Daily Archives: August 8, 2010


Perhaps antique medical terminology entices you. An image of surgeons wearing ties is appealing; you see them gathered around a patient, whose lungs are laboured (his breath sounds like “ph, th, ph, th”). It’s some infection. The gentleman in charge lifts his stethoscope from the chest and pronounces, “This is not staph; this is phthisis.”

But how does he pronounce it? Is this a word like exophthalmic, where the lower lip and the tip of the tongue exchange fricatives against the teeth? That’s one option, yes. But although it’s no great problem to make that sound (stick a little hair on the tip of your tongue and see how many times you make it until the hair is gone), it’s not part of the normal phonotactics of English. So some drop the /f/. Some go further, making the onset a simple /t/. Oh, but what a crisp, delicate touch that is, a tip-of-the-tongue stop, so far removed from the fricatives – and making four letters represent a single short sound.

The back half of the word is agreed on, at least. The remaining two consonants are also voiceless fricatives: it’s pronounced like Isis, the name of the goddess, or like “Aye, sis.” So no matter how you do it, there is ample hissing – or wheezing – for your consumption.

And, indeed, consumption is another word that used to be used to describe the same thing that phthisis was most often used to describe: what now we call tuberculosis. But it has been used to describe other wasting diseases, particularly of the lungs, as it has been ever since it was a Greek word. (One thing’s for sure: if you have phthisis, you’re not just up shit creek, you’re on shit ship.)

There is one kind of phthisis that is not of the lungs, however, and it may be a bit ironic, given the superficial kinship of form between this word and exophthalmic: ophthalmologists may speak of phthisis bulbi (not related to Taras Bulba), which is an atrophy of the eye, involving shrinkage of the eyeball.


Now, there’s an eye-popping word. Seriously, what are the odds your eyes even know what to do with the phth – other than bug out at the sight of them? The first three letters even look like the sequence your eye goes through when seeing a cluster like this: e squint, x close tightly for a moment to readjust, o open wide! The forest of ascenders makes it hard to see the trees – and, for that matter, it’s not the most natural thing to type, either.

In fact, in the most common word using this root – Greek οφθαλμος, ophthalmos, “eye” – people tend to reduce it in the thinking and saying, away from the watermelon-seed-spitting double fricative followed by tongue-tip liquid and towards a pair of stops with much less sliding: ophthalmologist is often thought to be optomologist (and why not? their partners in trade are optometrists and opticians).

But today’s word is not common enough to get that sort of shop wear. Like ophthalmoscope, it has retained its fricatives. It’s a special word, kept in a velvet-lined drawer with assorted other curious instruments, some gleaming, some tarnished, to be brought out when one fancies just the right amount of erudition or scientific bent – words such as etiolated. Now, one may have few chances in real life to use it, but if one is writing fiction, one may of course create a character to whom to apply it.

Indeed, as Margaret Gibbs has informed me, in every one of P.D. James’s novels there is a character with eyes described as exophthalmic – and another character described as etiolated. (“You find yourself waiting for those characters so you can get them out of the way and start following the plot instead,” Margaret says.)

Now, you may have sorted out that ex means “out” and ophthalmic relates to the eyes. Does that mean that exophthalmic means “having lost an eye or eyes”? No – rather, that the eyes look as though they are straining to leave the head. That is, they are protruding. The condition, called exophthalmus, exophthalmos, exophthalmy, or exophthalmia (talk about four eyes!), is often called bug eyes or pop eyes. Not something you see all that much in real life, but it does seem appropriate to mystery novels, no?