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What is the meaning of "with" in the following sentence,

His face was twisted with pain

Does "His face was twisted" mean "His face was twisted. And the pain was revealed in his face" ? Or does it mean "His face was twisted because of pain" ?

I thought that I understood this simple sentence, but now it is ambiguous. I have always interpreted "with" as "because of" in similar sentences. By the way, suddenly I feel like I have misinterpreted and understood it so far. Have I ever really known something wrong?

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    This is an instrumental use of with, similar to how you say "I write with a pen." – Max Jul 9 at 0:59
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If you think about it, there's really no difference between your two definitions. In this case "with" does mean "because of" -- but the only way an outside observer could know that he was in pain was by looking at the expression on his face. The man was in pain, and so his face was making a twisted (i.e. a tortured) expression.

A similar example:

Her face was shining with joy.

Is her face shining because she is joyful? Or do other people know she is joyful because her face is shining? It seems to me these are really two sides of the same thing.

  • If so, for example, a person is really not sick. But, a person want to prentend to be sick. He is twisted on his face not because he is in pain, but because his face was frowned(twisted) to cheat. If a person frowns and pretends to be painful, pretending to be sick, even though he is not sick, If this is the case, should we use "His face was twisted with pain" to express this situation? Or should not we use "His face was twisted with pain" to express this situation? – user22046 Jul 1 '18 at 2:14
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    @user22046 That seems like a meaningless distinction. There's no way to know from "fact twisted with pain" whether the person really is in pain or just faking. You have to find out that information from the context. For example, you can say a footballer "rolled on the ground in agony" after apparently being struck by another player, but how could any of us know if he's really in pain or just faking it? – Andrew Jul 1 '18 at 2:20
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    @user22046 if you want to be clear that it's a possible sham, then say "his face was twisted with apparent pain" or something similar. Then we know it just looks like he's in pain, but possibly is not actually in pain. – Andrew Jul 1 '18 at 2:21
  • I have known that a sentence of "A becuse of B" is presented a result(A), because we know the fact of B (the cause(B) of the result(A)). For example, Everyone did not know that he was suffering, but he frowns. Is it possible to express this situation as "His face was twisted because of pain" even in such cases? Or is it possible to express this situation as ""His face was twisted with pain" ? his face was twisted before we guessed that he was in pain. – user22046 Jul 1 '18 at 3:20
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    @user22046 It's not clear what you are trying to ask. There are few if any completely unambiguous statements in any language. Any sentence can mean something different depending on context, body language, intonation, etc. Without any additional information, we can just assume the most obvious or common meaning. – Andrew Jul 2 '18 at 1:01

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