Or maybe it’s just “Achoo!” with a really bad head cold.

Dear Word Detective: Most people, I realize, pronounce “ague” with two syllables; but my mother (probably the only person I ever heard use this word in a sentence) pronounced it with one syllable, to rhyme with “vague” (which makes sense if you think about it). Anyway, it occurred to me that that makes it a near homophone of “ache,” which of course triggered the Word Detective reflex in my keyboard finger. — Charles Anderson.

“Keyboard finger,” singular? You sound like me. I took typing in junior high school, but didn’t pay much attention because I was going to be a disk jockey like Murray the K. Now I hunt and peck all day long.

The way your mother pronounced “ague” does make a lot of sense, and I actually prefer it, although the standard pronunciation is “AY-gyoo.” Maybe she picked up some obscure folk pronunciation at some point. In any case, it’s not a common word, although it was much more popular before we all became mini-doctors via the internet and drug ads. “Ague” is a high fever marked by bouts of severe chills. The pattern of high fever and sweating interspersed with paroxysms of violent chilling and trembling is the signature of malarial infections, though diseases other than malaria can cause similar torment. “Ague” is also used in less dire circumstances to mean simply a severe chill or fit of shivering (“But soon his rhetorick forsook him … A sudden fit of ague shook him, He stood as mute as poor Macleane,” 1753).

“Ague” first appeared in English in the late 14th century, borrowed from the Old French “ague,” meaning “sharp fever,” which in turn was formed from the Latin “acuta,” meaning “sharp” (related to our adjective “acute,” which was first used in a medical sense). According to the Oxford English Dictionary, the name “ague” was first given to the “burning fever” stage, but later came to be associated with the shivering chills stage because that was the more outwardly dramatic phase of the cycle.

As a somewhat vague term for an extended high fever and chills, “ague” has made high-profile literary appearances in everything from Chaucer’s Canterbury Tales (“Ye schul have a fever terciane, Or an agu, that may be youre bane,” circa 1386) to Daniel Defoe’s Robinson Crusoe (“An Ague very violent; the Fit held me seven Hours, cold Fit and hot, with faint Sweats after it,” 1719). Unfortunately, the age of picky-picky clinical diagnosis seems to have banished such great evocative terms as “ague,” “chilblains” (swelling in the fingers and toes from cold), “apoplexy” (originally a stroke), “catalepsy” (seizures), “consumption” (tuberculosis), and “dropsy” (edema) from the popular lexicon. Even the “lumbago” once issued to every uncle over a certain age has now been driven out of our gossip in favor of the dull “lower back pain.” I blame Doctor Kildare and Ben Casey, personally. Oh well, we’ll always have “pleurisy.” (Been there; it’s awful.)

“Ache,” meaning a dull pain, does sound like your mother’s pronunciation of “ague,” but there’s really no etymological connection. The development of “ache” is murky and complex; the noun and verb were spelled and pronounced differently from each other in Old and Middle English and even in early Modern English. The ultimate source of “ache” is uncertain, but it’s thought to be a proto-Indo-European root having something to do with “guilt,” possibly with a bit of an imitation of a pained groan thrown in.

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