Defining words: Overactive bladder

In 1879, James Murray, President of the English Philologic Society, signed a contract with the Oxford University Press to compile and edit a comprehensive English language dictionary. The contract called for a 6,400-page, four-volume work to be completed by 1889. Murray, a child prodigy, who at age 7 had begun to compare Greek, Latin, Chinese, and Hebrew editions of the Bible, became obsessed with this project. In 1885, he resigned from his teaching post in London and moved to Oxford where he devoted 80–90 hours a week to the project until his death in 1915 at age 78. The Oxford English Dictionarywas finally completed in 1928 and consisted of 12 large volumes comprising 15,487 pages and 414,825 words [Winchester, 1998]. Philology is defined by theOxford English Dictionaryas “the scientific study of languages and their development.” The scientific methodology employed to develop this dictionary is worth considering. Thousands of volunteer readers were assigned individual words to research. In a systematic way, each reader searched out his or her word in contemporary and ancient writings. Each time a word was identified in a text, a citation was generated that consisted of the word and the complete sentence in which it was used. The citation was written on a single slip of paper, filed, and categorized in a massive scriptorium in Murray’s garden. Murray and his associates meticulously read each citation and compiled all the possible definitions for each word, based on the way the words were actually used. Now you all know what an overactive bladder is. It’s one that is too active. That means it functions too much. You all know exactly what that means—until we try to write it down and define it. No one, at the time of this writing, has come up with a definition of overactive bladder that is agreeable to all of us who can use that term. The reason for this is not so much that we disagree about what the word means; rather, it is because neither our language nor our measurement techniques are precise enough to satisfy a universal definition. Thus, just as it is not necessary to measure a 5-foot, 250-pound man to know that he is too fat, or to calculate your grandmother’s age to determine that she’s old enough to vote, it is not necessary to measure precisely a bladder to know that it’s overactive In the previous issue of this journal, a new format called “Sounding Board” was introduced. The purpose of this section is to allow ideas and opinions, unencumbered by the demands of strict peer review, to reach the readership to stimulate ideas, creativity, and debate. In that issue, Abrams and Wein [1999] made a plea for the Neurourology and Urodynamics 18:417–418 (1999)