Kefzol

First a simple exercise in pronunciation: centimetre, cerebellum, biceps, hydrocele. So far so good. Now how about encephalopathy. Come again? In all probability, if you are British, although you will have pronounced the letter c in each of the first four examples soft (like the letter s), in encephalopathy you will have pronounced it hard (like the letter k). Why that should be I don't know (and you're allowed to feel smug if you didn't). Perhaps the preceding n in encephalopathy makes you want to pronounce the c hard, but if so what about (say) concentric and cancer?

Now how about cephalosporin? Hard again in all probability, although there is no preceding letter of any sort this time. Here the habit of pronouncing the c hard is reinforced by the several brand names for cephalosporins that begin with the letter k (such as Kefadim, Kefadol, Keflex, Kefzol). But I think that the manufacturers' use of the K in these names was probably conditioned by the common pronunciation of cephalosporin rather than the other way around. Other brand names only add to the confusion. How do you pronounce Timacef and Zinacef? Probably with a soft c. And then there's Velosef (yes, spelt with an s). In the end, example and counterexample notwithstanding, it's probably what trips off the tongue that determines what you say.

The rule in English, of course, is that a c before an e is pronounced soft; in only two common cases is it pronounced hard. Celtic was originally pronounced /'sel-tic/. There is an alternative spelling Keltic (Greek K[Epsilon][Lambda][Tau]oi), but the earliest example in the Oxford English Dictionary occurs later than Celtic (Latin Celtae) by about 200 years. This is an instance in which a comparison of the first and second editions of the OED is instructive. In the first edition the only pronunciation of Celtic the dictionary gives is with a soft c, but in the second both soft and hard are on offer. Why the change? Well, the football team (soft c) was founded in 1888, at exactly the same time that James Murray, the first editor of the OED, was preparing the fascicle Cast--Clivy (published in 1889). Did the name of Glasgow Celtic, still pronounced with a soft c, subsequently induce scholars to abandon the original pronunciation and opt for a hard c instead? And the other word with a hard c + e? The Gaelic loan word ceilidh. A lone word indeed.

I think that we're stuck with pronouncing -cephalo- with a hard c, despite what the OED says, simply because the vast majority of people do it. Other dictionaries, yielding to force majeur, already offer hard and soft c as alternatives. I don't object to this--it demonstrates the democracy of language--but I do regret it a little. In America they order these things better--they use a soft c. I should welcome information about how -cephalo- is pronounced elsewhere in the world.

PS: Please don't write to me about all those Italian loan words (for example, cello and concerto), chalcedony, Cerenkov, ceorl, and ocean!

Jeff Aronson clinical pharmacologist, Oxford

We welcome articles of up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for "Endpieces," consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

COPYRIGHT 2000 British Medical Association
COPYRIGHT 2000 Gale Group