es” added to a singular noun to make it plural
(e.g., chair [chairs], box [boxes]). Study the table indicating the proper plural
ending associated with each singular noun ending.

Singular Suffixes Plural Suffixes

Greek
-on -a
-ma -mata
-sis -es
-nx -ges
Latin
-a -ae
-us -i
-um -a
-is -es
-ex -ices
-ix -ices
-ax -aces

1.60
Now see if you are able to recognize the suffix patterns and write them in the
blanks provided. Check your answers. Then look up each word in the medical
dictionary.
Greek Singular Noun Greek Plural Form
spermatozoon spermatozoa
ganglion ganglia
-on, -a suffix suffix

carcinoma carcinomata
lipoma lipomata
-ma, -mata suffix suffix
(continued)

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14 UNIT 1

ANSWER COLUMN
crisis crises
prognosis prognoses
-is, -es suffix suffix

larynx (laryng/o) larynges

pharynx (pharyng/o) pharynges
-nx, -ges suffix suffix

1.61
Use what you just learned about Greek to form the plurals for the following terms.
protozoa prō tō zō‘ ә protozoan (protozoon)
sarcomata sär kō‘ ma tә sarcoma
diagnoses dī ә g nō‘ sēs diagnosis
phalanges fә lan‘ jēz phalanx (phalang/o)
Great! Now go on to the Latin forms.

Acrosomal (head) cap

Sperm
Acrosome

Head
Polar body

Condensed
nucleus Zona
pellucida
Neck
Cell
membrane
Mitochondria Cytoplasm

Nucleus
Middle piece
Nucleolus

Corona radiata made

up of epithelial cells
Ovum (1/125 of an inch in diameter)
Flagellum

Principal piece
End-piece

S p e r m a n d ov u m (N o t e : A c t u a l s i z e c o m p a r i s o n o f s p e r m e n t e r i n g o v u m) Delmar/Cengage Learning

38892_01_unit01_p001-031.indd 14 10/10/09 7:24:10 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 15

ANSWER COLUMN

1.62
Latin Singular Noun Latin Plural Form
vertebra vertebrae
conjunctiva (kon junk‘ tiv ә ) conjunctivae (kon junk‘ ti vē)
-a, -ae suffix suffix

bacillus (ba sil‘ us) bacilli (ba sil‘ ī)

bronchus (bron‘ kus) bronchi (bron kī)
-us, -i suffix suffix

testis (test‘ is) testes (test‘ ēz)

-is, -es suffix suffix

ilium (il‘ ē um) ilia (il‘ ē ә )

bacterium (bak tear‘ ē um) bacteria (bak tear‘ ē ә )
-um, -a suffix suffix

cortex (kor‘ tex) cortices (kor‘ ti sēz)

-ex, -ices suffix suffix

appendix (a pen‘ dix) appendices (a pen‘ di sēz)

-ix, -ices suffix suffix

thorax (thor‘ aks) thoraces (thor‘ ә sēz)

-ax, -aces suffix suffix

1.63
Use what you just learned about Latin to form the plurals for the following terms.
cocci kok‘ sī coccus
calcanea kal kā‘ nē ә calcaneum
vertices ver‘ ti sēz vertex (vertic/o)
cervices ser‘ vi sēz cervix (cervic/o)
thoraces thôr‘ ә sēz thorax (thorac/o)
Great work! As you continue through the text, you may wish to refer back to this
section to review the rules for plural formation. Plural forms will be included with
many of the frames as you learn the singular noun form. When in doubt, consult
your dictionary.

1.64
A prefix is a word part that goes in front of a word root. You can change the
meaning of the word by putting another word part in front of it. This other part is
prefix a .
NOTE: Notice in this book the prefixes are highlighted in blue and are followed by
a hyphen. (continued)

38892_01_unit01_p001-031.indd 15 10/10/09 7:24:11 AM

16 UNIT 1

ANSWER COLUMN

Prefix Word New Word

extension extension
express express
displease displease
disease disease
post- after postherpetic

1.65
The prefix ex- means either from or out from. The word press means to squeeze
or push on. Placing ex- in front of press changes its meaning to “squeeze out.” In
prefix the word ex/press, ex- is a .

1.66
In the word dis/ease, dis- changes the meaning of ease. dis- is a
prefix .

1.67

im- In the words im/plant, sup/plant, and trans/plant, the prefixes are ,
sup-, trans- , and .

1.68
Before learning more, review what you have learned. The foundation of a word is a
word root * .

1.69
The word part that is placed in front of a word root to change its meaning is a
prefix . In a later unit, you will learn many prefixes.

1.70

suffix The word part that follows a word root is a .

1.71

adjective A suffix may change a noun to an or change the tense

verb of a .
Good!

1.72
When a vowel is added to a word root, the word part that results is a
combining form * .

38892_01_unit01_p001-031.indd 16 10/10/09 7:24:11 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 17

ANSWER COLUMN

1.73
When two or more word roots are used to form a word, the word formed is called
compound word a* .

PRONUNCIATION NOTE

1.74
Pronunciation symbols, descriptions, and rules are described on the inside front
cover. They will also appear through the text below new terms and at other
appropriate times. Refer to this Pronunciation Key or your medical dictionary
when in doubt about how to say a word. Also, listen to the Audio CD that
accompanies Medical Terminology: A Programmed Systems Approach, 10th edition.

Notice the diagrammed sentence below, which illustrates the use

of adjectives, nouns, and verbs.
adj noun verb adj noun adj noun
The medical assistant charted the patient’s history of duodenal ulcer.

subject predicate

Notice the diagrammed words below indicating their word parts.

dysmenorrhea acrodermatitis

dys- men o -rrhea acr o dermat -itis

prefix word root suffix word root word root suffix

combining form combining form

(vowel) (vowel)

1.75
How do you know what to put where? The following material will assist you with
INFORMATION word building. This is a system that you may have already figured out. If not, study
FRAME these rules.

RULE I: Most of the time the definitions indicate the last part of the word first. The
descriptive phrases usually start with the suffix and then indicate the body part.

EXAMPLES
1. Inflammation (1) of the bladder (2)
inflammation / itis
(of the) bladder cyst/
cyst/itis
(2) (1) (continued)

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18 UNIT 1

ANSWER COLUMN
2. One who specializes (1) in skin disorders (2)
one who specializes (studies) / /logist
(in) skin (disorders) dermat/o/
dermat/o/ logist
(2) (1)
3. Pertaining to the abdomen (1) and bladder (2)
pertaining to / / /ic
(the) abdomen abdomin/o / /
(and) bladder / /cyst/
abdomin /o / cyst / ic
(2) (1)
RULE II: Where body systems are involved, words are usually built in the order
that organs are studied in the system.

EXAMPLES
1. Inflammation of the stomach and small intestine
inflammation / /itis
(of the) stomach gastr /o / /
(and) small intestine / /enter/
gastr /o / enter / itis
2. Removal of the uterus, fallopian tubes, and ovaries
removal of / / / /ectomy
(the) uterus hyster/o / / / /
fallopian tubes / /salping/o/ /
(and) ovaries / / / /-oophor/
hyster/o/salping/o/-oophor/ectomy

RULE III: The body part usually comes first and the condition or procedure is the
ending.

EXAMPLES
1. dermat/o/mycosis
(skin) (fungal condition)
2. cyst/o/scopy
(bladder) (process of examining the urinary bladder with a scope)

1.76
In this learning program, the word root is followed by a slash and a vowel to make
word root a combining form. In acr/o, acr is the * ;
vowel o is the ;
combining form and acr/o is the * .

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THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 19

ANSWER COLUMN

1.77
acr/o is used to build words that refer to the extremities. To refer to extremities,
acr/o or acr physicians use these word parts .

1.78
acr/o is found in words concerning the extremities, which in the human body are the
acr/o arms and legs. To build words about the arms use / .

NOTE: Think of an acrobat.

1.79

acr/o To build words about the legs, use / .

1.80
acr/o any place in a word should make you think of the extremities. When you
extremities read a word containing acr or acr/o, you think of .

1.81

extremities In the word acr/o/paralysis (acroparalysis), acr/o refers to .

1.82

word root In megal/o (enlarged, large), megal is the * ;

vowel o is the ; and megal/o is the * .
combining form

1.83
-megaly is used as a suffix for enlarged. The words acr/o/megaly (acromegaly),
acr/o/cyan/osis (acrocyanosis), and acr/o/dermat/itis (acrodermatitis) refer to
extremities the .

1.84
A word containing megal/o or -megaly will mean something is
enlarged .

1.85
Acr/o/megaly means enlargement of the extremities. The word that
means a person has either enlarged arms and legs or hands and feet
acr/o/megaly is / / .
ak rō meg‘ ә Iē

1.86
ē Acr/o/megal/ic gigantism is a specific disorder of the body. The signs are
enlargement of the bones of the hands and feet as well as some of the bones of
acromegaly the head. The term describing these signs is .
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

38892_01_unit01_p001-031.indd 19 10/10/09 7:24:11 AM

20 UNIT 1

ANSWER COLUMN
Ac r o m e g a l y Delmar/
Cengage Learning

Normal proportion Acromegaly

STUDY WARETM C O N N E C T I O N

When you complete this unit, remember to go to your StudyWARE™ CD-ROM and take a practice
quiz.

1.87
-y is a suffix meaning the process or condition that makes a word a noun.
noun Acromegaly is a .

1.88
dermat/o refers to the skin. When you see dermat or dermat/o, think
skin immediately of .

1.89
-logy and -logist are suffixes.
-logos is Greek for study
-logy—noun, study of
-logist—noun, one who studies
A dermat/o/logist (dermatologist) is a specialist studying diseases of
skin the . The study of skin is
dermat/o/logy / / .
dûr mә tol‘ ō gē

1.90
Acr/o/dermat/itis (acrodermatitis) is a word that means inflammation of the skin
of the extremities. A person with inflamed hands has
acr/o/dermat/itis / / / .
ak‘ rō dûr mә tī‘ tis

38892_01_unit01_p001-031.indd 20 10/10/09 7:24:11 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 21

P R O FESSIO NA L P ROF I LE
A dermatologist is a physician specialist in the study of skin, hair, and nail disorders. Dermatologists pro-
vide diagnoses and treatments for skin cancer, infections, contact dermatitis, allergies, lesion removal,
burns, injuries, and cosmetic procedures. They are part of a team including other physicians and surgeons,
physician assistants (PA), nurse practitioners, and medical aestheticians who perform skin treatments and
promote healthy skin.

ANSWER COLUMN

1.91
Remembering the word acrodermatitis, which means inflammation of the skin of
inflammation the extremities, draw a conclusion. -itis is a suffix that means .

1.92
Paralysis is a word that means loss of movement. Form a compound word
acr/o/paralysis meaning paralysis of the extremities: / / .
ak‘ rō pә ral‘ ә sis

1.93

word root In dermat/o, dermat (skin) is the * ;

vowel o is the ;
combining form and dermat/o is the * .

Contact dermatitis—
poison ivy Photo by Timothy J.
Dennerll, RT(R), Ph.D.

38892_01_unit01_p001-031.indd 21 10/10/09 7:24:12 AM

22 UNIT 1

ANSWER COLUMN
SURFACE LESIONS

A. B.

Papule Macule
Solid, elevated lesion less Localized changes in skin
than 0.5 cm in diameter color of less than 1 cm
Example in diameter
Warts, elevated nevi Example
Freckle

C. D.

Wheal Crust
Localized edema in the Dried serum, blood, or pus
epidermis causing irregular on the surface of the skin
elevation that may be red Example
or pale Impetigo
Example
Insect bite or a hive

FLUID FILLED
E. F.

Boil (Furuncle) Bullae

Skin infection originating Same as a vesicle only
in gland or hair follicle greater than 0.5 cm
Example Example
Furunculosis Contact dermatitis, large
second-degree burns,
bulbous impetigo, pemphigus

G. H.
Pustule
Vesicles or bullae that Cyst
become filled with pus, Encapsulated fluid-filled or
usually described as less a semi-solid mass in the
than 0.5 cm in diameter subcutaneous tissue or
Example dermis
Acne, impetigo, furuncles, Example
carbuncles, folliculitis Sebaceous cyst, epidermoid
cyst

L e s i o n s Delmar/Cengage Learning

1.94
Analyze the word dermat/itis. -itis means inflammation; dermat means of
skin the .

1.95
Dermat/osis means any skin condition. This word denotes an abnormal
skin condition. The suffix that means condition, status, or process is
-osis .

38892_01_unit01_p001-031.indd 22 10/10/09 7:24:28 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 23

ANSWER COLUMN

CASE STUDY I N V E S T I G A T I O N ( C S I )
Dermatitis
A 45-year-old white male presents with hand dermatitis exacerbated by use of
hand soap. Physical examination revealed erythema and scaling on both hands.
Fissures and hypopigmentation was seen on the fingers. Allergy tests including
a scratch test for scented soaps revealing a ++ reaction at 48 hours indicating the
dermatitis resulted from an allergy to perfume scents in the soap. The patient
was advised to use unscented soaps and hand moisturizers and avoid other
scented products on his skin.

CSI Vocabulary Challenge

Use a medical dictionary to help you analyze the terms listed from the case study.
Divide the term into word parts by drawing in the slashes. Then, write the defini-
tion in the space provided.
dermatitis
exacerbated
erythema
fissures
hypopigmentation
allergy

1.96
Signs of inflammation include redness, swelling, pain, and heat. Acrodermatitis
could result from stepping in a patch of poison ivy. A person with red, inflamed
acrodermatitis skin on his or her feet has .

1.97
Dermat/itis means inflammation of the skin. There are many causes of
inflammation, including infection, allergic reaction, and trauma. The suffix that
-itis means inflammation is .

1.98
Bacterial, fungal, or parasitic infections may cause red, inflamed skin
dermat/itis called / .
dûr mә tī‘ tis

To complete your study of this unit, work the Review Activities on the
following pages. Also, listen to the Audio CD that accompanies Medical
Terminology: A Programmed Systems Approach, 10th edition, and practice
your pronunciation.

38892_01_unit01_p001-031.indd 23 10/10/09 7:24:29 AM

24 UNIT 1

ANSWER COLUMN

STUDY WARETM C O N N E C T I O N

To help you learn the content in this chapter, take a practice quiz or play an interactive game on
your StudyWARE™ CD-ROM.

Take five minutes and study the abbreviations listed below that were presented
in Unit 1.

Abbreviation Meaning
adj adjective
ccu critical care unit
ER emergency room
Gr Greek
HSV-1, HSV-I herpes simplex virus 1
HSV-2, HSV-II herpes simplex virus 2
L Latin
n noun
PA Physician Assistant
pl plural
s singular
v verb
VAR varicella zoster vaccine (chickenpox vaccine)
VZV varicella zoster virus

REVIEW ACTIVITIES
CIRCLE AND CORRECT

Circle the correct answer for each question. Then check your answers in Appendix E.
1. The base of the word is the 5. When joining two word roots together you may
a. prefix b. combining form need to use a(n)
c. ending d. word root a. combining form b. consonant
c. adjective d. prefix
2. A comes in front of a word root to
change its meaning. 6. Which word part would indicate inflammation when
a. prefix b. combining form building a word meaning inflammation of the
c. suffix d. pronoun stomach?
a. prefix b. word root
3. A suffix may change the
c. compound word d. suffix
a. part of speech b. meaning
c. plural/singular form d. all of these 7. When building words about conditions of
body parts, the word root for the body part
4. If two or more word roots are combined
usually comes
to build a word, this is a a. first b. last
word. c. the suffix comes first d. the condition
a. combining form b. complex comes first
c. compound d. plural

38892_01_unit01_p001-031.indd 24 10/10/09 7:24:31 AM

THE WORD-BUILDING SYSTEM—INTRODUCTION TO WORD PARTS 25

REVIEW ACTIVITIES
8. –y is a suffix that usually makes a word a(n) 13. –ism is a suffix that indicates
. a. condition or theory b. inflammation
a. adjective b. verb c. adjective d. lack of
c. noun d. plural 14. –ed and –ing are usually suffixes used to make a
9. When building words with a suffix that begins with a word a(n)
vowel, for example, -itis, you would a. noun b. adjective
a. put the suffix first b. use a combining c. verb d. plural
c. use a word root form in front 15. The suffix indicating a condition is
in front d. all of these a. –tic b. –itis
10. The correct plural form for thorax is c. –tion d. –er
a. thoraces b. thoraxes 16. The suffix indicating being full (i.e., full of a
c. thora d. thoranges substance) is
11. The part of speech that indicates action or state a. –ist b. –ous
of being is a(n) c. –er d. –tion
a. noun b. adjective
c. verb d. plural
12. –ity is a suffix that indicates
a. a condition b. quantity
c. lack of d. quality

SELECT AND CONSTRUCT

Select the correct word parts (some may be used more than once) from the following list and construct medical
terms that represent the given meaning.
acr/o an- cyt/o dermat/o duoden/o -emia
-er gastr/o -graph hydr/o -ic -itis
-megal/y -meter micr/o -phobia radi/o -scope
-scopy surgery therm/o -emic

1. enlargement of the extremities

2. instrument used to look at small things

3. pertaining to lack of blood

4. one who makes x-ray images

5. inflammation of the skin on the extremities

6. fear of water

7. instrument used to measure heat

8. surgery using a microscope

9. looking into the stomach and duodenum with a scope

10. instrument used to measure (count) cells

38892_01_unit01_p001-031.indd 25 10/10/09 7:24:31 AM

Exploring the Variety of Random
Documents with Different Content
contributions from such native tribes as can be made to pay them.
Since we have given up the country, the Volksraad has put a very
heavy tax on all imported goods, hoping thereby to beguile the
Boers into paying taxes without knowing it, and at the same time
strike a blow at the trading community, which is English in its
proclivities. The result has been to paralyse what little trade there
was left in the country, and to cause great dissatisfaction amongst
the farmers, who cannot understand why, now that the English are
gone, they should have to pay twice as much for their sugar and
coffee as they have been accustomed to do.

I will conclude this chapter with a few words about the natives who
swarm in and around the Transvaal. They can be roughly divided
into two great races, the Amazulu and their offshoots, and the
Macatee or Basuto tribes. All those of Zulu blood, including the
Swazis, Mapock's Kafirs, the Matabele, the Knob-noses, and others
are very warlike in disposition, and men of fine physique. The
Basutos (who must not be confounded with the Cape Basutos),
however, differ from these tribes in every respect, including their
language, which is called Sisutu, the only mutual feeling between
the two races being their common detestation of the Boers. They do
not love war; in fact, they are timid and cowardly by nature, and
only fight when they are obliged to. Unlike the Zulus, they are much
addicted to the arts of peace, show considerable capacities for
civilisation, and are even willing to become Christians. There would
have been a far better field for the Missionary in the Transvaal than
in Zululand and Natal. Indeed, the most successful mission station I
have seen in Africa is near Middleburg, under the control of Mr.
Merensky. In person the Basutos are thin and weakly when
compared to the stalwart Zulu, and it is their consciousness of
inferiority both to the white men and their black brethren that,
together with their natural timidity, makes them submit as easily as
they do to the yoke of the Boer.
CHAPTER II.

EVENTS PRECEDING THE ANNEXATION.

In or about the year 1872, the burghers of the Republic elected Mr.
Burgers their President. This remarkable man was a native of the
Cape Colony, and passed the first sixteen or seventeen years of his
life, he once informed me, on a farm herding sheep. He afterwards
became a clergyman noted for the eloquence of his preaching, but
his ideas proving too broad for his congregation, he resigned his
cure, and in an evil moment for himself took to politics.

President Burgers was a man of striking presence and striking

talents, especially as regards his oratory, which was really of a very
high class, and would have commanded attention in our own House
of Commons. He possessed, however, a mind of that peculiarly
volatile order that is sometimes met with in conjunction with great
talents, and which seems to be entirely without ballast. His intellect
was of a balloon-like nature, and as incapable of being steered. He
was always soaring in the clouds, and, as is natural to one in that
elevated position, taking a very different and more sanguine view of
affairs to that which men of a more lowly, and perhaps a more
practical, turn of mind would do.

But notwithstanding his fly-away ideas, President Burgers was

undoubtedly a true patriot, labouring night and day for the welfare
of the State of which he had undertaken the guidance; but his
patriotism was too exalted for his surroundings. He wished to
elevate to the rank of a nation a people who had not got the desire
to be elevated; with this view he contracted railway loans, made
wars, minted gold, &c., and then suddenly discovered that the
country refused to support him. In short, he was made of very
different clay to that of the people he had to do with. He dreamt of a
great Dutch Republic "with eight millions of inhabitants," doing a
vast trade with the interior through the Delagoa Bay Railway. They,
on the other hand, cared nothing about republics or railways, but
fixed their affections on forced labour and getting rid of the
necessity of paying taxes—and so between them the Republic came
to grief. But it must be borne in mind that President Burgers was
throughout actuated by good motives; he did his best by a stubborn
and a stiff-necked people; and if he failed, as fail he did, it was more
their fault than his. As regards the pension he received from the
English Government, which has so often been brought up against
him, it was after all no more than his due after five years of arduous
work. If the Republic had continued to exist, it is to be presumed
that they would have made some provision for their old President,
more especially as he seems to have exhausted his private means in
paying the debts of the country. Whatever may be said of some of
the other officials of the Republic, its President was, I believe, an
honest man.

In 1875, Mr. Burgers proceeded to Europe, having, he says in a

posthumous document recently published been empowered by the
Volksraad "to carry out my plans for the development of the country,
by opening up a direct communication for it, free from the trammels
of British ports and influence." According to this document, during
his absence two powerful parties, viz., "the faction of unprincipled
fortune-hunters, rascals, and runaways on the one hand, and the
faction of the extreme orthodox party in a certain branch of the
Dutch Reform Church on the other, began to co-operate against the
Government of the Republic and me personally…. Ill as I was, and
contrary to the advice of my medical men, I proceeded to Europe, in
the beginning of 1875, to carry out my project, and no sooner was
my back turned on the Transvaal than the conspiring elements
began to act. The new coat of arms and flag adopted in the Raad by
an almost unanimous vote were abolished; the laws for a free and
secular education were tampered with; and my resistance to a
reckless inspection and disposal of Government lands, still occupied
by natives, was openly defied. The Raad, filled up to a large extent
with men of ill repute, who, under the cloak of progress and favour
to the Government view, obtained their seats, was too weak to cope
with the skill of the conspirators, and granted leave to the acting
President to carry out measures diametrically opposed to my policy.
Native lands were inspected and given out to a few speculators, who
held large numbers of claims to lands which were destined for
citizens, and so a war was prepared for me, on my return from
Europe, which I could not avert." This extract is interesting, as
showing the state of feeling existing between the President and his
officers previous to the outbreak of the Secocœni war. It also shows
how entirely he was out of sympathy with the citizens, seeing that,
as soon as his back was turned, they, with Mr. Joubert and Paul
Kruger at their head, at once undid all the little good he had done.

When Mr. Burgers got to England, he found that city capitalists

would have nothing whatever to say to his railway scheme. In
Holland, however, he succeeded in getting £90,000 of the £300,000
he wished to borrow at a high rate of interest, and by passing a
bond on five hundred Government farms. This money was
immediately invested in railway plant, which, when it arrived at
Delagoa Bay, had to be mortgaged to pay the freight on it, and that
was the end of the Delagoa Bay railway scheme, except that the
£90,000 is, I believe, still owing to the confiding shareholders in
Holland.

On his return to the Transvaal the President was well received, and
for a month or so all went smoothly. But the relations of the Republic
with the surrounding native tribes had by this time become so bad
that an explosion was imminent somewhere. In the year 1874 the
Volksraad raised the price of passes under the iniquitous pass law,
by which every native travelling through the territory was made to
pay from £1 to £5. In case of non-payment the native was made
subject to a fine of from £1 to £10, and to a beating of from "ten to
twenty-five lashes." He was also to go into service for three months,
and have a certificate thereof, for which he must pay five shillings;
the avowed object of the law being to obtain a supply of Kafir labour.
This was done in spite of the earnest protest of the President, who
gave the Raad distinctly to understand that by accepting this law
they would, in point of fact, annul treaties concluded with the chiefs
on the south-western borders. It is not clear, however, if this
amended pass law ever came into force. It is to be hoped it did not,
for even under the old law natives were shamefully treated by Boers,
who would pretend that they were authorised by Government to
collect the tax; the result being that the unfortunate Kafir was
frequently obliged to pay twice over. Natives had such a horror of
the pass laws of the country, that when travelling to the Diamond
Fields to work they would frequently go round some hundreds of
miles rather than pass through the Transvaal.

That the Volksraad should have thought it necessary to enact such a

law in order that the farmers should obtain a supply of Kafir labour
in a territory that had nearly a million of native inhabitants, who,
unlike the Zulus, are willing to work if only they meet with decent
treatment, is in itself an instructive commentary on the feelings
existing between Boer master and Kafir servant.

But besides the general quarrel with the Kafir race in its entirety,
which the Boers always have on hand, they had just then several
individual differences, in each of which there lurked the possibilities
of disturbance.

To begin with, their relations with Cetywayo were by no means

amicable. During Mr. Burgers' absence the Boer Government, then
under the leadership of P. J. Joubert, sent Cetywayo a very stern
message—a message that gives the reader the idea that Mr. Joubert
was ready to enforce it with ten thousand men. After making various
statements and demands with reference to the Amaswazi tribe, the
disputed boundary line, &c. it ends thus:—

"Although the Government of the South African Republic has never

wished, and does not now desire, that serious disaffection and
animosities should exist between you and them, yet it is not the less
of the greatest consequence and importance for you earnestly to
weigh these matters and risks, and to satisfy them; the more so, if
you on your side also wish that peace and friendship shall be
maintained between you and us."

The Secretary for Native Affairs for Natal comments on this message
in these words: "The tone of this message to Cetywayo is not very
friendly, it has the look of an ultimatum, and if the Government of
the Transvaal were in circumstances different to what it is, the
message would suggest an intention to coerce if the demands it
conveys are not at once complied with; but I am inclined to the
opinion that no such intention exists, and that the transmission of a
copy of the message to the Natal Government is intended as a
notification that the Transvaal Government has proclaimed the
territory hitherto in dispute between it and the Zulus to be
Republican territory, and that the Republic intends to occupy it."

In the territories marked out by a decision known as the Keate

Award, in which Lieutenant-Governor Keate of Natal, at the request
of both parties, laid down the boundary line between the Boers and
certain native tribes, the Boer Government carried it with a yet
higher hand, insomuch as the natives of those districts, being
comparatively unwarlike, were less likely to resist.

On the 18th August 1875, Acting President Joubert issued a

proclamation by which a line was laid down far to the southward of
that marked out by Mr. Keate, and consequently included more
territory within the elastic boundaries of the Republic. A Government
notice of the same date invites all claiming lands now declared to
belong to the Republic to send in their claims to be settled by a land
commission.

On the 6th March 1876, another chief in the same neighbourhood

(Montsoia) writes to the Lieutenant-Governor of Griqualand West in
these terms:—

"My Friend,—I wish to acquaint you with the doings of

some people connected with the Boers. A man-servant of
mine has been severely injured in the head by one of the
Boers' servants, which has proved fatal. Another of my
people has been cruelly treated by a Boer tying a rein
about his neck, and then mounting his horse and dragging
him about the place. My brother Molema, who is the
bearer of this, will give you full particulars."

Molema explains the assaults thus: "The assaulted man is not dead;
his skull was fractured. The assault was committed by a Boer named
Wessels Badenhorst, who shamefully ill-treated the man, beat him
till he fainted, and, on his revival, fastened a rim round his neck, and
made him run to the homestead by the side of his (Badenhorst's)
horse cantering. At the homestead he tied him to the waggon-wheel,
and flogged him again till Mrs. Badenhorst stopped her husband."

Though it will be seen that the Boers were on good terms neither
with the Zulus nor the Keate Award natives, they still had one Kafir
ally, namely, Umbandeni, the Amaswazi king. This alliance was
concluded under circumstances so peculiar that they are worthy of a
brief recapitulation. It appears that in the winter of the year 1875,
Mr. Rudolph, the Landdrost of Utrecht, went to Swaziland, and,
imitating the example of the Natal Government with Cetywayo,
crowned Umbandeni king, on behalf of the Boer Government. He
further made a treaty of alliance with him, and promised him a
commando to help him in case of his being attacked by the Zulus.
Now comes the curious part of the story. On the 18th May 1876, a
message came from this same Umbandeni to Sir H. Bulwer, of which
the following is an extract:—"We are sent by our king to thank the
Government of Natal for the information sent to him last winter by
that Government, and conveyed by Mr. Rudolph, of the intended
attack on his people by the Zulus. We are further instructed by the
king to thank the Natal Government for the influence it used to stop
the intended raid, and for instructing a Boer commando to go to his
country to render him assistance in case of need; and further for
appointing Mr. Rudolph at the head of the commando to place him
(Umbandeni) as king over the Amaswazi, and to make a treaty with
him and his people on behalf of the Natal Government…. The
Transvaal Government has asked Umbandeni to acknowledge himself
a subject of the Republic, but he has distinctly refused to do so." In
a minute written on this subject, the Secretary for Native Affairs for
Natal says, "No explanation or assurance from me was sufficient to
convince them (Umbandeni's messengers) that they had on that
occasion made themselves subjects of the South African Republic;
they declared it was not their wish or intention to do so, and that
they would refuse to acknowledge a position into which they had
been unwittingly betrayed." I must conclude this episode by quoting
the last paragraph of Sir H. Bulwer's covering despatch, because it
concerns larger issues than the supposed treaty: "It will not be
necessary that I should at present add any remarks to those
contained in the minute of the Secretary for Native Affairs, but I
would observe that the situation arising out of the relations of the
Government of the South African Republic with the neighbouring
native States is so complicated, and presents so many elements of
confusion and of danger to the peace of this portion of South Africa,
that I trust some way may be found to an early settlement of
questions that ought not, in my opinion, to be left alone, as so many
have been left, to take the chance of the future."
And now I come to the last and most imminent native difficulty that
at the time faced the Republic. On the borders of Lydenburg district
there lived a powerful chief named Secocœni. Between this chief
and the Transvaal Government difficulties arose in the beginning of
1876 on the usual subject—land. The Boers declared that they had
bought the land from the Swazis, who had conquered portions of the
country, and that the Swazis offered to make it "clean from
brambles," i.e., kill everybody living on it; but that they (the Boers)
said that they were to let them be, that they might be their servants.
The Basutos, on the other hand, said that no such sale ever took
place, and, even if it did take place, it was invalid, because the
Swazis were not in occupation of the land, and therefore could not
sell it. It was a Christian Kafir called Johannes, a brother of
Secocœni, who was the immediate cause of the war. This Johannes
used to live at a place called Botsobelo, the mission-station of Mr.
Merensky, but moved to a stronghold on the Spekboom river, in the
disputed territory. The Boers sent to him to come back, but he
refused, and warned the Boers off his land. Secocœni was then
appealed to, but declared that the land belonged to his tribe, and
would be occupied by Johannes. He also told the Boers "that he did
not wish to fight, but that he was quite ready to do so if they
preferred it." Thereupon the Transvaal Government declared war,
although it does not appear that the natives committed any outrage
or acts of hostility before the declaration. As regards the Boers' right
to Secocœni's country, Sir H. Barkly sums up the question thus, in a
despatch addressed to President Burgers, dated 28th Nov. 1876:
—"On the whole, it seems perfectly clear, and I feel bound to repeat
it, that Sikukuni was neither de jure or de facto a subject of the
Republic when your Honour declared war against him in June last."
As soon as war had been declared, the clumsy commando system
was set working, and about 2500 white men collected; the Swazis
also were applied to to send a contingent, which they did, being only
too glad of the opportunity of slaughter.
At first all went well, and the President, who accompanied the
commando in person, succeeded in reducing a mountain stronghold,
which, in his high-flown way, he called a "glorious victory" over a
"Kafir Gibraltar."

On the 14th July another engagement took place, when the Boers
and Swazis attacked Johannes' stronghold. The place was taken with
circumstances of great barbarity by the Swazis, for when the signal
was given to advance the Boers did not move. Nearly all the women
were killed, and the brains of the children were dashed out against
the stones; in one instance, before the captive mother's face.
Johannes was badly wounded, and died two days afterwards. When
he was dying, he said to his brother, "I am going to die. I am
thankful I do not die by the hands of these cowardly Boers, but by
the hand of a black and courageous nation like myself…." He then
took leave of his people, told his brother to read the Bible, and
expired. The Swazis were so infuriated at the cowardice displayed by
the Boers on this occasion that they returned home in great
dudgeon.

On the 2d of August Secocœni's mountain, which is a very strong

fortification, was attacked in two columns, or rather an attempt was
made to attack it, for when it came to the pinch only about forty
men, mostly English and Germans, would advance. Thereupon the
whole commando retreated with great haste, the greater part of it
going straight home. In vain the President entreated them to shoot
him rather than desert him; they had had enough of Secocœni and
his stronghold, and home they went. The President then retreated
with what few men he had left to Steelport, where he built a fort,
and from thence returned to Pretoria. The news of the collapse of
the commando was received throughout the Transvaal, and indeed
the whole of South Africa, with the greatest dismay. For the first
time in the history of that country the white man had been
completely worsted by a native tribe, and that tribe wretched
Basutos, people whom the Zulus call their "dogs." It was glad tidings
to every native from the Zambesi to the Cape, who learnt thereby
that the white man was not so invincible as he used to be.
Meanwhile the inhabitants of Lydenburg were filled with alarm, and
again and again petitioned the Governors of the Cape and Natal for
assistance. Their fears were, however, to a great extent groundless,
for, with the exception of occasional cattle-lifting, Secocœni did not
follow up his victory.

On the 4th September the President opened the special sitting of the
Volksraad, and presented to that body a scheme for the
establishment of a border force to take the place of the commando
system, announcing that he had appointed a certain Captain Von
Schlickmann to command it. He also requested the Raad to make
some provision for the expenses of the expedition, which they had
omitted to do in their former sitting.

Captain Von Schlickmann determined to carry on the war upon a

different system. He got together a band of very rough characters
on the Diamond Fields, and occupied the fort built by the President,
from whence he would sally out from time to time and destroy
kraals. He seems, if we may believe the reports in the blue-books
and the stories of eye-witnesses, to have carried on his proceedings
in a somewhat savage way. The following is an extract from a
private letter written by one of his volunteers:—

"About daylight we came across four Kafirs. Saw them first, and
charged in front of them to cut off their retreat. Saw they were
women, and called out not to fire. In spite of that, one of the poor
things got her head blown off (a d——d shame)…. Afterwards two
women and a baby were brought to the camp prisoners. The same
night they were taken out by our Kafirs and murdered in cool blood
by order of ——. Mr. —— and myself strongly protested against it,
but without avail. I never heard such a cowardly piece of business in
my life. No good will come of it, you may depend…. —— says he
would cut all the women and children's throats he catches. Told him
distinctly he was a d——d coward."

Schlickmann was, however, a mild-mannered man when compared

to a certain Abel Erasmus, afterwards denounced at a public dinner
by Sir Garnet Wolseley as a fiend "in human form." This gentleman,
in the month of October, attacked a friendly kraal of Kafirs. The
incident is described thus in a correspondent's letter:—

"The people of the kraals, taken quite by surprise, fled when they
saw their foes, and most of them took shelter in the neighbouring
bush. Two or three men were distinctly seen in their flight from the
kraal, and one of them is known to have been wounded. According
to my informant the remainder were women and children, who were
pursued into the bush, and there, all shivering and shrieking, were
put to death by the Boers' Kafirs, some being shot, but the majority
stabbed with assegais. After the massacre he counted thirteen
women and three children, but he says he did not see the body of a
single man. Another Kafir said, pointing to a place in the road where
the stones were thickly strewn, 'the bodies of the women and
children lay like these stones.' The Boer before mentioned, who has
been stationed outside, has told one of his own friends, whom he
thought would not mention it, that the shrieks were fearful to hear."

Several accounts of, or allusion to, this atrocity can be found in the
blue-books, and I may add that it, in common with others of the
same stamp, was the talk of the country at the time.

I do not relate these horrors out of any wish to rake up old stories to
the prejudice of the Boers, but because I am describing the state of
the country before the Annexation, in which they form an interesting
and important item. Also, it is as well that people in England should
know into what hands they have delivered over the native tribes who
trusted in their protection. What happened in 1876 is probably
happening again now, and will certainly happen again and again.
The character of the Transvaal Boer and his sentiments towards the
native races have not modified during the last five years, but, on the
contrary, a large amount of energy, which has been accumulating
during the period of British protection, will now be expended on their
devoted heads.

As regards the truth of these atrocities, the majority of them are

beyond the possibility of doubt; indeed, to the best of my
knowledge, no serious attempt has ever been made to refute such of
them as have come into public notice, except in a general way, for
party purposes. As, however, they may be doubted, I will quote the
following extract from a despatch written by Sir H. Barkly to Lord
Carnarvon, dated 18th December 1876:—

"As Von Schlickmann has since fallen fighting bravely, it is not

without reluctance that I join in affixing this dark stain on his
memory, but truth compels me to add the following extract from a
letter which I have since received from one whose name (which I
communicate to your Lordship privately) forbids disbelief: 'There is
no longer the slightest doubt as to the murder of the two women
and the child at Steelport by the direct order of Schlickmann, and in
the attack on the kraal near which these women were captured (or
some attack about that period) he ordered his men to cut the
throats of all the wounded! This is no mere report; it is positively
true.'" He concludes by expressing a hope that the course of events
will enable Her Majesty's Government to take such steps "as will
terminate this wanton and useless bloodshed, and prevent the
recurrence of the scenes of injustice, cruelty, and rapine which
abundant evidence is every day forthcoming to prove have rarely
ceased to disgrace the Republics beyond the Vaal ever since they
first sprang into existence."[4]

These are strong words, but none too strong for the facts of the
case. Injustice, cruelty, and rapine have always been the
watchwords of the Transvaal Boers. The stories of wholesale
slaughter in the earlier days of the Republic are very numerous. One
of the best known of those shocking occurrences took place in the
Zoutpansberg war in 1865. On this occasion a large number of Kafirs
took refuge in caves, where the Boers smoked them to death. Some
years afterwards Dr. Wangeman, whose account is, I believe,
thoroughly reliable, describes the scene of their operations in these
words:—

"The roof of the first cave was black with smoke; the remains of the
logs which were burnt lay at the entrance. The floor was strewn with
hundreds of skulls and skeletons. In confused heaps lay karosses,
kerries, assegais, pots, spoons, snuff-boxes, and the bones of men,
giving one the impression that this was the grave of a whole people.
Some estimate the number of those who perished here from twenty
to thirty thousand. This is, I believe, too high. In the one chamber
there were from two hundred to three hundred skeletons; the other
chambers I did not visit."

In 1868 a public meeting was held at Potchefstroom to consider the

war then going on with the Zoutpansberg natives. According to the
report of the proceedings, the Rev. Mr. Ludorf said that "on a
particular occasion a number of native children, who were too young
to be removed, had been collected in a heap, covered with long
grass, and burned alive. Other atrocities had also been committed,
but these were too horrible to relate." When called upon to produce
his authority for this statement, Mr. Ludorf named his authority "in a
solemn declaration to the State Attorney." At this same meeting Mr.
J. G. Steyn, who had been Landdrost of Potchefstroom, said, "there
now was innocent blood on our hands which had not yet been
avenged, and the curse of God rested on the land in consequence."
Mr. Rosalt remarked that "it was a singular circumstance that in the
different colonial Kafir wars, as also in the Basuto wars, one did not
hear of destitute children being found by the commandoes, and
asked how it was that every petty commando that took the field in
this Republic invariably found numbers of destitute children. He gave
it as his opinion that the present system of apprenticeship was an
essential cause of our frequent hostilities with the natives." Mr. Jan
Talyard said, "Children were forcibly taken from their parents, and
were then called destitute and apprenticed." Mr. Daniel Van Nooren
was heard to say, "If they had to clear the country, and could not
have the children they found, he would shoot them." Mr. Field-
Cornet Furstenburg stated "that when he was at Zoutpansberg with
his burghers, the chief Katse-Kats was told to come down from the
mountains; that he sent one of his subordinates as a proof of amity;
that whilst a delay of five days was guaranteed by Commandant Paul
Kruger, who was then in command, orders were given at the same
time to attack the natives at break of day, which was accordingly
done, but which resulted in total failure." Truly, this must have been
an interesting meeting.

Before leaving these unsavoury subjects, I must touch on the

question of slavery. It has been again and again denied, on behalf of
the Transvaal Boers, that slavery existed in the Republic. Now, this
is, strictly speaking, true; slavery did not exist, but apprenticeship
did—the rose was called by another name, that is all. The poor
destitute children who were picked up by kind-hearted Boers, after
the extermination of their parents, were apprenticed to farmers till
they came of age. It is a remarkable fact that these children never
attained their majority. You might meet oldish men in the Transvaal
who were not, according to their masters' reckoning, twenty-one
years of age. The assertion that slavery did not exist in the Transvaal
is only made to hoodwink the English public. I have known men who
have owned slaves, and who have seen whole waggon-loads of
"black ivory," as they were called, sold for about £15 a-piece. I have
at this moment a tenant, Carolus by name, on some land I own in
Natal, now a well-to-do man, who was for many years—about
twenty, if I remember right—a Boer slave. During those years, he
told me, he worked from morning till night, and the only reward he
received was two calves. He finally escaped into Natal.
If other evidence is needed it is not difficult to find, so I will quote a
little. On the 22d August 1876 we find Khama, king of the
Bamangwato, one of the most worthy chiefs in South Africa, sending
a message to "Victoria, the great Queen of the English people," in
these words:—

"I write to you, Sir Henry, in order that your Queen may preserve for
me my country, it being in her hands. The Boers are coming into it,
and I do not like them. Their actions are cruel among us black
people. We are like money, they sell us and our children. I ask Her
Majesty to pity me, and to hear that which I write quickly. I wish to
hear upon what conditions Her Majesty will receive me, and my
country and my people, under her protection. I am weary with
fighting. I do not like war, and I ask Her Majesty to give me peace. I
am very much distressed that my people are being destroyed by war,
and I wish them to obtain peace. I ask Her Majesty to defend me, as
she defends all her people. There are three things which distress me
very much—war, selling people, and drink. All these things I shall
find in the Boers, and it is these things which destroy people to
make an end of them in the country. The custom of the Boers has
always been to cause people to be sold, and to-day they are still
selling people. Last year I saw them pass with two waggons full of
people whom they had bought at the river at Tanane" (Lake Ngate).

The Special Correspondent of the Cape Argus, a highly respectable

journal, writes thus on the 28th November 1876:—"The Boer from
whom this information was gleaned has furnished besides some
facts which may not be uninteresting, as a commentary on the
repeated denials by Mr. Burgers of the existence of slavery. During
the last week slaves have been offered for sale on his farm. The
captives have been taken from Secocœni's country by Mapoch's
people, and are being exchanged at the rate of a child for a heifer.
He also assures us that the whole of the High-veld is being
replenished with Kafir children, whom the Boers have been lately
purchasing from the Swazis at the rate of a horse for a child. I
should like to see this man and his father as witnesses before an
Imperial Commission. He let fall one or two incidents of the past
which were brought to mind by the occurrences of the present. In
1864, he says, 'The Swazis accompanied the Boers against Males.
The Boers did nothing but stand by and witness the fearful
massacre. The men and women were also murdered. One poor
woman sat clutching her baby of eight days old. The Swazis stabbed
her through the body, and when she found that she could not live,
she wrung the baby's neck with her own hands to save it from future
misery. On the return of that commando the children who became
too weary to continue the journey were killed on the road. The
survivors were sold as slaves to the farmers.'"

The same gentleman writes in the issue of the 12th December as

follows:—"The whole world may know it, for it is true, and
investigation will only bring out the horrible details, that through the
whole course of this Republic's existence it has acted in
contravention of the Sand River Treaty; and slavery has occurred not
only here and there in isolated cases, but as an unbroken practice,
and has been one of the peculiar institutions of the country, mixed
up with all its social and political life. It has been at the root of most
of its wars. It has been carried on regularly even in times of peace.
It has been characterised by all those circumstances which have so
often roused the British nation to an indignant protest, and to
repeated efforts to banish the slave trade from the world. The Boers
have not only fallen on unsuspecting kraals simply for the purpose of
obtaining the women and children and cattle, but they have carried
on a traffic through natives who have kidnapped the children of their
weaker neighbours, and sold them to the white man. Again, the
Boers have sold and exchanged their victims among themselves.
Waggon-loads of slaves have been conveyed from one end of the
country to the other for sale, and that with the cognisance of, and
for the direct advantage of, the highest officials of the land. The
writer has himself seen in a town, situated in the south of the
Republic, the children who had been brought down from a remote
northern district. One fine morning, in walking through the streets,
he was struck with the number of little black strangers standing
about certain houses, and wondered where they could have come
from. He learnt a few hours later that they were part of loads which
were disposed of on the outskirts of the town the day before. The
circumstances connected with some of these kidnapping excursions
are appalling, and the barbarities practised by cruel masters upon
some of these defenceless creatures during the course of their
servitude are scarcely less horrible than those reported from Turkey.
It is no disgrace in this country for an official to ride a fine horse
which was got for two Kafir children, to procure whom the father
and mother were shot. No reproach is inherited by the mistress who,
day after day, tied up her female servant in an agonising posture,
and had her beaten until there was no sound part in her body,
securing her in the stocks during the intervals of torture. That man
did not lose caste who tied up another woman and had her thrashed
until she brought forth at the whipping-post. These are merely
examples of thousands of cases which could be proved were an
Imperial Commission to sit, and could the wretched victims of a
prolonged oppression recover sufficiently from the dread of their old
tyrants to give a truthful report."

To come to some evidence more recently adduced. On the 9th May

1881, an affidavit was sworn to by the Rev. John Thorne, curate of
St. John the Evangelist, Lydenburg, Transvaal, and presented to the
Royal Commission appointed to settle Transvaal affairs, in which he
states:—"That I was appointed to the charge of a congregation in
Potchefstroom, about thirteen years ago, when the Republic was
under the presidency of Mr. Pretorius.[5] I remember noticing one
morning as I walked through the streets, a number of young natives,
whom I knew to be strangers. I inquired where they came from. I
was told that they had just been brought from Zoutpansberg. This
was the locality from which slaves were chiefly brought at that time,
and were traded for under the name of 'Black Ivory.' One of these
natives belonged to Mr. Munich, the State Attorney. It was a matter
of common remark at that time that the President of the Republic
was himself one of the greatest dealers in slaves." In the fourth
paragraph of the same affidavit Mr. Thorne says, "That the Rev.
Doctor Nachtigal, of the Berlin Missionary Society, was the
interpreter for Shatane's people in the private office of Mr. Roth, and,
at the close of the interview, told me what had occurred. On my
expressing surprise, he went on to relate that he had information on
native matters which would surprise me more. He then produced the
copy of a register, kept in the Landdrost's office, of men, women,
and children, to the number of four hundred and eighty (480), who
had been disposed of by one Boer to another for a consideration. In
one case an ox was given in exchange, in another goats, in a third a
blanket, and so forth. Many of these natives he (Mr. Nachtigal) knew
personally. The copy was certified as true and correct by an official
of the Republic, and I would mention his name now, only that I am
persuaded that it would cost the man his life if his act became
known to the Boers."

On the 16th May 1881, a native, named Frederick Molepo, was

examined by the Royal Commission. The following are extracts from
his examination:—

"(Sir E. Wood.) Are you a Christian?—Yes.

"(Sir H. de Villiers.) How long were you a slave?—Half a year.

"How do you know that you were a slave? Might you not have been
an apprentice?—No, I was not apprenticed.

"How do you know?—They got me from my parents, and ill-treated

me.

"(Sir E. Wood.) How many times did you get the stick?—Every day.
"(Sir H. de Villiers.) What did the Boers do with you when they
caught you?—They sold me.

"How much did they sell you for?—One cow and a big pot."

On the 28th May 1881, amongst the other documents handed in for
the consideration of the Royal Commission, is the statement of a
headman, whose name it has been considered advisable to omit in
the blue-book for fear the Boers should take vengeance on him. He
says, "I say, that if the English government dies I shall die too; I
would rather die than be under the Boer Government. I am the man
who helped to make bricks for the church you see now standing in
the square here (Pretoria), as a slave without payment. As a
representative of my people I am still obedient to the English
Government, and willing to obey all commands from them, even to
die for their cause in this country, rather than submit to the Boers.

"I was under Shambok, my chief, who fought the Boers formerly, but
he left us, and we were put up to auction and sold among the Boers.
I want to state this myself to the Royal Commission in Newcastle. I
was bought by Fritz Botha and sold by Frederick Botha, who was
then veld cornet (justice of the peace) of the Boers."[6]

It would be easy to find more reports of the slave-trading practices

of the Boers, but as the above are fair samples it will not be
necessary to do so. My readers will be able from them to form some
opinion as to whether or not slavery or apprenticeship existed in the
Transvaal. If they come to the conclusion that it did, it must be
borne in mind that what existed in the past will certainly exist again
in the future. Natives are not now any fonder of working for Boers
than they were a few years back, and Boers must get labour
somehow. If, on the other hand, it did not exist, then the Boers are
a grossly slandered people, and all writers on the subject, from
Livingstone down, have combined to take away their character.
Leaving native questions for the present, we must now return to the
general affairs of the country. When President Burgers opened the
special sitting of the Volksraad, on the 4th September, he appealed,
it will be remembered, to that body for pecuniary aid to liquidate the
expenses of the war. This appeal was responded to by the passing of
a war tax, under which every owner of a farm was to pay £10, the
owner of half a farm £5, and so on. The tax was not a very just one,
since it fell with equal weight on the rich man who held twenty
farms and the poor man who held but one. Its justice or injustice
was, however, to a great extent immaterial, since the free and
independent burghers, including some of the members of the
Volksraad who had imposed it, promptly refused to pay it, or indeed,
whilst they were about it, any other tax. As the Treasury was already
empty, and creditors were pressing, this refusal was most ill-timed,
and things began to look very black indeed. Meanwhile, in addition
to the ordinary expenditure, and the interest payable on debts,
money had to be found to pay Von Schlickmann's volunteers. As
there was no cash in the country, this was done by issuing
Government promissory notes, known as "goodfors," or vulgarly as
"good for nothings," and by promising them all booty, and to each
man a farm of two thousand acres, lying east and north-east of the
Loolu mountains—in other words, in Secocœni's territory, which did
not belong to the Government to give away. The officials were the
next to suffer, and for six months before the Annexation these
unfortunate individuals lived as best they could, for they certainly
got no salary, except in the case of a postmaster, who was told to
help himself to his pay in stamps. The Government issued large
numbers of bills, but the banks refused to discount them, and in
some cases the neighbouring colonies had to advance money to the
Transvaal post-cart contractors who were carrying the mails, as a
matter of charity. The Government even mortgaged the great salt-
pan near Pretoria for the paltry sum of £400, whilst the leading
officials of the Government were driven to pledging their own private
credit in order to obtain the smallest article necessary to its
continuance. In fact, to such a pass did things come that when the
country was annexed a single threepenny bit (which had doubtless
been overlooked) was found in the Treasury chest, together with
acknowledgments of debts to the extent of nearly £300,000.

Nor was the refusal to pay taxes, which they were powerless to
enforce, the only difficulty with which the Government had to
contend. Want of money is as bad and painful a thing to a State as
to an individual, but there are perhaps worse things than want of
money, one of which is to be deserted by your own friends and
household. This was the position of the Government of the Republic;
no sooner was it involved in overwhelming difficulties than its own
subjects commenced to bait it, more especially the English portion of
its subjects. They complained to the English authorities about the
commandeering of members of their family or goods; they petitioned
the British Government to interfere, and generally made themselves
as unpleasant as possible to the local authorities. Such a course of
action was perhaps natural, but it can hardly be said to be either
quite logical or just. The Transvaal Government had never asked
them to come and live in the country, and if they did so, it was
presumably at their own risk. On the other hand, it must be
remembered that many of the agitators had accumulated property,
to leave which would mean ruin; and they saw that, unless
something was done, its value would be destroyed.

Under the pressure of all these troubles the Boers themselves split
up into factions, as they are always ready to do. The Dopper party
declared that they had had enough progress, and proposed the
extremely conservative Paul Kruger as President, Burgers' time
having nearly expired. Paul Kruger accepted the candidature,
although he had previously promised his support to Burgers, and
distrust of each other was added to the other difficulties of the
Executive, the Transvaal becoming a house very much divided
against itself. Natives, Doppers, Progressionists, Officials, English,
were all pulling different ways, and each striving for his own
advantage. Anything more hopeless than the position of the country
on the 1st January 1877 it is impossible to conceive. Enemies
surrounded it; on every border there was the prospect of a serious
war. In the exchequer there was nothing but piles of overdue bills.
The President was helpless, and mistrustful of his officers, and the
officers were caballing against the President. All the ordinary
functions of Government had ceased, and trade was paralysed. Now
and then wild proposals were made to relieve the State of its
burdens, some of which partook of the nature of repudiation, but
these were the exception; the majority of the inhabitants, who
would neither fight nor pay taxes, sat still and awaited the
catastrophe, utterly careless of all consequences.
CHAPTER III.

THE ANNEXATION.

The state of affairs described in the previous chapter was one that
filled the Secretary of State for the Colonies with alarm. During his
tenure of office Lord Carnarvon evidently had the permanent welfare
of South Africa much at heart, and he saw with apprehension that
the troubles that were brewing in the Transvaal were of a nature
likely to involve the Cape and Natal in a native war. Though there is
a broad line of demarcation between Dutch and English, it is not so
broad but that a victorious nation like the Zulus might cross it, and
beginning by fighting the Boer, might end by fighting the white man
irrespective of race. When the reader reflects how terrible would be
the consequences of a combination of native tribes against the
Whites, and how easily such a combination might at that time have
been brought about in the first flush of native successes, he will
understand the anxiety with which all thinking men watched the
course of events in the Transvaal in 1876.

At last they took such a serious turn that the Home Government saw
that some action must be taken if the catastrophe was to be
averted, and determined to despatch Sir Theophilus Shepstone as
Special Commissioner to the Transvaal, with powers, should it be
necessary, to annex the country to Her Majesty's dominions, "in
order to secure the peace and safety of Our said colonies and of Our
subjects elsewhere."

The terms of his Commission were unusually large, leaving a great

deal to his discretionary power. In choosing that officer for the
execution of a most difficult and delicate mission, the Government,
doubtless, made a very wise selection. Sir Theophilus Shepstone is a
man of remarkable tact and ability, combined with great openness
and simplicity of mind, and one whose name will always have a
leading place in South African history. During a long official lifetime
he has had to do with most of the native races in South Africa, and
certainly knows them and their ways better than any living man;
whilst he is by them all regarded with a peculiar and affectionate
reverence. He is par excellence their great white chief and "father,"
and a word from him, even now that he has retired from active life,
still carries more weight than the formal remonstrances of any
governor in South Africa.

With the Boers he is almost equally well acquainted, having known

many of them personally for years. He possesses, moreover, the rare
power of winning the regard and affection, as well as the respect, of
those about him in such a marked degree that those who have
served him once would go far to serve him again. Sir T. Shepstone,
however, has enemies like other people, and is commonly reported
among them to be a disciple of Machiavelli, and to have his mind
steeped in all the darker wiles of Kafir policy. The Annexation of the
Transvaal is by them attributed to a successful and vigorous use of
those arts that distinguished the diplomacy of two centuries ago.
Falsehood and bribery are supposed to have been the great levers
used to effect the change, together with threats of extinction at the
hands of a savage and unfriendly nation.

That the Annexation was a triumph of mind over matter is quite

true, but whether or no that triumph was unworthily obtained, I will
leave those who read this short chronicle of the events connected
with it to judge. I saw it somewhat darkly remarked in a newspaper
the other day that the history of the Annexation had evidently yet to
be written; and I fear that the remark represents the feeling of most
people about that event, implying as it did that it was carried out by
means certainly mysteriously and presumably doubtful. I am afraid
that those who think thus will be disappointed in what I have to say
about the matter, since I know that the means employed to bring
the Boers—

"Fracti bello, fatisque repulsi"—

under Her Majesty's authority were throughout as fair and honest as

the Annexation itself was, in my opinion, right and necessary.

To return to Sir T. Shepstone. He undoubtedly had faults as a ruler,

one of the most prominent of which was that his natural mildness of
character would never allow him to act with severity even when
severity was necessary. The very criminals condemned to death ran
a good chance of reprieve when he had to sign their death-warrants.
He has also that worst of faults (so-called), in one fitted by nature to
become great—want of ambition, a failing that in such a man marks
him the possessor of an even and a philosophic mind. It was no
seeking of his own that raised him out of obscurity, and when his
work was done to comparative obscurity he elected to return,
though whether a man of his ability and experience in South African
affairs should, at the present crisis, be allowed to remain there, is
another question.

On the 20th December 1876, Sir T. Shepstone wrote to President

Burgers, informing him of his approaching visit to the Transvaal, to
secure, if possible, the adjustment of existing troubles, and the
adoption of such measures as might be best calculated to prevent
their recurrence in the future.

On his road to Pretoria, Sir Theophilus received a hearty welcome

from the Boer as well as the English inhabitants of the country. One
of these addresses to him says: "Be assured, high honourable Sir,
that we burghers, now assembled together, entertain the most
friendly feeling towards your Government, and that we shall agree
with anything you may do in conjunction with our Government for
the progress of our State, the strengthening against our native
enemies, and for the general welfare of all the inhabitants of the
whole of South Africa. Welcome in Heidelberg, and welcome in the
Transvaal."

At Pretoria the reception of the Special Commissioner was positively

enthusiastic; the whole town came out to meet him, and the horses
having been taken out of the carriage, he was dragged in triumph
through the streets. In his reply to the address presented to him, Sir
Theophilus shadowed forth the objects of his mission in these
words: "Recent events in this country have shown to all thinking
men the absolute necessity for closer union and more oneness of
purpose among the Christian Governments of the southern portion
of this continent: the best interests of the native races, no less than
the peace and prosperity of the white, imperatively demand it, and I
rely upon you and upon your Government to co-operate with me in
endeavouring to achieve the great and glorious end of inscribing on
a general South African banner the appropriate motto—"Eendragt
maakt magt" (Unity makes strength)."

A few days after his arrival a commission was appointed, consisting

of Messrs. Henderson and Osborn, on behalf of the Special
Commissioner, and Messrs. Kruger and Jorissen, on behalf of the
Transvaal Government, to discuss the state of the country. This
commission came to nothing, and was on both sides nothing more
than a bit of by-play.

The arrival of the mission was necessarily regarded with mixed

feelings by the inhabitants of the Transvaal. By one party it was
eagerly greeted, viz., the English section of the population, who
devoutly hoped that it had come to annex the country. With the
exception of the Hollander element, the officials also were glad of its
arrival, and secretly hoped that the country would be taken over,
when there would be more chance of their getting their arrear pay.
The better educated Boers also were for the most part satisfied that
there was no hope for the country unless England helped it in some
way, though they did not like having to accept the help. But the
more bigoted and narrow-minded among them were undoubtedly
opposed to English interference, and under their leader, Paul Kruger,
who was at the time running for the President's chair, did their best
to be rid of it. They found ready allies in the Hollander clientelle,
with which Mr. Burgers had surrounded himself, headed by the
famous Dr. Jorissen, who was, like most of the rulers of this singular
State, an ex-clergyman, but now an Attorney-general, not learned in
the law. These men were for the most part entirely unfit for the
positions they held, and feared that in the event of the country
changing hands they might be ejected from them; and also, they did
all Englishmen the favour to regard them with that peculiarly virulent
and general hatred which is a part of the secret creed of many
foreigners, more especially of such as are under our protection. As
may easily be imagined, what between all these different parties and
the presence of the Special Commissioner, there were certainly
plenty of intrigues going on in Pretoria during the first few months of
1877, and the political excitement was very great. Nobody knew how
far Sir T. Shepstone was prepared to go, and everybody was afraid
of putting out his hand further than he could pull it back, and trying
to make himself comfortable on two stools at once. Members of the
Volksraad and other prominent individuals in the country who had
during the day been denouncing the Commissioner in no measured
terms, and even proposing that he and his staff should be shot as a
warning to the English Government, might be seen arriving at his
house under cover of the shades of evening, to have a little talk with
him, and express the earnest hope that it was his intention to annex
the country as soon as possible. It is necessary to assist at a
peaceable annexation to learn the depth of meanness human nature
is capable of.

In Pretoria, at any rate, the ladies were of great service to the cause
of the mission, since they were nearly all in favour of a change of
government, and, that being the case, they naturally soon brought
their husbands, brothers, and lovers to look at things from the same
point of view. It was a wise man who said that in any matter where
it is necessary to obtain the goodwill of a population you should win
over the women; that done, you need not trouble yourself about the
men.

Though the country was thus overflowing with political intrigues,

nothing of the kind went on in the Commissioner's camp. It was not
he who made the plots to catch the Transvaalers; on the contrary,
they made the plots to catch him. For several months all that he did
was to sit still and let the rival passions work their way, fighting what
the Zulus afterwards called the "fight of sit down." When anybody
came to see him he was very glad to meet them, pointed out the
desperate condition of the country, and asked them if they could
suggest a remedy. And that was about all he did do, beyond
informing himself very carefully as to all that was going on in the
country, and the movements of the natives within and outside its
borders. There was no money spent in bribery, as has been stated,
though it is impossible to imagine a state of affairs in which it would
have been more easy to bribe, or in which it could have been done
with greater effect; unless indeed the promise that some pension
should be paid to President Burgers can be called a bribe, which it
was certainly never intended to be, but simply a guarantee that after
having spent all his private means on behalf of the State he should
not be left destitute. The statement that the Annexation was
effected under a threat that if the Government did not give its
consent Sir T. Shepstone would let loose the Zulus on the country is
also a wicked and malicious invention, but with this I shall deal more
at length further on.

It must not, however, be understood that the Annexation was a

foregone conclusion, or that Sir T. Shepstone came up to the
Transvaal with the fixed intention of annexing the country without
reference to its position, merely with a view of extending British
influence, or, as has been absurdly stated, in order to benefit Natal.
He had no fixed purpose, whether it were necessary or no, of
exercising the full powers given to him by his commission; on the
contrary, he was all along most anxious to find some internal
resources within the State by means of which Annexation could be
averted, and of this fact his various letters and despatches give full
proof. Thus, in his letter to President Burgers, of the 9th April 1877,
in which he announces his intention of annexing the country, he
says: "I have more than once assured your Honour that if I could
think of any plan by which the independence of the State could be
maintained by its own internal resources I would most certainly not
conceal that plan from you." It is also incidentally remarkably
confirmed by a passage in Mr. Burgers' posthumous defence, in
which he says: "Hence I met Shepstone alone in my house, and
opened up the subject of his mission. With a candour that
astonished me, he avowed that his purpose was to annex the
country, as he had sufficient grounds for it, unless I could so alter as
to satisfy his Government. My plan of a new constitution, modelled
after that of America, of a standing police force of two hundred
mounted men, was then proposed. He promised to give me time to
call the Volksraad together, and to abandon his design if the
Volksraad would adopt these measures, and the country be willing to
submit to them, and to carry them out." Further on he says: "In
justice to Shepstone I must say that I would not consider an officer
of my Government to have acted faithfully if he had not done what
Shepstone did."

It has also been frequently alleged in England, and always seems to

be taken as the groundwork of argument in the matter of the
Annexation, that the Special Commissioner represented that the
majority of the inhabitants wished for the Annexation, and that it
was sanctioned on that ground. This statement shows the great
ignorance that exists in this country of South African affairs, an
ignorance which in this case has been carefully fostered by Mr.
Gladstone's Government for party purposes, they having found it
necessary to assume, in order to make their position in the matter
tenable, that Sir T. Shepstone and other officers had been guilty of
misrepresentation. Unfortunately, the Government and its supporters
have been more intent upon making out their case than upon
ascertaining the truth of their statements. If they had taken the
trouble to refer to Sir T. Shepstone's despatches, they would have
found that the ground on which the Transvaal was annexed was, not
because the majority of the inhabitants wished for it but because the
State was drifting into anarchy, was bankrupt, and was about to be
destroyed by native tribes. They would further have found that Sir T.
Shepstone never represented that the majority of the Boers were in
favour of Annexation. What he did say was that most thinking men
in the country saw no other way out of the difficulty; but what
proportion of the Boers can be called "thinking men?" He also said,
in the fifteenth paragraph of his despatch to Lord Carnarvon of 6th
March 1877, that petitions signed by 2500 people, representing
every class of the community, out of a total adult male population of
8000, had been presented to the Government of the Republic,
setting forth its difficulties and dangers, and praying it "to treat with
me for their amelioration or removal." He also stated, and with
perfect truth, that many more would have signed had it not been for
the terrorism that was exercised, and that all the towns and villages
in the country desired the change, which was a patent fact.

This is the foundation on which the charge of misrepresentation is

built—a charge which has been manipulated so skilfully, and with
such a charming disregard for the truth, that the British public has
been duped into believing it. When it is examined into, it vanishes
into thin air.

But a darker charge has been brought against the Special

Commissioner—a charge affecting his honour as a gentleman and
his character as a Christian; and, strange to say, has gained a
considerable credence, especially amongst a certain party in
England. I allude to the statement that he called up the Zulu army
with the intention of sweeping the Transvaal if the Annexation was
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