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February 21, 1966


JAMA. 1966;195(8):681. doi:10.1001/jama.1966.03100080121039

The art of medicine, admittedly interpretive rather than creative in the context of patient-doctor relationship, becomes occasionally creative in the field of medical terminology. Here one may encounter a simple metaphorical "barrel chest," a whimsical "Christmas disease," an anthropomorphic "subclavian steal."

An interesting new metaphor with a strong anthropomorphic flavor has been recently introduced into medical nosology. The committee of the International Symposium on Opportunistic Fungus Infections suggested1 that the new term "opportunistic" designate "ubiquitous saprophytes and occasional pathogens that invade the tissues of man or animal with (1) predisposing diseases such as diabetes, leukemia, lymphoma, cancer, and aplastic anemias; or (2) predisposing conditions such as agammaglobulinemia, neutropenia, splenectomy, and roentgen therapy, and the use of steroids and antileukemic and antibiotic drugs."

Although few would take issue with an introduction of a new metaphor, many might query its aptness. Opportunism implies the sacrifice of principles for expediency, a Machiavellian

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