From Aarskog’s syndrome to Zahorsky’s disease, the history of medicine has granted fame to thousands of pioneering physicians and anatomists. But the convention of naming tests, symptoms, and diseases after their discoverers is confusing and should be abandoned, doctors say. An estimated 15,000 eponyms - terms where a discovery or invention is named after a person - are invoked in medicine today, says the website whonamedit.com. Famous examples include Alzheimer’s and Parkinson’s, Heimlich’s manoeuvre, Tourette’s syndrome and pasteurisation.

While eponyms appear to give credit where credit is due, researchers argue in the British Medical Journal, published today, that some terms do not accurately reflect scientific discoveries, are inconsistently used or tainted by the less than illustrious behaviour of their historical namesakes. Doctors and medical students are baffled by an increasingly cluttered medical lexicon, and it is time to abandon eponyms in favour of more descriptive terms, argue Alexander Woywodt, of Lancashire Teaching Hospitals, Preston, and Eric Matteson, of the Mayo Clinic, Minnesota.

Only 10 of 92 surgeons surveyed were able to give the correct description of Finkelstein’s test (for diagnosing tendon inflammation), while experienced trauma surgeons may spend some time in debating “whether a fracture is a Barton’s, a Smith II or a reversed Barton’s”, they write.

To make matters more complicated, some diseases have many different eponyms in different countries, they say. Sometimes the terms are also considered inappropriate, such as those derived from Nazi doctors during the Second World War.

They cite the case of Hans Reiter, a doctor who is remembered for his discovery for a variant of reactive arthritis, but was recently identified as having conducted experiments on prisoners in concentration camps. There has since been a decline in the use of the term Reiter’s syndrome, and a formal retraction of the term has even been proposed, the authors write.

“Eponyms often provide a less than truthful account of how diseases were discovered and reflect influence, politics, language, habit, or even sheer luck rather than scientific achievement,” they add. “Moreover, the continued use of tainted eponyms is inappropriate and will not be accepted by patients, relatives, or the public.

Instead of using eponyms, they suggest we should use our interest in medical history to provide fair and truthful accounts of scientific discoveries and to dissect individual contributions. They call on the editors of medical journals and textbooks to abandon the use of eponyms.

Writing in defence of the terms in the BMJ, Judith Whitworth, of the Australian National University, Canberra, says that eponyms remain a useful reflection of medical history.

Eponyms bring colour to medicine, provide a convenient shorthand for the profession and are so embedded in our vocabularies that abolishing them is unrealistic, she says.

“Do we really want to speak of violent muscular jerks of the face, shoulders, and extremities with spasmodic grunting, explosive noises, or coprolalia instead of Tourette’s syndrome?” she writes.

“The use of eponyms is often random, inconsistent, idiosyncratic, confused, and heavily influenced by local geography and culture. This is part of their beauty. For example, Plummer-Vinson syndrome in the United States, Paterson-Kelly’s syndrome in the United Kingdom and Waldenstrom-Kjellberg syndrome in Scandinavia all describe sideropenic dysphagia [a throat condition linked with iron deficiency].”

She adds: “If we abolish [eponyms] in medicine, can we still use them in other areas of science? Do we get rid of Avogadro’s number, Boyle’s law, the joule, the Kelvin, the hertz?

“Should we abolish the cardigan because he was a bully whose incompetence led to over a hundred unnecessary deaths in the charge of the Light Brigade? Should we instead speak of a front-opening sweater? What will we call the sandwich, sideburns, diesel or chauvinism?

“Eponyms are here to stay.”

What’s in a name?

James Parkinson English physician and palaeontologist (1755-1824), is best known for his description of “shaking palsy” in 1817, but his name was not attached to Parkinson’s disease until 40 years later. A political radical, he was also questioned over the “popgun plot” to assassinate George III.

Louis Pasteur, French chemist and bacteriologist (1822-1895), was the founder of the science of bacteriology who proved that microorganisms cause fermentation and disease. He was the first to use vaccines for rabies, anthrax and chicken cholera. He originated the process of preserving food known today as pasteurisation.

Alois Alzheimer, German neuropathologist and psychiatrist (1864-1915), spent years working with dementia patients and co-wrote an important six-volume study of the nervous system before becoming director of the psychiatric clinic at the University of Munich, where he described the disease that would bear his name. Diagnosis of Alzheimer’s today is still based on the methods he used in 1906.

Gilles de la Tourette, French neurologist (1857-1904). In 1884 he described nine patients who were afflicted with compulsive behaviour and tics, including the Marquise de Dampierre, an aristocratic lady who “ticked and blasphemed”. She had been assessed 60 years previously by a physician named Jean Itard, but experts preferred the sound of “Tourette” and his name was attached to the disorder.

Henry Jay Heimlich, American thoracic surgeon, (1920-), has been a household name since the 1970s because of his procedure for saving a choking victim. Dr Heimlich’s main field of study is disorders of the alimentary tract. He is president of the Heimlich Institute in Cincinnati.

Source: whonamedit.com

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