{"id":33345,"date":"2015-02-13T18:11:37","date_gmt":"2015-02-13T17:11:37","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=33345"},"modified":"2015-02-27T16:23:22","modified_gmt":"2015-02-27T15:23:22","slug":"when-i-use-a-word-say-aaaaaaah","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/02\/13\/when-i-use-a-word-say-aaaaaaah\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . Say “Aaaaaaah”"},"content":{"rendered":"

\"jeffrey_aronson\"<\/a>We may not know what the first spoken word was<\/a>, but we can be pretty sure that the first uttered sound (Greek \u03c6\u03ce\u03bd\u03b7\u03bc\u03b1) was a phoneme, a unit of sound that cannot be analysed into smaller units. English has 44: 24 consonantal sounds, 12 pure vowels (seven short, five long) (see picture, below), and eight diphthongs.<\/p>\n

Open your mouth and glottis. Now phonate. The sound will be a vowel. And if you\u2019ve opened wide it will be “aaaaaaaaah.”<\/p>\n

\"aronson_vowels\"<\/a><\/p>\n

English pure vowel sounds, showing the forms of the mouth and lips (left and bottom) and the part of the tongue affected (top) in the oral cavity, represented as a trapezium.<\/em><\/p>\n

The sound “aah” can express various emotions, including:
\n\u2022 sorrow, distress, regret\u2014\u201cYet much I fear (ah! may that fear be vain!)” (Alexander Pope\u2019s translation of The Iliad<\/em>);
\n\u2022 pleasure, surprise, wonder, admiration\u2014\u201cAh me, how sweet is love” (Romeo and Juliet<\/em>);
\n\u2022 entreaty, appeal, remonstrance\u2014\u201cAh Christ, that it were possible \/ For one short hour to see \/ The souls we loved” (Tennyson, Maud<\/em>);
\n\u2022 dislike, aversion, contempt\u2014\u201cAh villain, thou wilt betray me” (Henry VI Part 2<\/em>);
\n\u2022 opposition, objection (to what has been said)\u2014\u201c\u2018Ah, but no, Madame,’ the woman answered, with a shrill scream of protest.\u201d (Mary Braddon, Lady Audley’s Secret<\/em>);
\n\u2022 realisation, discovery, inspiration\u2014\u201cAh, you want money, Miss Frost” (J P Donleavy, The Ginger Man<\/em>);
\n\u2022 pain\u2014\u201cHe turned . . . and bit the professor’s finger till it bled. \u2018Oh! ah! yah!\u2019 cried he.” (Charles Kingsley, The Water Babies<\/em>).<\/p>\n

“Ah” can also be a conversational filler, like er or um, an interjection meaning “yes,”<\/a> and a verb meaning to say “ah.”<\/p>\n

But nowhere in standard dictionaries is \u201csay ‘aah’\u201d defined as a medical instruction to phonate with the back of the tongue in its lowest position, preferably with a falsetto pitch<\/a>.<\/p>\n

A colleague, composing an exam paper, wanted to describe a patient with a hoarse voice, whose palate moved upwards to the right when he phonated. How, he asked me, should he spell the sound? Now there\u2019s no standard way to spell utterances of this sort that are not proper words. I recommended “aaah,” but could have suggested “a,” “ah,” “aah,” and “aagh” or even “aargh.”<\/p>\n

In 14 textbooks on clinical examination that I have consulted, the instruction to ask the patient to say “ah” appears in the section on examining the ninth cranial nerve. In eight of them the spelling is “ah,” in four “ahh” or “ahhh,” and in two “aah.” Three of the instances of “ahh” were in American texts. In two cases (one “ah” and one “ahh”) the authors added an unnecessary exclamation mark.<\/p>\n

I prefer<\/a>\u00a0“aah<\/a>” or “aaah<\/a>,” because the sound that the patient is asked to make is prolonged and is the vowel sound a<\/em> (technically the maximally low and back rounded vowel sound), not the aspirate h<\/em> (technically a voiceless glottal fricative). It could even be “aaaah,” as used in the English translation of the title of a Dutch paper, “Zeg ‘ns Aaaa,<\/a>” which was not about the Dutch TV medical sitcom<\/a> Zeg ‘ns Aaa<\/em>. See the difference?<\/p>\n

Counter examples, such as “ahhh”<\/a> and “ah-h-h-h-h,”<\/a> are generally American.<\/p>\n

Other “aah\u2019s” include Aah III<\/a>, a haemorrhagic toxin from the venom of a snake Agkistrodon acutus<\/em>; Aah VI<\/a>, an N-glycosylated anti-insect toxin that has been isolated from the venom of the Androctonus australis hector<\/em> scorpion; and the AAH genes, which code for amino acid hydroxylases<\/a> or autotransporter-adhesin-heptosyltransferase<\/a>, not to mention AAH (asymmetrical apical hypertrophy [of the heart] or atypical adenomatous hyperplasia [of the prostate or lung]). Then (and I can stop this any time I like) there\u2019s Ah (the SI unit of charge, an ampere-hour); AH (anno Hegirae, in the year of the Hegira); and Say Aah,<\/em> the hip hop hit by Trey Songz.<\/p>\n

Ahem, I\u2019d better stop there.<\/p>\n

Jeffrey Aronson<\/strong> is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford’s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n

Competing interests:\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"

We may not know what the first spoken word was, but we can be pretty sure that the first uttered sound (Greek \u03c6\u03ce\u03bd\u03b7\u03bc\u03b1) was a phoneme, a unit of sound […]<\/p>\n

More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5762],"tags":[],"class_list":["post-33345","post","type-post","status-publish","format-standard","hentry","category-jeff-aronsons-words"],"yoast_head":"\nJeffrey Aronson: When I use a word . . . Say "Aaaaaaah" - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/02\/13\/when-i-use-a-word-say-aaaaaaah\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Jeffrey Aronson: When I use a word . . . 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