Built from the interrogative particle 'ay and the demonstrative koh, this adverb asks 'in what manner?' -- slightly more pointed than the simpler eikh. It appears in both genuine questions (Deut 1:12, 'How can I bear your problems alone?'; Deut 7:17) and anguished exclamations (Isa 1:21, 'How the faithful city has become a harlot!'; Lam 1:1, 'How lonely sits the city!'). Lamentations actually takes its Hebrew title from this word. In two occurrences in Song of Solomon 1:7, it functions as 'where?' -- a usage paralleled by Aramaic eikha, suggesting a northern dialectal coloring. Spanish distinguishes the nuances as 'como' (how, manner) versus 'donde' (where).