sick and ill

I'm pleased to welcome my former student, Solo, for her second guestblogging service here on SbaCL.  Take it away, Solo:


The Oxford Dictionary of English informs me that sick is an adjective meaning “affected by physical or mental illness,” suggesting that illness is the dominant term. Furthermore, to my BrE mind, the generic term when one is suffering from any form of malady is ill, which covers generally feeling unwell right through to serious, long-term affliction.  (The definition of ill incidentally is “suffering from an illness...”.)

I would have said the exception was poorly for the under-fives, but previous comments on this blog suggest most Britons consider poorly an old-fashioned or locali{s/z}ed Yorkshire expression to mean ‘very seriously ill in hospital’. In my personal (Southern) experience however, it’s just a word said to small children with stomach bugs.

The obvious transatlantic synonym is, of course, sick, which receives reasonable employment on this side of the pond too.  I’d argue that ill  is favo(u)red over here, however, it would seem that sick has broader meaning for AmE speakers than for BrE.

Case in point: I recently asked an American (and long-term UK resident) colleague how she was. She did seem a little under the weather. She replied “I’ve been sick.” My response to this was {sympathetic face/noise} “Oh, what was wrong?” To demonstrate the thought process here, I heard sick in an AmE accent and automatically translated to ill. If a fellow Brit had told me they’d been ill, that would probably mean they’d  had some specific, diagnosable malady.  I therefore anticipated greater explication at this stage in the conversation, e.g. “I’ve had a cold/flu/a stomach bug/malaria.” However, she simply reiterated “I’ve been sick.” As though this were explanation in itself. In my idiolect a reiteration like that would be followed with a slightly patroni{s/z}ing "haven’t I?" It therefore transpires that sick was not merely an umbrella term covering all manner of sickness, but also had some specific connotation for the AmE speaker; perhaps something akin to run down? If we say we are run down it means not feeling one’s best due to maybe working too hard, not getting enough sleep/exercise or eating badly, but without having an actual illness.

Sick in the ‘unwell’ sense does of course enjoy widespread popular use in BrE, but, I’d argue, with nowhere near the prevalence with which it is used in AmE. Exceptions would be compound phrases such as off sick (AmE equivalent: taking a sick day) and the related sick pay. Then there are sickness benefits, paid to those unable to work for health reasons. *Illness benefits would grate on British ears. So these are exceptions in which sick is used in BrE, but with very specific applications. Then there’s the very British sickie, which is the act off taking a day off (from) work claiming ill-health when actually either hungover or simply not in the mood for a day’s work. AmE phrases like sick day have become codified in the lexicon of the workplace, so on an application form one would have to state how many sick days one had taken in the last two years, but I wouldn’t use the phrase independently, I’d just say I’d had the day off, or I was off sick.  [Lynneguist’s note: I've been asked how much BrE medical leave I've taken.  Disturbingly for an American, it's legal here for a prospective employer to demand medical info.  I recently read that that may change soon...] The prevalence of AmE expressions in work practice seems to be growing exponentially, but that’s a topic for another post.

Etymologically, my highly academic sources lead me to believe that somewhere around the turn of the last century ill was the common parlance amongst the common people and should they wish to better themselves and their manner of speaking they were encouraged to employ the term sick, as was the preference of the more socially advantaged.  I’m fairly confident this is no longer a class shibboleth, in the fashion of sofa/settee, but I have noticed the BrE use of sick in this context is far more prevalent amongst more senior generations, especially the better to do thereof.

To me, the most obvious meaning is the verb phrase form to be sick (AmE equivalent presumably to get sick). Context aside, this would typically be my first interpretation of the word. I always thought this meaning was very closely linked to the mass noun use of sick, a direct synonym of ‘vomit’. Oxford however tells me the mass noun use is an informal and specifically British application, which appeared sixth in their pecking order of definitions. So do AmE speakers find this use odd or improbable?


For an example the last time I was at Thorpe Park (the UK’s secondary theme park), we were made to wait at the front of the Colossus (BrE) queue/(AmE) line, where we heard the following announcement:
Thorpe Park apologi{s/z}e for the temporary delay. This ride is closed for essential cleaning. There is sick on one of the seats and we have to clean it, or it will be on you. We would like to remind passengers to keep all food and drink inside themselves at all times whilst on the ride.
For this reason I have a lot of trouble hearing/using I’ve been sick to mean I’ve had an illness. I would always process it to mean the action in the recent past and then from context would have to work out what the speaker actually meant. Is this too broad a generali{s/z}ation, BrE speakers?

After those interpretations there is also the implication of depravity, propagated particularly by the gutter press (Ban this sick filth!), which seems to carry equal weight on both sides of the water, and lastly, though by no means leastly, in the sociolect of the kids it is also an expression of approval originating in London, which has graduated to Brighton. For example, That is sick, bruv.  Or Those alloys are well sick, and such words to that effect. I have reason to believe this employment of the word has enjoyed perennial popularity amongst the AmE adolescent populace too, but the ‘unwell’ usage carries far more weight in the US than it does here and the colloquial use is therefore far less likely to affect its salience to such an extent, though whether older or more Northern BrE speakers would find that the current slang use of sick affects their processing is not something I can judge. So with that, I’ll throw open the floor…

96 comments

  1. I believe (screaming generalisation alert here) that British people might be sick because they are ill, whereas American ones (and certain euphemistically-inclined Britons) might be ill because they are sick!

    People who are off work long-term due to illness can claim sickness benefits (see!). I think it was Jilly Cooper who memorably commented that in some circles it was referred to as being "on the sick", which, as she said, sounds rather slippery...

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  2. I’m fairly confident this is no longer a class shibboleth, in the fashion of sofa/settee,

    In BrE, "I've been sick" means "I have vomited" if one is a U-speaker. It has a wider meaning if one is non-U, though: that distinction does still exist. Neither the gutter press nor The Youth is generally concerned about U speech!

    Medically, it almost always means that vomit was involved, too.

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  3. I (from the north) would probably use "poorly" to describe a minor rather than a serious illness - if I said I felt poorly it would be with a mild virus rather than pneumonia. I've always taken the "she's poorly" where poorly means "at death's door" to be a sort of understood understatement.

    I think missing from the post is the use of "well" (and not well, and unwell, and feeling well or otherwise). I actually had a children's book (early 80s) called "I Don't Feel Well".

    Nineveh_uk

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  4. Another expression not yet mentioned is "to sick up", meaning to vomit. I can't remember if it's used transitively, intransitively, or both -- perhaps a BrE speaker could chime in?

    Mrs Redboots: "American [speakers...] might be ill because they are sick". I'm afraid that sentence doesn't make sense in (my) American English. Before I moved to England I considered "sick" and "ill" synonyms, with "sick" the normal word and "ill" used in some specific situations or when one wanted to sound sophisticated (or pretentious).

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  5. Am/E, sick is the generic term. If I told someone I was sick, and they asked me what was wrong, I'd think it intrusive, unless it was a close friend (or nurse,) and then I'd give my specific symptoms. More usually, I'd give a negative to well. Not feeling well, not up to snuff, under the weather, not myself.

    Strangely, ill sounds a more snobby way to say sick. I'd say poorly, for a mild discomfort, but only to be creative, it's not used normally.

    I'm aware of the slang and BR/E usages for sick as in vomit, noun and verb, which I would use only as a variant - to be colorful. After "throw up", "toss cookies", "worship porcelain god" etc.

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  6. Re "sick up", in my experience this is usually used to describe what small babies do, and may be used both transitively and intransitively.

    Re the first comment, I also understand that Americans use "ill" to mean "vomit" in a similar way to Brits using "sick".

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  7. In AmE, poorly adj. is an old-fashioned euphemism for having my/your/her period 'menstruating'.

    I think the repetition of I've been sick in your transatlantic dialogue resulted from your interlocutor feeling that your question was intrusive: if she wanted to tell you the nature of her illness, she would have done so.

    AmE get sick does not equal BrE be sick; it means simply 'fall ill'. Only strong context would imply 'vomit', as in He got sick when the roller-coaster turned upside down. The standard polite AmE expression would be throw up, with an optional object for the ejected substance. There are also, of course, a huuuuge variety of low register terms for vomiting, from puke to barf to pray to/kiss Ralph (the toilet).

    (As a perhaps atypical AmE speaker, I understand settee to be a synonym for loveseat; that is, a couch-like object with room for only two. To be a sofa it has to hold at least three seated persons or one reclining person. No particular class or register implications.)

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  8. Mrs. Redboots, Tony Finch: I don't think there is any such symmetry between BrE and AmE: AmE ill is what Jill says it is, a sophisticated/pretentious synonym for sick, like attorney for lawyer or pedagogue for teacher.

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  9. I remember hearing as a teenager (in 1970s Britain) boys asking girls if they 'were poorly', meaning 'are you on your period?' - a euphemistic way of asking someone to have sex, or at least finding out if it were feasible! I wonder if it's still used.

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  10. For almost a decade "sick" has meant "cool," "awesome," or "excellent" in U.S. slang. http://www.urbandictionary.com/define.php?term=sick

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  11. And they're off!

    I forgot about 'on the sick.' I also meant to mention the AmE 'Spit up' which I first came across in Judy Blume many years ago and it baffled me immensely. Firstly it was used in the past tense, even though 'spit' is clearly present tense and as I thought it referred to spitting, the 'up' seemed very odd. The sentence was "All of a sudden [the baby] spit up," which clearly doesn't make any sense, right? Anyway.

    I left 'well' and all its derivatives because that felt like a different topic, albeit with very similar subject matter.

    @John Cowan: I simplified the anecdote a lot for ease of explanation. I actually said something like "If you don't mind me asking," or something to the affect of 'I'm being concerned, not nosey.' The tone of the response was more that I was asking a question which had already been answered, rather than I was asking an intrusive question. Which is why it lead me to think 'sick' was more than a direct synonym of 'ill.'

    Fran: I've certainly never heard that and at my school you heard pretty much everything...

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  12. "We would like to remind passengers to keep all food and drink inside themselves at all times whilst on the ride."

    I love that. But I'm a sucker for wordplay.

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  13. I agree with the other Americans that "ill" is a synonym of "sick" (although one that sounds formal or affected). The most common informal term meaning "to vomit" would be "to throw up." The use of "sick" as a noun would mean the result, although it feels somewhat euphemistic.

    I hope this isn't too off topic, but on the other side of the health question, it seems to me that I've heard those from England answer "How are you?" with "I'm well," which is odd to me. As an AmE speaker, "well" is almost always an adverb except in the very narrow case of meaning "physically or mentally healthy." "I am good" would be grammatical when describing my general mood. It's entirely possible to feel bad and be well.

    I always regarded "feel poorly" as a substandard version of "feel poor," but I may be too young to recognize "poorly" as any sort of euphemism for having one's period.

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  14. Solo, I apologize for adding a "well" comment; it seems we were writing at the same time!

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  15. Don't apologise Brian, it's an interesting comment! Because when someone asks me 'How are you?' I take that to mean they're asking after my health. People will also say 'Are you well?' in the same manner.

    Over here the AmE 'I'm good' is widely considered to be utterly ungrammatical, although I have come to use it very often in recent years.

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  16. Can we leave well for another occasion, please? Though unwell is more apt for discussion--I hear and use that much more in BrE.

    I have to disagree with those who say that sick and ill are simply synonyms. In AmE I'd have to use ill with something more long-term and debilitating(cancer, for example) rather than for a cold or flu, and I'd only use ill to refer to mental illness--to say sick with that meaning would imply some sort of moral judg(e)ment.

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  17. With Lynneguist's provisos in mind, my (AmE) intuitions are:

    Physical health: Sick covers all unwellnesses, and ill means the same thing in a slightly more formal register. But I'm aware that others (AmE as well as Other-E) use the words differently, so I usually wait for others to make the first verbal diagnosis. My own usage tends either toward the vague "not feeling very well" or specifics like "chest cold," "flu," "stomach bug," etc.

    Mental health: Neither would be used alone, but "mentally ill" is used in all quasi-clinical senses, and "sick in the head" (informal) for something which, as in cases of sociopathy or sadism, implies a moral judgment.

    "Sick" in the vomit sense I understand but would never use, and I may have been known on occasion to use it in the "cool" sense.

    My automatic response to "how are you" or "how are you doing" is "good" or "fine" -- interrogating my intuitions, I think I tend to assume it's a question about my state of mind rather than my physical health. But then I'm young(ish) and (generally) healthy; that may change!

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  18. In Ireland, vomiting is "getting" sick, not "being" sick. As a child reading "Just William", when Violet Elizabeth Botts threatens to "thcream and thcream till I'm thick", I understood the threat to be merely to annoy William by continuing to scream indefinitely.

    "Throwing up" is informal and rather indelicate; not to the same extent as "puking", but heading there.

    As a noun for vomit, "sick" is very childish: like "doo-doo" for faeces. I can't think of a non-childish euphemism for the noun "vomit".

    I rarely here "ill" for "sick" in Ireland, though "illness" is more common than "sickness". The latter strikes me as marked: perhaps intimating moral failure or dread contagion, not mere medical malady.

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  19. >Because when someone asks me 'How are you?' I take that to mean they're asking after my health.

    In AmE I take it as purely phatic, with a gazillion possible responses along the lines of: "fine, how are you?" "great! And you?" "not bad -- did you see the game last night?" "can't complain" or "how are you" (yes, I've heard the exchange of "how are you"s without either party giving a response to the question, because it isn't findamentally a question). When someone is obviously really not well, it's permissible to reply "been better!" with a smile and a wry chuckle for both asker and askee.

    It's no more an inquiry about health than "whassup" is an inquiry about how the sky is faring.

    Scott Adams once drew a cartoon in which someone with an axe embedded in his head answered "how are you" with "can't complain" or some similar ritual response. I have been in a hospital emergency room, and was approached by a doctor who asked "? How are you?". I replied "fine, thanks, how are you", and the doctor then went on to ask about my health. Neither of us found it incongruous.

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  20. In AmE sicken is generally used quite literally to mean "become ill". I get the impression that in BrE it is more commonly used to mean "disgust", as in "I found this remark sickening".

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  21. My Welsh English (mid-20s) non-childish euphemism for the noun "vomit" (as well as the verb) would be "spew".

    I agree that "sick" (noun) is quite childish.

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  22. And I would understand sicken to mean taken really gravely ill and getting worse depending on the context but agree that is more commonly used metaphorically as in vp's example. i.e. "The Queen is sickening" as reported by a BBC newsreader would suggest she was on her deathbed but the same phrase by a republican complaining about taxes or a vegan about hunting would suggest disgust.

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  23. For my BrE (Manchester) two pennyworth:

    Ill is definitely the simplest term for generally unwell - covering anything from very mild to severe.

    Sick is biased to mean vomiting, and modified by context, however:
    Been / being Sick is always vomiting. Been / being ill is unwell.
    Off Sick is always away from work due to generic illness.

    Poorly is a diminutive of ill - covering "under the whether" or "off colour" up to mild illness.

    Finally, sickie is, to my mind, an Australian import and always as part of the phrase "throw a sickie"

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  24. Slightly off on a tangent, but does anyone else find it strange that someone can be "ill" without having having an illness? The most common context would be someone like a news report where we're told, "Random Celebrity has been involved in a car crash and is seriously ill in hospital".

    To me (BrE), this sounds incredibly incongruous. Seriously "injured", yes, but unless they've been hit by a car and also have cancer (poor thing), they're not "ill".

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  25. I (Derby, UK) have never been aware of any class distinction in this regard. I would have said that, to most Britons, the adjective "sick" implies nausea (though sometimes "physically" is added to clarify this), except in formal contexts like "sick leave" or "Hospital for Sick Children".

    Kate

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  26. Use of adverbs - I have always taken the phrase 'I am ill' to indicate that the word 'am' is used in the sense of 'exist' and therefore the adverb ill/well/poorly is quite correct.

    Jane Austen's Emma was criticised for behaving 'ill' - 'that was ill-done' - and we are perfectly happy to compliment people for doing something well... But 'I am good' suggests that I am a good person.

    'I feel good' / 'I feel bad' - definitely implies a description of happiness or of guilt to this Brit.

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  27. Another use of the word is when you say "That's just sick!" or "You're just sick!" to imply that the previous speaker has proposed something disgusting or off-colour (it is not usually meant seriously, although it can be).

    In terms of sickening, I would use it in the context of "How sickening!" as an expression of sympathy, but would say "The Queen is sickening for measles" rather than just "she is sickening", which might have a negative connotation.

    I've not heard "poorly" used as a euphemism for one's period, although I have heard "unwell" used in such a context, particularly if the poor woman is suffering! I would use both "poorly" and "unwell" as synonyms to refer to a minor illness, although I might say "poorly sick" to a child, and I might describe myself as "proper poorly!" if I've been felled by a minor virus of some kind. Mind you, it's one of those irregular verbs, isn't it: "I'm proper poorly, you're unwell, he's malingering!"

    I dislike the modern BrE usage of "I'm good" when the speaker means "I am well" or "I'm fine". To me it appears both ungrammatical and arguably incorrect! But then, I'm an old fogey....

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  28. My BrE understanding:

    I've been sick = I've vomited (usually, although if clearly an ongoing rather than acute incident, perhaps means I've been unwell)
    I've been ill = I've been unwell, or could be delicate way of saying, I've vomited.
    I've been poorly = understatement for significant unwellness

    I'm good sounds ungrammatical unless intended to mean I have behaved well. But (perhaps inconsistently with this view) my usual response to "how are you" is "not too bad".

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  29. As an AmE speaker, I have to agree with the others who have expressed the opinion that your American colleague knew "what was wrong," but replied as she did to preserve her privacy.

    As a slang term for the verb "vomit," the most vivid and expressive I have ever heard (I apologize if this is too vulgar) is "hurl chunks."

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  30. I, as an American speaker--find your colleague's repetition odd. The only time I could imagine using that repetition as a cautionary defense would be if I was suffering from some socially unacceptable disease and didn't want to announce it. Perhaps the colleague had simply lived long enough in the U.K. to have meant, "I vomited," and not understood why you wanted more specificity.

    Further, "spit up" in the U.S. is reserved pretty exclusively to babies, where the product is apt to be undigested milk and spittle rather than something worse. I think I've also heard it used in similar circumstances for the elderly or very ill, but the emphasis (for me) seems to be on the relative lack of complexity of the product.

    And, at least in some circles, there exist "mental health days," a very unofficial term for the sick days one takes simply because one needs the time off to clear ones head. I say "unofficial" because the official excuse is of course that one has had an attack of 24-hour leprosy, or has just lost the entire contents of one's digestive tract in the most disgusting way imaginable. You then phone a friend and announce that you're taking a mental health day.

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  31. @vp: Your claim about 'sicken' didn't strike me as right, so I just checked quickly on the Corpus of Contemporary AmE and the British National Corpus. Both use 'sicken' in both senses, but you're right that AmE has a lot more with the 'get ill' sense. It's funny, because they strike me as very old-fashioned.

    The BNC has 16 cases of 'sicken'--one of these is 'sicken of', which is kind of a different sense. So, out of those 15, 7 are apparently about getting ill and 8 about being disgusted (i.e. metaphorically ill).

    There are 78 hits on COCA, and I don't have time to go through them all, but of the first 15, 12 are about getting ill.

    So, nice observation.

    @Simon K: that 'ill in hospital' thing has surprised me too--and it strikes me as a particularly BrE thing. (Both the 'ill' and the 'in hospital' contribute to that, of course.) Very strange to hear it of people who've been injured rather than (oh, let's use that verb!) sickened.

    To test this, I looked in COCA and BNC for 'ill after'. In COCA (61 hits), people are ill after eating things, drinking things, visiting places or getting/exploding breast implants. In BNC (17 hits), people are ill after being stabbed, being crushed by a horse, being set on fire (in addition to eating toadstools and things like that). Those accidental ones just would not sound right in AmE. So, another nice observation!

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  32. “I’ve been sick.” ...
    “Oh, what was wrong?” ...
    “I’ve been sick.”


    - I assumed on first reading this exchange that the colleague actually had been sick (i.e. thrown up) and felt she'd been into quite enough detail already. Maybe she's been in the UK long enough to be second guessing her English counterpart and had translated it into BrE already?

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  33. AmE: When I hear "poorly", I think of someone on death's door, especially if the description comes from a third party. "How's Mary?" "I'm afraid she's doing poorly." I need to practically plan for the funeral.

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  34. While most of the time I agree that in AmE, ill and sick are synonyms, I will say that I usually would use ill to mean a stomach issue, but not usually to describe congestion, or a sore throat. Where I would use sick in either case. And either word, used with “going to be” would mean about to throw up…either seriously, as in after a roller coaster, or sarcastically, as in when you see two people making out in public. But “going to get sick” would be said if someone sneezed nearby or something like that.

    And as for meaning “sick” or “ill” to mean VERY sick, I think the connotation would more be in the emotion and “delivery” of the words than in what words are said. “She’s been sick” with a shrug of the shoulders means that she has been stuck in bed for a few days with a clogged nose. “She’s been sick” said in a lower tone would mean, she is in the hospital and it is a serious condition.

    Then of course there are the slang versions of each…as in “That beat is sick!” or the Beastie Boys famous question…”What’s the time? It’s time to get Ill!”

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  35. Well Roger Owen Green I have to say "Doing poorly" as in 'doing badly' or 'not doing well' is completely different to being poorly, where the word is an adjective rather than an adverb. In fact, till you mentioned it I had them in my head as two seperate and unrelated lexical items.

    Now you mention it, I recall reading "He's badly" to mean he's ill in old-fashioned Midlands speak. Is that familiar to anyone?

    I think I've caused a lot of confusion with that anecdote. Sufffice it to say, her meaning was made very clear by the delivery. On reflection I think she may have actually said "I'm sick" not "I've been sick", which seems to make far more difference now than it did when I was writing the post.

    @Jill: Well asking after someone's health is pretty much a figure of speech, I don't think people are asking for a full medical report. It seems to be falling out of popular use, but when inquring specifically and precisely into a person's state of mind I've often heard the phrase "And how are you in yourself?"

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  36. I was reading an BrE book where the characters used "well" as an intensifier [e.g.: 'she's well fit'], and my AmE ears liked the sound of the usage, but the phrase "She's well ill" is too precious (I like it). It reminds me of the Beastie Boys' "License to Ill," which included the line "It's time to get ill," and employed the word "illin'" to good effect (albeit I'm sure this is passé by this time (in AmE at least).

    Sorry if this is too tangential for out esteemed hostess.

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  37. Reminding people that there is a post on 'poorly'...would be nice to have comments on that there, so that future readers can find your contributions.

    Also, the 'how are you in yourself' that Solo mentions is discussed back here.

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  38. I've said some of this on the "badly" post, but it was very late, so I'll repeat the relevant parts here.

    I (Northeast US) can use "sick" to describe a general illness (I am sick) but not with "feel" in which case it would always be a reference to nausea (possibly figurative of course). I can say "I am ill" or even "I am feeling ill", but not "I feel ill". Given all this, the only non-participial "feel" sentence that sounds natural to me is "I don't feel well".

    About sick meaning "throw up", I have it, but only in a very narrow context, specifically in the "going to be sick" phrase.

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  39. To my northeast Ame/E ears, "I'm sick" means a generic non-serious malady, like a cold/flu/24 hour virus. Illness always means something much more serious. Sick to my stomach, or "I'm about to get sick" means look for a bucket.

    To me, the repetition is a gentle way of saying "mind your business."

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  40. Agree with Dilsnik that "I'm sick" defaults to something mundane like a head cold. The repetition in Solo's dialogue strikes me as resignation: I'm stuffy and sneezy and snotty -- what more can I say, I'm sick.

    "Ill" seems to be more often heard in AmE as an adjective, as in "Grandma's in ill health", although Grandma could also be in "poor health".

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  41. Oh and Dave, in BrE I'd expect to hear "Pull a sickie" rather than the AusE 'throw.' Does that sound more natural/

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  42. @Solo: spit is well attested as an alternative preterite, e.g. "He spit out the words then waved his arm toward the road." Perhaps it's AmE only?

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  43. Follow up search for "He spit out": 16 hits on COCA, 0 on BNC. Suggestive, but perhaps not conclusive.

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  44. As this is all getting a tad confusing, I suggest using the fine Scots word 'boak' (also 'boke') when one feels the urge to vomit. :)

    @Dave & @Solo, aye, definitely 'pull/take a sickie' in the UK (as opposed to 'chuck' in Aus). 'Sickie' is indeed of Aussie origin, I believe, but it's become such a part of the national fabric that I'd bet a lot of people think it's a British thing.

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  45. "that 'ill in hospital' thing has surprised me too--and it strikes me as a particularly BrE thing."

    So if someone were in hospital after a car accident, what would be the normal American Engish phrase be? Injured in hospital?

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  46. Simon K, I agree - hearing that someone is "ill" when they have been injured in an accident always grates. I have to admit, I had belived this to be an Americanism - I think it is compaatively recent. I would naturally say "X was [seriously] injured [and is in hospital]" and would only use "ill" of someone suffering from a disease or infection.

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  47. AmE feel sick certainly refers to nausea, but not to outright vomiting, I think.

    Solo: I think Townmouse's theory is right: your interlocutor was speaking BrE with an American accent in the hope of being understood.

    Brian: I've never heard an American use sick as a noun, except for the case of the sick, which is like the rich or the poor.

    I agree with American commentators that in the realm of the mental/behavioral, ill is neutral in AmE and sick is condemnatory: he acts like that because he's ill is completely different from he acts like that because he's sick, especially with stress on sick.

    VP: To me, sickening can either be moral/behavioral per the above, or refer (as you say) to becoming sick.

    Simon K.: I agree, except that one might become ill/sick as a result of an accident, as when you damage your liver and come down with jaundice.

    Biochemist: ill is one of the inherited monosyllables that can be either adjective (as in it's an ill wind that blows no one any good) or adverb. English-speakers have been walking slow, jumping high, and treating [someone] rough for centuries, ever since the general fall of final e, which used to distinguish adverb from adjective in these words.

    Marjorie: Nope, Americans plead not guilty this time.

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  48. @Simon K: Americans would never say 'injured in hospital' either, just because we'd never say 'in hospital'. But 'seriously injured and in the hospital' would be ok.

    Our news stories are more likely to say 'in stable condition', 'in serious condition', 'in critical condition' (etc.) and name the hospital.

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  49. "So if someone were in hospital after a car accident, what would be the normal American Engish phrase be? Injured in hospital?"

    In addition to what our hostess mentioned, he might also be "laid up in the hospital".

    "Slightly off on a tangent, but does anyone else find it strange that someone can be "ill" without having having an illness?"

    ISTR hearing that as a moderately common usage by American medical professionals. I too (AmE) find it unidiomatic, and I don't think I've ever heard it from real* people.

    For "taking a sickie", I've heard "taking a mental health day" or occasionally "taking a vision day - I just can't see myself going in to work today."
    * 8-)

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  50. Rick S said - spit is well attested as an alternative preterite, e.g. "He spit out the words then waved his arm toward the road." Perhaps it's AmE only?

    Yes indeed (although I don't know what a preterite is) - in BrE the past tense would be 'spat', similarly swim/swam, sing/sang - but curiously, while 'knit' is the past tense in AmE, UK usage is 'knitted', for garments and for mending wounds. It's an S-word thing.

    John Cowan - if I were a linguist I might have known about the adverb/adjective words - however I always use slowly and roughly in the examples you give, and I rationalise the use of sick/ill because of the ambiguity of the verb to be.

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  51. "Our news stories are more likely to say 'in stable condition'..."
    British English would be similar but 'in a stable condition'

    I haven't heard the mental health day expression but duvet day is a pretty common Br Eng equivalent.

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  52. "So if someone were in hospital after a car accident, what would be the normal American Engish phrase be? Injured in hospital?"

    Actually I think most AmE speakers would just say "They're in the hospital."

    The conversation would likely go something like this:
    "Where's Jim?"
    "He's in the hopsital."
    "Oh no, what for?"
    Then would come, "He was in an accident, but is fine." or "He is having some tests done." etc.

    Of course, there are the cases where you are more specific initially, as Lynne pointed out.

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  53. Doug: If I heard someone was "taking a mental health day", my assumption would be they felt so stressed/depressed/etc. they couldn't bear to come in to work. An actual sick day for mental health reasons, in other words.

    "Taking a sickie" clearly implies fraudulently calling in sick to have a day off.

    A "duvet day" is a day devoted to relaxation. I'd be happy to describe someone as having a duvet day without necessarily calling in sick -- using a leave day, for instance, or relaxing at the weekend.

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  54. Regarding: "X is in (the) hospital", I typically hear one of three responses:

    1) S/He had surgery.
    2) S/He was in an accident.
    3) S/He is sick (or S/He is ill).

    The first would be usually be something planned - if unplanned, it would be "S/He had an appendectomy/compound fracture/biopsy." Being in an accident would be imply physical injuries like broken bones or whiplash. The third would imply a serious illness (cancer of some kind, most likely) and would probably be followed up with the return question "Oh, what does s/he have?" if the question is not deemed too intrusive.

    Also, to me, sick (I've been sick) implies unspecific illness ala head cold, flu, etc. or a diagnosed illness you don't want to talk about (STD, cancer, kidney transplant). I would follow a response of "I've been sick" with the question "Oh, that's too bad. Do you feel better now?"

    "I've been ill" implies a more serious condition and would be result in the return questions "Is everything ok?" or "Is there anything I can do?"

    Most of the time, though, ill and sick are interchangable and ill is used specifically when you don't want someone to think you're about to throw up. Depending on how sick/ill I am, I usually go with a whiny "I don't feel good." :)

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  55. I don't think a person would say "seriously ill in hospital" in normal conversation of someone who'd had an accident, for instance. It's the news bulletins who say it, and I have a feeling they pick it up from the hospitals - Hospitals used to have (do they still?) a Dangerously Ill List and a Seriously Ill List of patients who needed particular care. If someone is stable, the news reports tend to say so.

    Incidentally in the UK we'd be more likely to say someone had an operation than that they had surgery. We also tend, although I think it's obsolescent, to talk about medicine rather than medication. And although we very often visit our doctors at a health centre, the older term, which is still in use, was that we went to the surgery, and GPs still keep surgery hours! I remember being on a bus going through a non-tourist part of London with some Americans who had obviously got on the bus to see where it went (something I, too, love to do in a strange city) and they burst out laughing when they saw, above a street door, a sign which read something like "W*** Road Surgery".

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  56. Following on from Mrs Redboots's comments, the British military compassionate leave system uses the terms Very Seriously Ill (VSI) and Dangerously Ill (DI) as two non-specific indicators of the urgency with which a serviceperson should be re-patriated to the UK from overseas when a near relative is "ill". This avoids the unnecassary detail about the actual medical condition which is likely to be life-threatening.

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  57. Now all I can think about is the bit from Firesign Theatre's I Think We're All Bozos on This Bus where a word-associating computer refers to "Chicago, Ill. [sic]"

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  58. As an American who has traveled around the nation, I suspect there is considerable regional, and perhaps generational, variation in American use of ill/sick/poorly.

    I've heard enough Americans use "to be sick" to mean vomit that I interpreted the repetition in the original post as a clarification, along the lines of "I just told you what was wrong, I threw up." People I've met who use sick this way also use the noun the way Thorpe Park does.

    I'm pretty sure people of my grandparents' generation, particularly from rural backgrounds, would use "I feel poorly" to describe suffering minor ailments such as indigestion or unusual fatigue.

    I do notice a distinction when referring to chronic conditions, as opposed to a more acute problem. Diabetes, for example is a 'chronic illness' and not a 'chronic sickness' and one is 'chronically ill'.

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  59. Like Townmouse, my initial interpretation of the anecdote was that your colleague had meant that she had vomited, and so couldn't understand why you needed further clarification on that. 'To be sick' is so firmly rooted in my (BrE, early-twenties) lexicon as meaning 'to vomit' that I've had conversations along the lines of:

    "Hey, you don't look so good."
    "No, I've been sick."
    "You've been SICK? Are you ok? Do you think you might be sick again?"
    "No... I don't mean I've been sick... I mean, just generally sick..."
    "Oh, you mean you've been ill."

    To be, it's the preferred term, since 'vomit' sounds so formal and biological, and it isn't at all childish.

    However, in my family (originally from Cambridge, if that makes any difference), we also use the euphemism 'to visit Ralph and Hughey' - as in, "He's not doing so well. He was visiting Ralph and Hughey all night last night". Those names were picked for their, erm, onomatopaeic qualities when it comes to this particular bodily function!

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  60. I don't think anyone has mentioned the US usage "sick to [my/his/her] stomach" to mean feeling nauseated.

    "What's wrong with your daughter?"
    "She's feeling sick to her stomach, poor thing."

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  61. There is a wonderful bit in a modern American translation of the bible where it talks about the people 'bringing all their sick to Jesus' and 'laying their sick on the ground in front of him', which I'm afraid always makes me, as a British English speaker giggle at the image of bowls of vomit being carefully carried across and put in front of Jesus.

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  62. @Ros:

    Your modern American translation was probably following the example of the rather old English King James/Authorized translation of 1611.

    Mark 6:56:

    And whithersoever he entered, into villages, or cities, or countrie, they laide the sicke in the streetes, & besought him that they might touch if it were but the border of his garment: and as many as touched him, were made whole.

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  63. Thank God for this post!
    As a non-native speaker of BE I've had several misunderstandings with my Northern bloke over the last months. It's an extremely wet/ now freezing Berlin winter and we've both had to convey our physical states to each other - and me never sure what to really say.

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  64. @vp Maybe, but there's something about the expression 'their sick' which makes it sound somehow funnier than 'the sick' which I would more easily read as 'the sick people'.

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  65. A colleague has just told me that her father (southern English, 40 years ago) used to say 'I feel a bit queer' when he felt ill. I would associate the phrase now with a dizzy sensation, perhaps a hangover, or early in an illness when one might say 'I think I'm coming down with something' (flu, a cold etc).

    And another 'adult/informal' term for vomiting or throwing up would be to puke. Like spewing, it might imply too much to drink or perhaps acute food poisoning.

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  66. Of course, we could fill an entire other post with euphamisms for vomiting...almost as varied as those for breasts...

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  67. @Paul, as I said, the problem is that "to be sick" only means "vomit" in (my dialect of) AmE in the set phrase "going to be sick" (gonna works too, but not other unrelated future tense modifiers). "He said he was going to be sick and, and he was" doesn't even work for me. Was what? Compare "He said he was going to be absent, and he was". Perfectly legible.

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  68. Speaking of 17th-century uses, I happened to read Shakespeare's _Julius Caesar_ this weekend, and I realized that the use of "sick" meaning "in poor health" is used repeatedly, especially in act II, scene I. One of Portia's speeches in that scene even uses the double meaning to ask if Brutus is sick before saying he must have some "sick offence" in mind.

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  69. Your post has reminded me of the lyrics to the Smiths song 'What Difference Does it Make?':

    Oh, I'm too tired
    I'm so sick and tired
    And I'm feeling very sick and ill today
    But I'm still fond of you, oh-ho-oh

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  70. "Being poorly" is a construction I've just never heard.

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  71. Interesting that Fritinancy says 'sick' is used to mean 'cool' in the US.

    I've noticed that in England (or at least in London) teenagers have started saying 'sick' to mean something good, as 'wicked', 'bad' and 'mental' were used in the 1990s.

    I thought I was being insulted the first time it happened to me.

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  72. @Fritinancy and Dangling Modifier: I did mention that in the post. I speculated that the newness and rapid uptake of this use of sick in BrE meant that it would be a more obvious interpretation to Brit speakers than to their US counterparts. Not founded on anything in particular.

    I heard a new one today: 'sick line. That's apparently the Scots equivalent of Doctor's Note, such as you would have to present to your employer in order to claim sick pay

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  73. Just read this on Swedish Blog:

    Sjukt = see above. Things can be sjukt bra (very good) sjukt snygg (very good looking) sjukt dyr (very expensive). Sjukt can aslo be used to describe something crazy and insane for example “Hur var filmen?” (How was the movie?) “Den var helt sjuk!” (It was totally insane/sick!)
    OBS! Sjuk ordinarily means sick in Swedish, as being in “Jag är sjuk” (I am sick) and is pronounced “schuuk”.

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  74. As a 50-something southern American I can offer the following: "sick" means not well, probably from something acute (cold, flu - not hives) whereas "ill" refers to something more severs. There are also the obvious extensions: sick day (whether real or for mental health), sick pay (compensation on a sick day), "sicko" (someone who is mentally unbalanced and especially someone who commits horrific acts on others - human or animal), "that's sick" (something abhorrent), "sick to my stomach" (nausea with or without vomiting), "sickly" (one who is pale, perhaps to the point of looking 'blue' or one who is very frail or prone to being sick), "sickening" (something that makes you sick to your stomach due to its repulsion)

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  75. This is obviously a Hot Topic: http://arnoldzwicky.wordpress.com/2010/01/13/illness-and-disability/#comments

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  76. I'm afraid I'm wandering off-topic, both with regard to the subject words (sick and ill), and the blog's theme (BrE vs. AmE), but I couldn't help but think of this post in the last day or two when I have heard numerous newscasters, referring to the terrible earthquake in Haiti, speak of "dead and wounded". To me, "wounded" are people (or animals) hurt by direct human activity, such as war or hunting. It's jarring to hear the word applied to victims of a natural calamity. I would have said "dead and injured".

    Returning you to your previously scheduled topic...

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  77. As with qs, apologies for the slight digression, but I always find "in a stable condition" odd, because, let's face it, how much more stable could your condition be than if you were dead? Death seems to me to be the ultimate stable condition!

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  78. Cameron- i think "stable" means a new normal. One can be in "serious, but stable condition". If one were in "critical condition", you could end up in your ultimate "stable" condition, death.

    WV: dysicie - hey, you, kick the bucket!

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  79. A very interesting article. I am from Leeds, Yorkshire, United Kingdom and found the comments on 'poorly' very interesting. I believe the usage of 'poorly' has changed quite a bit over the past decade, especially in my part of the region.

    Medial Professionals in the region tend to us 'poorly' in a similar way to the usage in the US and elsewhere, and, generally, once a local hears this phrase used by a Medical Professional, their usage often changes. 'Yorkshire English' seems to be in the process of slowly being washed out by the dominant London dialect.

    Interestingly, 'being ill' is frequently used in Yorkshire as a verb for 'vomiting'.

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  80. Way back in the comments, JD quoted:

    Oh, I'm too tired
    I'm so sick and tired
    And I'm feeling very sick and ill today
    But I'm still fond of you, oh-ho-oh

    This demonstrates several meanings of sick and ill - here 'sick and tired' is a British idiom, similar to 'fed up', meaning satiated, and not enjoying things...... as in 'I'm sick and tired of this paperwork'; 'She's fed up with his complaints'.
    Um, I think 'of' and 'with' both work with these phrases.

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  81. Biochemist: sick and tired is used in AmE too, but only with of, not with with, whereas for me at least fed up demands with.

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  82. On our local train line (Greater London area), the driver occasionally delivers reasons for delay over the tannoy: 'Passenger taken ill' is one - this would be a heart attack, fainting or other form of acute collapse that caused the train to be delayed while the passenger is attended by an ambulance crew.
    The full sentence in normal speech would be 'A passenger has been taken ill' but the drivers use stereotyped phrases (such as 'person under train' - long delay expected there).
    John Cowan, I agree with your note above about the use of 'of' and 'with' - writing a phrase makes it sound so wooden!

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  83. NW-England point of view:

    "sick" out of the work context ALWAYS means vomit. If someone says they've been sick, it can only mean that they have vomited. I have never used another word for it than be sick - I've never used the word vomit, or said throw up, etc - always 'to be sick' or 'I've been sick'.

    I would understand what people meant if they said they'd been ill, but I wouldn't tend to use the word 'ill' myself. I'd say "I've not been well" or "I don't feel well". Incidentally, up in the North I've never heard someone use the word "unwell" - that sounds very strange, and not BrE to me. The negative - "not well" - would be the favoured form.

    "Ill" to me would be used in one of two contexts. If someone is seriously ill, for example in hospital, or if you were trying to express just how bad you felt, as in "I feel REALLY ill" rather than just "I don't feel well" or "I don't feel at all well".

    In the context of work, I would say I had been "off sick" or had a "sick day", and I've heard people say "pulled a sickie". But outside off this use of the word sick, it would only ever mean vomit to me.

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  84. On the subject of sicken, I've only ever really used it in the sense of 'sicken for' as in to miss or crave (maybe not crave, perhaps a bit too short term that synonym, perhaps yearn).

    I guess it might be the passive verb usage of 'To be home sick', or 'to sicken for home'. I surely [BrE (Estuary)] can't be alone in extending this to sicken for half-decent English breakfast when abroad can I?

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  85. piersy: Yes, I think you are very much alone there. Sorry.

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  86. Regarding "I've been sick" or "I was sick", you hear this in BrE (particularly in the workplace) to mean "I've been (off) sick" or "I was (off) sick", eg. "Where were you last week?" "I was sick", or " I was sick 4.5 days last year" meaning the person had 4.5 sick days that year.

    As for "poorly", I disagree with it's interpretation as childish. It's used quite regularly in BrE (North-East) to simply mean 'ill' - sometimes a slighly gentler way of saying it, but no real difference in meaning.

    Also, in BrE, you hear a doctor in a hospital advise that their patient is "poorly", and this implies rather seriously. Well, of course they are ill, why else would they be in (the) hospital?!

    A common way of describing 'ill' in BrE (North-East) is "bad", eg. "I stayed off work yesterday because I was bad", or "I feel bad" - nothing to do with an act of mischief or malevolence, or feeling guilty! Intersted to know how localised this usage is?

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  87. The British English Usage of Sick is far more complicated than in American English. In American English Sick is a general term for any kind of illness. You can say Ill in American English as well but it just sounds like your trying to act smart or you some kind of nerd. If someone in the U.S told me Ive been sick for the past week, it means he had some kind of flue or cold. If you want to say you feel like throwing up we Americans would say "I feel nauseous". In England its also far more common, like the blogger mentions, to ask people "what were you sick or ill with." I was kind of shocked at first by this question because in the U.S nobody ever hardly asks what you were sick with. If some ones been ill/ or sick. They're not likely to want to tell you all the details.

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  88. biochemist

    A colleague has just told me that her father (southern English, 40 years ago) used to say 'I feel a bit queer' when he felt ill.

    A monologue written by Weston and Lee (1922) and performed by Stanley Holloway (1938) began:

    I've been very poorly but now I feel prime,
    I've been out today for the very first time.
    I felt like a lad as I walked down the road,
    Then I met Old Jones and he said, 'Well I'm blowed!'
    My word you do look queer!
    My word you do look queer!
    Oh, dear! You look dreadful: you've had a near shave,
    You look like a man with one foot in the grave.'
    I said, 'Bosh! l'm better; it's true I've been ill.'
    He said, 'I'm delighted you're better, but still,
    I wish you'd a thousand for me in your will.
    My word, you do look queer!'

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  89. I'll add my two cents to the Americans': here's my Canadian point of view.

    I would use sick to mean any range of maladies from a cold to something serious. I consider ill to be a synonym of sick, though I'd never say someone was ill (barring, perhaps, a severe illness like cancer that had left someone bedridden) -- it sounds too stuffy and old-fashioned. For nonspecific feelings of poor health, I would just say "I'm not feeling well." I agree with other posters that your experience with the woman reiterating "I was sick" was likely due to her perceiving your question as intrusive and overly personal.

    As for sick as vomit, that's definitely all British. I'm familiar with the usage, but I've never encountered it from a North American. Most of the time "I've been sick" would mean I have felt unwell in some way. If I wanted "I've been sick" to mean "I vomited", it wouldn't be because I consider sick a synonym of vomit, it would be as a more polite euphemism so as to avoid drawing attention to the action (similar to "I need to go to the bathroom" rather than "I need to urinate").

    The only verbs I'd use would be to vomit or to throw up. As a noun, there'd be vomit (proper), throw-up (usually only said by small children), or more vulgar slang such as "puke".

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  90. I'm a millennial from western Massachusetts USA, with a most decidedly atypical idiolect. Please bear with me.

    In no particular order:

    Sick and Ill both denote unspecified types and degrees of unwell.

    Sick has connotations of physicaly unwellness, especially gastrointestinal such as nausea, cramps, bloating, or the involuntary, often violent expulsion of bodily fluids.

    Ill is more likely to connote feelings of mental unwellness, such as anxiety or fatigue or the emotional reaction to being sick.

    Alternatively Ill can refer to chills or fever.

    Both are general terms, as contrasted to illness which refers to a specific disease or set of symptoms. Chronic illness can be referred to as ailing, though not commonly.

    Poorly in the form to be, as a condition or state doesn't register to me.

    I would only use poorly as to do poorly (at).

    I would however describe a person as being in poor health.

    All the words and phrases that describe the act of vomiting are indelicate, but then, so is the act itself.

    I have seen sick used in that sense, but only in the future tense and as a warning to steer clear.

    The Result of the act is referred to occasionally as sick, but more frequently in regards to babies and pets than to adult humans.


    In regards to the specific exchange mentioned in the post I can thing of several plausible interpretations.

    "What's the problem?" was interpreted as "what's wrong with being sick?" which is incredibly insensitive, hence the sparsity of detail in the reply.

    They were using sick in a general sense without having any particular symptoms in mind.

    "the exact nature of my sickness is personal, I maintain the right not to disclose it."

    "what's the problem?" can be interpreted or misheard as "what was that?" an informal way of saying "I didn't hear and/or understand you, please repeat that"

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  91. A different twist than I have read here on the usage of poorly: In my corner of AmE, which is southern Colorado, we use poorly to indicate declining health, making it a commonly used expression for elderly and infirm people who are failing, as in "I am so sorry to hear about your grandmother's feeling poorly".

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  92. I've never heard "off sick" in AmE, just "out sick." I would know what the first example means, but it just does not seem idiomatic to me.

    Oddly, "illness" and "sickness" seem to be pretty much equivalent in AmE. I could be wrong.

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  93. I've just listened to a TV news report where someone who had been seriously injured in an accident and was clearly fighting for her life was described as "seriously ill" - Is that accurate? She wasn't suffering from a disease; she had had the misfortune to be on a vehicle which crashed. She was badly HURT.

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  94. Yes, see Simon K's comment above and subsequent comments.

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AmE = American English
BrE = British English
OED = Oxford English Dictionary (online)