Of Diphthongs and Digraphs

Until recently I had no real idea what a diphthong was; I had a 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 Hemmingway and Vonnegut so it is good enough for me.

Anyway, my knowledge of grammatical arcana got a upgrade recently. When attempting to look up the correct medical spelling of ‘fetus/foetus’, I ended up down a rather deep and labyrinthine internet rabbit hole. It was a happy hour or two, bouncing around related topics on my laptop, quite 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. Now 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 origin of the Latin word fētus (meaning ‘child’). But why did foetus ever arise in the first place? Therein lies initial entrance tunnel of the aforementioned rather interesting rabbit hole. You see, during the 16th Century, a whole language of English medical words of Latin and Greek origin came into use to describe new medical discoveries. And as a result, a large number of words were introduced that retained some of the grammatical features of it’s origin.

Which led to multiple different spellings of fetus, foetus, phoetus and fætus before finally deciding on foetus. However, this is a little off in etymology. The original Latin fētus was pronounced with a long ‘e’, denoted by the little line above the letter (called a ‘macron’). So it 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 learnt, 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. The original thinking is, presumably, that ‘foetus’ should have been pronounced ‘foe-ee-tus’. Whereas it was always pronounced ‘fee-tus’. Hence the ‘oe’ diphthong is wrong.

The ‘oe’ bit is, in modern usage, 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’. Feetor, anyone?

I began to wonder about all the other different spellings between British and American medical English. Is it because haematology/hematology; hydrocoele/hydrocele, tumour/tumor were all originally misspelled by scientists of the Enlightenment? Well, no, as it turned out. As always, it is more complex than that and not just about dropping apparently redundant diphthongs or ignoring etymology.

American English, as a concept, started with lexicographer Noah Webster in 1828 and has continued since then. Webster was trying not to just simplify but also unify spelling across the then fledgling country. However, many modern medical words (like ‘paediatrics/pediatrics’) were coined well after Webster’s time. We Brits can’t point the finger 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 have been true originally but not now.

In one way, I feel lucky that English is the lingua franca of medicine. As a Brit, I can go to international conferences and everyone is speaking my birth tongue. But as a global tongue, it will evolve and keep evolving. Local variations of English have existed and will continue to do so. 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. So what if we don’t pronounce words like that anymore? So what if they are hard to spell and confusing for non-native speakers? It is just how we spell them and pronounce them. But if my American cousins want to spell things in an odd fashion, you guys go for it. Knock yourselves out. Whatever works for you.

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 knight 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 gobbledigook.

My overall thoughts? Ignore the grammar pedants, ignore the nationalists, ignore international standardisation committees. Minor spelling differences between countries cause no harm. I say leave things be and just celebrate our differences. 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.