Using Hyphens

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Hyphens
by Mary Morken and Bill Bentsen.

I have found the use of hyphens to be one of the most difficult parts of grammar to learn and use. These complex abstract rules escape me; read them outloud fast for a good laugh. Concrete examples which might be more helpful are listed below.

From article on hyphens in JAAMT, May-June 1992

Hyphens are used in compound modifiers of nouns:
1. Compound adjectives preceding a noun.
2. Two or more eponymic names used as multiple-word modifiers.
3. Most compound adjectives that contain a preposition.
4. The use of "high" and "low" in compound adjectives.
5. Adjectives with participles before and after a noun.
6. Nouns with participles before a noun.
7. Sometimes a noun and an adjective.
8. An adjective-noun compound preceding a noun.
9. Two equal nouns used as a single noun.
10. Words and numerals in compound modifiers preceding a noun.
11. When necessary for clarity.

Hyphens are not used for:
1. A noun or adjective used as a verb.
2. Some official titles.
3. Spelled-out Greek letter forms.
4. The term "status post."
5. Chemical terms and disease entities.
6. Compound modifiers commonly read as a unit.
7. Eponymic names of one person.
8. After the word "very" or adverbs ending in "ly."
9. With percentage numbers.
10. Foreign expressions in compound adjectives unless always hyphenated.
12. Proper nouns of more than one word.
13. Combined proper nouns and common nouns.

Discussion of Rules:
1. Compound adjectives preceding a noun. Rule: adjective + adjective.
--A. Don't hyphenate independent adjectives preceding a noun:
--a long and tiring trip ("long" and "tiring" each modify trip)
--a warm, enthusiastic reception ("warm" and "enthusiastic" each modify "reception"; a comma marks the omission of the word "and")
--a distinguished public orator ("public" modifies "orator"; "distinguished" modifies "public orator")

--B. In a few special cases two adjectives joined by "and" are hyphenated because they function as one-thought modifiers. These, however, are rare exceptions to the rule stated above.
a cut-and-dried presentation
an out-and-out lie
a hard-and-fast rule
an up-and-coming lawyer
a high-and-mighty attitude
a rough-and-tumble environment
a tried-and-true method
a spic-and-span kitchen
an open-and-shut case
sweet-and-sour sauce

--C. Hyphenate two adjectives that express the dual nature of the thing that they refer to:
a true-false test
a compound-complex sentence
BUT: a bittersweet ending

--D. Hyphenate repeated or rhyming words used before a noun:
a go-go attitude
an artsy-craftsy boutique
a rah-rah spirit
a fancy-schmancy wedding
never-never land
a rinky-dink setup
a teeny-weeny salary increase
a ticky-tacky operation

--E. Hyphenate expressions such as blue-black, green-gray, snow-white and red-hot before and after a noun. However, do not hyphenate expressions such as bluish green, dark gray or bright red: Sales have been red-hot this quarter.
Her dress was bluish green.

2. Two or more eponymic names used as multiple-word modifiers.
Use a hyphen to join compound nouns, compound surnames and compound eponyms:
a David-Crowe mouth gag
She is of Mexican-American ancestry.
Antonio is the new secretary-treasurer.
Dr. Asser is the chief-of-staff.
Epstein-Barr virus.
Swan-Ganz catheter

Gregg: "Hyphenate the names of races, peoples, tribes and languages when they are used as adjectives; for example, African-American enterprises, French-Canadian voters, an Afro-American style, the Anglo-Saxons, the Indo-Chinese."

3. Most compound adjectives that contain a preposition. Hyphenate phrases used as compound adjectives before a noun only:
These are up-to-date expense figures
The expense figures are up to date.
These are down-to-earth projections
These projections are down to earth.
I had on-the-job training
I got my training on the job.

Note: Adverbs normally modify adjectives:
a not too interesting report (adv: too modifies adj: interesting which modifies noun: report)
a rather irritating delay (adv: rather modifies adj: irritating which modifies noun: delay)
a very moving experience (adv: very modifies adj: moving which modifies noun: experience)
a quite trying day (adv: quite modifies adj: trying which modifies noun: day)

5. Adjectives with participles before and after a noun:
high-ranking
rough-hewn
long-standing
odd-sounding
ready-made
smooth-talking
sweet-smelling
hard-hitting

6. Nouns with participles before or after a noun:
awe-inspiring
face-saving
law-abiding
market-tested
smoke-filled
tailor-made
computer-aided design
The layout of the catalog cover is eye-catching.
Buying custom-tailored suits is habit-forming.

7. Sometimes a noun and an adjective: Always, a noun plus an adjective used as a compound is hyphenated. It may either come before or after a noun in another part of the sentence:
accident-prone
age-old
brain-dead
sky-high
water-repellent
tax-exempt
HIV-positive

8. An adjective-noun compound preceding a noun:
broad-minded
quick-witted
hot-tempered
single-spaced
These symptoms commonly occur in middle-aged executives.
I'm too old-fashioned to be that broad-minded.

9. Two equal nouns used as a single noun:
actor-director
dinner-dance
owner-manager
secretary-treasurer
wheeler-dealer
clerk-typist
cardioverter-defibrillator

10. Words and numerals in compound modifiers preceding a noun:
one-way street
first-person account
first-rate job
two-piece suit
three-ring circus
5-liter container
8-foot ceiling
20-year mortgage
50-cent fee
100-ml flask
8 1/2- by 11-inch book
55-mile-an-hour speed limit
2-million-ton shipment
10-inch-thick panel

11. When necessary for clarity:
There was a soft-tissue lesion on the surface.
(The lesion is composed of soft tissue.)
There was a soft tissue lesion on the surface.
(The lesion was soft.)

Hyphens are not used for: (5.) Chemical terms and disease entities.
Usually this is right. I'd check in a medical dictionary, however. The following are hyphenated:
9-nor-delta-THC
9-nitroanthra(1,9,4,10)bis(1)oxathiazone-2
7-bisdioxide
5-fluorouracil
5-fluorocytosine

Gregg: "A hyphenated compound adjective and an unhyphenated possessive expression often provide alternative ways of expressing the same thought. Do no use both styles together:"
a one-year extension
a one year's extension
a two-week vacation
a two weeks' vacation
NOT a one-year's extension or a two-weeks' vacation

Self-image, self-esteem:
"Self" is being used as a suffix in these examples. It shouldn't be confused with a compound word. Webster's New Collegiate Dictionary says that "self-" is often used as a prefix as denotes "a person or thing affected." Gregg says to use a hyphen after "self" when it serves as a prefix: self-addressed, self-evident, self-important.

Always hyphenated: All the self- words: self-image, self-concept, self-discontinued, self-referred, self-examination. What about these? long-term, breast-feeding, full-time, part-time, blue-black, yellow-green, red-hot, broad-minded, brain-dead, HIV-positive, accident-prone, middle-aged, habit-forming, age-old, smoke-filled, by-product, hot-tempered, face-saving, awe-inspiring, show-off, air-conditioning, sweet-smelling, high-ranking, smooth-talking, owner-manager, goal-directed, disease-free, seizure-free, slow-growing, near-syncope, opiate-dependent, oxygen-dependent, bed-wetting.

Don't hyphenate "self" when it's being used as the root word with a suffix attached: selfdom, selfish, selfhood.

He had a part-time job. He worked part-time.
This is an adjective plus noun which isn't represented above. The rule is: if the expression continues to function as a compound adjective, retain the hyphen:
This job is part-time (compound adjective.) "Part-time" modifies job.
I work part-time (compound adverb.) "Part-time is adverb telling "how."

This is a well-developed, well-nourished, 58-year-old man.
He was 58 years old, well developed and well nourished.
This is a very ill-appearing, moderately distressed white male.
He is very ill appearing.
He is on a 10-day course of steroids.
He has a 4- to 5-day history of fever.
He has a several-week history of malaise.
Self-worth, self-esteem and self-attitude are good.
He had beat-to-beat variability on-and-off and took over-the-counter medication.
He was on patient-controlled analgesia.
He had a part-time job.
He worked part-time.
He had blood-tinged sputum.
His sputum was blood tinged.
She has community-acquired pneumonia.
Her pneumonia was community acquired.
She had gram-negative rods.
Rods were gram-negative.
A one-eighth-inch incision was made.
A through-and-through laceration had been made.
He may have small-cell carcinoma, giant cell arteritis, or squamous cell carcinoma.
Diet was low cholesterol and low salt.
She was on a low-cholesterol, low-salt, low-fat diet.
He had an end-to-end anastomosis.
The anastomosis was end to end.
He was high risk.
He was in the high-risk category.
He had Hemoccult-positive stool.
Stool was Hemoccult positive.
He was HIV positive.
He had an HIV-positive history.
He had no AIDS-defining illness.
She had diet-controlled diabetes.
Diabetes was diet controlled.
She had a real-time ultrasound.
Her ex-husband, stepfather, mother-in-law and great-grandmother all appeared in her visual hallucinations.
She had biopsy-proven carcinoma.
Carcinoma was biopsy proven.
She exercises every-other-day.
He is up-to-date on his immunizations.
The baby-sitter took the baby to the emergency room.
No air-fluid levels.
He had a left hand laceration.
She has moderate-to-severe dysplasia.

Suspended hyphenation:
long- and short-term securities
private- and public-sector partnerships
single-, double-, or triple-spaced copy
six- to eight-week delay
a three- or four-color cover
purple- and red-topped tubes (purple-topped and red-topped tubes)

Suspended hyphenation with numerals:
We inserted a 10- to 12-mm port in the umbilical incision.
8 1/2- by 11-inch paper
10- and 20-year bonds
3-, 3-, and 8-gallon buckets
6-, 12-, and 24-month CDs
10- to 12-hour trip
3- x 4-cm incision
3- x 4-inches-long abrasion

You may even suspend hyphenation when you have two or more solid adjectives with common elements:
light- and heavyweight versions
day- and nighttime phone numbers

Some compound nouns are combined, some hyphenated, some not combined:

airfreight, air bag, air-conditioning, checklist, check mark, check-in, closeout, close shave, close-up, crossroad, cross section, cross-reference, daytime, day care, day-tripper, doubleheader, double take, double-dipper, eyewitness, eye shadow, eye-opener, freeway, free lance, free-fall, goodwill, good sense, good-bye, halftime, half hour, half-truth, jobholder, job action, job-hopper, lifeline, life span, life-style, lightweight, light bulb, light-year, moneylender, money market, money-maker, placeholder, place mat, place-name, pocketbook, pocket money, pocket-handkerchief, showdown, show biz, show-off, sickroom, sick pay, timetable, time deposit, time-saver, trademark, trade name, trade-off, bondholder, bond paper, bookstore, book review, cashbook, cash flow, handbook, hand truck, homeowner, home port, masterpiece, master plan, paperwork, paper clip, payroll, pay dirt, salespeople, sales tax, schoolteacher, school board, standby, stand-in, workstation work load bylaw, by-product, voiceprint, voice-over.

If a noun is not in the dictionary, keep the components as separate words.

From Toni Mercadante (tmerc@ix.netcom.co)
I found cafe au lait spot(s) in:
- Taber's (16th ed.)
- HPI Orthopedic/Neurology Words
- Duncan's Dictionary for Nurses
- Robbins Pathologic Basis of Disease (5th ed.)
- Stedman's OB/GYN Words
- Stedman's Pathology Lab Medicine Words
- Stedman's Electronic
- Stedman's Medical Dictionary (25th ed.), p. 1458 (spot)
- Sloane & Dusseau, A Word Book in Pathology & Laboratory Medicine
- Sloane, The Medical Word Book, p. 412

But cafe-au-lait spot(s) in:
- Stedman's Cardiology Words
- Stedman's Radiology Words
- Sloane, The Medical Word Book, p. 290, 790
- Signet/Mosby Medical Encyclopedia