{"id":34551,"date":"2015-06-26T16:35:36","date_gmt":"2015-06-26T15:35:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=34551"},"modified":"2015-06-26T16:35:36","modified_gmt":"2015-06-26T15:35:36","slug":"jeffrey-aronson-when-i-use-a-word-an-indefinite-article","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/06\/26\/jeffrey-aronson-when-i-use-a-word-an-indefinite-article\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . An indefinite article"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-32935\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg\" alt=\"jeffrey_aronson\" width=\"155\" height=\"209\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg 223w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg 446w\" sizes=\"auto, (max-width: 155px) 100vw, 155px\" \/><\/a>The grapheme &lt;a&gt; is used as a symbol for the phoneme \/a\/ when it is pronounced as the low front unrounded form of the vowel, as in the Scottish pronunciation of \u201cback.\u201d In the International Phonetic Alphabet (IPA) it is called Cardinal vowel number 4. The grapheme that looks like a handwritten version &lt;\u0251&gt;, Cardinal vowel number 5, represents the low back unrounded version; it has a slight hint of an <em>o<\/em> in it, but probably only phoneticists can reliably distinguish the two sounds.<\/p>\n<p>But the letter <em>a<\/em> is also a word in its own right, the so called indefinite article. Originally it was \u201can,\u201d a form of the Old English word for one, \u00e1n, but by 1150 it was reduced to \u201ca\u201d before consonants (for example a word) and before vowels that are pronounced as consonants (for example a eucalyptus, a one, a urinal); \u201can\u201d was retained before words beginning with a vowel (an operation) or an <em>h<\/em> (an hour), even if aspirated (an historian), although not nowadays.<!--more--><\/p>\n<p>In about the 15th century both forms were commonly written in combination with the noun as a single word, for example aman or anoke. When a century or so later they became separated again, there was often uncertainty about where the division should occur. In some cases this led to spurious words (for example, a nox), a few of which persisted, becoming part of the language, as some examples show:<br \/>\n\u2022 adder (OE naedre);<br \/>\n\u2022 aitchbone (the rump bone in cattle; OFr nache, Latin natis, buttock);<br \/>\n\u2022 apron (OFr naperon, from Latin mappa, a table napkin);<br \/>\n\u2022 auger (OE nafu-gar, something that pierces (gar) the nave of a wheel);<br \/>\n\u2022 umpire (OFr noumpere, one without equal);<br \/>\n\u2022 newt (OE an efeta);<br \/>\n\u2022 nickname (OE an ekename, an alternative name).<\/p>\n<p>In the first five examples the <em>n<\/em> was lost from the noun to the article, and in the other two it happened the other way round.<\/p>\n<p>In a variant of this, \u201cfor then once\u201d became \u201cfor the nonce.\u201d By the same process, in Scotland \u201cmine own self\u201d became \u201cnainsell,\u201d sometimes used jocularly to mean a Highlandman. And when the Fool calls Lear \u201cnuncle,\u201d he means \u201cmine uncle,\u201d although perhaps he also has \u201cnanunculus,\u201d a little man, in mind.<\/p>\n<p>When the Arabic word \u201cnaranj\u201d was converted in this way to \u201corange,\u201d it was at least partly influenced by the Latin aurum, gold. Some Indo-European languages retain the <em>n<\/em> (Azerbaijani nar\u0131nc\u0131, Spanish naranja), some do not (French orange, Dutch oranje). In Spanish \u201cnaranjo\u201d is an orange tree. The Naranjo probability scale, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8529335\">a method<\/a> for determining the likelihood of an association when a drug is suspected of causing an adverse reaction, was devised by the late <a href=\"http:\/\/www.rskane.ca\/book-of-memories\/1952415\/Naranjo-Dr-Claudio\/obituary.php\">Claudio Naranjo<\/a>, a clinical pharmacologist in Toronto. His method, although <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25266970\">problematic<\/a>, continues to be used.<\/p>\n<p>The interaction of grapefruit and grapefruit juice with drugs that are metabolized in the gut and liver by the oxidative enzyme CYP3A4 is well known. For example, the antihistamine terfenadine was removed from over the counter sales some years ago because grapefruit inhibits its metabolism, and that can lead to <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10668858\">dangerous cardiac arrhythmias<\/a> (picture). What is less well known perhaps is that the same interaction can occur with other members of the citrus family, including <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12811362\">limes<\/a> and <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11180034\">Seville oranges<\/a>. Other types <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10734174\">of oranges<\/a> seem to be innocent.<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-34552\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite.png\" alt=\"aronson-definite\" width=\"139\" height=\"89\" \/><\/a><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite-2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone  wp-image-34553\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite-2.png\" alt=\"aronson-definite-2\" width=\"337\" height=\"94\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite-2.png 409w, https:\/\/blogs.bmj.com\/bmj\/files\/2015\/06\/aronson-definite-2-300x84.png 300w\" sizes=\"auto, (max-width: 337px) 100vw, 337px\" \/><\/a><\/p>\n<p><em>The <a href=\"http:\/\/www.bmj.com\/content\/324\/7335\/470\">normal electrocardiogram<\/a> (left) and the <a href=\"http:\/\/www.bmj.com\/content\/324\/7340\/776\">typical type of abnormal cardiac rhythm<\/a> (right) that occurs during interaction of grapefruit juice with drugs such as terfenadine.<\/em><\/p>\n<p>Originally, the process by which these linguistic changes occurred was called provection, but that covered only those cases in which the letter <em>n<\/em> moved from the article to the noun and not the other way round. In 1914 therefore, the grammarian Otto Jespersen coined a word to cover both processes; he called it metanalysis. Not to be confused with the form of systematic review called meta-analysis, which is the definite article.<\/p>\n<p><em><strong>Jeffrey Aronson<\/strong> is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford&#8217;s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n<p>Competing interests:\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The grapheme &lt;a&gt; is used as a symbol for the phoneme \/a\/ when it is pronounced as the low front unrounded form of the vowel, as in the Scottish pronunciation [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/06\/26\/jeffrey-aronson-when-i-use-a-word-an-indefinite-article\/\">More&#8230;<\/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-34551","post","type-post","status-publish","format-standard","hentry","category-jeff-aronsons-words"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jeffrey Aronson: When I use a word . . . 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