Using culinary descriptions to describe biochemical wisdom

Cafe au lait, port wine and anchovy sauce all help doctors diagnose disease.

These culinary descriptions pepper most medical textbooks, helping physicians identify often unusual ailments – from harmless birthmarks to sight-threatening conditions.

Dr Ritu Lakhtakia, from Sultan Qaboos University in Oman, described these titbits of knowledge in the journal Medical Humanities.

She says they were an integral part of her medical degree, making hard scientific facts less dry and huge chunks of biochemical wisdom more palatable.

Cafe au lait

Cafe au lait spots look like a dash of coffee and milk, according to medical text books

Food imagery has been used in medicine for many years. Here is an easy one to start with.

Cafe au lait spots – flat patches of milk-coffee coloured skin are a tell-tale sign of diseases such as neurofibromatosis in which usually non-cancerous masses grow along nerves.

More solitary spots can be seen in people without disease too.

Cherries

When a vessel occludes at the back of the eye a cherry red spot can be seen at the centre

And visions of fruit can give doctors clues to diseases that are much harder to see.

A cherry red spot at the back of the eye suggests the main vessel supplying blood to the eye has been blocked – an emergency situation, which needs immediate medical attention.

Splashes of port

Port wine stains are commonly seen on the face

And harmless birthmarks that look like a splash of a favourite tipple are described in medical text as port wine stains.

The relatively common marks are caused by areas of small, abnormal blood vessels and can vary in hue from deep red to purple.

About one in 3,000 babies is born with one and laser treatment can help them fade.

Growing grapes

Bacteria can sometimes grow in clusters that resemble grapes

Grapes crop up in various guises, not just in their alcoholic form.

Some bacteria, such as staphylococcus aureus, that are often present harmlessly on our skin, can resemble bunches of grapes as they grow.

Seeds

X-rays can show how TB can spread throughout the chest like tiny seeds

The chest X-ray above shows miliary tuberculosis – a form of TB where the disease has spread around the body in a manner that is said to look like a scattering of millet seeds.

Some people with tuberculosis can develop masses of bacteria in their lungs. And if you were to inspect them more closely they are said to resemble and have the consistency of soft cheese – medical students learn of them as caseating (cheese-like) granulomas.

Dr Lakhtakia says: “For me it changed forever the delights of the cheese counter at the delicatessen.”

Pickled livers

She mentions perhaps even less palatable phrases including anchovy sauce – a term used to illustrate the dark pus seen in certain liver abscesses.

But more popular treats have not escaped this medical treatment. Chocolate cysts can help diagnose a condition called endometriosis, when tissue behaving like the lining of the womb is found outside the uterus.

It can cause the ovaries to fill with a dark fluid akin to chocolate.

Yet perhaps most ubiquitous of all is the common beer-belly – used by doctors and patients alike to describe a stomach that has had a few too many.

Drinking too much alcohol can contribute to obesity

Dr Lakhtakia now uses food to teach her students – often walking round with samples of nutmeg and turmeric to help illustrate some of the more colourful workings of the inner body.

She says turmeric can match the urine of patients with severe jaundice, while nutmeg helps illustrate the appearance of congested livers.

They need fairly strong stomachs, she says.