Jarrod Shapiro, DPM
Practice Perfect Editor
Mountain View
Medical &
Surgical Associates,
Madras, Oregon
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Eponyms (Part 2): Take ‘Em or Leave ‘Em
Ok, you history diehards — let’s talk more about eponyms. During part one of our eponym discussion — take ‘em or leave ‘em — I tried to discuss both sides of the issue. On the “pro” side, the eponymophiles argue the importance of eponyms in disorders with multiple components as a way to ease their naming and clarity in addition to recognizing the importance of history and those who came before us. On the “con” side, the eponymophobes assert that eponyms do not in fact clearly describe pathology, thereby making memorization more difficult for our students while decreasing clarity in the medical literature and increasing the risk for terminology mistakes.
Eponymo-foe?
With these arguments in mind we have to step back to one other point of the eponymophobes. The argument has been made that certain eponyms give credit to those in history who have behaved in atrocious ways and should be eliminated from the historical record rather than given credit. I mentioned previously Reiter’s syndrome as an example that simplifies description, eliminating a potentially cumbersome name. But when one looks back on history, use of the term Reiter’s syndrome becomes more than unpalatable.
Dr Hans Conrad Julius Reiter, in addition to his eponymous distinction, also happened to have been a Nazi who pledged his allegiance to Adolf Hitler in 1932. He was a prominent member of the eugenics movement who performed experiments on thousands of prisoners at Buchenwald Concentration Camp. He broke the Hippocratic oath in ways I won’t go into here. The Journal of Clinical Rheumatology in 2000 recommended changing the name of this condition to “reactive arthritis syndrome” or “reactive cutaneo-arthropathy” JCR 2000; 6 (1): 49-54.
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Doctor injecting one of the Tuskegee test subjects with placebo
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In the case of Dr Reiter I have to agree that his eponym should be replaced. However, I would urge caution in going too far with this eliminationist approach. When we consider history we need to include ALL of it, the good and the bad. We can’t cherry pick those events of the past that make us uncomfortable. In fact, it’s just the opposite. Post holocaust Jews say, “Never forget.” We need to realize that the history of medicine — as is true for all human pursuits — is full of events and people who commit reprehensible acts that embarrass us to even consider. But this is part of the rich history of medicine that we should embrace.
This is true for the Tuskegee syphilis experiments. It’s clear why this terrible moment in history is dredged up during medical ethics classes. In 1932 the US Public Health Service in conjunction with the Tuskegee Institute recruited 600 black men, 399 of which had on testing asymptomatic early syphilis. The test subjects were misled and denied treatment in spite of available medications like Salvarsan in order to observe the natural disease course. Meanwhile, their disease did in fact progress over time. Eventually 187 people died, including many wives and children of the test subjects. This was a dark point in medical history to say the least, and it happened not in Nazi Germany but in the US.
This is why “Never forget” is so important: so we never repeat those events. By remembering, understanding, and absorbing the downfalls of Dr Reiter, the Tuskegee doctors, and other reprehensible people, we have provided that all important check and balance. We’ve now used the past to better prepare ourselves for the future.
For me, I have a new appreciation for the use of eponyms. When I hear one my desire is sparked to find out more about the person behind the name. Who was Dr Hoke? Who was Dr Girldestone? How did Meary’s angle come to exist? Who was Hibbs? Young? McBurney? Fowler? Cotton? Lapidus? Kocher? We practice a profession with a rich history, and the greatest daily reminder are the eponyms that surround us. Whether you like it or not, eponyms are here to stay.
Keep writing in with your thoughts and comments or our eTalk discussion forum on PRESENT Podiatry and start or get in on the discussion. Best wishes.
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]
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