-Medicine is traditionally known as an 'art', and not an exact 'science'. Medical images of clinical signs and pathology were communicated through 'metaphors' in the 19th and early 20th centuries to make recognition easier in anticipation of the clinical counterpart when encountered in medical practice. They have served as teaching aids, enhancing memory retention for medical students, nurses and doctors and have withstood the test of time. Standard medical textbooks contain metaphors that have become entrenched in teaching, learning and examining in medical schools and hospitals worldwide. The continued use of metaphors has given rise to an ongoing debate, particularly in Africa, due to the usage of inappropriate or unfamiliar metaphors which are not locally or culturally relevant. Despite this, medical analogies will no doubt continue to be useful for medical education, clinical practice and 'aide memoirs' for examinations, and bring light humour, for a long time to come.
KEY WORDS: analogies, clinical medicine, clinical signs, medical textbooks, metaphors, teachingMedicine is traditionally known as an 'art' , and not an exact 'science' , with the practice of bedside medicine being nurtured by experience and everyday encounters. Standard textbooks written in English contain vivid descriptive terminology using metaphors that have become entrenched in teaching, learning and examining in medical schools and hospitals worldwide. 1,2 These texts, written by British authors in English, arose from traditional medical practice in the UK and thus the terms are influenced by local culture. Doctors of all disciplines have been fascinated, and sometimes obsessed, by naming and relating abnormal symptoms, signs and pathology seen in clinical practice to analogous states seen in real life.Translating medical images of clinical signs and pathology encountered in practice through 'metaphors' was necessary due to lack of accurate diagnostic services in the 19th and early 20th centuries. Metaphors relating to familiar analogous items make recognition easier in anticipation of the clinical counterpart when encountered in medical practice and serve as teaching aids, enhancing memory retention for medical students, nurses and doctors. For example, before the advent of microscopy and microbiology, naked eye examination of stools was an essential component of a thorough medical consultation. This experience was related to day-to-day analogous items seen at lunch or dinner with recognition of similarities with items of food. [3][4][5][6] It is not surprising that these resulted in classic descriptions of stools such as 'rice water' stools of cholera, 'pea soup' stools of typhoid, 'red currant jelly' stools of intussusception, and 'anchovy sauce' stools of amoebic dysentery.Over the past century, over 450 metaphors have accumulated in the medical literature 1,5,7 related to fruit, vegetables, cereals, seafood, dairy products, fauna, flora, astronomical bodies, weapons, dining table utensils, laboratory equipment, drinks and c...