Opinions 27 September 2021

A pouch of Douglas by any other name …

Earning trust to change skeptics’ minds - Featured Image
Authored by
Jane McCredie
IN a search for distraction from record-breaking lockdowns, thuggish “freedom” protesters, and – can this really be happening – earthquakes, I found myself thinking last week about anatomical naming. As you do.

Our glorious human bodies have so many moving parts it takes a dictionary to list all the anatomical terms used to describe them.

Some are beautiful, poetic even. I have a particular affection for the names taken from ancient Greek or Latin: the vinegar bowl holding our thigh bone in place, the sea horse carrying our memories, the labyrinth curled within our ear.

The names of many anatomical parts are eponyms, meaning they take their names from people. This Wikipedia page lists around 200 of them.

Often, the terms honour anatomists who claimed discovery rights, though they also include mythological humans such as Adam and Achilles.

The one thing the names on the Wikipedia list appear to have in common is that they all belong to men.

I imagine those early men of science frantically dissecting cadavers, legally obtained or otherwise, seeking some obscure anatomical feature they could apply their name to. It’s eerily reminiscent of colonial explorers who planted their poles on newly “discovered” geographical features, blithely renaming them after themselves or their mates.

Nowhere is the proliferation of male names more obvious than in the specifically female parts of the body. Think Fallopian tubes, Bartholin’s glands, pouch of Douglas and so on.

Even the possibly mythological G-spot is named for a man: German gynaecologist Ernst Grafenburg who, in 1950, claimed to have discovered inside the vagina “a primary erotic zone, perhaps more important than the clitoris”.

Queensland gynaecologist Dr Kirsten Small drew attention to this male naming of female bodies in 2020, when she posted on Twitter:

“I teach anatomy and have found there is always an alternative to the dead man’s name for body parts. Fallopian tube = uterine tube. Pouch of Douglas = rectovaginal pouch. We have a personal choice to decolonise our language. Make use of it.”

The Twitter conversation prompted three West Australian emergency doctors to delve deeper into the widespread and longstanding use of eponyms in anatomy and histology.

“We found myriad inconsistencies, confusion, misogyny [and] inaccuracy…” they wrote.

The 700 terms they identified derived from the names of 432 people, of whom 424 were male physicians. The other eight included five gods, a king, a classical hero, and a woman.

The inclusion of gods allows Venus to make the list, for her eponymous mound, but also opens the door to Hymen and other male deities.

The lone mortal woman was 19th century Russian pathologist Raissa Nitabuch, who gave her name to the internal fibrinoid layer of the placenta.

It’s probably surprising to see even one woman, given the average date of naming was 1847 when medical schools were an all-male preserve. By the time the 20th century rolled around, there really weren’t that many body parts still up for grabs.

Analysis of the list reveals other aspects of the history of medical authority too. Although 30 countries are represented, a phenomenal 57% of the eponyms come from just three: Germany, France and Italy.

The authors note the tainted history of some eponyms. The Clara cells of the bronchiolar epithelium, for example, are named for Max Clara who acknowledged in his 1937 paper obtaining his sample from a prisoner executed by the Nazis. Wikipedia also has a list of medical eponyms with Nazi associations.

All in all, these authors argue, the eponyms have to go, if only because of the confusion they create.

Often they’ve entered the medical nomenclature in “a haphazard and chaotic manner”. Some anatomical parts are claimed by more than one discoverer, while the most prolific medical men have sprinkled their names across numerous parts of the body.

The winner on that front is 18th century Italian pathologist Giovanni Battista Morgagni, whose devotion to anatomy and dissection saw him score an extraordinary 15 eponyms.

For another take on all this, I’d recommend watching Hannah Gadsby’s Douglas, on Netflix.

Not only does Gadsby make you think about Douglas’ eponymous pouch in a new light, she also asks men to imagine how things might have gone if women had been in the room when the anatomical names were handed out.

How, she wonders, might men feel if they had to ask their urologist about an issue, not with their testicles, but with their “Karen’s handful”.

Jane McCredie is a Sydney-based health and science writer.

 

 

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.

 

 

 
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