Proctology

Proctology (pronounced prok-tol-uh-jee)

(1) The branch of medicine dealing with the pathology of the colon, rectum and anus.

(2) Historically, the branch of medicine dealing with the surgery of the colon, rectum, and anus.

(3) In modern use, colorectal surgery as a specialty inside (as it were) proctology.

(4) A department or building so named in a hospital, university or clinic etc.

1896: The construct was procto- +‎ -logy or proct- + -ology.  Procto was from a Latinized form of the Greek prōktos (anus), from the primitive Indo-European prokto-, the source also of Armenian erastan-k' (buttocks).  The suffix -ology was formed from -o- (as an interconsonantal vowel) +‎ -logy.  The origin in English of the -logy suffix lies with loanwords from the Ancient Greek, usually via Latin and French, where the suffix (-λογία) is an integral part of the word loaned (eg astrology from astrologia) since the sixteenth century.  French picked up -logie from the Latin -logia, from the Ancient Greek -λογία (-logía).  Within Greek, the suffix is an -ία (-ía) abstract from λόγος (lógos) (account, explanation, narrative), and that a verbal noun from λέγω (légō) (I say, speak, converse, tell a story).  In English the suffix became extraordinarily productive, used notably to form names of sciences or disciplines of study, analogous to the names traditionally borrowed from the Latin (eg astrology from astrologia; geology from geologia) and by the late eighteenth century, the practice (despite the disapproval of the pedants) extended to terms with no connection to Greek or Latin such as those building on French or German bases (eg insectology (1766) after the French insectologie; terminology (1801) after the German Terminologie).  Within a few decades of the intrusion of modern languages, combinations emerged using English terms (eg undergroundology (1820); hatology (1837)).  In this evolution, the development may be though similar to the latter-day proliferation of “-isms” (fascism; feminism et al).  A physician specializing in proctology is a proctologist although some may prefer the punchier construction Bart Simpson (from the cartoon TV series The Simpsons), used: “butt doctor”.  The noun proctalgia (pain in the anus or rectum) existed in the medical literature as early as 1811 while the first known use of “proctologist” dates from 1897.  Proctology & proctologist are nouns and proctologic & proctological are adjectives; the noun plural is protologists.

In 1974, The British Medical Journal (BMJ) used the term “guitar nipple” to describe “the irritation to the breast that can occur from the pressure of the guitar against the body.”  In the same spirit, two years later a contributor to the Journal of the American Medical Association (JAMA) was more imaginative still, coining “hot pants syndrome” when documenting cases in which a burn to the skin had been induced by a patient carrying a battery-powered transistor radio in the pocket of their trousers.  There was also in 1978 the New England Journal of Medicine's (NEJM) “disco digit” which referred to “a sore or infected finger caused by too much finger snapping while dancing.”  These terms were indicative of the trend in the English-speaking world for newly-identified (and in some cases novel conditions) to be constructed with English elements, rather than the Latin historically used.  In the fields of proctology, the historic terms (of discomfort in the region) were:

Rectalgia (pain in the rectum), the construct being rect- (a clipping of the New Latin rectum, itself a clipping of the Latin rectum intestinum (literally “the straight intestine”), neuter of rectus (straight) +‎ -algia (from the New Latin -algia (pain), from the Ancient Greek ἄλγος (álgos) (pain).

Proctalgia (pain in the anal or rectal region), the construct being proct- (a New Latin combining form, from Ancient Greek πρωκτός (prōktós) (anus).+‎ -algia.

Anodynia (anal pain; anorectal pain), the construct being ano- (from the Latin anus) + -dynia (an alternative (used when the preceding morpheme has a terminal vowel) form of -odynia (a New Latin combining form, from the Ancient Greek ὀδύνη (odúnē) (sorrow, grief, anguish, unhappiness).

Confusingly though, because terminology evolved often independently an in parallel, medicine contrived to use anodynia also to mean “the absence of pain in a previously painful region” and in that case the construct differed, being an- (from the Ancient Greek ἀν- (an-); a doublet of un- and in- (used her in the sense of a negation) +‎ odynia (a New Latin combining form, from the Ancient Greek ὀδύνη (odúnē) (sorrow, grief, anguish, unhappiness).  So for the non-medically trained, confusion could arise given anodynia can mean either “pain in the butt” or “pain has gone away” although because it’s a word unlikely much to be seen by other than the medically trained, instances of this have presumably been rare.  But in the context of “butt pain” there would seem to be some overlap in meaning between rectalgia, proctalgia & anodynia but while all are used to refer to “pain in or around the rectal area”, in the profession there are distinctions in use, particularly in clinical and diagnostic work 

Rectalgia is used to describe pain localized in the rectum and tends to be used as general term for the condition and often without specifying a cause.  Conditions associated with rectalgia include anorectal abscesses and fissures.  Proctalgia encompasses pain in the anorectal region (both anus and rectum) and is commonly used of proctalgia fugax, a specific condition characterized by sudden, severe, and brief rectal pain with no obvious underlying cause.  As the etymology suggests, proctalgia’s remit is broader than that of rectalgia because it includes both anus and rectum.  Whether or not related to the duality of meaning, anodynia is now not in general clinical use but historically it referred to pain in the vicinity of the anus.  The modern terms for that are “anal pain” & “anorectal pain”.  So, although lay-readers might be forgiven for thinking they could be used interchangeably, clinicians applied them based on anatomical location: rectalgia (rectum), anodynia (anus) &, proctalgia (anorectal region).

In the thoughts of Kellyanne Conway: A protologist's ultrasonic rectal probe (available in 140 & 200 mm (5½ & 8 inch) length versions) by the Electro Surgical Instrument Company (ESI (1896)).

Protology and pains in the butt do feature in idiomatic use in English.  Kellyanne Conway (b 1967; senior counselor to the US president, 2017-2020) when discussing the “Muller probe” (an investigation by special counsel Robert Mueller (1944) into Donald Trump (b 1946; US president 2017-2021; president elect 2024) and the matter of alleged Russian interference in the 2016 US presidential election) told a press conference the whole project was “a political proctology exam.”  She clearly liked the imagery because later, when Mr Muller handed down his report, she told the assembled press pack it was the “best day” since Mr Trump’s (2016) election, repeated the phrase “political proctology” and, sticking with medical allusions, said the verdict delivered “a clean bill of health.”

PITB (and its variations) is widely used.

Kellyanne Conway in hoodie: Miss January, Clare Boothe Luce Policy Institute's annual Conservative Women Calendar (2009).

So like Mr Trump, Ms Conway would have found the Muller probe a (metaphorical) pain in the butt but “political proctology exam” was both a more polite and elegant way of saying it.  The saying “pain in the butt” belongs to a class of such expressions (all meaning “a nuisance; a source of trouble or annoyance”) which variously are used according to the need for politeness, the hierarchy of rudeness (in ascending order) being: “pain in the neck”, “pain in the brain”, “pain in the back” (all about equal), “pain in the rear”, “pain in the bum”, “pain in the ass” & “pain in the arse” (the choice between “ass” & “arse” dictated by linguistic tradition).  All are often used as initializms (PITN PITB, PITR, PITA) and PITA seems the most popular while in oral use “pain in the neck” and “pain in the ass (arse)” vie for popularity although some do like “pain in the brain” for the rhyme.

First edition (hardcover, 1956) of Soranus' Gynecology, published by Johns Hopkins University Press, translated and with an introduction by Owsei Temkin MD (1902-2002).

Quite when the idea of “specialists” in the modern sense of the word came to the practice of medicine isn’t certain but long before such things were formalized by the creation of colleges or specialist qualifications, it’s likely the early physicians did tend to develop particular areas of expertise and would have had certain patients referred to them, much as is the modern practice.  Probably, this emergence of specialties would have happened organically, based on geography: a physician in a fishing community on the sunny Aegean coast would have encountered a different patient profile than one who worked in the cold of the mountains.  Thus, while it’s not known who can be though the “first proctologist”, medical students everywhere will probably nominate Soranus of Ephesus, a Greek physician who practiced in both Alexandria and Rome during the first & second century AD.  His four-volume treatise on gynecology still exists so he probably deserves to be remembered as an early gynecologist but, as many medical students will confirm, his name is pronounced sawr-ey-nuhs so a proto-proctologist he must be.  Such things do happen: Winston Churchill’s (1875-1965; UK prime-minister 1940-1945 & 1951-1955) neurologist was Russell Brain (1895–1966).

Comeback

Comeback (pronounced kuhm-bak)

(1) A return to a former higher rank, popularity, position, prosperity etc, typically after an extended period of obscurity, under-performance etc.

(2) In sporting competition, a team or individual overcoming a substantial disadvantage in points to win or draw.

(3) Of products, ideas, practices etc, to again become fashionable.

(4) To reply after a period of consideration (as in “to come back” to someone).

(5) A clever or effective retort; a rejoinder; a retort; a riposte (especially if recriminatory).

(6) In informal use, a basis or cause of complaint.

(7) To return (in the sense “come back”).

(8) Of something forgotten, to return to one's memory.

1815–1825: A noun use of verb phrase “come back”, the construct being come + back.  Come was from the Middle English comen & cumen, from the Old English cuman, from the Proto-West Germanic kweman, from the Proto-Germanic kwemaną (to come), from the primitive Indo-European gwémt (to step), from gwem- (to step).  Back was from the Middle English bak, from the Old English bæc, from the Middle Low German bak (back), from the Old Saxon bak, from the Proto-West Germanic bak, from the Proto-Germanic baką, possibly from the primitive Indo-European bheg- (to bend). The adverb represents an aphetic (in phonetics, linguistics & prosody, of, relating to, or formed by aphesis (the loss of the initial unstressed vowel of a word)) form of aback.  Similar forms included the West Frisian bekling (chair back), the Old High German bah and the Swedish and Norwegian bak.  The use of comeback (for long used also as “come-back”) in the sense of a verbal (usually oral) retort dates form 1889 and was an adaptation of the verbal phrase, the implication especially of a “quick or clever response”.  The familiar modern meaning “recovery, return to former position or condition after retirement or loss” was a creation of American English, documented since 1908.  Comeback is a noun (the use as a verb is a misspelling of “come back”; the noun plural is comebacks.

In idiomatic use a “comeback kid” is a person who on more than one occasion had demonstrated a propensity to overcome tragedy, reversal or failure and rebound to triumph and victory.  It has also been used of someone who has achieved such a thing only once but in an especially notable or dramatic way such as Bill Clinton (b 1946; US president 1993-2001) who recovered from a mediocre performance in the 1992 Iowa Caucus but managed to secure an unexpected second place in the New Hampshire primary, despite (cynics would say “because”) reports of his extramarital affair with Gennifer Flowers (b 1950; “Gennifer with a ‘G’”).  Variations include “comeback king”, “comeback queen”, “comeback specialist” etc and those for whom comebacks seem to be a calling are said to stage “serial comebacks”.  When writing of comebacks (usually in sport, politics or entertainment), it not uncommon for them to be described as a “rebound”, “resurgence”, “return”, “revival”, “resurrection” or “resuscitation” (or a “redux” for those wanting something more literary).  In gambling, “comeback money” is that used by an agent of a bookie to place a large bet on a horse at large odds, thereby causing the odds on that horse to decline, reducing the bookie's potential losses in the event that the horse wins.

Thames Comeback Sauce.

Comeback sauce is a dipping sauce and salad dressing, most associated with central Mississippi and while there are variations, the classic recipes typically are based on mayonnaise and chili sauce.  A creamy & tangy Southern condiment, someback sauce is a Mississippi staple and has spread far beyond the city of Jackson, where it originated as an example of “fusion cuisine” (in this case Greek + Mississippi influences).  It’s thought the sauce's name is merely the idea “it tastes so good diners keep ‘coming back’ for more”.  It was first served in Greek-owned restaurants (some claim the Mayflower Cafe was first) in Mississippi in the mid-twentieth century and it has much evolved and in addition to the base of mayonnaise and chili sauce, other popular ingredients include ketchup, spices and Worcestershire hot sauce.

Noted comebacks in modern US politics

F Scott Fitzgerald’s (1896–1940) oft-quoted phrase “there are no second acts in American lives” appears as a fragment in his posthumously published, unfinished novel The Last Tycoon (1941) but he first published it in the early 1930s in the essay My Lost City, a kind of love letter to New York.  The quote is frequently misunderstood as an observation that for those Americans who suffer disgrace or destitution, there is no redemption, no comeback.  However, from politics to pop culture (there is still some slight distinction), there are many examples of temporarily disreputable Americans resurrecting their public lives from all but the most ignominious opprobrium.  Fitzgerald was a professional writer and his observation was an allusion to the structure used by playwrights in traditional three-act theater: (1) problem, (2) complication & (3) solution.  He thought the nature of the American mind was to prefer to skip the second act, going straight from a problem to finding a solution.  His point was well-made and it’s one of the themes of the narrative which underlies the discussions (which became arguments and sometimes squabbles) of military and political strategy between Washington and London during the World War II (1939-1945).

The concept of the comeback is well understood and the zeitgeisters at The Cut (an online publication of New York magazine) noted the phenomenon, in September 2024 posting a piece which looked at Lindsay Lohan’s latest comeback and reviewed those of the last ten-odd years.

That photograph by Doug Mills (b 1960), who has shot (in the photographic sense) every president since Ronald Reagan (1911-2004; US president 1981-1989).

What Donald Trump (b 1946; US president 2017-2021; president elect since 5 Nov 2024) did in regaining the presidency in the 2024 presidential election was perhaps the most remarkable comeback in modern US political history and as notable as any that has happened anywhere.  When one considers the prelude to the 2024 triumph, (Trump (1) lost the popular vote in 2016, (2) lost the popular vote and the electoral college (and thus the presidency) in 2020 and (3) suffered between 2021-2024 a myriad of legal problems including civil judgements in which he was found liable for hundreds of millions in damages and even a felony conviction, a historic first for a US president), his comeback seems more remarkable still.  It’s something even the Trump haters (of which there seem to be a few) must acknowledge, even if it’s not a thing of which they dare speak.

The analysis of the voting patterns in 2024 have revealed some interesting findings but talk of a “political realignment” (such as the shift of the South from the Democrats to the Republicans in the wake of the civil rights legislation of the 1960s) may be premature because there seems still not to be an understanding of just how bizarrely unique a political figure Mr Trump is.  His effect on the political dynamic is undeniable but it may be that it’s something unique to his very existence and that when he departs (God forbid), the construct called MAGA Republicanism, while it may live on as a label, ceases to exert its pull.  These personal creations do seem to behave like that, Gaullism (from Charles de Gaulle (1890-1970; President of France 1959-1969) in France and Peronism (from Juan Perón (1895–1974; President of Argentina 1946-1955 & 1973-1974) in Argentina both surviving as labels but those who have in recent decades appropriated them haven’t always pursued policies of which the two men would have approved; nor have they always aligned with the definitions political scientists have constructed.

The 2024 election:  Conde Nast's Vanity Fair makes clear its editorial position.

It was a strange election campaign.  Trump actually talked much about specifics, there were a lot of policies and many specific details: what he was going to do and to whom.  Kamala Harris (b 1964; US vice president since 2021) however appeared to have only three items on the campaign clipboard: (1) I am not Donald Trump, (2) I am not Joe Biden and (3) abortion on demand.  Had the Trump brand been as toxic as her team seemed to believe the her tactic of basing every appearance around platitudes, slogans and clichés endlessly recited (obediently to be repeated by the crowd), that might have won the election (it’s been done before) but clearly, Trump had more appeal for enough of those in the demographics the Democrats had pencilled in as “ours”.  Quickly, the analysts “scoped down” on the voting patterns and discovered (1) there were women for whom abortion was not the central issue (although it is clear women also took advantage of differential voting where possible, voting to making abortion available in their state wheen the option was on the ballot while also voting for Trump), (2) a significant proportion of Latino voters appeared to be motivated by self-interest rather than ethnic solidarity (which the Democrats seemed to assume they’d made compulsory) and (3) the black male vote for the Democrats was lower that was achieved by Barack Obama (b 1961; US president 2009-2017) in 2008 & 2012.  That last statistic intrigued some who drew what may have been a long bow in speculating that while black men don’t like being told what to do by a white man, at least they’ve had several centuries to get used to it whereas the thought of being told what to do by a black woman is just unthinkable.  It was an opportunistic conclusion to draw from an electoral behaviour which happened only at the margins but it was that sort of election.

Interest now shifts to the second Trump administration and whether it will be Trump 1.1 (ie more of the same which was experienced in the first term) or Trump 2.0 (something different).  Many analysts are suggesting it will be combination of both and structurally, the possibilities available to Mr Trump if the Republicans hold working majorities in both chambers of congress are more inviting.  Mr Trump will have learned lessons from his first term and at least some mistakes (not a word he's believed often to have used of himself) presumably won't be repeated and it's no secret a whole industry of lobbyists, specialists and obsessives have been for four years at work crafting documents detailing how they think things should be done so he won't lack for advice.  There is much talk about the "shift to conservatism" in the US (and elsewhere) but a second Trump administration promises to be one of the more radical seen since the 1960s.    

Four dead white men, left to right: Barry Goldwater, Dwight Eisenhower, Richard Nixon and Thomas Dewey, meeting to discuss the Republican platform for the 1966 mid-term elections, Washington DC, 1 June 1965.  It was a meeting of some significance because this period was the high point of the Democratic Party's control of all branches of government.

Until Trump did what he did, the greatest political comeback in the US was probably that achieved in 1968 by Richard Nixon (1913-1994; US president 1969-1974).  After two terms as VPOTUS (Vice President of the United States) to Dwight Eisenhower (1890-1969; US president 1953-1961), Nixon lost the 1960 presidential election to John Kennedy (JFK, 1917–1963; US president 1961-1963), the margin described at the time as “an electoral eyelash”.  Although it was made clear to Nixon JFK’s victory had probably been made possible by old Joe Kennedy (1888–1969 and JFK’s father) using his money to arrange some blatant vote rigging, Nixon declined to pursue his right to mount a legal challenge, arguing the institution of the office was too important to taint with scandal and telling aides: “Nobody steals the presidency of the United States”, a very different attitude that that taken in 2020 by Mr Trump  Politically, the loss in 1960 may not have been fatal but what did seem to write finis was his loss in 1962 in the Californian gubernatorial contest, an event which would now be forgotten had not Nixon, the day after, held what he called his “last press conference”.  California was then a solidly Republican state and Nixon’s loss was a surprise to most and a shock to some, most conspicuously the defeated candidate who, at the Beverly Hilton Hotel, delivered a quarter-hour tongue-lashing to the assembled press pack, accusing them, not without justification, of having hated him since first he came to prominence in 1948 and having since assiduously and unfairly worked against him.  He concluded: “I leave you gentlemen now.  And you will now write it.  You will interpret it.  That's your right.  But as I leave you, I want you to know—just think how much you're going to be missing.  You don't have Nixon to kick around anymore.  Because, gentlemen, this is my last press conference.”  Nixon sat out the 1964 presidential election, appearing at the Republican National Convention only as “a simple soldier in the ranks” to nominate Barry Goldwater (1909–1998) who he described as “Mr Conservative” and the 1964 convention was the only one between 1952-1972 from which Nixon didn’t emerge as the party’s nominee for POTUS (President of the United States) or VPOTUS.  Goldwater lost the 1964 election to Lyndon Johnson (LBJ, 1908–1973; US president 1963-1969) in one of the biggest landslides ever but Goldwater managed to engineer his own, somewhat abstract, comeback, later arguing the victory of Ronald Reagan (1911-2004; US president 1981-1989) was really him winning, sixteen years on.  Barry invented the “proto-virtual comeback”.

Harry Truman, St. Louis Union Station, St. Louis, Missouri, 3 November 1948.  United States.  In Florida, 76 years later, Donald Trump would wear the same smile.

Harry Truman’s (1884–1972; US president 1945-1953) comeback victory in the 1948 presidential election was one of those events remember for one photograph: that of a smirking Truman holding aloft the 3 November 1948 edition of the Chicago Daily Tribune, the front page’s banner headline reading: “DEWEY DEFEATS TRUMAN”.  Really, the Tribune was unlucky because for reasons both technical and related to labor relations, the Wednesday edition had “gone to bed” and been printed earlier that the historic practice, the staff relying on the early returns which they interpreted as guaranteeing a solid Republican victory, not only Thomas Dewey (1902–1971) taking the White House but also both houses of congress; as things turned out, the Democrats secured all three.  For Truman, the 1948 victory was a remarkable comeback because he’d inherited the presidency only because Franklin Delano Roosevelt (FDR, 1882–1945, US president 1933-1945) had died on the eve of victory in World War II (1939-1945) and, compared with his illustrious predecessor, he seemed plain and uncharismatic, his reputation not helped as post-war economic struggles, labor strikes, and internal divisions within the Democratic Party soon took the gloss of the celebrations which had greeted the end of four years of war.  By 1948, almost universally he was expected to lose the 1948 election.

What Truman did was return to what seemed to most a kind of “pre-modern” campaign strategy in which he embarked on what came to be known as the “Whistle Stop Tour”, traveling around the nation by train, speaking in person to the voters rather than having them receive his words on the airways or in the newspapers.  Although now remembered more as part of the political lexicon, the term “whistle stop” was originally US railroad jargon and terminology and referred to small towns or rural stations where trains would only stop “on signal” and usually only if there was something or someone to pick-up or deliver (or if the conductor had, in advance, been notified).  Such stops often had little infrastructure (sometimes only the most rudimentary “platform”) and as the trains slowed down, the driver would blow the “whistle” to announce their arrival.  Although now rarely undertaken by train, the term “whistle-stop tour” remains widely used to describe campaigns that involve making multiple brief appearances in many locations.  Truman’s trip proved a great success, often delivering his speeches from the back of the railcar, his team having travelled ahead to ensure he always had an audience and in the pre internet age, he had the advantage also of being able to recycle the same text, often changing only the odd reference to “localize” the context.  His straightforward, relatable and fiery style was quite a change from the elegant, patrician FDR but it resonated with the voters who warmed to his populist message of fighting the “…do-nothing [Republican] Congress."  Against all expectations (possibly even his own), Truman enjoyed a comeback victory in what was a major upset, proving a persistent campaign with the right message can succeed even the most daunting odds.

Anesthetist

Anesthetist (pronounced an-aes-the-tist or uh-nes-thi-tist)

(1) A person who administers anesthetics, usually a nurse or technician (US, Canada and some others).

(2) A physician who specializes in the administration of anesthetics (UK & Commonwealth).

1880–1885: From the New Latin anesthet(ize) (loss of feeling) + ist (From the Old French iste & Latin ista, from the Ancient Greek ιστής (istḗs), from ίζω (ízō, ize, ise, verbal suffix) +‎ τής (tḗs, the agent-noun suffix).  The construct of the Ancient Greek anaisthēsia (absence of sensation) was an (prefix meaning opposite; without) + aisthēsis (feeling).  The word anesthesia was coined by physician Oliver Wendell Holmes (1809–1894) in 1846, the construct being the Greek ἀν (an) (without) + αἴσθησις (aisthēsis) (sensation) and refers to the inhibition of sensation.  Anesthetist & anesthesia are nouns, anesthetize is a verb, anesthetical is an adjective and anesthetically is an adverb; the noun plural is anesthetists.

Anesthetist or anesthesiologist?

In North America, the medical study and application of anesthetics is called anesthesiology, and a physician in the specialty is called an anesthesiologist.  In these jurisdictions, the word anesthetist is used to refer to advanced non-physician providers of anesthesia services such as anesthesiologist assistants and nurse anesthetists.  Elsewhere, in most of the English-speaking world, the specialty is instead referred to as anaesthesia or anaesthetics (with an extra "a").  The term anaesthetist is used only to refer to a physician practicing in the field; non-physicians involved in anaesthesia use other titles such as "physician assistant".  Some countries which formerly used anaesthesia and anaesthetist, such as Ireland and Hong Kong, have transitioned to anaesthesiology and anaesthesiologist, or are in the throes of transition.  It’s a case of the influence of London receding and internationalism prevailing as the (admittedly sketchy and actually multi-way) linguistic standardization of the British Empire fades.  Anaesthesiologist is the spelling adopted by the World Federation of Societies of Anaesthesiologists and most of its most of its member societies, as well as the European Society of Anaesthesiology.  It is the most commonly used term found in the titles of medical journals.

Navadha's oral anesthesia training manikin head with light & sensor.

Navadha's oral anesthesia training manikin is a device on which may be practiced the methods of intra oral anesthesia.  Augmented with both light and sound sensors, it's intended to provide students a safe and realistic experience while undergoing training on the techniques of local anesthesia.  The model consists of a metal skull with a flexible silicone face and mouth lining over an anatomically correct jaw with 28 permanent teeth, movable tongue and a jawbone with landmarks for placement of dry injection which can be seen and palpated (the silicone will not show needle marks).  The conduction sensors aid in practicing Gow Gates and Standard Mandibular Block anesthesia and local infiltration may also be administered in their respective regions.  Four electronic sensors for light and sound, triggered when the landmarks are touched by dry injection, are included and the battery-powered LED light at the top of the head displays a green light when the correct position and angle of injection have been achieved (requires three AAA batteries (batteries not included)).

Available for US$1980.00; accessories include a table top stand (US$360.00), Columbia dental chair head rest mount (US$780.00), torso for chair mount (US$360.00) & bench mount (US$410.00)

For those who really enjoy their work.

Sometimes, an anesthetist needs a court order to proceed.  

Slag

Slag (pronounced slag)

(1) The substantially fused and vitrified matter separated during the reduction of a metal from its ore; also called cinder.

(2) The scoria (the mass of rough fragments of pyroclastic rock and cinders produced during a volcanic eruption) from a volcano.

(3) In the post-production classification of coal for purposes of sale, the left-over waste for the sorting process; used also of the waste material (as opposed to by-product) from any extractive mining.

(4) In industrial processing, to convert into slag; to reduce to slag.

(5) In the production of steel and other metals, the scum that forms on the surface of molten metal.

(6) In commercial metallurgy, to remove slag from a steel bath.

(7) To form slag; become a slaglike mass.

(8) In slang, an abusive woman (historic UK slang, now a rare use).

(9) In slang, a term of contempt used usually by men of women with a varied history but now to some degree synonymous with “unattractive slut” (of UK origin but now in use throughout the English-speaking world and used sometimes also of prostitutes as a direct synonym, the latter now less common).

(10) In the slang of UK & Ireland, a coward (now regionally limited) or a contemptible person (synonymous with the modern “scumbag” (that use still listed by many as “mostly Cockney” but now apparently rare).

(11) In Australian slang, to spit.

(12) Verbally to attack or disparage somebody or something (usually as “slag off”, “slagged them”, “slagged it off” etc); not gender-specific and used usually in some unfriendly or harshly critical manner; to malign or denigrate.  Slang dictionaries note that exclusively in Ireland, “slagging off” someone (or something) can be used in the sense of “to make fun of; to take the piss; the tease, ridicule or mock” and can thius be an affectionate form, rather in the way “bastard” was re-purposed in Australian & New Zealand slang.

1545–1555: From the Middle Low German slagge & slaggen (slag, dross; refuse matter from smelting (which endures in Modern German as Schlacke)), from the Old Saxon slaggo, from the Proto-West Germanic slaggō, from the Proto-Germanic slaggô, the construct being slag(ōną)- (to strike) + -gô (the diminutive suffix).  Although unattested, there may have been some link with the Old High German slahan (to strike, slay) and the Middle Low German slāgen (to strike; to slay), the connection being that the first slag from the working of metal were the splinters struck off from the metal by being hammered.  Slāgen was from Proto-West Germanic slagōn and the Old Saxon slegi was from the Proto-West Germanic slagi.  Slag is a noun & verb, slagability, deslag, unslag & slaglessness are nouns, slagish, slagless, slagable, deslagged unslagged, slaggy & slaglike are adjectives and slagged, deslagged, unslagged, slagging, deslagging & unslagging are verbs; the noun plural is slags.  As an indication of how industry use influences the creation of forms, although something which could be described as “reslagging” is a common, it’s regarded as a mere repetition and a consequence rather than a process.

In the UK & Ireland, the term “slag tag” is an alternative to “tramp stamp”, the tattoo which appears on the lower back.  Both rhyming forms seem similarly evocative.

The derogatory slang use dates from the late eighteenth century and was originally an argot word for “a worthless person or a thug”, something thought derived from the notion of slag being “a worthless, unsightly pile” and from this developed the late twentieth century use to refer to women and this is thought to have begun life as a something close to a euphemism for “slut” although it was more an emphasis on “unattractiveness”.  The most recent adaptation is that of “slagging off” (verbal (ie oral, in print, on film etc) denigration of someone or something, use documented since 1971 although at least one oral history traces it from the previous decade.  In vulgar slang, slag is one of the many words used (mostly) by men to disparage women.  It’s now treated as something akin to “slut” (in the sense of a “women who appears or is known to be of loose virtue) but usually with the added layer of “unattractiveness”.  The lexicon of the disparaging terms men have for women probably doesn’t need to precisely to be deconstructed and as an example, in the commonly heard “old slag”, the “old” likely operates often as an intensifier rather than an indication of age; many of those labeled “old slags” are doubtless quite young on the human scale.  Still, that there are “slags” and “old slags” does suggest men put some effort into product differentiation.

How slag heaps are created.

All uses of “slag”, figurative & literal, can be traced back to the vitreous mass left as a residue by the smelting of metallic ore, the fused material formed by combining the flux with gangue, impurities in the metal, etc.  Although there’s much variation at the margins, typically, it consists of a mixture of silicates with calcium, phosphorus, sulfur etc; in the industry it’s known also as cinder and casually as dross or recrement (the once also-used "scoria" seems now exclusively the property of volcanologists).  When deposited in place, the piles of slag are known as “slag heaps” and for more than a century, slag heaps were a common site in industrial regions and while they still exist, usually they’re now better managed (disguised).  A waste-product of steel production, slag can be re-purposed or recycled and, containing a mixture of metal oxides & silicon dioxide among other compounds, there is an inherent value which can be realized if the appropriate application can be found.  There are few technical problems confronting the re-use of slag but economics often prevent this; being bulky and heavy, slag can be expensive to transport so if a site suitable for re-use is distant, it can simply be too expensive to proceed.  Additionally, although slag can in close to its raw form be used for purposes such as road-base, if any reprocessing is required, the costs can be prohibitive.  The most common uses for slag include (1) Landfill reclamation, especially when reclaiming landfills or abandoned industrial sites, the dense material ideal for affording support & stability for new constructions, (2) the building of levees or other protective embankments where a large cubic mass is required, (3) in cement production in which ground granulated blast furnace slag (GGBFS) can be used as a supplementary component material of cement, enhancing the workability, durability and strength of concrete, (4) manufacturing including certain ceramics & glass, especially where high degrees of purity are not demanded, (5) as a soil conditioner in agriculture to add essential nutrients to the soil and improve its structure, (6) as a base for road-building and (7) as an aggregate in construction materials such as concrete and asphalt.  The attraction of recycling slag has the obvious value in that it reduces the environmental impact of steel production but it also conserves natural resources and reduces the impact of the mining which would otherwise be required.  However, the feasibility of recycling slag depends on its chemical composition and the availability of an appropriate site.

Harold Macmillan, Epsom Derby, Epsom Downs Racecourse, Surrey, 5 June 1957.

The word “slag” has been heard in the UK’s House of Commons in two of the three senses in which it’s usually deployed.  It may have been used also in the third but the Hansard reporters are unlikely to have committed that to history.  In 1872, Benjamin Disraeli (1804-1881, UK prime-minister Feb-Dec 1868 & 1874-1880) cast his disapproving opposition leader’s gaze on the cabinet of William Gladstone (1809–1898; prime-minister 1868–1874, 1880–1885, Feb-July 1886 & 1892–1894) sitting on the opposite front bench and remarked: “Behold, a range of extinct volcanoes; not a flame flickers upon a single pallid crest.”.  Sixty-odd years later, a truculent young Harold Macmillan (1894–1986; UK prime-minister 1957-1963) picked up the theme in his critique of a ministry although he was slagging off fellow Tories, describing the entire government bench as “a row of disused slag heaps”, adding that the party of Disraeli was now “dominated by second-class brewers and company promoters.”  Presumably Macmillan thought to be described as a “slag heap” was something worse than “extinct volcano” and one can see his point.  The rebelliousness clearly was a family trait because in 1961, when Macmillan was prime-minister, his own son, by then also a Tory MP, delivered a waspish attack on his father’s ministry.  When asked in the house the next day if there was “a rift in the family or something”, Macmillan said: “No.”, pausing before adding with his Edwardian timing: “As the House observed yesterday, the Honorable Member for Halifax has both intelligence and independence.  How he got them is not for me to say."

Lindsay Lohan and the great "slagging off Kettering scandal".

Although lacking the poise of Macmillan, Philip Hollobone (b 1964; Tory MP for Kettering since 2005), knew honor demanded he respond to Lindsay Lohan “slagging off” his constituency.  What caught the eye of the outraged MP happened during Lindsay Lohan’s helpful commentary on Twitter (now known as X) on the night of the Brexit referendum in 2016, the offending tweet appearing after it was announced Kettering (in the Midlands county of Northamptonshire) had voted 61-39% to leave the EU: “Sorry, but Kettering where are you?”

Philip Hollobone MP, official portrait (2020).

Mr Hollobone, a long-time "leaver" (a supporter of Brexit), wasn’t about to let a mean girl "remainer's" (one who opposed Brexit) slag of Kettering escape consequences and he took his opportunity in the House of Commons, saying: “On referendum night a week ago, the pro-Remain American actress, Lindsay Lohan, in a series of bizarre tweets, slagged off areas of this country that voted to leave the European Union.  At one point she directed a fierce and offensive tweet at Kettering, claiming that she had never heard of it and implying that no one knew where it was.  Apart from the fact that it might be the most average town in the country, everyone knows where Kettering is.”  Whether a phrase like “London, Paris, New York, Kettering” was at the time quite as familiar to most as it must have been to Mr Hollobone isn’t clear but he did try to help by offering advice, inviting Miss Lohan to switch on Kettering's Christmas lights that year, saying it would “redeem her political reputation”.  Unfortunately, that proved not possible because of a clash of appointments but thanks to the Tory Party, at least all know the bar has been lowered: Asking where a town sits on the map is now “slagging it off”.  Learning that is an example of why we should all "read our daily Hansards", an observation Mr Whitlam apparently once made, suggesting his estimation of the reading habits of the general population might have differed from reality.

Screen grab from the "apology video" Lindsay Lohan sent the residents of Kettering advising she'd not be able to switch on their Christmas lights because of her "busy schedule".

Lace

Lace (pronounced leys)

(1) A net-like, delicate & ornamental fabric made of threads by hand or machine and formed historically from cotton or silk (modern forms also using synthetics), woven almost always in an open web of symmetrical patterns and figures .

(2) A cord or string for holding or drawing together (shoes, garments, protective coverings etc) as when passed through holes in opposite edges.

(3) An ornamental cord or braid, especially of gold or silver, used to decorate military and other uniforms, hats etc.

(4) A small amount of alcoholic liquor or other substance added to food or drink.

(5) A snare or gin, especially one made of interwoven cords; a net.

(6) In the illicit drug trade, to add a (usually) small quantity of another substance to that being offered for sale (also sometimes deliberately undertaken by users for various purposes).

(7) To fasten, draw together, or compress by or as if by means of a lace.

(8) To pass (a cord, leather strip etc) through holes usually intended for the purpose.

(9) To interlace or intertwine.

(10) For decorative purposes, to adorn or trim with lace.

(11) To lash, beat, or thrash.

(12) To compress the waist of a person by drawing tight the laces of a corset (used descriptively with undergarments like shapewear which don’t use laces).

(13) To mark or streak, as with color.

(14) To be fastened with a lace:

(15) To attack (usually verbally but the term is rarely applied to physical violence), often in the form “laced into”.

(16) As the acronym LACE, Used variously including the liquid air cycle engine (a propulsion engine used in space travel), the Luton Analogue Computing Engine (a computer used by the UK military) and the Lunar Atmospheric Composition Experiment (a research project conducted on the final Apollo Moon mission).

1175–1225: From the Middle English noun lace, laace, laz & las (cord made of braided or interwoven strands of silk etc), from the Old French laz & las (a net, noose, string, cord, tie, ribbon, or snare), from the Vulgar Latin lacium & laceum, from the Classical Latin laqueum from laqueus (a noose or snare).  The Latin was the source also of the Italian laccio, the Spanish lazo and the English lasso, a trapping and hunting term, probably from the Italic base laq- (to ensnare) and thus comparable with the Latin lacere (to entice).  The verb was from the Middle English lasen & lacen, from the Old & Middle French lacer, lacier, lasser & lachier (which endures in Modern French as lacer), from the Latin laqueāre (to enclose in a noose, to trap).  Derived forms have been coined as required including enlace, lace-up, lacemaker, laceman, self-lacing, unlace, re-laced & well-laced although de-laced seems to be exclusive to the IT industry where it has a specific application in video displays (interlaced, non-interlaced and all that).  Lace is a noun & verb; lacer is a noun, lacing is a verb, lacelike & lacy are adjectives and laced is a verb & adjective; the noun plural is laces.

Vulcan Surprising Venus and Mars in Bed before an Assembly of the Gods (1679), oil on canvas by Johann Heiss (1640-1704).

The metal net weaved by the god Vulcan was in renaissance art called “Vulcan’s lace”, reflecting the general use to describe snares, fish nets etc and vividly it was described in both the Odyssey (the Greek text from the eighth or seventh century BC attributed to Homer) and Ovid's (the Roman poet Publius Ovidius Naso; 43 BC–17 AD) Metamorphoses (Transformations; 8 AD).  The god Helios had happened upon the gods Venus and Mars in a passionate, adulterous liaison and he rushed to inform god Vulcan of his wife's faithlessness.  Enraged, Vulcan forged a net of bronze so fine it was invisible to the naked eye and carefully he place the lace over Venus’ bed so he could entrap the lustful pair at their next tryst.  It didn’t take long and thus ensnared, Vulcan called upon all of the other Olympians to witness the scene, the cuckolded Vulcan making his case before his peers.

Train of lace wedding gown.

Because of the method of construction, the word lace evolved by the turn of the fourteenth century to describe “a net, noose or snare”, simultaneously with it coming to mean “a piece of cord used to draw together the edges of slits or openings in an article of clothing”, a concept which survives in the modern shoelace although in Middle English it was used most frequently in the sense of “a cord or thread used particularly to bind or tie”.  It was used of fishing lines and (especially poetically) of the hangman’s rope and noose, the struts and beams used in architecture, and in the sixteenth century “death's lace” was the icy grip said to envelop the dying while “love’s lace” was the romantic feeling said to cloak youth enchanted with each other.  By the 1540s, improved technology meant increased production of “ornamental cords & braids” which influenced the meaning “fabric of fine threads in a patterned ornamental open net” becoming the predominant use of the English word and the trend continued because by the late nineteenth century a review of catalogues revealed dozens of varieties of commercially available lace.  Noted first in 1928 was an interesting use as an adjective of “lace-curtain” as a piece of class snobbery; it meant “middle class” or “lower-class with middle-class pretensions”) although it was often used in US cities of Irish-Americans, so it may also be thought both an ethnic and anti-Catholic slur.

Casting a practiced eye: Lindsay Lohan assessing a lace-up boot.

The verb developed from the noun and emerged so closely most etymologists consider it a concurrent form, the original sense being “fasten clothing etc with laces and ties”, a direct adoption of the sense of the Old French lacier “entwine, interlace, fasten with laces, lace on; entrap, ensnare” developed from the noun las or laz (net, noose, string, cord).  From the early fourteenth century it was oral shorthand meaning “tighten (a garment) by pulling its laces” and by at least the late sixteenth century (though probably earlier) it conveyed the idea of “adorning with lace”, applied both to furniture and fashion.  The meaning “to intermix (one’s coffee etc.) with a dash of liquor (typically brandy or whisky)” emerged in the 1670s, a product doubtlessly of the spike in popularity of coffee houses.  That sense was originally used also of sugar (from the notion of “to ornament or trim something with lace” while the meaning “beat, lash, mark with the lash” dates from the 1590s, the idea being the pattern of streaks left by the lash; from the early nineteenth century this idea was extended also to verbal assaults (usually as “laced into).  With his punctilious attention to such things, Samuel Johnson (1709-1784) in his A Dictionary of the English Language (1755) noted “laced mutton” was “an old word for a whore”.  The most enduring use is probably the shoelace (also as shoe-lace although the old form “shoe string” seems to be extinct). The “length of lace used to draw together and fasten the sides of a shoe via eyelets”, the noun dating from the 1640s.  Also extinct is another older word for the thong or lace of a shoe or boot: the Middle English sho-thong which was from the Old English scoh-þwang.

1997 Toyota Century V12.  Cars sold on the Japanese domestic market (JDM) are famous for frequently being adorned with what are known as Japanese car seat doilies.  While most are mass produced from modern synthetics and appear in things like taxis, some used in up-market cars are genuine hand-made lace.  Interestingly, while Toyota created the Lexus brand because of the perceived “prestige deficit” suffered by the Toyota name in overseas markets, for decades the Century (sold only in the JDM) has been supplied to the Imperial household.

Lindsay Lohan in lace top, 2004.

The adjective lace-up dates (adj.) from 1831 and was originally a cobblers’ description of boots, directly from the verbal phrase “lace up”; in the mid-twentieth century it was re-purposed in the form “laced-up” to imply someone was “repressed, overly conservative and restricted in their attitudes” the notion being of someone (a woman of course” who never “loosened her stays” with all that implies, the significance being the use emerged decades after corsets had ceased to be worn, the suggestion being a throwback to what were imagined to be Victorian (nineteenth century) attitudes towards personal morality.  This adaptation of lace wasn’t entirely new.  The early fifteenth century adjective “strait-laced” referenced stays or bodices “made close and tight” which was originally purely descriptive but soon came to be adopted figuratively to suggest someone “over-precise, prudish, strict in manners or morals”.  The adjective lacy (which differs from lace-like in that the former references extent, the latter resemblance) and dates from 1804; it’s wholly unrelated to the given name Lacey (which although technically gender-neutral is now conferred predominately on girls and was of Old French origin meaning “from Lacy (or Lassy)” and was originally the surname of French noblemen, the De Lasi, from the Normandy region; it reached the British Isles during the Norman conquest (1066).  The trade of laceman (one who deals in laces) was known since the 1660s while the necklace (“a flexible ornament worn round the neck”) was first so described in the 1580s although such things had been worn by both men & women for thousands of years.  A gruesome use emerged in Apartheid era South Africa during the 1980s where “necklacing” was a form of extrajudicial summary execution which involved drenching a car tyre in a mixture of oil and petrol (or pure diesel) and forcing it around a victim's chest and arms, then setting it alight.  Although never officially condoned by the African National Congress (ANC), it was widely used in black townships as a form of public execution of black Africans suspected of collaborating with the white minority government.  Victims were said to have been “necklaced” and the practice spread elsewhere in Africa, to South Asia and the Caribbean.

Real Housemom’s Irish Coffee Royale

Ingredients

2 oz brandy or cognac
2 oz Irish cream
4 oz brewed coffee (served strong)
Granulated sugar crystals (optional and nor recommended)

Instructions

Warm brandy and Irish cream in small saucepan over low heat, then combine with coffee.  A small amount of sugar can be added but there is sweetness in the Irish cream and the sugar tends to detract from the taste.  The difference between an Irish coffee and a coffee royale is that the former is laced with Irish Whiskey, the latter with brandy or cognac.