November 19, 2006

Fomite: panacea or backformation?

An article by Martin Veitch ("Are dirty keyboards truth or fiction?", Inquirer, 11/17/2006) taught me a new word, and so I'll offer to teach him a research technique in return. Veitch wrote:

Being ignorant about the truth or otherwise of the dangers of dirty keyboards, I asked for expert readers to mail in. Hospital physician Dtaylor took up the filthy gauntlet, replying to suggest that:

“Any ‘fomite’ (medical term for an inanimate object that can transfer contagious disease) can be a problem. Keyboards are certainly one such, and they are hard to clean. (Not as hard to clean as stuffed animals and toys in a hospital playroom, but I digress.) ‘Hospital-grade’ devices that can be cleaned more easily might conceivably help, but are certainly no panacea.”

This is a rare opportunity to correct the OED, which says that fomite is a "rare" variant of fomes (from Latin fōmes, fōmites "touchwood, tinder")

a. The morbific matter (of a disease) (obs.). b. ‘Any porous substance capable of absorbing and retaining contagious effluvia’ (Mayne).

The first mistake here is in the gloss, which reflects an old-fashioned medical misconception. As I understand it, infectious agents are sometimes better transmitted by non-porous surfaces than by porous ones; in any case, restricting the concept to porous substances is wrong. The second mistake is in retaining the original Latin singular fomes, and suggesting that fomite is a rare variant. The OED gives one citation in its entry for fomite:

1859 R. F. BURTON Centr. Afr. in Jrnl. Geog. Soc. XXIX. 134 This must be an efficacious fomite of cutaneous and pectoral disease.

and three in its entry for fomes -- but three of the four are the plural form "fomites":

1773 Gentl. Mag. XLIII. 554 If this putrid ferment could be more immediately corrected, a stop would probably be put to the flux, and the fomes of the disease likewise removed.
1803 Med. Jrnl. X. 213, I cannot say that I have known it spread from fomites.
1851-9 A. BRYSON in Man. Sc. Enq. 248 Either simply through the medium of the atmosphere or by means of fomites.
1882 Quain's Dict. Med. s.v., The most important fomites are bed-clothes, bedding, woollen garments, carpets, curtains, letters, &c.

Presumably fomite is a backformation from the plural fomites. But the current situation seems to be that the back-formation fomite is in wider use than the original fomes.

MEDLINE has 75 hits for {fomite} and 217 hits for {fomites}. There are 54 hits for {fomes}, but 53 of them are instances of fungus species, such as Fomes cajanderi, Fomes fomentarius, etc.). Ironically, in the one article where fomes is used to mean "inanimate object that can transfer contagious disease" (KL Autio, S Rosen, NJ Reynolds, JS Bright, "Studies on cross-contamination in the dental clinic", J Am Dent Assoc 100(3) 1980), it's construed as a plural:

Use of 5% iodophor in 70% isopropyl alcohol was effective in sterilizing certain fomes in the dental operatory.

The wikipedia entry for fomite also implies that this back-formation is now the standard medical term. Encarta has no entry for fomite, giving only fomites as a "plural noun" glossed as "inanimate objects capable of carrying germs from an infected person to another person". AHD gets it right, glossing fomite as "An inanimate object or substance that is capable of transmitting infectious organisms from one individual to another", and indicating that it's a back-formation from the plural fomites of fomes. Merriam-Webster gets it right as well -- the online version gives fomite as a "an object (as a dish or an article of clothing) that may be contaminated with infectious organisms and serve in their transmission", also noting its source as a back-formation.

I didn't know any of this -- or rather, I remembered the fungus species name from an old hobby of mushroom hunting, but I had never heard of the medical term until I looked it up after reading Martin Veitch's article. After quoting Dtaylor's conclusion about fomites -- "'Hospital-grade' devices that can be cleaned more easily might conceivably help, but are certainly no panacea." -- Veitch continues:

Btw, have you ever heard of anybody using the word ‘panacea’ without ‘no’ or ‘not a’ before? But now it’s me that’s digressing.

Having learned a new word from Veitch's article, I'm going to offer to return the favor by pointing out that questions about the distribution of adjacent words can now be explored by using web search. Before I looked, my own memory certainly agreed with Veitch in reckoning that panacea usually gets a preceding negative. But a quick web search turns up plenty of uses like these:

No matter what problems you face in your life, meditation is really a panacea.
Locust-bean bark seems to be a panacea for anything from toothache to impotence.
This book is a panacea for all the misinformation being disseminated about exercise, diet, weight control, and training for sports.
Determination is a true panacea, and cancer cannot win without concession.

And even a W.S. Gilbert lyric (from The Grand Duke):

Come, bumpers – aye, ever so many –
        And then, if you will, many more!
This wine doesn't cost us a penny,
        Tho' it's Pomméry seventy-four!
Old wine is a true panacea
        For ev'ry conceivable ill,
When you cherish the soothing idea
        That somebody else pays the bill!

More interesting, though, web search brings up a kind of phrasal template, often used in headlines, that hadn't occurred to me but is instantly familiar:

X: panacea or Y?

Many examples feature alliteration in the Y position, and sometimes in X as well:

Prozac: Panacea or Pandora?
Pending POPs Pact: Environmental Panacea or Parody?
Trillion FER: Is it panacea or poison?
The ITIL Configuration Management Database: Panacea or Pandora's Box?
Xenotransplantation: panacea or poisoned chalice?
E.Society - panacea or apocalypse?
Total Quality Management: Panacea or Pitfall?
Research governance: panacea or problem?
Appropriate Technology : Panacea or Pipe Dream?
Omega-3 fatty acids - panacea or poison for prostate cancer patients
DNA Evidence: potential panacea or pandemonium?
Situationism: Panacea or Placebo
RFID - panacea or pain?
Digital images: panacea or problem?
Medicare--Panacea Or Death Potion?
Abiotic oil - panacea or pipedream?
E-learning: panacea or pandemonium?
Anti-D in Midwifery: Panacea or Paradox?
Open Access: a panacea or something to be panned?
Growth hormone: panacea or punishment for short stature?

But of course there are plenty of examples without alliteration, or with alliteration only in the X position:

Open access publishing -- panacea or Trojan horse?
Private equity: panacea or crisis in waiting?
Smart Drugs - Panacea or nightmare.
Basel II: panacea or a missed opportunity?
Quantum Theory: Spiritual Panacea or Red Herring?
Outsourcing: Panacea or Bogeyman?
CDM – panacea or niche player?
Broadband aggregation : Panacea or folly?
Flat Panel Displays - panacea or fad?
JavaServer Pages: Panacea or Quagmire

There are lots more -- Google claims 215,000 pages containing the string "panacea or", and another 38,200 for "or panacea". And there's the usual penumbra of variant structures.

These snowclonish headlines may not be counter-examples, however -- it's characteristic of "negative polarity items" that they work in question contexts as well as negative ones, presumably because questions and negations share a property of "non-veridicality".

As the positive examples that I gave earlier showed, panacea is by no means a true negative polarity item. But it's got a sort of preference for non-veridical contexts, all the same.

Posted by Mark Liberman at November 19, 2006 01:00 AM