Capital letters are larger than lowercase letters and are used as initial letters in the first word of sentences and for proper names. They are also often used as the initial letter of major words in titles, heads, and subheads. (Caput is Latin for head.1) Use of all capital letters in large blocks of text should be avoided as legibility is decreased; other ways should be used to add emphasis if needed.1,3 JAMA and the Archives Journals use all capital letters sparingly (eg, for level 1 heads).
A dropped cap (a form of initial cap) is an oversized capital letter of the first word that begins a paragraph and drops through several lines of text. It may be used in a complicated page to draw the reader’s attention to the beginning of an article, chapter, or important section (see Figure 1 for an example). An initial cap may also be a raised cap when the capital letter is raised above the main line of text.