Appropriate use of outdated vocabulary and terms?
I'm in the process of planning a story right now, without the intention of sharing it it with others, but I would like it to be comprehensible if I do. It's set in the 1880s and is formatted like a journal which belongs to a doctor, and there would be some words used that people now might not be familiar with. Should I replace these with their modern counterparts, or is it okay to use the period-correct version? If the latter, would it interesting and useful to include annotations (say, as if someone had later found the journal)?
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If you are after verity, you have far more to worry about than vocabulary. In the nineteenth century the whole style of writing was different. Paragraphs and sentences were much longer than we typically use today and the overall tone was far more formal. Language usage was far more of a marker of class than it is today. (Many of our grammatical shibboleths that are slowly dying out stem from the desire in that period to clearly delineate the speech and writing of the upper classes from that of the lower.)
But stories are always written for a modern audience. Setting a story in the past (or in space, or in wonderland) is simply a device for creating the right stage on which to tell your story. Even those in the historical fiction community who scream blue murder about the wrong number of buttons on a lady's glove don't bat an eyelash as monstrously anachronous speech, opinions, or actions. Almost no historical novelist, for instance, make any attempt to portray the religious or class attitudes that would be common to ordinary people of a given period, except as marks of villainy.
So, your doctor's journal is a device for telling a story to a modern audience, and it only needs as much faithfulness to the period as is required to tell the story you want to tell. Too much will do as much harm to verisimilitude as too little, by distracting the reader from the story. But exactly how much you need to do really depends on the story you are trying to tell.
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