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When did we start describing comatose patients as “vegetative”?

A comatose patient

A study published last Wednesday in the New England Journal of Medicine revealed that British and Belgian scientists were able to communicate with a patient in a “persistent vegetative state” using high-tech brain scans. When did we start describing comatose patients as “vegetative”?

In the mid-1800s, although the word itself has been around much, much longer. In De Anima,Aristotle used the word vegetative (or, rather, the ancient Greek equivalent) to denote lesser forms of life. Plants, he wrote, have a “vegetative” soul, capable only of growth and reproduction, whereas humans have a “rational” soul that allows for thought. Starting in the 18th century, English speakers employed this Aristotelian word in a more metaphoric sense—living a merely physical life, devoid of intellectual activity or social intercourse. From here we get “vegetative state” to describe reduced brain function. The earliest example of this medical usage in the Oxford English Dictionary dates from 1893—when the Daily News, a now-defunct British paper, referred to a man in a “vegetative state” who was “incapable of connecting two ideas together.” But the Explainer also uncovered a slightly earlier reference. An 1866 report from Guys Hospital in London mentions a man admitted to the hospital in the midst of an apoplectic fit. He lay in a “vegetative state” for 15 months and never woke up.

Scottish neurosurgeon Bryan Jennett and American neurologist Fred Plum coined the specific term “persistent vegetative state” in a 1972 Lancet article. It denotes patients who have no apparent internal or external awareness. Jennett and Plum acknowledged that the term had been used for years as unofficial lingo. In fact, they intentionally avoided making it sound like medical jargon, in part because they wanted journalists and the general public to latch onto it.

The more colloquial expression “he’s a vegetable”—meaning someone who leads a monotonous life without intellectual activity—has been around since at least the 1920s. In Back to Methuselah, George Bernard Shaw wrote, “What use is this thousand years of life to you, you old vegetable?” And in a 1933 letter, Aldous Huxley wrote, “It will be a weary business for a bit … sitting still and being a vegetable.”

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Explainer thanks Anatoly Liberman of the University of Minnesota, Nicholas D. Schiff of Weill Cornell Medical College, Jesse Sheidlower of the Oxford English Dictionary, Ford Vox of Washington University in St. Louis, Ben Zimmer of the Visual Thesaurus, and Carl Zimmer of Discover magazine.

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