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English for Medicine and Health
Sciences

Shehdeh Fareh, PhD

Professor in Linguistics and TEFL, Director of the English Language
Center, Department of English Language and Literature, Author of a series
of books for TEFL, University of Sharjah

Inaam A.F. Hamadi, MA

Applied Linguistics, Certificate of Competency in Teaching and Learning
from the Institute of Academic Leadership, Department of English
Language and Literature, University of Sharjah
Table of Contents

Cover image

Title page

Copyright

Dedication

Reviewers

Foreword

Preface

Acknowledgments

1. Medical terminology
Language of medicine

Medical terms

Spelling of medical terms

Pronunciation of medical terms

 Focus on reading

Vocabulary development

Focus on grammar

Oral skills

Focus on writing

Pronunciation exercise

Review exercises

Self-assessment

2. Suffixes
Medical terms

Suffixes

Focus on reading

Vocabulary development

Focus on grammar

Case report

Oral communication skills

Focus on writing

Pronunciation of medical terms

Review exercises

Self-assessment

3. Prefixes
Medical terms

Prefixes

Focus on reading

Vocabulary development
 Focus on grammar

Oral communication skills

Focus on writing

Pronunciation of medical terms

Review exercises

Self-assessment

4. Body structure
Body structure

Principal body systems

Planes of the body

Orientation and directional terms

Body positions

Body cavities

Focus on reading

Vocabulary development

Focus on grammar

Oral communication skills

Focus on writing

Review exercises

Self-assessment

5. Body systems
Body systems

Focus on reading

Vocabulary development

Focus on grammar
 Oral communication skills

Focus on writing

Pronunciation of medical terms

Review exercises

Self-assessment

Glossary

Index
Copyright

Elsevier Limited

7th Circle, Zahran Plaza, 7th Floor, PO Box 140825, Amman, 11814,
Jordan

English for Medicine and Health Sciences, by Shehdeh Fareh and

Inaam A.F. Hamadi

Copyright © 2017 Elsevier Limited.

ISBN: 978-0-7020-7550-6
e-ISBN: 978-0-7020-7551-3

All rights reserved. No part of this publication may be reproduced or

transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details
on how to seek permission, further information about the Publisher’s
permissions policies and our arrangements with organizations such as the
Copyright Clearance Center and the Copyright Licensing Agency, can be
found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected

under copyright by the Publisher (other than as may be noted herein).
Notices
Practitioners and researchers must always rely on their own experience
and knowledge in evaluating and using any information, methods,
compounds or experiments described herein. Because of rapid advances in
the medical sciences, in particular, independent verification of diagnoses
and drug dosages should be made. To the fullest extent of the law, no
responsibility is assumed by Elsevier, authors, editors or contributors for
any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any
methods, products, instructions, or ideas contained in the material herein.

Content Strategist: Rasheed Roussan

Sr Project Manager—Education Solutions: Shabina Nasim
Content Development Specialist: Amani Bazzari
Project Manager: Nayagi Athmanathan
Cover Designer: Milind Majgaonkar

Printed in India
Dedication

This book is gratefully dedicated to:

Our sincere wives and children for their patience
and encouragement,
our wonderful readers and colleagues,
all those who helped us produce this book.
Reviewers
Hussam Rajab, PhD, Professor, Head of Research Unit, English
Language Institute (ELI), King Abdulaziz University (KAU), Jeddah,
Saudi Arabia
Ghada A. Abdel-Hamid, MD, Associate professor of anatomy, Faculty
of Medicine, Suez Canal University, Egypt
Sesin Kocagoz, PhD, Professor, Acıbadem University School of
Medicine, Head of Department of Infectious Diseases and Clinical
Microbiology, Co-Coordinator of Medical English, Istanbul, Turkey
Foreword
PROF QUTAYBA HAMID, MD, PhD, FRCP, FRS, Dean, College of Medicine, University of
Sharjah

There is an urgent need for a comprehensive book such as English for

Medicine and Health Sciences. This book is one of the few to address the
specific needs of non-native speakers who are attending medical education
institutes.
One of the book’s landmark features is its ability to communicate
complex structures of medical English in a clear and engaging manner,
with the learner at the core of the pedagogical context of the book.
With an array of key terminologies, medical roots, and illustrative
examples, the book is an essential reference that brings together medical
knowledge and language skills indispensable to medicine and health
sciences students today.
Offering relevant and cutting-edge literature pertaining to medical
English, including an English–English–Arabic Glossary, the book is a
hands-on tool for leveraging the students’ understanding of the basic
principles of written and spoken English required to start a career in
medicine and health care.
Moreover, the book is equally invaluable to medical English instructors
who are keen to provide the most relevant linguistic material to their
students.
I believe that this book offers an opportunity for the students to develop
a comprehensive and up-to-date understanding of medical English, offered
by a team of highly experienced medical English instructors.
Preface

English for medical and health

sciences
In order to be successful professionals, students in the fields of medicine
and health sciences need to be competent in using medical terminology.
They need to familiarize themselves with as many medical terms as
possible in order to function properly in their study and future careers.
This means that students should know the meanings of medical terms used
in their fields and how they are composed. Furthermore, they need to
enhance their essential language skills including reading, writing and
speaking. English for Medical and Health Sciences is especially designed
to meet these basic needs. It consists of five chapters that cover the
structure of medical terms, prefixes, suffixes, body structure, and body
systems. Each chapter consists of at least 10 basic components as follows:

• Medical terms: Lists of terms relevant to the content of each chapter are
provided and their meanings are also given. Prefixes and suffixes are
also explained in detail with illustrative examples.

• Practice exercises: Activities are provided after each section to check the
students’ understanding. Teachers can use these activities as formative
assessment tools.

• Focus on vocabulary: This part of each chapter provides students with

two lists of academic vocabulary that are essential for developing
students’ lexical competence. Furthermore, this part provides students
with 20 medical collocations with illustrative examples and practice
activities. Students are also introduced to medical idioms commonly
used in their fields.
• Focus on reading: This section aims at promoting students’ abilities to
handle and comprehend medical texts. It also familiarizes them with
medical terms used in context.

• Focus on grammar: Each chapter handles a certain grammatical notion

that is common in medical and scientific texts.

• Focus on speaking: This part aims at enhancing the students’ oral

communication skills. Students are trained to speak in clinical contexts
with each other, with their instructors, and with patients.

• Focus on writing: Writing is a complex skill that needs to be developed

through a systematic training. Students are given practice in writing
definitions of terms and in writing referral letters throughout the five
chapters of the book.

• Pronunciation list: New medical terms in each chapter are listed at the
end of the respective chapters for students to pronounce. They are also
encouraged to know their meanings. Students can listen to the proper
pronunciation from their instructors or from a CD especially prepared
for this purpose.

• Review exercises: These exercises provide students with more practice

activities on all the components of the chapter. Teachers can also use
them as summative assessment tools.

• Case studies: Each chapter provides one or two case studies for students
to learn from. Case studies present clinical descriptions and diagnoses
of certain medical cases.

• Glossary of medical terms and their meanings in English and Arabic for
Arab students.

• Teacher’s manual: This guidebook offers teachers with answers to the

practice activities and review exercises in each chapter. It also contains
quizzes and tests that the teacher can use. Finally, it contains a number
of reading comprehension texts that can be used in tests and quizzes,
and for training as well.
The distinctive features of English for Medical and Health Sciences can be
summed up as follows:

• Provides exhaustive lists of medical roots, combining forms, prefixes,

and suffixes with illustrative examples.

• Offers an integrated course that combines medical knowledge with

essential language skills.

• Focuses on developing students’ reading skills in medical contexts.

• Develops students’ oral communications skills necessary for interaction

in their fields.

• Reinforces students’ academic vocabulary needed for effective

communication.

• Promotes students’ awareness and competence of medical collocations

and idioms.

• Enhances students’ writing skills in their medical fields.

• Develops students’ grammatical competence in areas relevant to their

medical majors.

• Provides ample and frequent practice and review exercises in each

chapter.

• Provides teachers with sample quizzes, tests, and answer keys for each
chapter.

• Provides a glossary of the major medical terms.

The outstanding features of this well-organized book help students

develop their medical knowledge and linguistic competence as well. These
integrated skills can hardly be found in any existing textbook in this field.
Acknowledgments
First and foremost, all thanks and praise goes to Allah, who granted us the
knowledge and power to write this book.
We wish to express our thanks and gratitude to all those who helped us
in producing the first edition of English for Medical and Health Sciences.
Thanks to the development team and Amani Bazzari who were keen to
produce the book in its best shape.
Thanks are also due to the book reviewers for their valuable feedback
that improved the quality of the book.
Special thanks and appreciation are due to our students in the medical
colleges who volunteered to read the chapters of the book and give us their
feedback that was highly appreciated since it reflected the students’ views
regarding the contents of the book.
Dr Mustafa Hammadeh, from Twam Hospital, was our consultant in all
medical issues. His assistance was invaluable.
We would also like to thank Mr Rasheed Roussan and his team for their
follow-up and encouragement.
CHAPTER 1

Medical terminology

CONTENTS
Language of Medicine 1
Medical Terms 3
Roots 3
Suffixes 9
Prefixes 12
Combining Forms 3
Spelling of Medical Terms 19
Pronunciation of Medical Terms 27
Focus on Reading 29
Vocabulary Development 33
Medical Collocations 33
Academic Words 35
Focus on Grammar 37
Oral Communication Skills 41
Focus on Writing 45
Pronunciation Exercise 48
Review Exercises 51
Self-Assessment 63

Learning outcomes
 At the end of this chapter, students are expected to be able to:
1. explain the need for medical terms
2. define the constituents of medical terms: root, suffix, and prefix
3. define medical combining forms
4. analyze medical terms into their constituents
5. construct medical terms by applying general rules
6. use certain medical collocations and academic words properly
7. pronounce medical terms properly
8. skim and scan medical texts for main ideas and details
9. paraphrase a sentence or a paragraph
10. prepare an oral presentation

Language of medicine
Terminology is the set of terms, expressions, or symbols associated with a certain
discipline of study, profession, or activity. Developing a functional competence in
terminology is an essential component of being able to work in a given field or
profession. Medical terminology is the variety of language that health care
professionals and providers use in practicing their careers. Medical terms
constitute a standardized means of communication among health care providers
because all such specialists use special terminology to describe human body,
diseases, symptoms, diagnostic procedures, drug administration, and treatment in
the fields of medicine, nursing, pharmacy, dentistry, physiotherapy, medical lab
sciences, clinical nutrition, and dietetics, environmental health sciences, and
medical diagnostic imaging. Medical terms are used in both speaking and writing
during the process of communication between health care professionals and their
clients. Therefore, it is essential for students in any medical profession to learn
the meanings of medical terms pertaining to each one’s career. It is also necessary
to learn how to pronounce and spell medical terms properly because mistakes in
such fields are intolerable. The significance of learning medical terms stems from
the following reasons:

■ Medical terms enable health care workers to communicate efficiently with each
other and with their patients in one language.

■ They ensure complete and mutual understanding of patients’ issues, including

diagnosis and treatment procedures.
■ Medical terms help us decipher complex information because they are made up
of roots, prefixes, and suffixes that generally have fixed meanings to all
workers in health care careers.

■ Medical terms facilitate the process of documentation and make it easy and fast
due to the frequent use of abbreviations in recording medical information.

It has become clear that possessing an adequate functional knowledge of

medical terms is indispensable to all people working in health-related disciplines.
Knowledge of medical terms involves a number of aspects such as knowing the
meaning/s of a medical term, its structure, its derived forms, spelling, and
pronunciation.
Medical terms are almost universal because most of them are derived from
Latin or Greek origins. Table 1.1 provides samples of modern medical terms and
their Latin or Greek origins. Learning medical vocabulary is a strenuous and
highly demanding process because it is always changing and developing. Although
most medical terms are based on classical Latin and Greek roots, they are no
longer restricted to such origins. Many medical terms nowadays have been
borrowed from ordinary English words such as scanning, screening, and bypass
operation. In order to learn the meanings of medical terms, students need to
familiarize themselves with the way medical terms are structured and created. A
medical term is usually composed of a root that carries the basic sense of the term
to which prefixes and suffixes may be added.

Table 1.1
Latin and Greek Origins of Some Current Medical Terms

Current Term Origin

artery Latin arteria; Greek arteria
cardi(o) the heart Greek kardia
cell Latin cella
ligament Latin ligamentum
nephropathia Greek nephros
ventricle Latin venter
umbilicus Latin umbilic
tendon Latin tendo
sinus Latin sinus
vein Latin vena
nerve Latin nervus
hernia Latin hernia
gastr Greek gaster (stomach)
ovary Greek oophor
cancer Greek carcin
Medical terms
Constituents of medical terms: Roots, suffixes,
prefixes, and combining forms
Roots
The primary constituent of each medical term is the root that carries its basic
meaning. Prefixes and suffixes can be added to the root to modify its meaning.
A root is the part of a word that carries its basic meaning. The root in medical
terms cannot stand alone to give a complete meaning. A prefix or a suffix may be
added to it in order to make a full term that has meaning. This is due to the fact
that most medical roots are borrowed from different source languages such as
Latin and Greek. In the word gastroscopy, for example, the root is gastr (stomach)
and -scopy is a suffix (visual examination). Adding the meaning of the suffix to
that of the root will make up the entire meaning of the medical term gastroscopy
(visual examination of the stomach).
 FIGURE 1.1 Gastroscopy: visual examination of the stomach.

A medical term may consist of one or more roots but only one suffix, as shown
in Table 1.2. We can only add a prefix whenever we need to modify the meaning of
the root.
Table 1.2
Medical Terms with One or More Roots

One root hem/o/globin

Two roots electr/o/cardi/o/gram
Three roots ot/o/rhin/o/laryng/o/logy
Four roots esophag/o/gastr/o/duoden/o/jejun/o/stomy

It is worth noting that certain body parts have more than one word root, because
one root comes from Latin and the other from Greek. You should be familiar with
both roots because you may encounter both of them in your study. Table 1.3
provides some illustrative examples.

Table 1.3
Body Parts/Organs that Have Two or More Roots
 FIGURE 1.2 Colonoscopy: visual examination of the large intestine.

Common combining forms

 FIGURE 1.3 Otorhinolaryngology: study of ear, nose, and larynx.

Suffixes
A suffix is a letter or group of letters added to the end of a word to change its
meaning or to produce a new word (part of speech). For example, if the suffix -
tomy (cutting into) is added to the root gastr, the resulting term gastrotomy will
mean incision into the stomach. However, if the suffix -ectomy is added to the
same root, the resulting term gastrectomy will mean excision of the stomach.
Moreover, adding -al to the root dent (noun) produces dental (adjective).
Notice the difference between neuralgia, neuritis, and neuroplasty. The
meaning of each term differs from that of the other because of the different
suffixes added to the same root neur which means nerve. The suffix -algia means
having pain; -itis means inflammation; and finally -plasty means plastic repair.
The first word means condition of having pain in the nerve; the second means
inflammation of the nerve and third means plastic repair of the nerve. Table 1.4
provides examples of commonly used but confused suffixes.

Table 1.4
Commonly Used but Confused Suffixes
 FIGURE 1.4 Adenectomy excision of a gland.

It is worth noting that medical terms are briefly defined throughout the entire
book.

FIGURE 1.5 Gastroduodenostomy: communication between the stomach and

first part of the small intestine.
Table 1.5

Terms Using the Suffix -Scopy (Visual Examination of)

Medical Term Meaning

bronchoscopy visual examination of the bronchial tubes
laryngoscopy visual examination of the larynx
laparoscopy visual examination of the abdomen
gastroscopy visual examination of the stomach
arthroscopy visual examination of joints
cystoscopy visual examination of the urinary bladder
ophthalmoscopy visual examination of eyes
otoscopy visual examination of ears
sigmoidoscopy visual examination of the sigmoid colon
rhinoscopy visual examination of the nose
uroscopy visual examination of the urinary tract
colonoscopy visual examination of the large intestine
esophagoscopy visual examination of the esophagus

Table 1.6

Terms Using the Suffix -Logist

Medical Term Meaning

cardiologist specialist in the study and treatment of the heart diseases
dermatologist specialist in the study of skin
oncologist specialist in the study of tumors
nephrologist specialist in the study of the kidneys
gynecologist specialist in the study of women’s diseases
trichologist specialist in the study of hair
urologist specialist in the study of the urinary system
hematologist specialist in the study of the blood
biologist specialist in the study of living tissues
otorhinolaryngologist specialist in the study of the ear, nose, and larynx
ophthalmologist specialist in the study of eyes
endocrinologist specialist in the study of the endocrine system
gastroenterologist specialist in the study of the stomach and intestine

Commonly used suffixes

 FIGURE 1.6 Erythrocyte: red blood cells.

It is worth noting that sometimes there might be two or more suffixes that have
the same meaning but they are not interchangeable. That is to say, where one is
used, the other cannot. For example, the suffixes -opsia and -opia mean vision, but
we can only say diplopia (double vision) not diplopsia.

Prefixes
A prefix is a letter or a group of letters attached to the beginning of a root to
modify its meaning. For example, the term hyperglycemia consists of a prefix
(hyper), a root (glyc), and a suffix (-emia).
Consider the following examples and note the different meaning that results
when a new prefix is added to the same root.

Prefix Medical Term Meaning

hemi- hemiplegia paralysis of one side of the body
para- paraplegia condition of having lower half paralysis
quadri- quadriplegia condition of having paralysis in the four limbs
pan- panplegia condition of having total paralysis
pseudo- pseudoplegia condition of having false paralysis
 FIGURE 1.7 Quadriplegia: paralysis of the four limbs of the body.

The root cardi may be preceded by two different prefixes. The addition of
brady- (slow) and tachy- (rapid) to the same root results in two different terms:
brady/card/ia (having slow heart rate) and tachy/card/ia (rapid heart rate).
Similarly, the root later can be preceded by the prefixes bi- and uni- as in
bi/later/al, which means pertaining to both sides, and uni/later/al, which means
pertaining to one side.

Commonly used prefixes

 FIGURE 1.8 Sublingual (under the tongue).

When a suffix starting with a consonant is added to a root ending with a

consonant, a vowel is added between the root and the suffix in order to ease the
articulation of the resulting form. This vowel is referred to as the combining
vowel. The root plus the combining vowel are called the combining form. The
term cystoscope, for example, consists of the root cyst-, a combining vowel -o-
and the suffix -scope. However, the combining vowel is omitted if the suffix starts
with a vowel as in gastrectomy (gastr + ectomy), cephalic (cephal + ic), adenitis
(aden + itis), neuralgia (neur + algia), carcinoma (carcin + oma), and hematuria
(hemat + uria).

Examples
cyst (root): urinary bladder
o (combining vowel): does not add anything to meaning.
scope (suffix): instrument to examine a body organ visually
Cystoscope is an instrument to visually examine the urinary bladder.

Notice that the combining vowel is omitted because the suffix -ic begins with a
vowel as in:
 Similarly,

In this context, it is worth noting that the combining vowel is retained if a root
is added to another root even though the second root begins with a vowel as in:
 FIGURE 1.9 Cystoscope: instrument to visually examine the urinary bladder.

Practice 1.1 Form medical words from the following prefixes, combining forms,
and suffixes. Delete unnecessary components.

a. electr/o/encephal/o/gram _________________________________________

b. enter/o/itis _____________________________________________________

c. nephr/o/ectomy _________________________________________________

d. ophthalm/o/scope _______________________________________________

e. trans/urethr/o/al __________________________________________________

f. retro/gastr/o/ic __________________________________________________

g. bi/o/opsy _______________________________________________________
h. hyper/thyroid/o/ism ______________________________________________

i. arthr/o/algia _____________________________________________________

j. cerebr/o/vascul/o/ar ______________________________________________

Reading medical terms

Reading a medical term in order to get its meaning is quite easy. You should
always start from the end, then move to the beginning, and across the term. A
word such as electr/o/encephal/o/graphy consists of two roots, two combining
vowels and a suffix. We start reading from the last part (-graphy), which means
act of recording; then we move to the first part (electr/o), which means electricity;
and finally (encephal/o), which means brain. The entire word means the act of
recording the electrical activity in the brain.
Notice that if you read medical terms backward, you will change the whole
meaning of the term. Consider the meaning of the following two words (reading
from the suffix, back to the beginning of the term).
If the word hemat/o/ur/ia is read backward, it will mean condition of having
urea in the blood, which is wrong because this condition is called ur/o/em/ia.
Therefore, a medical term has to be read from the end and then to the beginning
and across not backward. Thus, the meaning of hematuria is a condition of having
blood in the urine, whereas uremia means a condition of having urea in the blood.
A medical term may not always consist of prefix + root + suffix. In fact, it can
be made up of different combinations as shown in the Tables 1.7–1.12:

Table 1.7
Terms Using One Root + Suffix
Table 1.8
Terms Using One Root + Combining Vowel + Suffix

Table 1.9
Terms Using Root + Combining Vowel (V) + Root + Combining Vowel +
Suffix

Table 1.10
Terms Using Root + Combining Vowel + Root + Suffix
Table 1.11
Terms Using Prefix + Root + Suffix

Table 1.12
Terms Using Prefix + Root + Combining Vowel (V) + Suffix

It is worth noting that the combining vowel is retained when a root is added to
another root even though the second root starts with a vowel as can be noticed in
the examples in Table 1.9.
 FIGURE 1.10 The anatomy of a kidney.

In conclusion, a medical term may consist of one or more of the preceding

combinations. In brief, the major constituents of a medical term are as follows:

1. Root: the part of the term that conveys its basic meaning.

2. Prefix: a letter or a group of letters attached to the beginning of a term to

modify its meaning.

3. Suffix: a letter or a group of letters attached to the end of a term to produce a

new word form in general or to modify the meaning of the root.

4. Combining form: a root with a combining vowel.

5. Combining vowel: a vowel inserted between a root and a suffix that starts with
a consonant or a root and another root to ease pronunciation.

Practice 1.2 Write the medical term for each of the following definitions.

a. The study of women’s diseases is called ______________________________.

b. Record of electricity in the brain is called ___________________________.

c. Low level of hormone from a gland in the neck is called _______________.

d. An instrument that examines the patient’s eye is called ____________

_______________________.

e. Pertaining to behind the stomach __________________________________.

Practice 1.3 Divide the following terms into their component parts and provide
the meaning of the whole term.

Spelling of medical terms

Correct spelling to writing is as important as correct pronunciation to speaking.
Misspelling medical terms may lead to wrong meanings or to life-threatening
situations such as death or serious injury to patients. Therefore, it is necessary that
you learn the correct spelling of the terms you use in your field. When in doubt
about the spelling of a term, you should not hesitate to consult your medical
dictionary.
Table 1.13

The “rh” Rule

When a suffix beginning with the letters “rh” is added to a root, the
letter “r” is doubled.

Table 1.14

The “x” Rule

In nouns ending with “x” preceded by a consonant, change the “x”
into “g” when you derive an adjective from those nouns, or when a
suffix is added to them.
FIGURE 1.11 Laryngectomy: excision (removal) of the larynx.
 When adjectives are derived from nouns ending with “x” that is preceded with a
vowel, the “x” is changed into “c.”

Word Adjective Meaning

cervix cervical pertaining to the neck
thorax thoracic pertaining to the chest

Basic medical terms

The following terms are frequently used in health care fields.

Diagnosis: The act or process of identifying or determining the nature and cause
of a disease or injury through evaluation of patient history, examination, and
review of laboratory data (state of complete knowledge).

Prognosis: A prediction of the probable course and outcome of a disease (state of

prior knowledge).

Sign: Objective evidence of disease or the physical manifestation of injury,

illness, or disease. Objective means that the sign can be evaluated or measured
by the patient or others.

Symptoms: Subjective evidence of disease or what the patient experiences about

the injury; subjective means that it can be evaluated or measured only by the
patient.

Syndrome: A group of symptoms and signs that collectively indicate or

characterize a disease, psychological disorder, or other abnormal condition.

Acronym: A word formed by combining the initial letters of a multipart name or

major parts of a compound term, such as GERD from Gastro Esophageal Reflux
Disease.

Abbreviation: A shortened form of a word or phrase used chiefly in writing to

represent the complete form, such as AMI, for Acute Myocardial Infarction.

Eponym: One whose name is or is thought to be the source of the name of

something such as a disease, structure, operation, or procedure named for the
person who discovered it first, for example, Marfan syndrome, Fallopian tube,
Rinne test, Huntington disease.
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delivery to car, conveyance for shipment.
(7) Bone Department.—Includes all labor in manufacturing bone
products such as horns, hoofs, manufacturing, bone grinding, bone
and neatsfoot oils. The collecting and drying of pizzles and sinews,
manufacture includes the packing and shipping of all products.
Per ton handled. Sum of weight received and weight shipped.
(8) Oleo Department.—The expense for manipulating raw fat to
make oil, stearin, tierce, pack and ship. Fat is considered as
delivered to oleo department when placed in chilling or washing vats.
Includes cooperage work occurring in oleo department. The
skimming of all catch basins connected with and a part of the oleo
department.
(9) Tallow.—Labor for inspecting, products, filling tanks, cooking,
pressing and all other work involved in making tallow or grease.
Tallow to be tierced for shipment includes all labor for skimming
catch basins and collecting the fats.
(10) Fertilizer Department.—The collection of tank water and the
care including evaporation and returning of skimmed grease to
rendering department. The drying, storing, grinding, packing and
shipping of tankage. The collection, cooking, pressing, drying,
screening, bagging and shipping of blood.
(11) Hog Killing.—All expense involved in dressing pigs from their
receipt in yards to delivery in chill rooms. Including any attention in
pens, cleaning pens.
The dressing of pigs completely, including the disposal and
disposition of all offal and the delivery of separated offal to rendering
tanks or to chill rooms. Include all labor, cleaning department,
utensils and equipment. At times this department is separated into a
dressing department which performs all labor incidental to dressing
the hog, all labor on the heads and entrails being separated into
another item.
(12) Hog Cutting.—To begin with the receipt of pigs at cooler. To
cut pigs into various parts and dispose of said parts. Sausage
department, lard refinery, rendering department or to curing cellars.
Includes packing of any and all cut meats for disposal for sale.
 (13) Pork Trimming Room.—This department takes the fats as
delivered to them by the hog cutting gang, performs the trimming
and assorting of same, delivering the lean trimmings to the sausage
or curing departments, and the bones or fat to the lard tanks.
(14) Curing Cellars.—The expense for curing, salting, boxing and
packing meats, being all labor of every nature involved on the receipt
from cutting department to its disposal, as a finished product.
Includes unloading supplies and boxes. Includes all overhauling
and any labor involved in curing processes. This department is
usually divided into sweet pickle and dry salt sections upon the basis
of the meat handled by each—but operated entirely separate.
(15) Sausage Department.—Expense for manufacturing sausage
in all its work from receipt of green meat to its saleable condition
boxed, and shipped. Includes smoking, boiled ham, work. This
department is at times divided into a manufacturing and shipping
department, in which case the manufactured goods are delivered to
the packing room.
(16) Lard Refining.—The expense for handling processing,
manufacturing, packing and shipping lard, including all labor used on
receipt and care for supplies.
(17) Smoke House.—The soaking, washing, scrubbing, smoking,
inspecting, packing and shipping of all meats, care of houses and all
supplies.
(18) Tripe and Pig Feet.—The receiving of raw tripe from the rough
tallow gang, washed ready for use. The cleaning, curing, packing,
shipping, pig feet as cut from ham or shoulder and their complete
manufacture ready for shipment.
(19) Beef Curing.—This department takes products as delivered to
it, curing and loading same or delivering to next department. The
cleaning of ox lips is charged to this department. Also against tongue
department for curing, packing and loading tongues.
(20) Sheep Killing.—To be the complete expense for dressing
sheep from their receipt in the pens to delivery to chill rooms;
including all occupations, necessary thereto except the disposal of
sheep offal and sheep by meats.
(21) Sheep Tallow.—All labor on sheep other than that described
in the preceding paragraph, including disposal to manufacturing
departments of all parts and of all meats to the chill rooms. Involving
all work on sheep offal other than sheep casing.
General Principles.—The following items describe the intent of
the instructions.
(22) Delivery.—Constituted by trucking the product into the
department and unloading the trucks or in case mechanical means
such as conveyors are provided for delivering from one department
to another, delivery is constituted by placing in the conveyor leading
to the department.
(23) Cleaning.—Each department is to keep clean the premises,
utensils and equipment used by it in the operating or manufacture.
(24) Supplies.—Each department is to receive, unload, care for,
and be responsible for all packages, such as wrappings, tins, boxes,
bags, kits, barrels, tierces, or casks, used for filling with product
produced in that department.
(25) Shipping or Loading.—The item of shipping or loading
expense shall be borne by the respective producing departments,
upon a pro rata basis.
(26) Returned Utensils.—Any department using a vehicle for the
delivering of the product to another department shall take the
vehicle, truck or car back to the originating department.
(27) Cleaning and Icing Cars.—This department includes all labor
of cleaning and icing cars and hooking up same for beef loading.
The cleaning of refrigerator boxes being done by this department, a
transfer is made against the departments using same on the basis
obtained from the relative number of boxes used in each
department.
(28) Steam Expense.—The total labor, cost for taking coal from
quantity store alongside boiler room, to and firing boilers and
disposal of ash. Includes all boiler cleaning, conveyor attention and
labor connected with pumps on water connected with the making of
steam. Expense of transportation from ship not included. Expense
per ton fuel burned.
(29) Power Expense.—All labor for engineers, engine watch,
oilers, janitors, pumpmen, ammonia or brine piping tenders,
electricians or other labor attendant to or used in the production of
electrical power, refrigeration, water production on pumping of water
or brine.
(30) Repair Department.—Machinery. In this item are to be
included all expense for wages for machinists, blacksmiths, pipe
fitters, tin smiths and workers in metal, performing work for repairs
for operating departments.
(31) Carpentry.—In this item, shall be included wages for all
carpenters or wood workers and their helpers used in performing
work for repairs for operating departments.
(33) Laborers.—Under this class shall be included the wages of all
employes other than those named in the two preceding sections for
operating departments.
(34) Store Department.—In this item is to be included all labor
employed in the stores department for disbursing and distributing
and the accounts of the repair, carpentry, labor and kindred
departments. Items not directly chargeable to operating
departments.
 TOPICAL INDEX

A
Abattoir Building 15
Absorption Equipment 34
Accounting, Departmental (Chapter XXIX) 453
Acidity of Milk 424
Test for Determining 426
Adopting of Refrigerating System 35
Advantages of Fireproof Construction 28
Advice as to Exhaust Steam 58
Air Circulating 37
Ammonia 30
Compression System, Diagram (Fig. 15) 30
Machines 29
Value, Slime from Intestines has High 204
Animal Feeding 189
Antwerp Back Cut (Fig. 146) 331
Approval of Plans 28
Arrangement of Butterine Factories 422
B
Back, Clear (Fig. 133) 300
Fat, Test on, Converted into Neutral and Prime Steam Lard
Backing Hides 100344
Backs, Pork (Fig. 122) 286, 325
Bacon Bellies, Smoked Breakfast (Fig. 123) 287
Curing Fancy 317
Hogs 267
Choice (Fig. 111) 270
Balanced Brine System 38
Barrel Pork, Curing 327
Barreled Beef 123, 225
Pork 324
Basement Freezers 88
Beef, Barreled 123, 225
Bladders 213
Bungs 212
Carcasses Being Split and Hung on Trolley, View of, (Fig. 42)
Casings, Machines for 214102
Description of 208
Chucks (Fig. 48) 122
Cooler, View in, of a Chicago Packing House (Fig. 20) 66
Coolers, Dividing 60
Cuts 116
(Pounds) Average Weight of Straight 118
Domestic 62
Freezing 64
Glass Jar 225
Grading 118, 131
Hams, (Fig. 49) 124
Curing 222
Formulas for Curing 223
Smoked, Shrinkage of 225
Stripping 222
Tests on Smoking Regular 224
Handling 61
Hearts 218
Hides and Tallow, Yield of 107, 108, 111, 113
Hides, Building of Packs 133
Diagram of (Fig. 52) 128
Green 126
Proper Storage for 129
Salting of 132
Shrinkage of 130, 134
Trimming of Green 133
Truck for Carting (Fig. 51) 126
Livers 217
Loading 64
 Loins (Fig. 45) 119
Middles 211
Miscellany (Chapter XXIII) 217
Percentage of Various Cuts 115
Plates, Shanks and Flanks 123
Ribbing 63
Ribs (Fig. 46) 120
Rounds, (Fig. 47) 121
Surplus 222
Shanks (Fig. 50) 125
Smoking Dried 370
Spreader, Ordinary (Fig. 40) 100
Spring (Fig. 41) 101
Switches, Salting 133
Tails 218
Tongues 219
Test on Freezing 221
Trimming of 63
Trimmings 225
Weasands 213
Bellies, Curing 316
Pork (Fig. 121) 285
Belly Pork 325
Rib (Fig. 134) 303
Bladders, Beef 213
Blades and Ribs, Cattle 167
Bleaching Kettle 349
Lard 350
Blood 201
and Tankage, Quotations and Values 203
Cooking 202
Handling 202
Pressing 202
Storing 202
Blow-off, Operating the Tank 181
Boiled Ham 397
Boiler Feed Pumps 54
 Water, Heating 55
Boilers 59
Boiling Hams, Rules for 398
Shrinkage in 398
Points, Table of 193
Bologna Varnish 396
Bone, Crushed 168
Department (Chapter XIII) 159
Grinding 168
Hard 159
Products 160
Quantity, Conversion Factors of, into Another Term 207
Saw (Fig. 61) 163
Washer Revolving (Fig. 64) 165
Boneless, Ham 393
Pigs Feet 391
Bones, Cutting Sinews and Saving 163
Glue 159
Jaw 162
Shins, Cooking 164
Systems of Drying 167
Box, Surface 174
Cars, Using 6
Boxes and Cooperage (Chapter XXXIII) 440
Specifications for Packing 440 to 448
Breast Sawing 99
Brine, Calcium 73
Chilling 37
Circulation, Gardner “Curtain” System (Fig. 28) 79
Coolers, Types of 38
Methods—Recommendations 38
Pipes, Simple Method of Supporting (Fig. 27) 78
Salt 73
and Spray Systems, Section Showing (Fig. 23) 74
Spray, Arrangement of Piping for 73
System, Balanced 38
Low Temperature 50
 vs. Water in Cream Ripener 427
Breakfast Bacon Bellies, Smoked 287
Bruise, Trimming 102
Brush, Fountain (Fig. 43) 104
Bucks (Fig. 82) 235
Build, How to 26
Building, Division of, To avoid Insurance Area 90
Errors in 11
Freezer and Storage, Ground Plan of (Fig. 31) 85
Buildings, Fire Proof 70, 83
Freezer 82
How to Subdivide 88
Location of 83
Permanence of 83
Storage 82
Bung Gut Skins 212
Bungs, Beef 212
Bunker “Curtain” System, Cross Section Cooler (Fig. 30) 82
Bunkers, Chill-Room 82
Business, Character of 12
Butcher Fats 153
Hogs (Fig. 109) 268
Butt, Dry Salt, and Square Cut (Fig. 127) 293
Butterine, (Chapter XXVII) 420
Churn Room for (Fig. 165) 431
Colors of 421
Cost of 438
Emulsion Churn (Fig. 162) 423
Equipment Required for Manufacture of 421
Factories, Arrangement of 422
Formulas for Making 437
Graining or Tempering 432
High Grade 434
Ingredients of 421
Kneading Table (Fig. 167) 434
Low Grade 430
Milk in 425
 Origin of 136
Packing 434
Print Cooler for (Fig. 169) 436
Prints, Making (Fig. 166) 433
Quality in 430
Solid Packing Room (Fig. 168) 435
Test Showing Shrinkage and Cost of 438
Testing Milk for 422
Truck (Fig. 163) 423
Utensils, Cleanliness of 435
Working of 433
Butts and Plates 290, 292
By-Products, Concentration Permits Manipulation of 1
Saving 5
C
Calcium Brine 73
Calves (Fig. 92) 245
and Sheep (Chapter XIX) 229
Slaughtering 250
Canvased Meats, Weight of 367
White Wash for 369
Yellow Wash for 369
Canvasing Hams 367
Care of Coolers 67
Carriage for Tracks in Smoke House, Detail of (Fig. 160) 375
Casings, (Chapter XVII) 208
Beef 107, 109, 111, 113
Description of 208
Packages for 214
Clearing of 214
Export 209
Fatting Machine for 210
Hog 214
Inspecting and Measuring 211
Machines for 214
Preparation of, for Summer Sausage 404
 Round 208
Selection of Round 209
Small 215
Sausage 382
Temperature of Water for Cleaning 214
Turning and Sliming the 211
Catch Basin 188
Cattle Blades and Ribs 167
Casings 107, 109, 111, 113
Cuttings, Dressing Yields and (Chapter X) 106
Dressing 104
Driving 93
Feet 162
Flooring 99
Head Splitters (Fig. 60) 161
Heading and Skinning (Fig. 37) 96
Heads and Feet 107, 109, 112
Heavy 62
Knocking and Stunning 94
Resting in Pens Before Being Slaughtered (Fig. 34) 93
Skulls and Feet, Test Yield from 166
Slaughtering (Chapter IX) 92
Stunned, Being Hoisted for Sticker (Fig. 36) 95
Stunning, Modern Method of (Fig. 35) 94
Trimmings 107, 109, 111, 113
Washing 103
Yields of 106
Cellar Ceiling Suspension of Pipes 78
Cellars 69
Curing 311
Cereals for Sausage 382
Character of Business 12
Chicago Beef Cuts (Fig. 44) 117
Chicago Cuts, Beef 115
Chilling Fat 138
Hogs 67
Lard 49
 Meat 46, 60
Room, The 6
Slaughtered Sheep 238
Chill-Room Bunkers 82
Care of Hogs in 261
Shrinkage of Hogs in 264
Chucks, Beef (Fig. 48) 122
Churn Room for Butterine (Fig. 165) 431
Clarifying Kettles 141
Clean Floors 127
Cleaning Hogs Bodies 259
of Casings 214
Skulls 162
the Evaporators 193
Cleanliness 11
and Collection of Oleo Fats 137
of Butterine Utensils 435
Clear Back (Fig. 133) 300
Tests 301
Long (Figs. 136 and 137) 321, 322
Clearing the Shanks 101
Clears, Short (Figs. 131 and 132) 299, 300
Closed System 40
Coil, Length of 80
Room Systems 37
Rooms 75
Coils, Method of Erecting Pipe 75
Cold Storage House, Section of, Equipped with Spray System
(Fig. 22) 72
Test Oil 362
Collecting Grease 191
Color of Butterine 436
Colors of Butterine 421
Commercial Fertilizer 206
Compound, Lard—What It Is 354
Compressor 31
Compressors, Two-Stage 42
Computations, Summary 49
Computing from Unit Basis 34
Concentration and By-products 1
Concentrating Arrangement, Balanced Brine System, Closed
Type (Fig. 18) 41
Concrete Columns 84
Condenser 32
Condensing Water 33
Construction, Floor 70
of Spray Systems, Types of 72
Slow Burning 28
Wall 86
Types of 84
Conversion Factors of Bone Quantity into Another Term 207
Conveyors, Dressing 104
Cook Room for Sausage 377
Cooking Blood 202
Feet 164
of Killing Stock 177
Schedule for Various Kinds of Sausage 377
Shin Bones 164
Skulls 162
Steam for 185
Cool Room, Stuffing Sausage in a 400
Cooler Building 17
Diagram (Fig. 11) 23
Cross Section, Bunker “Curtain” System (Fig. 30) 82
End View of: Detail of Pipe Hangers (Fig. 24) 75
for Fresh Sausage 379
Ground Sausage Meats 373
or Expansion Tank 32
Coolers, Care of 67
(Chapter VII) 60
Cooling Room for Sausage 400
Towers 55
Cooperage and Boxes (Chapter XXVIII) 440
Specifications 449 to 450
Copperas 194
in Water to Evaporate 194
Cost of Butterine 438
Cottage Ham 393
Cottonseed Oil 354
Deodorizing 356
Stearine 359
Country Packing House, Ground Plan for (Fig. 8) 20
Cream Ripeners (Fig. 164) 427
Crude Oil, Refining 355
Crushed Bone 168
Cultivating the Milk 429
Cultures, Preparatory 428
Reason for Using, in Milk 426
Cumberland Cut (Fig. 139) 328
Curing Barrel Pork 327
Beef Hams 222
Cellars 311
Dry Salt Meats 321, 323
Fancy Bacon 317
Hams, Time Required for 318
Meats (Chapter XXII) 311
for Sausages 373
“Curtain” System, Gardner 80
Cuts, Beef 116
Average Weight of Straight 118
Chicago Beef (Fig. 44) 117
New York Beef (Natives) 115
of Beef, Percentage of Various 115
Packing House, Beef 116
Philadelphia, Beef 115
Cutter, Oleo Fat 138
Cutting Sinews and Sawing Bones 163
Tanks 178
Cycle, The 33
Cylinder Arrangements 36
 D
Defrosting 80
Deodorizing Cottonseed Oil 356
Tank, Section Through Exhaust Head (Fig. 157) 360
Department, Bone 159
Departmental Accounting (Chapter XXIX) 453
Departments, Requirements as to Arrangements of 12
Description of Plants 14
Design 11
Fireproof 27
of Steam Jacketed Surface Box (Fig. 69) 175
Plant 14
Principles of 13
Warehouse 70
Diagram Ammonia Compression System (Fig. 15) 30
Arrangement for String Gang (Fig. 80) 232
Balanced Brine System (Fig. 17) 39
Cooler Building (Fig. 11) 23
Cutting Beef 118
Hydraulic Press with Piping and Pump (Fig. 70) 177
Manufacturing Building (Fig. 10) 22
Slaughtering and Rendering Department (Fig. 9) 21
Digesters 174
Direct Expansion 42
Piping 81
Dividing Beef Coolers 60
Domestic Beef 62
Rounds 209
Sausage (Chapter XXV) 372
Draft, Force 37
Dressing Cattle 104
Conveyors 104
Hogs 254
Sheep by Piece Methods 230
Yields and Cattle Cuttings (Chapter X) 106
Dried Beef, Smoking 370
 Sausage (Chapter XXVI) 399
Dry Cured Meats for Sausage 381
Drying Apparatus (Figs. 75 and 76) 405
Bones, Systems of 167
Tankage 204
Dry Room Caution in Handling Sausage 403
Salt Meats 319
Curing 321
Standard Pumping Schedule for Curing 322
Smoking 323
Time Required for Curing 323
Dublin Cut (Fig. 145) 330
Duo-Purpose Compressor, Suction Connection for (Fig. 16) 36
E
Early Methods 1
Economic Factors 4
Economizers 56
Emulsion Churn, Butterine (Fig. 162) 423
Engines, Steam 56
English Meats 327
Salting 328
Shipping Ages for 333
Equipment Absorption 34
Refrigeration 29
Required for Manufacture of Butterine 421
Evaporating Stick, Expense of 199
Tank Water 191
Evaporator, Swenson (Fig. 73) 192
Evaporators, Cleaning the 193
Ewes (Fig. 86) 239
Exhaust Steam 57
Expansion, Direct 42
Tank 32
Valve 32
Expense, Cooking Test and 185
for Drying Tankage 206
Export Casings 209
Packing House (Fig. 14) 27
Export Plant, Deep Water (Fig. 13) 26
Exterior Walls 84
Extra Long Clear (Fig. 137) 322
F
Fan and Ventilation 71
Fat, Chilling 138
Mutton 155
Fats 136
Butcher 153
Grading 149
Fatting Machine for Casings (Fig. 77) 210
Feeding, Animal 189
Feet and Heads, Cattle 107, 109, 112
Cattle 162
Cooking 164
Fell Beating 99
Cutting 99
Fertilizer (Chapter XVI) 201
Commercial 206
Grease in, a Detriment 203
Materials, Mixing 206
State Regulations Applying to 206
Filter Press (Fig. 153) 351
for Lard and Clear Oil (Fig. 158) 361
Fire-proof Buildings 70, 83
Construction, Advantages of 28
Design 27
Fittings, Detail of End Pipes, Showing Different (Fig. 26) 77
Flanks, Shanks and Plates, Beef 123
Floor Area 70
Construction 70
Flooring Cattle 99
Floors, Clean 127
Floors of Hog Cutting Rooms 273
Fly, Skipper 371
Foot Skinning 97
Force Draft 37
Fore-Cooler 61
Formula for Export Hog Tongue Pickle 338
Wilder Ham Pickle 315
Formulas for Curing Beef Hams 223
Making Butterine 437
Sausage 383 to 388, 404 to 419
Fountain Brush (Fig. 43) 104
Freezer and Storage Room, Longitudinal Section of a (Fig. 32)
Buildings 8289
Requirement 35
Freezer Section, Transverse Section through (Fig. 33) 90
Space 48
Freezers, Basement 88
in Small Plants 36
Freezing Beef 64
Meats 7, 69
Fullers Earth 348
and Lard, Tank, for Mixing 348
Kettle for Small Houses 349
G
Galvanized Sheet Iron Pipes 73
Gardner “Curtain” System of Refrigeration, Plan of (Fig. 29) 81
Gardner’s “Curtain” System for Brine Circulation (Fig. 28) 79
Gate Valve, Tank 174
Glass Jar Beef 225
Glue Bones 159
Government Specifications for Beef or Pork Packages 451
Grading, Beef 118, 131
Fats 149
Graining or Seeding Oil 142
Tempering Butterine 432
Gravity System 20
Grease, Collecting 191
 in Fertilizer a Detriment 203
Yield of—Test on Condemned Hogs 186
Greases, Lard Compound and (Chapter XXIII) 340
Grinding Bone 168
Ground Plan of Freezer and Storage Building (Fig. 31) 85
of Small Local Packing House (Fig. 12) 25
for Country Packing House (Fig. 8) 20
for Export Packing House (Fig. 14) 27
Grubs in Hides 132
Gutting 100
H
Ham, Boiled 397
Boneless 393
Cottage 393
Curing Pickle 314
Facing and Cutting 259
Long Cut (Fig. 140) 328
Manchester (Fig. 141) 329
Minced 389
New England or Pressed 389
New Jersey 389
Pump (Fig. 135) 313
Staffordshire (Fig. 142) 329
and their Treatment 312
Beef (Fig. 49) 124
Curing 222
Formulas for Curing 223
Stripping 222
Boneless Rolled (Fig. 115) 276
Canvasing 367
“Italian” 279
Lone Cut (Fig. 116) 277
Cumberland Tests 334
“Manchester” 279
Picnic (Fig. 126) 293
Rules for Boiling 398
 Short Cut (Fig. 113 and 114) 274
Shrinkage in Boiling 398
Smoked Dried Beef, Shrinkage of 225
“Stafford” 279
Time Required for Curing 318
Two General Kinds of 275
Wilder 315
Handling Beef 61
Hanging Room for Sausage 406
Hard Bone 159
Short Ribs (Fig. 128) 297
Head Cheese 391
Heading 96
and Skinning Cattle (Fig. 37) 96
Heads and Feet, Cattle 107, 109, 112
Hogs, Stuffed 393
Hearts, Beef 218
Heating Boiler Feed Water 55
Heavy Cattle 62
Hide Dropping, Clearing Out and 101
Truck for Carting Beef (Fig. 51) 126
Hides and Pelts (Chapter XI) 126
Tallow, Beef, Yield of 107, 108, 111, 113
Beef, Building Packs of 133
Diagram of (Fig. 52) 128
Proper Storage for 129
Salting of 132
Scores in 127
Shrinkage of 130, 134
Beef, Trimming of Green 133
Green, Beef 126
Grubs in 132
High Grade Butterine 434
Historical—Pork Packing Industry 251
The Refining of Lard in Packing Houses 340
Hog By-Products 265
Carcasses, Cleaning (Fig. 106) 262