Jarrod Shapiro, DPM
Practice Perfect Editor
Mountain View
Medical &
Surgical Associates,
Madras, Oregon
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Eponyms: Take ‘Em or Leave ‘Em, Part 1
When I was a podiatry student, one of the most frustrating things about learning medicine was the number of names there are for one anatomical structure or disease process. More frustrating yet was having to memorize some old doctor’s name instead of a Latin term that clearly described the pathology. Virchow’s triad, Pupart’s ligament, Morton’s neuroma, Guillain-Barré, Alzheimer’s disease, Huntington’s chorea, Prinzmetal’s angina. The list goes on. For years, I dutifully memorized the names, understanding it was just a part of learning medicine, one of those hoops we students and residents just had to jump through.
Recently, though, I’ve had a change of heart. I was in the operating room waiting for my anesthetist to complete her general anesthesia routine. Standing there, I realized that I was surrounded on all sides by eponyms. Perhaps this contemplative state of mind is due to age (though I am still a young 37 years-old). Perhaps this is a result of my son’s recent 5th birthday. Either way, I’ve had a somewhat radical change of mind when it comes to eponyms and what they represent to us as physicians.
Why Do We Use Eponyms?
According to www.whonamedit.com there are about 15,000 eponyms in current use. Eponyms have been used for ages as a method to give credit to those individuals who have named or described a concept. Eponyms have been used outside of medicine as well as within. Think of all those street names we’re so used to hearing: Martin Luther King street, Washington, Jefferson, etc. The vast majority of our surface streets and freeways are named after specific individuals. Is this necessary? Of course not. We could just as easily name our streets after numbers or letters (which is also commonly done). The sciences too have been especially judicious with the use of eponyms. Think of the “boson” in physics named after the physicist Satyendra Nath Bose.
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Alois Alzheimer
1864 - 1915 |
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I think the reason for our use of eponyms is twofold. First, humans are a backward-looking organism. Our sense of history binds us to those who came before, anchoring the present in an understanding of the past that allows us a clear view into the future. As such, the use of eponyms marks important events and individuals from history. When we use a term such as Alzheimer’s disease, we are cognizant of the physician, Alois Alzheimer, (even if we don’t know his name) who first described this disease. Medicine has been built over its greater than 2500 year history on the shoulders of those who have come before us. Using eponyms provides us the opportunity to recognize this fact.
The second reason for our eponymophilia is its ease of use. In many cases, using an individual’s name for a pathological term or exam technique actually makes discussing these topics easier. If I were to describe a certain disease by the following term arthritis urethritica, venereal arthritis and polyarteritis enteric, would you have a rapid idea of what I’m referring to? How about Reiter’s syndrome? A little easier? Definitely. This may not always be true, but in certain cases, especially in syndromic diseases, the eponym may be simply easier to use.
Epoynmophobia
Some argue that eponyms are more trouble than they’re worth. It may be successfully argued, for example, that eponyms do not clearly describe the disease process to which they refer and may even increase conceptual difficulty. Eponyms lack accuracy and lead to confusion, especially for medical students striving to learn the new language of medicine, if not also for those in active practice.
Eponyms may also create difficulty using the medical literature. Adding the possessive form may increase the error rate while performing a search. A recent study examined the use of the possessive vs. nonpossessive forms of “Down(s) syndrome” during medical searches and showed a continental difference in the use of the possessive form (Europe uses Down’s while America employs Down). Additionally, researchers found that using the nonpossessive form (Down) lead to 5% greater numbers of articles during an online search.1 This study indicates not only a difference in eponym use – nonstandardization that may make international communication more cumbersome – but a potential decrease in the efficiency of medical searches.
Additionally, the argument may be made that clinical errors are increased with the use of eponyms. In a 2005 study, researchers systematically reviewed the use of Finkelstein’s test for DeQuervain’s stenosing tenosynovitis of the wrist by orthopedists for those who are interested. The researchers found that only 10 of 93 orthopedists were able to accurately describe this test as originally described by Finkelstein.2 This misuse potentially increases the error of both written and verbal interprofessional communication.
Are you in the philic or phobic camp? Should eponyms be kept or eliminated? What do you think? As a quick teaser for part 2 of our discussion, I’d like to refer the reader again to our friend Dr Hans Reiter. I’ll present a relatively controversial topic surrounding Dr Reiter and other physicians from history and hopefully convince you phobics to keep eponyms around at least for the short term future. Best wishes.
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