When I use a word . . . Medical slangBMJ 2023; 381 doi: https://doi.org/10.1136/bmj.p1330 (Published 09 June 2023) Cite this as: BMJ 2023;381:p1330
- Jeffrey K Aronson
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Twitter @JKAronson
Every year since 20161 I have been contributing articles to The BMJ documenting medical anniversaries. The 2016 anniversaries included William Harvey’s 1616 Lumleian lecture to the College of Physicians on the circulation of the blood,2 René Laennec's invention of the stethoscope in 1816,3 and the description of the Guillain–Barré syndrome by Georges Guillain, Jean Alexandre Barré, and André Strohl in 1916.4
On occasion, I have accompanied those articles with pieces on what I call lexicographic anniversaries, by which I mean words whose first instances, recorded in the Oxford English Dictionary (OED), can be dated to anniversaries of the year in question. For example, the 170 medical examples for the year 20205 that I discovered included cardialgic (1620), aegophony and stethoscope (both 1820), and electromyographic (1920).
The problem with this is that, although the OED’s lexicographers do an excellent job of tracing the earliest uses of the words the dictionary includes, on not a few occasions earlier examples can be found, so called antedatings. Indeed, the editor of the first edition of the dictionary, James Murray, estimated that about three quarters of its headwords could be antedated. He also pointed out, in a presidential lecture to the Philological Society in 1884, that words are generally spoken before they are written down, so that written sources will generally postdate the date of invention or introduction of a word. In my experience of antedating medical terms, I have found earlier instances in about 10% of cases.
Take the example of “premedication.” The earliest instance listed in the OED is from an editorial titled “N.A.R.S. Anesthesia Survey” published in a supplement on anaesthesia to volume 34 of the American Journal of Surgery, published in 1920. Incidentally, this is not the current journal of that name, which was first published in 1926. However, there is a much earlier instance of the word in the title of an 1849 book by Samuel A Cartwright, called “Some remarks on premedication: and the doctrine of a retrograde action from collapsion [sic] of the absorbent and capillary vessels.” Cartwright’s book was included in a list of donations to the library of the Academy of Natural Sciences of Philadelphia, published in the academy’s proceedings in late 1849 and it was reviewed twice in that year in the New Orleans Journal of Medicine, in September and November 1849 (pages 265-72 and 366-75). The word also appears in another book by Cartwright, “The Pathology and Treatment of Cholera,” which was also reviewed in the New Orleans Journal of Medicine in September 1849 (page 224). The texts of these reviews make it clear that the word had been in use before 1849, so further antedating is possible.
Commenting on my piece on lexicographic anniversaries for 2020 and antedatings of medical terms in the OED, Jonathan Green, identifying himself as @MisterSlang, author of many books on slang, in which he is an acknowledged expert, tweeted: “v. interesting piece, but tech stuff, dare I say, is easier to hunt than slang, in which 80% of terms simply play with SE. Try searching a newspaper database for one of slang's 125+ ‘dog’ terms. In the end, it's the hard way: reading. Then reading more.” [“SE” stands for “Standard English.”]
Green was saying, if I have understood him correctly, that because so many slang uses involve ordinary English words, it is often difficult to trace the origins and first uses of slang terms without reading the context in which they occurred, and even then it may not be straightforward. Whereas technical terms, he suggests, are much easier to study. That has not always been my experience. Physicists, for example, are good at taking ordinary words, such as “colour” and “flavour,” “beauty,” “charm,” and “truth,” and giving them extraordinary meanings.6 AI experts use the term “hallucination” when describing gobbledegook created by a programme such as ChatGPT. And medical terms sometimes emerge in the same way. For example, the noun “arrest,” first recorded in Chaucer, and meaning stoppage, halt, or delay, was adapted for medical use in the late 19th century to refer to cessation of cardiac or respiratory function. The intransitive use of the verb did not emerge until the 1980s. And without reading texts published before 1849 it will be difficult if not impossible to determine whether there are earlier instances of “premedication.”
All this started me thinking about medical slang.
I began by wondering about the etymology of the word. And where better to start than with IndoEuropean? The standard texts refer to a hypothetical root, variously spelt as SLENK, [S]LEIDH, and SLENGWH, meaning something like to slide or sling, to hurl or throw. They give us words such as sling and slink. In German “slang” means a snake, as in the Africaans loanwords boomslang, a tree snake, nachtslang, a nocturnal snake, such as the night adder, and spuugslang, a spitting cobra. And then there is the Yiddish loanword schlong, slang for a penis.
Next I turned to Eric Partridge’s Short Etymological Dictionary of Modern English.7 At the entry “slang, slangy” he writes “See SLING.” And at “sling” he writes
“Perh[aps] from ‘to sling’—prob[ably] from the dial[[ectal] p[ast]p[articiple] slang—and therefore elliptical for ‘slang, i.e. slung, language,” is the n[oun] slang, orig[inally] the language of the underworld, now merely the unconventional (non-dial[ectal]) speech of all classes; cf the sl[ang] ‘sling off at’, to cheek, to abuse, and Nor[wegian] slengja kjeften, to use slang (lit[erally], to sling the jaw), and slengjeord.”
It is as if slang, or slanguage, is language that is hurled at you.
In A Classical Dictionary of the Vulgar Tongue (3rd edition, 17768), Francis Grose gives a similar, albeit shorter, explanation and adds a phrase from Kipling, to sling the bat, to talk the vernacular. Grose doesn’t give the source, but it’s from a poem called “Route Marchin’”: “An' 'ow they would admire for to hear us sling the bat.” Grose is wrong, however, to imply that “vernacular” specifically refers to slang; the context of Kipling’s poem makes it clear that the soldiers are talking about speaking the local language, Hindi, which they actually speak very badly; “bhasha” is a Hindi word for language. Others support this supposed origin by referring to “mud-slinging,” which is, however, irrelevant.
The OED, on the other hand, is having none of this. It defines “slang” as “The special vocabulary used by any set of persons of a low or disreputable character; language of a low and vulgar type,” and cites the first recorded instance from 1756.9 As for etymology, it states that “The date and early associations of the word make it unlikely that there is any connection with certain Norwegian forms in sleng- which exhibit some approximation in sense.” And other reputable dictionaries generally say “origin unknown.” The Chambers Dictionary10 says “of cant origin; connection with sling very doubtful.”
For what slang actually is, watch this space.
Competing interests: none declared.
Provenance and peer review: commissioned; not externally peer reviewed.