The Pestilential Lexicon of Disease

WHO Director Tedros Adhanom is more effective than any Classics teacher at making everyone in the world learn the Greek alphabet.

On Friday, the World Health Organisation named a concerning new variant of Covid-19 for the Greek letter Omicron. The WHO initiated this arcane naming convention earlier this year, to avoid stigmatising countries where variants arose. This tactic is politic, a means of heading off racism of the kind that some Asians suffered in the early days of what former US President Donald Trump insists on calling the “China virus.”

In a weird way, Mr. Trump is much more in line with traditional naming conventions for diseases. Most of the famous epidemics of history are known by where they originated. The last great one was the Spanish flu of 1918–1920. (Spain gets an undeserved bad rap: the disease probably originated either in China or France, but the Spaniards were the only ones in Europe who did not censor news about it, so everyone else assumed it came from there.) It was preceded by the Russian flu of 1889–1890, and followed by the Asian and Hong Kong flus two generations later. All this followed in a tradition stretching back deep into the pestilential past. (In ancient times, when all the world was under one empire, rulers took the blame, as in the Antonine and Justinianic plagues that wiped out millions of Romans in spite of their namesake emperors’ best efforts. A few Democratic campaigners tried to revive this custom during the 2020 US presidential election.)

In early 2020, French tabloids announced a “yellow alert.”

Until 2020, no one really questioned the validity of such intuitive, non-scientific means of naming outbreaks. We still have West Nile and Ebola viruses; just a few years ago, international travel had a sort of Covid walk-through with Middle East Respiratory Syndrome. Indeed, before Covid was Covid, news reports referred to the Wuhan coronavirus.

There are more irrational ways to talk about diseases. Many terms we still use today are literally medieval. Malaria is Italian for “bad air,” dating back to when people thought disease was wrought by miasma in the air. Cholera takes its name from choler, referring to the four humours theory of disease that prevailed in medicine until shockingly recently (likewise, melancholy refers to an overabundance of black bile).

Most relevant today is the word quarantine. It comes from the Italian for “forty,” referring to the forty days of confinement necessary to prevent travellers from spreading the Black Death. I can attest that the fourteen-day quarantines many countries required in the past year were boring and lonely, but it made me feel a bit better that I never spent one in a medieval jail.

Experts in the 19th Century assumed that epidemics in industrial cities were caused by noxious fumes. A visitor from back then would assume that everyone today is wearing masks to ward off miasma.

Other terms are even more simplistic. Smallpox comes from, you guessed it, the small pock marks it raises on the skin. Yellow and scarlet fevers are similarly obvious; the Black Death’s name is poetic, but those suffering through it usually called it simply “the great dying,” or “the plague.”

The common cold is so named because its symptoms are similar to those of being cold. In the less scientific past, warning kids going out without coats that they would “catch cold” meant both things at once; my grandmother used to warn me more bluntly that I would “catch my death.” The English word “influenza” comes from Italian, referring to the malign influence of the disease. Most Continental European languages borrowed the German word Grippe, after the grip it seizes on sufferers’ throats.

For obvious reasons, people were and are inclined to speak about such subjects in euphemisms. In Spanish, mal as an adjective simply means “bad,” but as a noun, it is an illness; the same can be said of the English word “ill.” More erudite terms are generally painstakingly general. Plague and pestilence were traditionally general terms for catastrophes, whose meanings narrowed over time. Less Classically-oriented etymologists can appreciate our current favoured word “disease” as classic English understatement. It must have taken a certain sort of mind to examine victims wracked by horrific medieval plagues and observe that they were ill at ease.

An age of greater expertise called for more expert-sounding terminology.

Later generations were more artful. “Epidemic” is a modern medical term coined as an adjective, from the Greek meaning “upon the people;” I dislike the newer “pandemic,” meaning “all the people,” which does not make sense etymologically. Anyway, the best way to prevent them is with vaccines, which thankfully no longer involves inoculating people with infected tissue from cows (Latin: vacca).

Some terms are just bizarre. To the Romans, “virus” meant a sort of noxious sap, but it was somehow picked up by modern researchers searching for vocabulary to describe a brave new frontier of medicine. “Cancer” is an ancient term, based on the fact that swollen veins on tumors can kind of look like crabs. When syphilis arrived in Europe from the New World, observers were bewildered and horrified. Our word derives from a 1530 Veronese pamphlet about a hypothetical patient zero whom the author gave a faux Greek name meaning “goat lover;” he also offered an amusing alternative, “the French disease.”

As medicine became more scientific and professional, those who practiced it began to prefer more erudite vocabulary. In Old English, those who tried to heal people were called “leeches,” probably after their favoured treatment. Educated people, who wrote in Latin, preferred medicus, variants of which are still popular in Romance languages (medical students at Oxford are still sometimes called “medics”). But over time, they came to be known by their degree of academic qualification, with no inherent reference to their field: doctors.

Do you have to be a doctor to be a leech? (As an aside, I was extraordinarily bored deep in lockdown, and assembled a plague doctor costume from Amazon. It didn’t seem to comfort anyone at the grocery store.)

By late in the 20th Century, medical researchers, like economists and so many other types of experts, started really to go in for fancy acronyms. A new immune disease from Southern Africa was Aids; a respiratory one from South China was Sars. Early last year, public health officials and journalists flexed their euphemistic muscle, spurning “Wuhan coronavirus” and “SARS-2” (which is still the scientific name) in favour of the impressively bland COronaVIrus Disease-2019.

In April, languishing through a long day of quarantine in Puerto Rico, I read an entertaining article in The Economist about how swear words in Dutch often refer to diseases. An irritating person might be told to krijg de tering (“get consumption”), or even be called a kankerhoer (“cancer whore”). For something that so viscerally affects everyone, it is impossible to prevent some amount of colloquial abuse. We can only hope that in our relatively enlightened age, we do not end up referring to the current pandemic as the Trump virus, bat-lover’s disease, or the kung flu.

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Former linguistics student; current investment bank analyst who sometimes thinks about something other than spreadsheets

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Sam Quillen

Sam Quillen

Former linguistics student; current investment bank analyst who sometimes thinks about something other than spreadsheets

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