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Escharotomy, Eschar & Scar
Warning: Surgical photograph at the bottom of this column may disturb some readers.
The Scar Issue
Our English word scar begins as the ancient Greek word for fireplace or hearth, eschara ἐσχάρα. Even in ancient Greek, eschara came to refer to the bad burn or burn mark or resultant scab a person could receive around a fireplace or large fire. Borrowed by the Romans into Late Latin, eschara entered Middle French as escare and then entered Middle English as escare and then scar.
There is also influence or semantic blending from an unrelated borrowing into English from a later Viking word, Old Norse skarð scarth ‘notch, cleft’ that became scar with obsolete English meanings of ‘chink, crack, incision, slice.’ In its Norse form, scarth had a brief life in English as a noun meaning ‘fragment’ or ‘sherd.’ Skarth is related to Old Norse skor ‘tab notch,’ the source of our English word score (Late Old English scoru) which originally meant keeping count by cutting notches into a wooden stick, that is, keeping score. The first meaning of to score in English was to scratch a counting mark on a surface. The verb still has some use with that meaning.
Notched or scored talley sticks using Roman numerals
Eschar, a Valid Medical Term
Eschar is a word in English medicine naming slough (pronounced sluf), the necrotic tissue left after a third-degree burn, an acid accident or gangrene.
Etymology & Performance of An Escharotomy
In a hospital burn unit, an escharotomy (literally ‘cutting the eschar’) is a common surgical procedure. The medical suffix –tomy begins in Greek –τομία ‘a cutting’ borrowed into medical Latin as -tomia and now the concluding root in hundreds of international medical terms like anatomy: basic meaning ‘cutting up (ana) a body,’ appendectomy ‘cutting out (ex, ec) the appendix,’ lithotomy ‘surgical excision of gallstones (lithos ‘stone’),’ tracheotomy et alia.
Let’s suppose an upper arm has suffered third-degrees burns, extending around the entire circumference of the upper arm. Third-degree or full-thickness burns show necrosis (tissue death) of the entire skin, but perhaps only locally. Such burns produce tough, thick leathery scabbing, called eschar in medicine. As the underlying new tissue rehydrates, the infilling liquid constricts the tight skin and the resulting severe edema swells so much under the hard, unyielding burnt tissue that blood circulation distal to the burn is reduced or dangerously impaired. For example, a severe burn on the upper arm may cause the skin and tissue to become so tight that the hand does not receive sufficient blood flow.
Escharotomies are surgical incisions down or across the length of the crusted burned tissue to expose the fatty layer below. The escharotomy incisions widen and help re-establish blood flow to nearby healthy tissues and then widen to restore circulation to the burned tissues as they heal after other therapeutic procedures. If the chest is severely burned, such edematous tightness of swollen burned tissue across the chest can make breathing difficult for the patient. You can see on the patient shown below several transverse escharotomies (performed across the chest) to alleviate this hindered ventilation.
If you’re keeping score, that’s the game for today.
copyright © 2012 William Gordon Casselman
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wordguy@shaw.ca
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Reviews of my New Book
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Jenni French of San Fancisco, California writes on her blog "My Corner of the Universe" for March 19, 2011:
Casselman, Bill. Where a Dobdob Meets a Dikdik: A World Lover's Guide to the Weirdest, Wackiest, and Wonkiest Lexical Gems. Avon, MA: Adams Media, 2010.
"I admit it: I'm a word nerd. I love words: weird words, long words, obscure words, funny words. This book is right up my alley. With chapters like "Nautical Words," "Creepy Words," and "Edible Words," I have enjoyed every page of this book.
And the author has quite a way with words, so I have found myself rereading many sentences in this book and slowing my progress through it.
My current favorite sentence is found in a discussion of dog hybrid breed names: "What a revolting concatenation of cutesiness and smarmy nomenclatorial treacle parading under the name of canine hybrid breed names" (19).
I'm sure I'll have another favorite sentence in a day or two.
This book is just that good and just that entertaining."
Author Bill Casselman replies: "Thanks, Jenni!"
Just a reminder that this book contains my ALL-NEW word esssays, none of which are available anywhere else in print or online.
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Cindy Lapeña on her blog "Creativity Unlimited" of July 19 ,2011, writes:
Posted by mimrlith in 365 Things to Look Forward to.
Tags: 365 things to look forward to, books, reading
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19. Starting a book
To a certified bibliophile like me, a.k.a. bookworm, one of the most exciting things to look forward to is to start reading a new book. In fact, sometimes the prospect of starting to read a new book is so exciting that I have to hurry to finish the book I am currently reading, just so I can start a new one.
If there’s one thing I can’t resist, it’s a book, especially if it promises to be a good one. Of course there are certain books I just won’t touch or be seen with, but at the risk of being hung by my thumbs by fans of such literature, I will not mention any genres in particular. . .
Seeing a book with a title that totally captivates me, like Where a Dobdob meets a Dikdik (yes, that is a book title!) has me so worked up, I just can’t wait to dive in. I imagine all sorts of deliciously fancifully outrageous words with a title like that. Is it obvious? I just love books on words. You won’t believe how many dictionaries I own. Or books on lexical oddities and other lexical explorations. Yes, I am a logophile of sorts. I love the new words I pick up from new books. I relish finding out the meanings of all manner of words and phrases and expressions. What could be more fun?"
(Replies author Bill Casselman: Please scroll to bottom of page or click here to link to a free seven-page preview of my new book, Where a Dobdob Meets a Dikdik.
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Sample My Newest Book. Click Below.
Jan. 3, 2011
“Mr Casselman,
I wanted to write to thank you for your thoroughly enjoyable [new] book. By background, I am a technologist practicing the somewhat arcane crafts of Information Security.”
David Gamey, Canada
Testimonial Email
Thursday, February 3, 2011
Dear Mr. Casselman,
A search for the origins of an improbable-looking word, paraprosdokian, led me to the first piece of your prose I have had the pleasure of reading, "The Bogus Word Paraprosdokian & Lazy Con Artists of Academe." I have just placed an order for Where a Dobdob Meets a Dikdik, Canadian Words & Sayings, and As The Canoe Tips, and will add more of your titles as I finish these.
I have just retired from a 40-plus year career in book publishing, the last thirty years spent as director/editor of a number of university presses, attempting to sort the genuine writers from the "Lazy Con Artists of Academe." Sad to say, the latter have so over-bred the former that I could no longer see the rare gem in the avalanches of offal that daily swamped my office and desk. I visited your website and spent far too long there; it was a pleasure to meet a real writer through his work.
. . . I revisited the paraprosdokian page, and have finally quit laughing again at “Casselman's Conclusion.” You were not unkind to the "profligate prof-lets." During my years as an acquisitions editor, in rejection letters I often quoted Prof. Moses Hadas, classicist at Columbia University, who wrote a young scholar in response to having been sent the prof-let's first book, "Thank you for sending me your book. I will waste no time reading it."
I know I will enjoy your books. Keep up the good work.
Thank you,
Luther Wilson
Director (Retired)
University of New Mexico Press, among others
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