Until recently I had no real idea what a diphthong was. I had the vague notion it was some form of sprocket or perhaps part of an internal combustion engine. You see, Dear Reader, I didn’t have a classical education. When I was at school, “Grammar” was what we called my mother’s mother. I’m therefore a self-taught writer, almost entirely lacking any technical knowledge of English literature. Writing in the vernacular is all I have. But it worked for Hemingway and Vonnegut, so it is good enough for me.
Anyway, my knowledge of grammatical arcana got a upgrade recently. When looking up the correct medical spelling of “fetus/foetus,” I spent a happy hour or two down a rather deep internet rabbit hole, bouncing around related topics, completely divorced from reality. As it turns out, there is an accepted spelling of the term in British medical practice. And that is “fetus.”
As I was brought up spelling it “foetus,” this was a minor shock. Unbeknownst to this adult radiologist, it has officially been “fetus” for over a decade not just on this side of the Atlantic but globally so. Our American cousins may celebrate this as a win, thinking the Brits have come to their senses and started using the simpler American spelling. But it isn’t quite the win they might think it is.
It is simply that fetus is closest to the original Latin word fētus (meaning breeding or birth). But why did foetus ever arise in the first place? Therein lies the entrance to the aforementioned rabbit hole. You see, during the 16th Century, a whole language of English medical words derived from Latin and Greek came into use to describe new medical discoveries. It wasn’t an intellectual flex, just that they were the scholastic languages of the time. As a result, a large number of words were introduced that were supposed to retain some of the grammatical features of its source.
Hypercorrections
Except translators often hypercorrected matters, introducing prestigeful spelling based on etymological fallacies. Which led to multiple different spellings of fetus, foetus, phoetus and fætus before finally agreeing on foetus. Except they settled on the wrong spelling. The original Latin fētus was pronounced with a long “e,” denoted by the little line above the letter (called a “macron”). So fetus should really have been spelled “feetus” if we are going to utterly logical about it. But it is a bit late for that now.
The “oe” bit in the middle of foetus is supposed to be, I learned, a diphthong. This is where two letters create a syllable that glides across the mouth. The exclamation “Ah!” is a monophthong, whereas “Ow!” is a diphthong. Perhaps the original thinking was, presumably, that “foetus” should have been pronounced “foe-ee-tus.” However, it was always pronounced “fee-tus,” so the diphthong argument for the “oe” in foetus doesn’t stand up.
More: the “oe” bit is also a digraph. This is where two letter combine to form a sound, potentially unrelated to the spelling. The digraph “oe” usually denotes a long flat “o” such as in “toe” or “poet.” Fetus was never pronounced “fow-tus,” so justifying foetus as a digraph doesn’t hold water either. The same is true with the words “fetor” and “fetid,” from the Latin fētor, meaning “stinking.” We Brits should have never used “foetor” or “foetid,” and it has been largely dropped. Feetor, anyone?
I began to wonder about all the other different spellings between British and American medical English. Were haematology/hematology, hydrocoele/hydrocele, and tumour/tumor all originally misspelled by scientists of the Enlightenment? Well, no, as it turned out. It is more complex than just dropping redundant diphthongs and ignoring etymology.
Many American English medical spellings are along the principles set forth by U.S. lexicographer Noah Webster. Webster’s 1828 American Dictionary of the English Language was trying not just to simplify spelling but also to unify spelling across the then fledgling U.S. However, many modern medical words (like “paediatrics/pediatrics”) were coined well after Webster’s time. We Brits can’t point the finger directly at the Webster on this one. Nor can we blame the Merriam brothers who bought the rights to Webster’s work after his death.
I’ve read many arguments that British medical spelling is more accurate because it reflects the etymology of the word. Hence “oesophagus” should retain it’s initial “o” because the original Greek word was οἰσοφάγος or oisophagos. But we don’t call Egypt “Aegypt” just because the Greeks and Romans spelled it with an “A.” I’ve also read that we should retain the digraphs “oe” and “ae” as they are pronounced subtly differently to “e.” Well, that might once have been true but not now.
Does it matter?
Does it really matter about there being one ultimately correct medical spelling of the word denoting the unborn child or gullet? Not really. I feel lucky that English is the lingua franca of medicine. As a Brit, I can go to international conferences and everything is in my birth tongue. But as a global language, English is ever evolving and will keep evolving. Local variations of English exist in multiple dialects across the world. But the spoken word and the written word evolve at different speeds. The written word lags behind by some distance. Several hundred years in many cases.
Aside from my new love of all thing fetus, I’m largely averse to changing the spelling of British English medical terms. We’ve never had the equivalent of Académie Française, a 400-year old French institution solely dedicated to regulating French grammar, spelling and literature. English has a 1,600-year history from its roots as a West German language from Anglo-Saxon invaders. It then absorbed many words from others, largely Norse and French invaders. This mish-mash of odd words give a richness and depth but its loose grammar structure allows flexibility and ease of use. It’s too late to change spelling of words wholesale. Moreover, we don’t want to. We like it as it is — albeit a tad messy.
So what if we now pronounce many words quite differently from their spelling? So what if they are hard to spell and confusing for nonnative speakers? All languages have oddities that way. But if my American cousins want to spell things differently, you guys go for it. Knock yourselves out. Whatever works for you. Just don’t expect us to change. Or agree that one way is somehow “better.”
Because if we start changing the spelling of British English words to match modern global pronunciation, we’d be absolutely screwed. For example, the sentence “Worcester knigknight Colonel Geoff sliced the tough sugar cake using a sword” makes complete sense to Brits. But if you change it to “Wuster nite Kernel Jeff slysed thu tuff shugar cayk yoosing ay sord” it makes phonetically sense but it becomes absolute gobbledygook.
My overall thoughts? Ignore the grammar pedants, ignore the nationalists, ignore international standardization committees. Minor spelling and grammatical differences cause no harm. I say leave things be and just celebrate our differences. Let language evolve naturally. Don’t fight with dialects or correctness of spelling. It comes across as sneering cultural snobbery. No snobbery is good but that is definitely the worst sort.
Fred Astaire and Ginger Rogers had it right in 1937 when they sang “potato, potahto; tomato, tomahto, let’s call the whole thing off!” We need each other too much to squabble over words; we can be happy and work together productively, spelling notwithstanding.
Paul McCoubrie, MBBS, is a consultant radiologist at Southmead Hospital in Bristol, U.K. Competing interests: None declared.
His new book — More Rules of Radiology — is available via its publisher Springer and also local bookstores ( ISBN-13 978-3031640933).
The comments and observations expressed herein do not necessarily reflect the opinions of AuntMinnie.com, nor should they be construed as an endorsement or admonishment of any particular vendor, analyst, industry consultant, or consulting group.
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