The process of discourse: usages of a Japanese medical term.

Analysis of the usages of the term "autonomic nervous disorder" among Japanese physicians and patients suggests that medical terms lack essential meanings. Their meanings vary according to speaker, addressee, and context. Autonomic nervous disorder is a term employed to give different perspectives on the origins and treatment of menopausal problems in Japan. Through its changing meanings, it demonstrates aspects of the process of discourse, the shifts language undergoes because it is embedded in power relations. Through discourse, autonomic nervous disorder serves the purposes of both the powerful and the powerless, creating a debate concerning middle-aged women and the control of biomedicine over them. The Japanese case highlights the importance of separate contexts to the process of discourse. Groups with varying degrees of power establish their points of view in contexts of formal respect at one extreme or informal intimacy at the other, thus enabling sharp debate while maintaining surface harmony.