For this Mythology Monday, we’re going to talk about Kelpies. They are a mythical water spirit found in lochs in Scotland. They are shape shifters that look like horses but can become human. Kelpies are the dangerous kind of mythological creature, so be careful.
Etymology and Origin
The origin of the word is unclear but it could be from the Gaelic word ‘calpa’ or ‘cailpeach’ which means heifer or colt – words used to describe livestock. A heifer is a young cow, usually up until after she has her first calving. A colt is a young male horse aged 2-4 years.
The first recorded use for a mythological creature appears in an ode by William Collins before 1759, where it was spelled ‘kaelpie’.
Kelpie stories are associated with the majority of significant bodies of water in Scotland, especially Loch ness. The stories are, like many folklore and myths, warning children to stay away from dangers water and warning young women to be wary of handsome strangers.
What are Kelpies Like?
The common description of a kelpie is a stunning black horse. They inhabit the deep pools of rivers and streams, preying on any humans it encounters. Their hooves are reversed compared to normal horses, similar to the nykur of Iceland.
Local variations exist. In Aberdeenshire, kelpies are portrayed as having a mane of serpents, a bit like Medusa. The resident kelpie in the River Spey is white and entices victims onto its back by singing. A bit like siren song.
A similar creature known as each-uisge – literally ‘water horse’ is believed to be the creatures that live in lochs while kelpies live in rivers. The each-uisge is far more vicious.
Tales of the Kelpies
Most of the stories around kelpies involve them taking their victims into the water, eating them and leaving the entrails at the water’s edge. As an equine, a kelpie can extend its back to carry many riders down to the depths.
A common theme in the stories involves several children climbing onto the kelpies back, with one child remaining on the shore. The child pets the horse and his hand sticks to it. Some stories involve him cutting off his hand to get free and survive while the other children are taken and drowned. Several versions of these tales exist, in Glen Keltney in Perthshire, Thurso in Caithness and Sunart in the Highlands.
Kelpies could mate with horses and the offspring were impossible to drown and had shorter than normal ears.
Kelpies can shapeshift and appear to be human. They could be identified by having water weeds in their hair. Many tales describe a kelpie appearing as an old man and potentially attacking people in that form.
Barra’s Kelpie Story
There is a tale from Barra, an island in the Outer Hebrides, where a kelpie becomes a handsome young man to woo a young woman. She recognises him as a kelpie and removes his silver necklace (acts as a bridle) while he sleeps so he reverts to his equine form. She puts him to work on her father’s farm for a year.
The tale does have a happy ending. She rides the kelpie to a wise man for advice. He tells her to return the silver necklace and decides he wants to be a mortal man while she agrees she would be his wife if he was a man. They get married, and presumably live happily ever after. Cute.
In most stories about kelpies, they are male but there are a few tales featuring female ones. When Christianity came along in the 6th century, kelpies were associated with Satan due to their hooves, similar to the Greek god Pan.
Robert Burns refers to this in ‘Address to the Devil’ from 1786:
“When thowes dissolve the snawy hoord An’ float the jinglin icy boord Then, water-kelpies haunt the foord By your direction An’ nighted trav’llers are allur’d To their destruction.”
It was believed that when a kelpie appeared as a horse with no tack, a halter stamped with the sign of a cross could capture it. The kelpie could then be put to work.
The Laird of Morphie
A story exists about the Laird(Lord) of Morhpie using a kelpie to carry stones to build his castle. He released the creature once the job was done and it cursed him in revenge.
“Sair back and sair banes/ Drivin’ the Laird o’ Morphies’s stanes,/ The Laird o’ Morphie’ll never thrive/ As lang’s the kelpy is alive”
Meaning that as punishment for the pain the kelpie endured, the Lord of Morphie wouldn’t survive. This is believed to have resulted in the extinction of his family.
Capturing and Killing a Kelpie
Kelpies might appear with full tack, a bridle and saddle, but if someone mounted them they would run off and drown the person. It was believed you could exorcise a kelpie by removing its bridle. The bridle could have magical properties and transform someone into a horse or pony.
Like many other mythological creatures, certain metals can harm them. They can be killed with a silver bullet, like a werewolf. There’s also a story of a blacksmith killing a kelpie that was scaring his family by stabbing it with two heated iron spears.
Some people believed the Loch Ness monster to be a kelpie and tales of monsters associated with Loch Ness and the River Ness have been around since the 6th century. See my previous article on the beloved Nessie for more details.
The equine aspect of this myth could have roots in horse sacrifices from ancient Scandinavia, according to Derek Gath Whitley.
Many stories of dangerous water spirits exist to keep children away from dangerous water. Many of Scotland’s lochs are dangerous to swim in with hidden currents and drop offs. Shape-shifters posing as handsome men were used to warn young women to be wary. Often these kinds of stories are used as moral lessons, so the creatures only harmed you if you did something wrong.
If you visit Falkirk, you can see the Kelpies at The Helix park. Andy Scott designed the sculptures and the project was completed in October 2013. You can see them from the M9 motorway and they form a gateway of the Forth and Clyde Canal, which meets the River Carron. The Kelpies are 30m tall and at night they are lit up, making for a stunning view.
The project represents the horses that worked in Scottish industry and economy. The Falkirk area has a long history of mining and foundries. It has quite a fascinating history in general. I used to work in Falkirk and I recently visited Callendar House with a friend and learned a lot about it. If you are in the area, I highly recommend visiting the Kelpies for yourself.
Steven Straiton, CC BY 2.0 , via Wikimedia Commons
Welcome back to Fixing Friday. This week is ‘Scene by Scene’ where I go through my notes after reading the first draft and plot out the scenes and what needs changing. At this stage, I’m focusing on the ‘big picture’ stuff. The overall story structure and if everything was in the right place. It did feel like it was missing something.
A New Outline
Before I touched the manuscript again, I worked through a revised outline. I’m what is known as a ‘plantser.’ This means I usually start a writing project with a vague idea and just plough ahead and write, discovering the story as I go. Although I don’t always complete a draft this way. I then go on to create an outline from what I have, to figure out how to get to the ending.
I use the Three Act structure for this story, which is one of the most common story structures, although there are plenty of options. So I took my notes from my first read through and used the plotting tool on Lore Forge to fit all the story events into this structure.
It’s important to have a combination of action and reaction moments. Not every scene has to be high drama and excitement, there has to be space for characters to take a breath and react to their situation. It also gives your readers a moment before moving onto the next thing.
Creating The Outline
So what do I include in this? A few things. I’m learning as I go on this, so my process has improved since this early stage. But here’s the details I included in my revised outline, scene by scene. I created an entire date system for my world and part of the outline included a timeline with dates for each scene.
What happens in the scene? This is probably an obvious one but it is essential.
When it happens in the story. I add the date.
What the scene’s purpose is. Is it character development, discovering new information, a significant event in the plot? There is one chapter where one of the characters makes an important discovery that will lead them to what they need, but it won’t pay off for a long time.
Off the back of the last point, noting if something is significant for a character. Like one of them being forced to confront something from their past, or how they feel about a decision they made.
Scenes should always do more than one thing and worldbuilding is a part of that. I do my best to avoid info-dumping too much, so I try to sprinkle world details throughout and show them through events in the story.
Sub-plots and secondary storylines and how each scene interacts with them.
It’s a lot of detail, but the first draft is only the skeleton. This is where we dig into the meat of the story and flesh it out. I know that’s a bit of a creepy metaphor but it’s accurate.
Next Steps
I examine the outline for consistency and decide if it’s in the right order. Are events following on from each other in a logical way, while escalating the tension? Are there scenes that are not pulling their weight? In which case they either need to be improved or removed.
Cutting scenes is difficult. You wrote them for a reason, but sometimes they are just not doing enough to be there. I hate deleting things permanently, even if I’m ‘killing my darlings’ so I keep old versions of the documents just in case. It needs to happen, though.
After that, I felt ready to start writing the next draft. I chose to rewrite from scratch, using the first draft as a reference. I did occasionally copy over some bits from the original draft but most of it was rewritten. It still felt like it was missing something and I realised that one of the major characters was too involved to not be a main character. That meant I needed to upgrade him and give him his own story arc. I’ll get into more details on that next week.
Outlines are great to have but it’s important to remember that they are not etched in stone. If your outline is not fitting where the draft is going, then it can easily be changed. It’s all a part of the process.
Next week, we’ll be going into how I wrote draft two, upgraded a character to a main character and fleshed out his backstory. So I hope you’ll join me for that.
We all know that the first draft just needs to exist while the second draft is to make it all make sense. That’s what the goal was for this. I have a draft zero for this project where I realised the structure was too much for a single stand-alone book, causing me to rush through to the ending. So I had something to base draft one on, after splitting it up and expanding the story.
The entire thing grew from a random scene I wrote several years ago when I was struggling with insomnia. Which happens a lot. I found it again a while later and started vaguely writing scenes here and there. When my health got too bad and I had to stop working, it occurred to me that it might be a good outlet.
Like many authors these days, I spent a lot of time writing fanfic when I was younger. It helped me cope with university, which was intense and stressful. I enjoyed it a lot and I did mess around with some more original stuff back then. I finally decided to try and make a go of it, so I did. And here we are.
After I finished draft one I took a break from it for a few weeks. I worked on book two and world-building details I knew I was going to need. A lot of experienced authors recommend this and I can see why. When you’ve spent hours and hours working on a draft, it’s all in your mind and that makes it harder to see what isn’t working. Taking a break gives your brain space to return with fresh eyes and see where changes are needed.
The First Readthrough
After I came back to it, I spent some time reading through it and making notes. I do my best thinking and planning with a pen and paper as it makes my brain slow down so I can keep up. I picked it apart piece by piece and figured out what needed changed or rearranged.
I also decided exactly what point in the overall story I wanted to end book one. I did come up with a colour coding system with coloured pens and sticky tabs. That didn’t really help me much so I retired it for the next version.
I was still shaping the story at this point and getting to know the characters. Most of the major events were pretty much set in stone but I felt the opening chapters were very slow. At this point, I was still learning how to use story structuring methods. I wanted to ensure that the plot followed a good structure that made sense and I decided to use the Three Act structure as it made the most sense.
New Software
I discovered a brilliant writing software called LoreForge. (Not sponsored, I just love it) It provides a ton of useful things. It has space for you to put characters, locations, cultures, races/species, discoveries and more. It has guidance and profiles to make sure you cover all the bits you need to cover. It also has a plotting tool where you can choose from several established story structure templates or a custom one.
You can also put in chapter and scene summaries, bookmark pages to access in a side-bar to see while writing and colour coded sub-plots. You can edit metadata for each chapter and scene with POV, characters included and link to notes. This software is so flexible and it is free for offline use or you can pay for the premium version that gives more customisation and cloud storage so you can work from multiple devices.
It has been brilliant for helping me put this story together and I will continue to use it. Books can be exported and the default formatting seems to be pretty good. My later edits are done in Word using tracked changes, one feature that LoreForge doesn’t have. But I highly recommend it for authors, especially if you’re writing fantasy/sci-fi and need to corral a lot of world-building details.
Once I had finished my readthrough and figured out the major changes I needed to make, it was time to plan out the next draft. I’ll get into details on that next week. The thing that helped me the most was taking a break from it. I don’t want to rush and put out an inferior book, especially not with my debut.
Just like Goldilocks and the Three Bears taught us, for life to exist things need to be just right. Temperature regulation in animals is essential. Bodily functions and physiological processes require specific temperatures to work properly. Too hot or too cold, and these functions will fail.
Our planet is at the perfect distance from the sun to have temperatures capable of sustaining life. We have liquid water and an oxygen rich atmosphere which only exists because the temperature is perfect, more or less. There is a temperature gradient where it is hottest around the equator and coldest at the poles. Climate change is also creating a shift in the average temperatures.
Living things function due to a whole range of biochemical reactions which need specific temperatures to be effective and efficient. The specific temperatures needed depend on species and the function in question. For example, many mammals have external testicles because sperm generation is more efficient at temperatures a couple of degrees below the normal body temperature.
Ecosystem Adaptations
The various ecosystems in the world are well adapted to their native environment. Species have evolved all kinds of ways to maintain their optimum temperature. That’s why a polar bear couldn’t survive in the Sahara Desert. Climate change is impacting this, as global temperatures rise. We have many species under threat of extinction, if not extinct already.
For other species, the climate shift might be beneficial. A current example is two different species that live in the Atlantic Ocean. The Atlantic Horseshoe Crab is declining in number as the ocean warms. In contrast, Atlantic Blue Crabs are thriving and their numbers are actually increasing.
So what does this mean? One of my goals with these articles is to help fellow writers understand various factors in the natural world. That way when you are including animals in your writing, whether they are real, mythological or original, they can fit into the right ecological niche. Let’s start with some definitions.
Definitions
Thermoregulation: physiological or behavioural methods for regulating the body temperature.
Endotherm: organisms that can generate their own body heat through their metabolism – colloquially referred to as ‘warm-blooded.’
Ectotherm: organisms that rely on external heat sources to keep their body temperature where it should be and regulate it through behaviours – colloquially ‘cold-blooded.’ It can be used interchangeably with poikilotherm but there are distinctions. Ectotherms generally want to stay at a constant temperature and use the environment to maintain it.
Poikilothermic: this is another term used to describe ectothermic organisms. It comes from the Greek word poikilos which means ‘various’ or ‘spotted.’ There is some crossover with ectotherms but poikilotherms are species that seek to vary their temperature dependent on physiological needs. Most reptiles, amphibians and fish fit this category. Mammals that are poikilothermic include the naked mole-rat and sloths.
Hyperthermia: A physiological state where the body temperature is too high from external means like an abnormally high environmental temperature or failure of the body’s cooling mechanisms. Heat stress or heat stroke are clear examples. Hyperthermia is dangerous as many enzyme reactions fail above a certain temperature and it can result in damage, especially to the brain.
Hypothermia: the opposite, the body is too cold and eventually the normal physiology that attempts to maintain core temperature high enough will fail and this leads to physical damage. It is equally serious and potentially fatal.
Fever/Pyrexia: both words mean the same thing. Fever is different from hyperthermia. The body raises its temperature in response to an infection, which can hinder the infectious agents while boosting the function of the immune system. Fever is unpleasant but it doesn’t always need treatment.
How Endotherms Regulate Their Temperatures
The simplest answer is that endotherms generate heat via their metabolism to maintain their body temperature. It does come with an energy cost, but they are less vulnerable to external temperature changes.
They employ mechanisms that help maintain the right temperature. In cold climates shivering and using up brown adipose tissue (brown fat.) Brown fat can be metabolised much faster than white fat. Many new-born mammals have this fat to keep them warm until they have dried off and had their first feed. For hot climates, things like sweating and panting can help keep the body cool. The circulation system can alter blood flow to lose or retain heat as well.
Endotherms are less vulnerable to external temperature fluctuations such as the day and night cycle. Many deserts get very cold at night, despite being very hot in the daytime.
The downside is having a higher metabolic rate and increased energy demands. This requires more food intake. Endotherms can’t last as long in periods of starvation, in general. Some endotherms will bask in the sun and rest a lot to reduce energy demand. This is why cats enjoy snoozing in sunny spots!
Only birds and mammals are true endotherms but there are some species can become endothermic during their reproductive season. Some endotherms will enter temporary hypothermia, a controlled physiological state that can be part of the normal circadian rhythm.
Hibernation
Hibernation is a longer seasonal cycle, usually to survive over winter when food is less available. It involves lowered metabolic rate, low body temp, slowed breathing and heart rate. Some species will eat a lot of food before winter to store the energy as fat. Smaller animals will use food caching, hiding stores of food nearby. Some of them carry a pregnancy through their hibernation period, such as black bears. They give birth shortly before or after they wake up.
The exact changes differ between species but hibernation is a way of surviving harsh winter weather and prevents a period of starvation. Especially since energy is required to maintain body temperature and if food is less available, it would be difficult to maintain the caloric intake required.
Sloths
Sloths are mammals that behave more like ectotherms. Their body temperature fluctuates according to their environment. This means they are capable of starving to death with a full stomach of food. If the temperature drops too low, they can’t digest their food and it can then rot and produce toxins. This can happen in reptiles too.
Polar animals have specialised structures that help them maintain their temperature in cold conditions. Features like insulating fur, waterproof feathers or blubber under their skin help them stay warm.
Penguins have specialised blood vessels that act as heat exchangers where the veins sit next to the arteries where the blood is warmer, so heat is exchanged to warm the blood returning to the heart.
Hot Climates
Animals that are native to hot climates have peripheral blood vessels that allow them to lose heat – elephants have these in their ears. It’s also why fennec foxes have such large ears compared to their body size. Panting is a common way of losing heat as well, especially in canine species. Some species like humans and horses sweat to lose heat with evaporation. Dogs are at risk of hyperthermia because they don’t really sweat, they only have sweat glands on their paw-pads so panting is their main way of losing heat.
Ectothermic species don’t produce much internal heat from their metabolism and so they rely on the environment to keep their body at the right temperature. Reptiles, amphibians and fish are generally all ectotherms. Most insects are too.
Most deep sea aquatic species are adapted for the temperature of where they live, such as in the abyss level of the ocean. Water temperature is stable and constant so they rarely need to do anything.
Reptiles especially keep warm by basking in the sun to raise their temperature or seeking shade to cool down. They also employ reduced metabolism in the cold to maintain their body and minimise energy usage when food is more scarce. Most reptiles do have body fat stores, usually within the coelomic cavity (abdominal cavity in essence) or sometimes in extremities like the tail. Leopard geckos store a lot of fat in their tails, for example.
Due to this, many ectothermic species are slower at night or early in the morning. They need to warm up before going about their day! They tend to be more active in the daytime although nocturnal species exist. Geckos are usually nocturnal and they wait for food to pass by rather than searching for it as this uses less energy.
Ectotherms can last much longer without food because they are capable of slowing down their metabolism when it is cold. However, if they are unable to find a suitable basking spot and heat, they can starve to death even if food is plentiful. They need to warm themselves to digest and metabolise their food – kind of like the sloths we mentioned earlier. Sadly I have seen this happen in captive reptiles – such as a snake whose basking lamp and heating system broke down after it had been fed and the prey began to rot and made the snake sick. Very sad.
This is the reason that reptiles are not found in the polar areas. Many that live in temperate regions will hibernate or ‘brumate’ over winter. Species that live in the equatorial areas like most of Africa, do not hibernate as there’s no need for it. It never gets cold enough.
Antifreeze
There are naturally occurring anti-freeze proteins. Yes, really. Some species of fish, amphibians and reptiles can freeze in the winter and wake up in the spring. They survive with the help of antifreeze proteins that prevent ice crystals forming in the body. These crystals would damage the organs and kill the animal without these proteins. Just like the radiator of a car!
Some plants also have this capability. Many of the cabbage related vegetables can do this like kale, spinach, brussels sprouts. Hellebores, pansies, cornflowers, poppies and lavender produce antifreeze proteins.
Interestingly the sacred lotus, an aquatic plant that grows in ponds and deltas, or in flood plains. It is the national flower of India and has the ability to regulate the temperature of its flowers just like an endothermic animal. This seems to be a way of attracting insect pollinators by promising a cosy environment, I suppose!
Species have adaptations to suit their native environments and make sure they can survive the conditions they live in. This is why introducing non-native species can be difficult and detrimental to the local ecosystem. Animals that live in colder climates will struggle when it is hot, and vice versa. That’s why huskies love being outside in the snow and ice, while a greyhound will hate it and usually require a coat of some kind to go outside in winter. Just like us, we don’t have much body hair to insulate us, which is one reason we wear clothes.
Hyperthermia
This is defined as overheating, where body temperature is elevated above normal. It is due to a failure in thermoregulation or temperature extremes beyond what the body can cope with. This is not the same as a fever, or pyrexia, which we’ll get to.
Hyperthermia is a medical emergency in both humans and animals as it can result in death and significant damage, particularly brain damage. Heat stroke where the body temperature is elevated from excessive heat exposure that overwhelms the body’s temperature regulation. Severe cases will result in blood pressure drops, confusion, dehydration and even seizures. Organ failure and death will result if not attended to.
Heat stroke is very serious, especially in young or elderly people. Dogs are also very vulnerable to it, especially the brachycephalic (flat faced breeds) like bulldogs. They struggle to pant enough to cool down because of their restricted airways and I have seen dogs die from heat stroke, or suffer permanent damage from it. PSA – do not leave dogs, young children or animals in a hot car in summer. Exertion in hot weather is also a risk for both people and animals so avoid long walks, running about or doing anything strenuous when it is excessively hot.
Hypothermia
The opposite – remember your prefixes. Hyper- means too high, while hypo- means too low. Hypothermia occurs when the body temperature drops too low and the body cannot maintain internal heat generation to sustain it. It can be serious and risks death in some cases too.
Mild cases will show confusion and shivering – this is muscle contractions to try and generate some heat. Once hypothermia progresses the shivering stops. Severe cases can result in hallucinations and a risk of death. People will often show paradoxical undressing in severe hypothermia. This is likely due to the blood flow. In cold temperatures, the peripheral vessels (arms and legs) contract to keep blood pressure and heat in the core of the body. They become exhausted and relax, allowing blood to flow and make the person feel warm, so they start stripping off. Which makes the whole thing worse. Very scary.
Hypothermia can be caused by exposure to cold weather, especially cold water immersion like falling through the ice of a frozen lake. Being wet increases heat loss from the skin. There are other factors that can impact temperature regulation. Low body fat, old age and low blood sugar increase the risk of hypothermia. So does alcohol intoxication – it’s not uncommon in winter for people to present with hypothermia after a night out where they have overindulged. Alcohol can make you feel warmer and thus not notice the cold.
It should be noted that the heart rate drops and respiratory rate also slows down. If you’ve watched Grey’s Anatomy, you will have heard the phrase: “They’re not dead until they’re warm and dead.” That is true, as even if there’s no detectable pulse, with aggressive rewarming and medical care, people can be revived. The same applies to some small animals where they can appear to be dead when cold but recover when warm – hamsters are notorious for this one! So you should always attempt to warm them up in case they can recover.
Fever
Finally, fevers are a different thing altogether. The body has it’s internal regulation system that keeps the temperature at a ‘set point’ in endothermic animals. The hypothalamus is responsible for this. In case of infection and an immune response, this set point is increased to raise the body temperature. Fever is thought to improve effectiveness of white blood cells and hinder the reproduction of pathogens like bacteria.
It’s a common symptom of illnesses, particularly infections. This can range from the common cold, where recovery will happen in a few days, and sepsis which is much more serious and requires intensive intervention. It is important to distinguish a fever from hyperthermia, as hyperthermia is much more life threatening.
Treating a fever may not always be necessary or recommended but there isn’t much evidence that treating the fever with antipyretics like paracetamol improves or affects outcomes in sepsis. Fever is uncomfortable and unpleasant to experience but it is rarely life threatening in itself, even if the cause is serious. Rarely young children can experience ‘febrile seizures’. Fever makes you miserable and can affect cognition. It is not the same as hyperthermia, though, and fevers do seem to be beneficial in aiding the body fighting off pathogens.
Regarding animals, normal temperatures vary by species. So the threshold for a fever is different in dogs to chickens. Normal human body temperature is accepted to be around 37°C or 98.6°F. Fever would be above 38°C or 100.4°F. In dogs the normal temperature is between 38.3°C to 39.2°C or 101°F to 102.5°F. Fever is above 39.4°C or 103°F. In chickens normal temperature is 40.6°C to 41.7°C (105°F to 107°F). Anything above 43°C or 110°F is a fever in this species.
What happens when characters take control of your narrative? This is a familiar situation for many writers. It can be frustrating when the characters just walk all over your carefully planned outline. Our plans and early drafts are how we really get to know our characters and that means that things can change during the process. So let’s talk about when characters take over and whether you should let it happen or not.
Plans Change All The Time
Not everyone likes to plan their stories out but even ‘pantsers’ have some idea of what’s going on and where the plot will go. For others, having a detailed outline is essential for structuring and writing the narrative. I personally work with a combination of both but I spend a lot of time getting to know my characters, both through detailed backgrounds and profiles and through writing them.
However, sometimes people get stuck on their outline because they get through two thirds of the story and realise the next plot point makes no sense. Or the character has changed and their next move is now out of character for them, which can be jarring for the reader. Trying to force them to get back on track with the plan makes the writing feel forced, which can contribute to writer’s block.
It’s okay for things to change as you write. It’s pretty normal, actually. Your plan is simply a guideline for the original idea and if a new idea or direction feels better then you can absolutely follow the new path. I wouldn’t throw out the original plan and any scenes or chapters you decide to remove, though. Keep them in a separate file, just in case you want to refer back to them or use them somewhere else.
What if the Characters Take Over?
As you write, you get to know your characters better. No matter how detailed their profile and background might be, you’ll still find yourself learning things about them. As you understand them better, you know how they’re going to respond to events. You know what kind of decisions they will make.
This means that the characters ultimately take control of the narrative and can push it in unexpected ways, even for the writer. If that’s what is happening, I think it’s okay to let it happen if that makes more sense to you. Being too rigid about your outline can stifle the flow of your writing and block your creativity. So if it feels right, let it happen.
My Example
In my current work-in-progress, one of the secondary protagonists has been upgraded to a primary protagonist. Aidan Kynaston joins the other two main characters on their journey. However I felt he was introduced quite late in the story. He also has an important plot point later on, so I realised he needed to play a bigger role in the story.
The other reason was that the first half of the book focused exclusively on the other two main characters. So introducing a few chapters focused on Aidan before he meets up with the other two made sense. Including his point of view also facilitated adding more world-building and details about the stakes.
Aidan also decided to tell me an important dark secret which I could then show to the reader to add more of his internal conflict. It makes him a lot more interesting, especially in his interactions with my morally grey assassin Alonso. They’re getting to know each other and I think it’s going to be very interesting going forward.
So really, I had no choice but to upgrade him to a full main character with his own chapters and tell more of his story. I’m excited to see where this ends up taking him, alongside my other characters. I am having a lot of fun putting it together. I’m hoping to have it ready for beta readers very soon.
My Advice to Other Writers
If your characters are taking control of your story and the original plan no longer feels right, I would let it happen. Your best work will come by letting the story tell itself so forcing yourself to stick to the original outline can weaken your story.
I think planning can be a helpful tool to structure your writing and keep your story on track. But it doesn’t have to be rigid and set in stone. Characters can take on a mind of their own, but do you know what that means? That means they’re well developed and becoming who they are supposed to be. So if your characters take control, you might be surprised how much better your story is if you let them.
Have your characters taken control? Let me know your thoughts, and subscribe below if you want to see more. Every week I’ll be sharing some insights into my writing process or talking about a related subject.
The body needs energy to function. This energy must be obtained from food, processed and metabolised so it is ready for the cells to use. Glucose, a sugar molecule, makes up the most important energy source. The brain alone uses 20% of the glucose produced by the body.
Like many other factors, blood glucose must be maintained at the correct levels for everything to function as it should. Blood glucose and blood sugar are the same thing, so we’ll use ‘glucose’ going forward. The two main hormones oppose each other to maintain the balance of blood glucose.
Important Definitions
Glucose: a small sugar molecule the body uses for energy to function.
Glycogen: a long branched molecule, made up of glucose molecules. It acts as storage of energy for later use, mainly in the liver and skeletal muscles.
Glycogenolysis: the breakdown of glycogen into glucose.
Glycogenesis: the creation of glycogen from glucose. Don’t mix these two up!
Gluconeogenesis: the process of making glucose from non-carbohydrate sources such as fats and proteins.
Hypoglycaemia: low blood glucose.
Hyperglycaemia: high blood glucose. Don’t mix these two up, check your prefixes!
Insulin: The Anabolic Hormone
The hormone insulin controls anabolism: the storage and utilisation of energy. Insulin secretion takes place in the beta-cells of the islets of Langerhands, within the pancreas. It promotes glucose uptake from the blood into the body cells. It also promotes glycogenesis and fat generation, in other words, the storage of energy.
High blood glucose levels stimulate insulin secretion by the pancreas, with the aim of reducing blood glucose to normal again. For this reason, insulin follows a cycle where it is released shortly after a meal to store away the energy from food.
Most people have heard of diabetes mellitus, an endocrine disease involving insulin function. There are two main types of diabetes mellitus, which I am specifying because there is another kind of diabetes that is less well known, diabetes insipidus. So, let’s look at the details of diabetes mellitus.
Type 1 Diabetes Mellitus
An autoimmune condition, the immune system attacks the beta-cells in the pancreatic islets. Insulin production is halted or massively reduced, which is why T1 diabetics need to inject insulin regularly to manage their blood glucose. The result is excessively high blood glucose.
Type 2 Diabetes Mellitus
This form is much more complex and still not completely understood. Various risk factors contribute to reduction of beta-cells and insulin resistance. The cells don’t respond to insulin like they should and take up glucose from the blood. Increased glucagon secretion, unresponsive to blood glucose, could also be a factor.
The end result is a persistent hyperglycaemia which results in the symptoms of diabetes. We’ll cover the details of this later.
Glucagon: The Catabolic Hormone
Glucagon opposes insulin, counteracting all of its effects. The alpha-cells of the pancreatic islets produce glucagon in response to low blood glucose. Glucagon raises blood glucose and fatty acids, stimulates glycogenolysis and gluconeogenesis. In other words, taking glucose out of storage and making more of it.
Excessive glucagon levels contributes a lot to the development of hyperglycaemic ketoacidosis in undiagnosed or poorly managed type 1 diabetics. Ketoacidosis (DKA) becomes a diabetic coma if untreated and is life-threatening.
The Effects of Hyperglycaemia
An excessively high blood glucose impacts almost all of the body in some way. The main symptoms of diabetes mellitus include the triad of polyphagia, polydipsia and polyuria. Polyphagia means increased appetite or eating more than normal. Polydipsia means increased thirst or drinking more than normal. Polyuria means producing more urine than normal, referring to volume rather than frequency. That said, a higher volume of urine will typically increase the frequency of urination.
Other symptoms include vision changes, fatigue, weight changes, poor wound healing, neuropathy (tingling in legs and feet), recurrent infections, coma and seizures.
As mentioned before, ketoacidosis is a life-threatening complication of persistently high blood glucose levels. When the cells can’t use glucose, they produce ketone bodies to make energy from instead. These ketones make the blood more acidic and cause damage. Some people can smell the ketones, usually described as a ‘fruity’ smell or like nail polish. I personally can’t smell ketones very well.
Other diseases cause hyperglycaemia including other endocrine disorders, sepsis and brain pathology. Certain medications also affect blood glucose, particularly certain steroids, beta-blockers, statins and antipsychotics.
Stress impacts blood glucose, as the physiology of stress prepares the body for fight or flight, including making energy available. Stress induced hyperglycaemia matters a lot in cats, because they show extreme changes in blood glucose when stressed. For this reason, diagnosing diabetes mellitus in cats is not straightforward.
Most cats are stressed simply visiting the vet, especially if a blood sample is taken, so one high glucose result in a cat means nothing. Further testing needs to be done to confirm a diagnosis of diabetes.
The Effects of Hypoglycaemia
Hypoglycaemia is more immediately life-threatening than hyperglycaemia. Symptoms of low blood sugar include headaches, confusion, light-headedness, heart palpitations, anxiety, nausea and tremors. Severely low blood sugar causes seizures, loss of consciousness and even death.
The brain relies on glucose for energy, with no other option available to the cells. Hence the neurological symptoms and risk of seizures and brain damage.
Excessive insulin causes hypoglycaemia, whether it is an accidental overdose, not eating after taking insulin, being injected with insulin when not diabetic or an insulinoma. Insulinomas are tumours of the pancreatic islet cells and while benign, they produce insulin in an uncontrolled way.
Adrenal disease like Addison’s disease (hypoadrenocorticism), sepsis (glucose stores are used up) and other serious illnesses can cause low blood sugar too. Alcohol consumption, fasting and intense exercise, especially if diabetic will risk hypoglycaemia. Starvation, including eating disorders and neglect as well.
Xylitol, the artificial sweetener, causes a rapid release of insulin in dogs. This results in hypoglycaemia and liver damage. Xylitol only affects dogs in this manner, but it is a common ingredient in gum, mints, peanut butter, medications, supplements, sunscreen, toiletries and cosmetics. Dog owners, beware because xylitol toxicity is an emergency and needs rapid treatment.
Thanks for reading! April’s themes will be the physical impact of mental health problems on Mondays, and cats on Fridays for our Creature Features! Subscribe for updates when new posts are live. See you soon!
The ‘stress hormone’ cortisol is extremely important for managing and regulating the body’s response to stress. Cortisol regulates metabolism, the response to stress and the immune system. The adrenal glands release cortisol, regulated by the hypothalamus and the pituitary gland in the brain.
Adrenal Glands
The paired adrenal glands live just above each kidney and are directly connected to part of the autonomic nervous system. The adrenal medulla produces adrenaline (epinephrine) and noradrenaline (norepinephrine), both of which play a role in the ‘fight or flight’ response. Read more about that system here.
The adrenal cortex produces glucocorticoids, of which cortisol is the most important. The hypothalamus regulates cortisol secretion via the HPA axis, the hypothalamus—pituitary—adrenal cortex axis. A negative feedback loop maintains cortisol at an appropriate level.
The hypothalamus releases CRH – corticotropin releasing hormone. This stimulates the anterior pituitary to secrete ACTH – adrenocorticotropic hormone. ACTH reaches the adrenal glands and causes cortisol secretion. Cortisol levels feed back into the hypothalamus and pituitary gland to reduce secretion of CRH and ACTH, keeping cortisol levels where they need to be.
Role of the HPA Axis
This system maintains homeostasis in the body by regulating metabolism, the cardiovascular system, immune system, reproductive system and the central nervous system. That’s a lot of jobs! Serious illness results from this system going wrong.
Cortisol
A glucocorticoid or ‘steroid’ hormone, cortisol is the stress hormone. It follows a diurnal cycle, increasing after waking, slowly dropping until late afternoon. It then resurges before dropping to its lowest point in the middle of the night.
Pharmaceutical versions include hydrocortisone, prednisolone and several other ‘corticosteroids’. Applications include treating inflammation, managing autoimmune disorders, chemotherapy and treating allergies.
The Effects of Cortisol
Glucose Metabolism
Cortisol stimulates glucose synthesis and the breakdown of glycogen in the muscles. It also increases the breakdown of fats and blocks insulin. It causes insulin resistance in an effort to increase blood glucose levels, i.e. blood sugar.
Immune System
Cortisol reduces the immune response, the inflammation cascade and reduces T-cell growth. That means it is immunosuppressive. This is why pharmaceutical steroids are used to treat immune-mediated and autoimmune diseases like rheumatoid arthritis, psoriasis, eczema and allergies.
Cortisol delays wound healing, because it suppresses inflammation. The inflammation process plays a role in healing of wounds, whether injuries or surgical. Steroid treatment is withdrawn prior to surgery whenever possible, for this reason.
Electrolytes and Water Homeostasis
Cortisol increases GFR (glomerular filtration rate), in other words, function of the kidneys. It causes excretion of phosphate and potassium, along with water and sodium retention. Too much cortisol or not enough cortisol will cause electrolyte disturbances.
Cortisol also stimulates secretion of stomach acid, which explains why chronic stress causes problems like heartburn and stomach ulcers. People who are stressed for a long time have high ciruclating cortisol levels.
Memory
Cortisol combined with adrenaline stimulates memories of short-term emotional evens in order to ensure we avoid the same thing in future. This effect is part of how trauma affects the mind and body in the long term. It is absolutely a factor in the development of PTSD.
Long term exposure to excess cortisol damages the hippocampus, the part of the brain essential for storing long term memories and learning. This means excess cortisol impairs the ability to learn.
Pregnancy
During pregnancy, cortisol plays two essential roles. At 30-32 weeks gestation, cortisol stimulates production of pulmonary surfactant. Surfactant allows the lungs to expand when the first breaths are taken after birth. Without it, the newborn cannot breathe. One of the byproducts of beef production is extracting this surfactant from the cow’s lungs. Cattle lung surfactant massively improved survival rates of premature babies.
The second role is to stimulate parturition, to initiate labour. Foetal cortisol triggers conversion of progesterone to oestrogen which in turn stimulates prostaglandin secretion and oxytocin receptor development. Oxytocin is the hormone that stimulates contractions of the uterus. Because it reduces progesterone, treatment with steroids can induce miscarriage in early pregnancies.
Stress
So why does this matter? The adrenal glands function to help the body cope with stressors. Adrenaline and sympathetic nervous system is there for acute dangers and cortisol is there for longer term stresses. If you are writing about someone who has been living a stressful life, they will have high levels of cortisol which impacts their physiology.
Cortisol increases insulin resistance and thus contributes to potential risk factors for type 2 diabetes mellitus. Research into this is ongoing and while stress or high cortisol alone isn’t enough to cause diabetes, it could be part of the complex of risk factors.
Cortisol affects the immune system and impacts immune-mediated disease. Interestingly, cortisol can both suppress the immune system and over-activate it. We know that stress impacts autoimmune diseases.
The HPA axis is regulated by dopamine, serotonin and norepinephrine – neurotransmitters responsible for regulating mood and emotions. This connection shows how psychological stress impacts our physiology, and vice versa.
Oxytocin down-regulates the HPA axis, reducing stress. Oxytocin is the ‘love hormone’, aside from its role in giving birth and milk let down in animals, it is released when we are close with people we love, including hugging and even during orgasm. So it proves that spending time with those we are close to can help reduce stress. This even applies to our pets!
I talked previously about the term ‘psychosomatic’ discussed in the medical terminology series. Psychosomatic means that psychiatric changes, such as mental health disorders, have an impact on our physical bodies. It does not mean that your problems are ‘all in your head’ and not real. They are real, and mental distress has an impact on our physiology too.
Endocrinology for writers is the new Monday blog series for March. Endocrinology is the study of the system of hormones and signals the body uses to manage its functions. It’s a complex subject and many people find it confusing. I’m here to help try to make it easier to understand.
Why will this help writers? It allows you to understand important body functions such as responses during stress and fear, illnesses and conditions like diabetes and reproduction. Knowing what each of the important hormones actually do helps you understand and describe the effects and behaviours. So let’s get into it with some definitions.
Endocrinology Definitions
Hormone: signalling molecules secreted by endocrine glands to regulate physiology and behaviours. Hormones take different forms; amino acid complexes, steroids, eicosanoids, leukotrienes and prostaglandins.
Glands: glands that produce and secrete hormones into the bloodstream. Some organs have endocrine functions as well as their other functions in the body.
Neuroendocrine system: thepart of the brain that connects to the endocrine system and controls the release of hormones based on input from the nervous system.
Axis: a sequences of endocrine glands that signal each other in a specific order to control hormone secretions.
Homeostasis: the steady state of optimal physiological function. The endocrine system manages the body in order to maintain this.
Tropic hormones: these hormones target other endocrine glands and organs to stimulate them to produce other hormones. The anterior pituitary gland secretes the majority of these hormones.
Feedback loops: the endocrine system has negative feedback loops that control the production of hormones. For example, high levels of cortisol will cause the hypothalamus to stop producing hormones that stimulate cortisol production. This stops the body producing too much of a hormone.
Endocrine Glands and Organs
The endocrine system involves the entire body and many organs and glands are involved, both secreting hormones and responding to hormones. The neuroendocrine system is the part of the brain responsible for controlling hormone release.
Neuroendocrine System
Pineal gland: the pineal gland within the brain produces melatonin, a homrone derived from serotonin, which regulates the sleep cycle. The pineal gland links to a light sensing organ called the ‘parietal eye’ or ‘third eye’ in reptiles and amphibians. This is most notable in tuataras, a lizard-like reptile that is the last surviving species of its category.
Hypothalamus: this part of the brain organises inputs from all other parts of the brain and responds by releasing hormones and tropic hormones. This triggers the pituitary gland.
Pituitary Gland: there are three lobes of the pituitary gland:
Anterior: responds to tropic hormones and releases other hormones
Intermediate: only functional in the foetus
Posterior: direct nerve connection to hypothalamus and produces oxytocin and vasopressin (anti-diuretic hormone or ADH)
This system controls all aspects of reproduction; bonding, sexual behaviour, spermatogenesis (sperm production), ovarian cycle, parturition (giving birth), lactation (milk production) and maternal behaviour.
It also controls regulation of metabolism, eating and drinking, fat metabolism, mood regulation, fluid and electrolyte homeostasis and blood pressure.
Glands
Glands are organs that specifically produce hormones as their main function. You may know some of them already. So let’s get into the details.
Thyroid gland: The thyroid gland is located just below the larynx and has two lobes. It secretes the thyroid hormones thyroxine (T4) and triiodothyronine (T3) to control metabolism.
Parathyroid glands: Four tiny glands located behind the thyroid gland, hence the name. The parathyroid glands produce parathyroid hormone (big surprise!) an important hormone for calcium homeostasis.
Adrenal Glands: a pair of glands located above the kidneys, split into two regions with different functions. We’ll cover this in detail in a later post.
Adrenal cortex: produces glucocorticoids, mineralocorticoids and androgens
Adrenal medulla: adrenaline (epinephrine) and noradrenalin (norepinephrine)
The adrenal glands also produce dopamine and enkephalin
Gonads: the primary organs producing sex hormones and gametes. I’m including the uterus and placenta too.
Testes: the male gonads produce androgens such as testosterone, oestradiol (estradiol Am. Eng.) and inhibin.
Ovaries and Corpus Luteum: progesterones, oestrogens (estrogens Am. Eng.) and inhibin.
Placenta: progesterone, oestrogens, human chorionic gonadotrophin (hCG) and human placental lactogen.
Uterus: during pregnancy it produces prolactin, which stimulates milk production, and relaxin which affects blood flow and relaxes the pelvis and birth canal.
Organs With Endocrine Functions
Several organs have endocrine functions in addition to their other functions. Not only do they produce hormones, they also respond to hormones as well as other changes in the body’s physiology.
Pancreas: the pancreas has exocrine functions (digestive enzymes) and endocrine functions related to blood glucose (blood sugar) and metabolism.
Insulin – produced in the β-islet cells (beta-islet) to reduce blood glucose and stimulate glucose uptake by cells.
Glucagon – produced in the α-islet cells (alpha-islet) to increase blood glucose and glucose production in the liver.
Somatostatin – produced in the δ-islet cells (delta-islet) to inhibit release of insulin and glucagon.
Kidneys: the kidneys produce erythropoietin which stimulates production of red blood cells in the bone marrow. They also release renin, which is involved in the RAAS system and calcitrol, the active form of vitamin D3.
Liver: produces insulin-like growth factor (IGF), thrombopoietin (THPO) to stimulate platelet production, hepcidin, angiotensinogen and angiotensin. The later two are also part of the RAAS system, which we’ll cover at a later date.
Heart: ANP (atrial natruiretic peptide) and BNP (brain natruiretic peptide) released from the muscle cells of the heart control blood pressure.
This covers a basic introduction to endocrinology for writers. Over the next few weeks we will cover the important systems that will help you understand how important endocrinology is for our behaviours and emotions. Don’t forget to subscribe for more updates and find me on my social media channels.
Let’s discuss the cultural impact of snakes. Snakes form an important part of many cultures in the world, both modern and historical. Ophidiophobia (phobia of snakes) is commonplace. Last week, we discussed the potential dangers certain snakes pose. The main risks include venomous bites and the largest constrictors. Non-venomous snakes are not a threat to humans.
Snake Charming
You will know this from various cartoons and movies. Snake charming is an Indian roadside show where the charmer plays a flute-like instrument and the snake responds to the music. Typically, the Indian cobra species.
The snake is actually responding to the movement of the instrument, they lack external ears so they don’t hear in the conventional sense. Animal welfare laws prohibit snake charming.
Snake Catchers
The Irula tribe from India have been catching snakes for generations professionally. The snake skin industry was outlawed in 1972. The Irula tribe now catch the snakes to milk their venom. The venom is collected and used for producing antivenom, biomedical research and other medicinal products.
There are modern day experts elsewhere in the world, who specialise in catching snakes both for study and to remove them from homes and property.
Consumption
Many people eat snakes, especially in Asia: China, Taiwan, Thailand, Indonesia, Vietnam and Cambodia. Snakes are believed to have health benefits and aphrodisiac properties. Snake wine, which is wine infused with whole snakes, is used in Chinese traditional medicine.
Pets
People keep snakes as pets, especially the more docile smaller snakes like the corn snake and the ball python. Snakes require specialist housing for optimum health but usually only need fed once every week or two. You need to seek expert veterinary care for snakes as well, not all vets are knowledgable or comfortable handling them.
Symbolism and Mythology of Snakes
Ancient Mesopotamia
Nirah means ‘little snake’ in Sumerian. Nirah is a messenger god and may be lord of the underworld. Sumerian art features representations of two intertwined serpents. Ancient deities iconography in Assyria and Babylon feature snakes.
Hopi Tribe of Arizon
The Hopi Native American tribe celebrate snakes as a symbol of fertility. They release snakes into the fields to guarantee good crops. So they represent the umbilical cord joining all humans to mother Earth.
Egypt
Ancient Egyptian iconography commonly incorporates snakes. The Nile Cobra adorns the crown of the pharaoh. Snake iconography associated with Ra, Wadjet, Renenutet, Nehebkau and Meretseger.
More sinister purposes for snakes exist in Ancient Egypt – using them to murder an adversary or to comit a ritual suicide. Cleopatra is famous for allowing an asp (Egyptian Cobra) to bite her, according to popular belief.
Ouroboros
Found in Ancient Egyptian iconography and Greek magical tradition, the symbol of a snake eating its own tail. Gnosticism, Hermeticism and alchemy adopted the ouroboros icon.
The ouroboros represents the eternal cyclic renewal, or a cycle of life, death and rebirth. Snake’s shed their skin as they grow, hence this is representative of the transmigration of souls or immortality.
The act of biting its own tail is a fertility symbol in some religions: the tail is a phallic symbol and the mouth is a yonic or womb-like symbol. So, the ouroborous represents sexual intercourse and reproduction.
Ancient Greece: Medusa
The legend of Medusa depicts a monster with snakes for hair that can turn those who look at her into stone. The hero Perseus slayed Medusa. She had two sisters, Stheno and Euryale who were both gorgons as well. Her image symbolises warding off evil.
In Ovid’s Metamorphoses the tale of Medusa is a bit different by comparison. Medusa, a priestess of Athena and suffered sexual assault by Poseidon, the god of the sea. Athena turned her into a gorgon after this. Some say as punishment, others believe it was so she could protect herself. Because of this, Medusa is an important symbol for sexual assault survivors in the modern day.
Asclepius
The Greek god of healing, Asclepius, represented by a rod or staff with a serpent wrapped around it. The sick and injured went to Asclepius’ temples for healing and care. Hence, the staff of Asclepius became a symbol for medicine.
Similarly, Hermes’ staff, Caduceus has wings and two serpents intertwined around it. With a V included in the symbol, it represents veterinary medicine. Hermes was messenger to the Olympian gods.
India
Indian traditions and deities feature snakes a lot. Shiva has a cobra around the neck. Vishnu is sometimes depicted as sleeping on a seven-headed snake or within the coils of a serpent.
Temples dedicated to cobras called Nagraj are common. Snakes symbolise fertility and people celebrate them during the Hindu festival of Nag Panchami.
China
The Chinese Zodiac features snakes as one of the twelve celestial animals. 2025 is the year of the snake, hence my choice of topic for this month. Snakes associate with traits like intelligence and unscrupulousness. Ancient China related snakes to the river deities.
Christianity and Judaism
The Garden of Eden
We can’t talk about snakes in culture and society without discussing this. In the book of Genesis, a serpent tempts Eve to eat the forbidden fruit from the Tree of Knowledge. God throws Adam and Eve out of the Garden as punishment and this confers the concept of ‘Original Sin’ on humanity. Whether you believe it or not, nobody can deny the importance of this story on shaping our society and culture. Genesis doesn’t name the serpent, but it is a common belief that the serpent is the Devil.
Moses
In the book of Exodus, Moses turns his staff into a snake as proof of God’s power. In the book of Kings, God instructed Moses to create the Nehushtan – a bronze snake on a pole that cured people of snake bites in the desert.
Satan
The final book in the New Testament, the book of Revelation contains the final mention of serpents in the Bible. There, serpents are symbolic of Satan, the fallen angel who tempts people towards sin. He plays a role in the apocalypse described by the book of Revelation.
It’s clear that snakes represent evil and sin in Christianity. There is less of this in Judaism and Islam.
Conclusion
It’s clear that snakes play an important role in a lot of cultures. They can symbolise fertility, the cycle of life, rebirth, evil and temptation. People fear and revere snakes across the world. Often maligned and misunderstood, yet they have played an important role in shaping society as it is today.
However, snakes also represent healing, recovery and caring for people and animals alike. I love snakes, they are fascinating creatures and get a bad rap. They have personalities, unique abilities and an important place in the ecosystem.
I hope you enjoyed this summary of the snakes cultural impact and why they matter so much. They have a number of representations which you can use in your writing to symbolise different things. As always, if you have any thoughts or questions, I’d love to hear them.
Understanding medical terminology – colour, position and quantity. These word roots are essential for accurate descriptions of medical and anatomical items.
Many words used to describe the colour of something in the medical world exist. Both Latin and Greek roots are used for the most part with the exception of yellow which also has a French prefix. These roots are combined with suffixes to describe many things. Here’s the list of prefixes:
Colour
Greek Root
Latin Root
French Root
Black
Melan-
Atr- or Nigr-
–
Blue
Cyan-
Cerule-
–
Gold
Chrys-
Aur-
–
Grey
Poli-
Can-
–
Green
Chlor-
Vir-
–
Purple
Porphyr-
Purpur- or Purpureo-
–
Red
Erythr- or Rhod-
Rub-, Rubr- or Ruf-
–
Red-Orange
Cirrh-
–
–
Silver
–
Argent-
–
White
Leuc- or Leuk
Alb- or Cand-
–
Yellow
Xanth-
Flav-
Jaun-
Once you know these roots you will spot them in medical words and in Latin names for species. You’ll find that you recognise some of these words already. So let’s take a look at a few examples:
Cells
The suffix ‘-cyte’ refers to a body cell. So melanocytes (black cells literally) are the cells in the skin that contained melanin pigment. Melanoma means a cancer of these cells. Erythrocyte translates literally as ‘red cell’ so it’s referring to red blood cells. Leucocyte (also spelled leukocyte) is a white cell – white blood cells.
-osis
This suffix means ‘condition, disease process or increase’ and is used a lot. Cyanosis means a blue discoloration of the skin/lips due to hypoxia (low oxygen). You describe someone as ‘cyanotic’ which is the adjective form. Poliosis describes a localised patch of grey or white hair. Chlorosis describes a yellow/green tinge to the skin in cases with severe iron deficiency.
Bile Pigments
Two of the main bile pigments use the latin roots. Bilirubin is the red bile pigment. It is produced in the liver by breaking down dead red blood cells. Another bile pigment, which is responsible for the green/yellow colour is biliverdin. You can guess that the prefix ‘bili’ relates to the bile.
These pigments build up in the body due to liver or gall-bladder disease or a condition causing high destruction of red blood cells. This leads to the bile pigments moving into the body tissues and causing a colour change. It’s usually first noticable in the white of the eye (sclera) but eventually will change the skin and mucous membranes. This is called ‘jaundice’ and uses the French root. A fancy way of saying you look like a Simpson.
Albumin
Albumin is a protein that is found in the blood. It has a lot of functions, including transporting other substances and osmotic pressure to maintain the right balance of fluid between the cells and the circulation of the body. It is also found in egg whites, hence the name!
Porphyria
Porphyria is a disorder where porphyrins build up in the body. Porphyrins are used to make haem, the protein and iron molecule within red blood cells that carry oxygen around the body. Porphyria causes seizures, vomiting and all kinds of horrible symptoms, but it’s usually genetic.
One of the key characteristics is the change in urine colour in response to sun exposure. The urine will turn purple. Porphyria causes an extreme sensitivity to sunlight. It has been theorised that this might explain some aspects of legends around vampires and werewolves but this may not be true. There are a number of historic royals who are suspected to have had this disease, including Mary, Queen of Scots and Maria I of Portugal. Vincent Van Gough, the artist, may have suffered from acute intermittend porphyria.
Medical Terminology – Roots Of Position
These roots describe locations in a lot of adjectives and nouns in the medical world. They can tell you where something is located, or which isomer of a molecule is present. Isomers are molecules that are identical in terms of properties, except for the direction they rotate polarised light. Such as ‘levothyroxine’ which is an L isomer of thyroxine (T4), the main thyroid hormone. Only the L isomer is active, the D isomer has no effect on the body.
Description
Greek Root
Latin Root
Around/Surrounding
Peri-
Circum-
Internal/Within
Endo-
Intra-
Left
Levo-
Laev- or Sinistr-
Middle
Meso- Mes-
Medi-
Right
Dexi-
Dex-, Dextr- or Dextro-
So here’s a few examples: Pericardium is the tough capsule that surrounds the heart. It contains a small amount of fluid and is there to protect the heart. So ‘peri-‘ means around and ‘cardium’ means the heart.
Endometriosis
Endometriosis is a topical condition right now, because it takes an average of seven years to diagnose. As we mentioned before the suffix ‘-osis’ means condition or disease. Endometrium is the term for the lining of the uterus, the part that is shed every monthly cycle. ‘Endo-‘ means inside and ‘-metrium’ is related to the uterus. So endometriosis means that the cells normally found inside the uterus start growing in other places in the body and cause severe symptoms. It’s extremely debilitating.
Mediastinum
Mediastinum is the anatomical term for the space between the lungs. The middle of the chest, in essence. This is where there are mediastinal lymph nodes, the thymus and the heart. A rare but interesting condition is ‘dextrocardia’ where the heart is on the right side of the chest instead of the left. There’s even an extreme version called ‘situs inversus’ where all the organs are flipped left to right and mirrored.
Medical Terminology – Quantity or Amount
There are a few prefixes that denote the number of something or the amount of something. You will encounter these a lot in medical terminology and other scientific writing. There is one that could trip you up but we’ll get to that.
Description
Greek Root
Latin Root
Other (French)
Double
Diplo-
Dupli-
–
Equal
Iso-
Equi-
–
Few
Oligo-
Pauci-
–
Half
Hemi-
Semi-
Demi-
Many/Much
Poly-
Multi-
–
Twice
Dis-
Bis-
–
One you’ve probably heard a lot is ‘isotonic’. This term describes a fluid that has the same concentration as another. Intravenous fluids are usually isotonic, meaning they have the same concentration of electrolytes as the blood.
Hemivertebrae is a condition where the vertebrae of the spine don’t form properly, only half of the vertebrae is present. It can cause all kinds of pain and difficulty. It’s congenital, meaning it is present from birth.
When writing instructions for medication, we use a shorthand Latin acronym. Not for patients, of course, but between doctors, nurses and pharmacists they will use these. B.I.D stands for bis in diem – that means twice a day.
‘Equi-‘ means equal in Latin. Don’t get caught out by this anatomical term! The ‘cauda equina’ describes the tail end of the spinal cord where a bundle of nerves extend past the end of the cord. It looks like a horses tail so in this case ‘equina’ is referring to ‘equine’, that is to horses. ‘Cauda’ refers to the tail – a term used a lot more in animal medicine than humans.
Thanks for reading, I hope you enjoyed this rundown of medical terminology – colour, position and quantity. If you missed the previous ones you can find them here and here. Subscribe to be updated when a new post is live and find me on my social media channels.
