Ails

In Southern and Appalachian speech, "ails" means to trouble, bother, or cause pain. Often heard in the question "What ails you?" it’s an old English word that has lingered in rural American dialect.

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synonyms: troubles, bothers, afflicts, pains

Hillbilly Dude Says...

I do hear 'ails' from time to time, but I'd say it's a country one, mainly old timers.

Pronunciation

[AYLZ] /eɪlz/

Meaning & Usage

- To trouble, bother, or cause pain (verb)

Clara:

He’s been sittin’ quiet all evening.

Elmer:

Don’t know what ails him.

Origin

From Middle English ailen (to trouble, afflict), with roots in Old Norse eila. In general English it became less common, but in Southern and Appalachian dialects, forms like "What ails you?" survived as everyday speech.

Notes

What ails you? is one of the most common expressions, still familiar in rural Southern/Appalachian communities.
Outside these regions, the word sounds old-fashioned or literary.
Can describe physical illness ("My back ails me") or emotional/spiritual trouble ("Something ails his spirit").

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Common Questions

What does "ails" mean?

It means troubles, bothers, or causes pain.

Do people still use it?

Yes - especially in the South and Appalachia, where "What ails you?" is still a common phrase.

Is it only Southern?

No. It’s an older English word, but it’s been preserved in Southern/Appalachian everyday talk long after falling out of common national use.