Vascular accidents, Part 2: Strokes

[This entry consists of the second section of a new chapter ("Words about vascular accidents", still unincorporated) of Part II of the open-source textbook Spanish-English Cognates: An Unusual Introduction to Spanish Linguistics.]

The noun stroke (/ˈstɹoʊ̯k/) in English can refer to ‘a sudden disabling attack or loss of consciousness caused by an interruption in the flow of blood to the brain’ (COED), which results in cell death. This is the fifth (out of five) senses for the noun stroke in the COED dictionary. The AHD gives a similar, but more complete, definition (sixth sense out of thirteen):

A sudden loss of brain function caused by a blockage or rupture of a blood vessel to the brain, characterized by loss of muscular control, diminution or loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. Also called cerebral accident, cerebrovascular accident.

The original sense of the patrimonial noun stroke is, of course, ‘the act of striking’ or, in the words of the AHD, ‘the act or an instance of striking, as with the hand, a weapon, or a tool; a blow or impact’ (AHD). Most dictionaries still give that as the word's primary sense, though it would seem that for most speakers that sense is probably marginal nowadays, compared to the one we are discussing here. The Spanish equivalent of this sense is golpe.[1] By the 14^th century, the word stroke came to be used for ‘a blow with the hand or a weapon … inflicted on or aimed at a living being’ (OED) or, metaphorically ‘an act which causes pain, injury, or death; often, an act of divine chastisement or vengeance’ (OED). The noun stroke is also commonly used for ‘one of a series of repeated movements’, as in rowing or swimming. These senses came around in the 19^th century.

The use of the word stroke for the health issue at hand is from the late 16^th century and it seems to derive from the phrase Stroke of God’s Hand based on those earlier meanings. It would seem to be a calque of an earlier Latinate expression for this cerebrovascular accident. The earlier term was apoplexy, meaning ‘sudden fit of paralysis and dizziness’, which as late 14^th century loan from Latin (perhaps through French, which borrowed it first). The Latin word was apoplexĭa ‘apoplexy, stroke’, which was itself a loan from Greek ἀποπληξία (apoplēxía) ‘paralysis, etc.’, a noun derived from the verb ἀποπλήσσειν (apoplḗssein) ‘to cripple by a stroke’, which consisted of the parts ἀπό (apó) ‘from’ and the verb πλήσσειν (plḗssein) ‘to strike’.

The noun apoplexy /ˈæp.ə.ˌplɛk.si/ in English is still used as a synonym of stroke, though it is dated or old-fashioned, if not archaic. This is probably because the noun apoplexy developed a secondary colloquial sense over time, namely ‘a fit of extreme anger; rage’ (AHD), ‘extreme anger’ (COED). Interestingly, not all dictionaries mention this ‘secondary’ sense and not all mention that the medical sense is dated.

The cognate of Eng. apoplexy in Spanish is apoplejía, which is also used to refer to a stroke in medicine, though, like its English cognate, it is used less commonly than its alternatives.

There are other words formed with the Greek word part -πληξία (-plēxía), words that end in ‑plexy or ‑plegia in English (the ‑plegia variant was more rare in Greek, but more common in English) and ‑plejia or ‑plejía in Spanish (‑plejia is more common, but not in the word apoplejía). The most comon ones are Eng. hemiplegia ~ Sp. hemiplejia/hemiplejía and Eng. paraplegia ~ Sp. paraplejia /paraplejía:[2]

• Eng. hemiplegia/hemiplexy ~ Sp. hemiplejia/hemiplejía come from New Latin hēmiplēxia, from Ancient Greek ἡµιπληξία ‘a stroke on one side of the body’; the first part of this word is hemi‑ a Latinized version of Greek ἡμι- (hēmi‑) ‘half’. (The variant hemiplegy /ˌhɛ.mɪ.'pli.ʤə/ in English is more common than the hemiplexy /ˈhɛ.mɪ.ˌplɛk.si/ variant and it comes from a rare variant of Gk. ἡµιπληξία, namely ἡµιπληγία.)
  
• Eng. paraplegia /pæ.ɹə.'pli.ʤə/ ~ Sp. paraplejia/paraplejía come from the New Latin words paraplēgia or paraplēxia (respectively) of the equivalent Ancient Greek terms παραπληγία and παραπληξία (respectively), both being synonyms of the former terms in Greek, since they also mean ‘a stroke on one side’, for the first part of these compounds was παρα‑ ‘beside, aside’. The English and Spanish words, however, mean ‘paralysis of the legs and lower body, typically caused by spinal injury or disease’ (COED). More common are the derived adjectives cum nouns Eng. paraplegic ~ Sp. paraplégico/a, derived from the noun paraplēgia by means of the adjectival suffix ‑ic‑.

We should mention that in addition to the noun stroke, which is related to the verb strike, there is also a verb to stroke in English, which means ‘to move your hand gently over something’ (DOCE). The two seem to share the same original root. The verb stroke is attested in Old English as stracian, from the Proto-Germanic root *straik-, from the PIE root *streig-, presumably meaning ‘to stroke, rub, press’ as well as perhaps ‘to strike’. Interestingly, the noun stroke is not attested in Old English, for the noun does not appear in writing until around 1300. The Old English source of the noun stroke has been reconstructed as *strāc and it is believed to come from a variant (o-grade *stroig‑) of the PIE root *streig-.[3]

As we saw, a stroke results in damage to the brain. Strokes are the third cause of death in the Western world and the first cause of disability among adults. The cause of the damage can be of two types. In other words, there are two types of stroke: (1) the most common, ischemic stroke, which is due to lack of blood flow to the brain due to blockage, and (2) the less common, hemorrhagic stroke, due to bleeding in the brain. Almost two thirds of strokes are ischemic and one third hemorrhagic. Other terms for ischemic stroke are cerebral infarction and brain ischemia.

The adjective ischemic /ɪ.ˈski.mɪk/ (spelled ischaemic in the UK) is related to the noun ischemia /ɪ.ˈski.mi.ə/ (spelled ischaemia in the UK), which refers to a restriction in blood supply to tissues, which results in damage to the parts of the body suffering from the restriction, a localized anemia due to lack of blood flow. These are all New Latin words, created in the 19^th century, derived from the actual Ancient Greek word ἴσχαιμος (iskhaimos) ‘stanching or stopping blood’. This word was derived from the morpheme ἴσχ‑ (ískh-) from the Greek verb ἴσχειν (ískhein) ‘to hold back’, and the root αἷμ‑ of the noun αἷμα (haîma) ‘blood’ (the final ‑os is the word’s inflectional ending). To the stem of this word, the Greek derivational suffixes ‑ic and ‑ia were added to come up with ischemic and ischemia (see Part I, Chapter 5). The Spanish cognate of the noun is isquemia and of the adjective is isquémico and they are calques from the English words.

There are several terms in Spanish that are equivalent to Eng. stroke. The most general technical term is accidente cerebrovascular, literally ‘cerebrovascular accident’, which is also a technical term for stroke in English, as we saw above in the AHD definition of stroke. The most common technical and popular term for ‘stroke’ in the Spanish-speaking world nowadays is probably ictus, however. The familiar two types of ictus we saw above are recognized: ictus isquémico ‘ischemic stroke’, also known as infarto cerebral ‘cerebral infarction’, and ictus hemorrágico ‘hemorrhagic stroke’, also known as derrame cerebral or hemorragia cerebral.

English	Spanish
stroke, cerebrovascular accident	ictus, accidente cerebrovascular
ischemic stroke, cerebral infarction, or brain ischemia	ictus isquémico, infarto cerebral
hemorrhagic stroke	ictus hemorrágico, derrame cerebral

The word ictus is a very recent Latin loanword, as its ‑us ending indicates. As all such words, it is felt to be as a Latin word in Spanish (Sp. latinismo). Its generalized use among the general public to refer to (both types of) strokes in Spanish would seem to be a fairly recent calque from Eng. stroke. Latin ictus meant ‘blow, stroke’ (Sp. golpe), which in Latin referred primarily to a ‘rhythmic stroke’. It is derived from the past participle of the third conjugation verb īcĕre (principal parts: īciō/īcō, īcĕre, īcī, īctus), which meant primarily ‘to hit, strike, smite’ and, secondarily, ‘to stab, sting’.

The word ictus had been used in medicine for a while in Spanish. The 22^nd edition of the DRAE (2001) tells us that, in addition to ‘metrical accent’ or ‘rhythmic stroke’, Spanish ictus also means ‘morbid symptoms that appear suddenly and violently as if produced by a blow’.[4] This dictionary’s successor, the 23^rd edition DLE (2014), changed the definition to something like that of ‘stroke’, namely ‘brain illness of vascular origin that appears suddenly’,[5] without making any reference to the origin of the “illness”.

In Spanish, the word ictus has become popular in recent times to refer to what in English is called a stroke. Earlier, it seems, in the Spanish-speaking world, it was more likely that people would refer to a stroke by the type or the subtype of stroke, such as embolismo, aneurisma, etc. So we should explore those other terms as well.

There are four types of ischemic stroke, the main two being Eng. thrombosis ~ Sp. trombosis (or ictus trombótico) and Eng. embolism ~ Sp. embolismo (or ictus embólico). The cognates Eng. thrombosis ~ Sp. trombosis are medical New Latin (18^th century) terms that mean ‘local coagulation or clotting of the blood in a part of the circulatory system’ (COED), with ‘local’ here meaning inside the brain. They are taken from Ancient Greek θρόμβωσις (thrómbōsis) ‘curdling, clotting’, a word derived from θρόμβος (thrómbos, root: thromb‑) ‘lump; blood clot; milk curd’. This last word has also been borrowed by English (late 17^th century) as thrombus and by Spanish as trombo for ‘a blood clot formed in situ within the vascular system of the body and impeding blood flow’ (COED). In the word thrombosis, we recognize the New Latin medical suffix ‑osis (plural ‑oses in English and ‑osis in Spanish) which denotes ‘a process, condition, or pathological state’ (COED). Its source is Ancient Greek ‑ωσις (‑ōsis), meaning ‘state, abnormal condition, or action’. This suffix itself can be subdivided into the ‑ō‑, which indicates that the suffix is attached to an -όω (-óō) stem verb, and the suffix -σις (-sis) found in many Greek loanwords in English and Spanish (e.g. thesis ~ tesis, crisis ~ crisis).

The other type of ischemic stroke is Eng. embolism ≈ Sp. embolia (they are semi-cognates, since they have the same stem, but different derivational endings), also medical New Latin words that mean ‘obstruction of an artery, typically by a clot of blood or an air bubble’ (COED), one which in this case takes place outside the brain but has consequences to blood circulation in the brain. English embolism comes from Late Latin embŏlismus, which meant ‘insertion, intercalation’, primarily ‘insertion or interpolation of days in a calendar (to correct errors)’. English borrowed the word embolism with the ‘intercalation (of days)’ meaning in the 14^th century, but then, in the mid-19^th century, was put to use for the medical sense that we just saw. Spanish had kept its cognate embolismo for the ‘intercalation of days in the calendar’ meaning and has created or borrowed embolia, for the medical sense.

Late Latin borrowed embŏlismus from Late Greek ἐµβολισµός (embolismos) ‘intercalation’, related to ἐµβολή (embole) ‘a throw in, putting in; insertion’ and ἔµβολος (embolos) ‘a plug, wedge, stopper; penis’, derived from the verb ἐµβάλλειν (émbállein) ‘to throw in; to put in, to lay on’, formed from the prefix ἐν‑ in and the verb βάλλειν ‘to throw’. Late Latin also borrowed Greek ἔµβολος (embolos), as embolus, but in Latin, it came to mean ‘piston of a pump’.  English and Spanish have also borrowed this word from New Latin as the cognates Eng. embolus ~ Sp. émbolo. Nowadays, the main meaning of this pair of words is ‘a blood clot, air bubble, piece of fatty deposit, or other object obstructing a blood vessel’ (COED).[6] The Latin term was first borrowed by a German doctor in the mid-19^th century. The other meaning of émbolo in Spanish is ‘piston (plunger)’.

There are few more Spanish-English cognates that share the same stem or the same root as embolism and embolus. One of them is Eng. emblem ~ Sp. emblema, which come from Latin emblema ‘raised ornaments on vessels, tessellated work, mosaic’, from Ancient Greek ἔμβλημα (émblēma) ‘an insertion’, derived from the same verb from ἔμβάλλειν (émbállein). Derived from this word, we have Eng. emblematic ~ Sp. emblemático.

The pair Eng. symbol ~ Sp. símbolo also share the root with the preceding words. They come from Lat. symbŏlus ‘a sign or mark by which one gives another to understand something’, which is a loanword from Gk. σύμβολον (same meaning), derived from συμβάλλειν ‘to throw together, compare, etc’, from the prefix σύν (sún) ‘with, together’ the verb βάλλειν ‘to throw, cast, hurl’. Derived from this pair of cognates there are also other pairs of cognates, such as Eng. symbolic ~ Sp. simbólico/a, Eng. symbolism ~ simbolismo, and Eng. symbolize ~ Sp. simbolizar.[7]

The cognates Eng. problem ~ Sp. problema, also share the same root. They come from Lat. problēma, which is a loanword from Gk. πρόβλημα (próblēma) ‘anything thrown forward, hindrance, obstacle, anything projecting, etc.’, from Gk. προβάλλειν (probállein) ‘to throw out, to put forth’, from προ‑ (pro‑) ‘in front of’ and βάλλειν ‘to throw, cast, hurl’. Related to this pair of cognates are Eng. problematic ~ Sp. problemático/a.

There are also two types of hemorrhagic stroke, namely cerebral hemorrhage (Sp. hemorragia cerebral), which happens inside the brain, and subarachnoid hemorrhage (Sp. hemorragia subaracnoidea), which happens inside the skull but outside the brain. The cognates Eng. hemorrhage ~ Sp. hemorragia are loanwords from Latin haemorrhagia, from Ancient Greek αἱμορραγία (haimorrhagía) ‘a violent bleeding’, a noun derived from αἷμα (haîma) ‘blood’ and ‑ραγία (-ragía), a suffix derived from the verb ῥηγνύναι (rhēgnúnai) ‘to break, burst’.

The cognates Eng. cerebral ~ Sp. cerebral are, of course, adjectives that mean ‘pertaining or relating to the brain’ derived from the unattested Latin adjective *cerebrālis, derived from the noun cĕrēbrum ‘brain; top of the head; skull’, source of Spanish cerebro ‘brain’. This adjectival form seems to have been created in French first, as cérébral, in the 16^th century and then borrowed by English and Spanish.

Another word that is often mentioned in cases of stroke is aneurysm/aneurism ~ Sp. aneurisma. The word means ‘a localized, pathological, blood-filled dilatation of a blood vessel caused by a disease or weakening of the vessel's wall’ (AHD). Ancient Greek ἀνεύρυσμα (aneúrusma) ‘a widening, an opening, a dilation’, from the verb ἀνευρύνειν ‘to widen out’, from the prefix ἀνά (aná) ‘up, back’ and the verb εὐρύνειν to widen’, derived from the adjective εὐρύς (eurús) ‘wide’. The word aneurysm was already in use in English in the mid-17^th century with pretty much the same meaning it has today, hence the rather unorthodox rendition of a Greek word ending in ‑usma. Its Spanish cognate is a more recent borrowing.

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[1] Sp. golpe is said to come from Vulgar Latin *colpus, from an earlier unattested *colŭpus, which was an alteration of Latin cŏlăphus ‘a blow with the fist, cuff, box on the ear’ (Sp. bofetón), from Greek κόλαφος (kólaphos). There is a cognate of Sp. golpe in English, namely Eng. coup /ˈku/, which is a loanword from French coup /ˈku/, which has the same meaning as Sp. golpe (Eng. coup doesn’t have the basic meaning of Fr. coup, only some of the derived ones). Sp. golpe does not conform to what would have been the expected patrimonial evolution of V.Lat. *colpus, which would have been *cuelpo (with initial g, no diphthongization of the short o, and the final -e). In Medieval Spanish, golpe alternated with colpe. Basque kolpe is obviously an early loanword from Romance.

[2] Other medical words formed with the ‘suffix’ ‑plegia in English are cardioplegia, facioplegia, laryngoplegia, logoplegia, monoplegia, nephroplegia, ophthalmoplegia, and panplegia.

[3] The PIE root in question had several forms, basic streig‑, O-grade stroig‑, and zero grade strig‑. Among the English words that descend ultimately from one of these roots (either directly through Proto-Germanic or through Latin as borrowings) are astringent, constrain, distress, prestige, restrict, strain, strait, streak, stress, strict, strike, stringent, stroke, and tricot.

[4] The original Spanish definition is ‘cuadro morboso que se presenta de un modo súbito y violento, como producido por un golpe’. The 22nd edition gives three types for such an illness: ictus apopléjico, ictus epiléptico, and ictus traumático, which are not how the types of ictus are defined today. By the way, the adjective apopléjico is derived from apoplegía, from the Late Latin noun apoplēxia, from Greek ἀποπληξία. This noun’s English cognate is apoplexy, which can mean ‘an illness in your brain which causes you to suddenly lose your ability to move or think’ (DOCE), i.e. it is synonymous with stroke, though that use is rare nowadays, since the most common meaning of this word today is a derived one, namely ‘a fit of extreme anger; rage’ (AHD).

[5] Original: ‘enfermedad cerebral de origen vascular que se presenta de un modo súbito’.

[6] English has also borrowed the other related word ἐµβολή (embole) as embole as a medical term, which is now obsolete. Another, closely related, New Latin medical term in English is emboly, which in embryology, now means ‘the process by which cells move inward during gastrulation to form the archenteron’ (WNW) and, less commonly, in surgery, ‘the name of a particular operation for hernia’ (OED). It is supposedly derived from Gk. ἐµβολία (embolia), which is presumably the source of Sp. embolia, though this Greek word is unattested, so it is probably a New Latin creation.

[7] Late Latin ballāre ‘to dance’ has been said to be a loanword from Gk. βαλλίζειν (ballizein) ‘to dance or jump around’, lit. ‘to throw (one’s body)’, from the same root ball‑. This Latin verb is the source of Sp. bailar ‘to dance’ and balada ‘ballad’, and in English it is the source of the word ball that nowadays means ‘social gathering’ (not the one that means ‘round object’) and, of course, ballad. Another possibility is that the Late Latin verb ballāre is instead a loanword from Gk. πάλλειν ‘to dance, jump about’.