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There is a longstanding tradition in the medical world of naming diseases and conditions after individuals who made valuable contributions to their discovery. But who gets to be an eponym, and who gets forgotten?
In a perspective published in the Medical Journal of Australia, Dr Leya Nedumannil and Dr Diana Lewis of Northern Hospital, Melbourne, examine the potential pitfalls of medical eponyms, acknowledging their value while also reflecting on who gets left behind in traditional naming conventions.
“While not with the purpose to discredit the diligence of nor imply that unethical intentions always drove those after whom eponyms are coined, we believe their ongoing use in medicine without reflective deliberation may be detrimental,” the authors wrote.
Who gets excluded from medical eponyms?
Dr Nedumannil and Dr Lewis note that one issue with the use of eponyms is that the broader teams involved in medical discoveries don’t get the same recognition as the person used in the eponym.
An example of this is seen with Crohn’s disease, which is named after Burril B Crohn despite two other authors co-writing the paper where the condition was first described — Leon Ginzberg and Gordon D Oppenheimer.
“Medical progress is seldom a solo feat, and the use of eponyms may threaten important values of collaboration and collegiality in this realm,” Dr Nedumannil and Dr Lewis wrote.
There is also the issue of women in medicine throughout history being excluded from proper recognition, with only 4% of medical eponyms being credited to women.
“Numerous women have historically had their scientific achievements forgotten or inaccurately credited to men, a notion of systemic bias so widespread that it has ironically acquired an evocative eponymous title itself [the Matilda Effect], named after suffragist Matilda Gage,” the authors wrote.
When names are best left in the past
Another unintended consequence of using medical eponyms occurs when an individual is found to have engaged in unethical research or even crimes against humanity, as in the case of research undertaken by Nazi collaborators.
“An example is the replacement of Wegener granulomatosis with granulomatosis with polyangiitis, due to Friedrich Wegener’s associations with the Nazi Party,” the authors wrote.
There is also a risk of medical eponyms continuing a culture of colonialism through favouring Eurocentric researchers over knowledge from other nations and cultures.
Research shows that 97% of medical eponyms celebrate European and North American physicians, despite 40% of pharmacological agents used in current practice originating from non-western medicine.
“The failure to acknowledge accomplishments of cultural medical practices that often pre-dated and potentially inspired those of conventional medicine is not uncommon, and some eponyms may reflect this,” the authors wrote.
A diagnosis by any other name…
Even from a merely logistical standpoint, eponyms can cause confusion due to multiple systems or conditions being named after the same person, and because eponyms are not descriptive of the condition, this can make it difficult to communicate with patients.
Both Dr Nedumannil and Dr Lewis argue that moving away from the use of medical eponyms would help medical terms avoid ethical pitfalls, while creating opportunities for more easily understandable terminology.
“This could not only help dissociate medical terminology from the contentious milieu in which several eponyms came to existence, but potentially also facilitate more precise communication between clinicians and with patients,” they concluded.
Read the perspective in the Medical Journal of Australia.
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I certainly agree with any attempt stem the ToFA (tsunami of fracking acronyms!). Medicine is confusing enough without talking at cross purposes.
Gender politics and colonialism in medical history is recognised now in recent issues of The Lancet and NEJM. It is viewed not ‘politically correct’ but justice – as harms to health were caused by these discourses and by the omission of equitable discourses.
The idea of objective science has also been challenged as objectivity always involves a human subject.
Knowledges in medicine have a binary structure- medical content and patient context …or laboratory science and patient life-world aka medical science and socioscience.
Despite all the issues raised like attribution etc eponyms are a part of the history of medicine. I for one enjoy reading about these mostly pioneering individuals..
Am very suspicious of individuals advocating the eradication such history. What has happened has happened so lets move on and worry about the issues of the day instead of dredging over the past.
It is well known among gynaecologists that Dr Marion Sims, who invented the Sims speculum, which we use in almost every gynaecological operation, developed this instrument and the techniques for repairing vesicovaginal and rectovaginal fistulas by experimenting on slaves in America. The Sims speculum and these techniques are still used to repair fistulas in hospitals in Africa now. He also instituted the first Women’s Hospital in the USA, devoted to care of women. We cannot use the Sims speculum without acknowledging how it came about, and simultaneously being grateful for its invention without which we could not operate on any woman. We have to accept the good with the bad, while always remembering the bad.
“What’s in a name?” indeed! I’m with Juliet on this one. Righting historical wrongs might be a noble goal, but care should be taken not to contrive assumptions to make the point. We are not obliged to assume that the eponymous person of a disease name was the sole “discoverer” of the disease, or that they were the first to describe it, or that we must commemorate them or that we agree with their ethics; or, indeed, that an apostrophe s after the name assumes that they somehow “own” the disease. We should be perfectly capable of assuming, as did Shakespeare’s Juliet, that it is just, after all, a name.
I can totally understand the sentiment, but the argument doesn’t consider the costs. For the sake of a contrived principle we will have to re-learn, re-teach, re-write and re-phrase an entire canon and replace eponyms with terms most often longer, more convoluted and just as ambiguous – and which of course are mainly derived from the Latin (but weren’t the Romans imperialists?). Worse, those who have trouble with this sudden change of language, might suffer the ignominy of being considered out-of-touch, insensitive or prejudiced (hence my anonymity).
Juliet’s fate notwithstanding, at least we can admire her courage. She didn’t let the history bother her, made no nomenclature-based assumptions and saw her Romeo “retain that dear perfection which he owes without that title”.
VAD = voluntary assisted dying OR ventricular assist device
SCC = squamous cell carcinoma OR spinal cord compression
ASD = autism spectrum disorder OR atrial septal defect
AI = aortic incompetence OR artificial insemination OR artificial intelligence
ICD = intercostal drain OR implanted cardioverter defibrillator
MS = mitral stenosis OR multiple sclerosis
PE = pleural effusion OR pulmonary embolus
ICGO (I could go on)!
I can think of no better way of diminishing the history of medicine than removing eponyms. It even helps when people discuss the problems with them BUT please don’t try and replace them.
I agree with Dr Dawson, acronyms have become an increasing problem for me during my 50+ years as a GP.
Not only for duplications (the classic being SPP – Smith Peterson Pin/ Suprapubic Prostatectectomy), but the many new ones that crop up in hospital discharge summaries and specilaist reports.
As soon as I see gender politics and terms such as “colonialism’ being used in these discussions I know that ideologies rather than science and common sense are driving the narrative. Medical eponyms honour ( in most cases appropriately) those who came before us and contributed immeasurably to our knowledge. They also provide a convenient abbreviation for diseases, anatomical structures or medical and surgical instruments that would otherwise take up two sentences to describe. How are you going to describe Parkinson’s disease in less than a paragraph ? In relation to most eponymous names being male, this is because most of the doctors and researchers were male when these things were discovered. I would like to have my name attached to something but i came along too late too discover or describe anything really new. This is history and can’t be changed. Leave eponyms alone, we have managed very well with them for a century or more.
while abhorring nazi or any extremist ideology, we still honour Wagner’s music despite his antisemitism. No one is unidimensional, good or evil.
Eponyms’ problem is an issue of fairness not confusion and is a “cosmetic issue” not affecting the practice of Medicine apart from different eponyms in different countries e.g. Lou Gehrig’s Disease in USA, Motor Neuron Disease here. A more pressing issue is the problem of acronyms which are proliferating and causing confusion. There is no central database of acronyms, nor a naming body restricting duplication like there is for business names or websites, so the same acronym is being appropriated by different groups of people without checking who else is using it, and doctors like General practitioners and General Physicians (the few that are left) who have to deal with all fields of medicine are left with a confusing array of acronyms meaning different things to different people. A simple answer is to just use English, especially for the names of diseases (e.g. everyone knows what Motor Neuron Disease is), and in place of both eponyms and acronyms. When someone mentions ICE are they talking about the solid frozen form of water (which can kill), the Internal Combustion engine (which also kills) or Crystal Methamphetamine (which probably kills less than the first two!)? Perhaps they are talking about the abbreviation which is standard on everyone’s mobiles phones, but few people bother to look at and use (ICE= In Case of Emergency (worldwide)= 112) and is intended to save lives as ringing 112 anywhere in the world gets you to the local emergency services who can geolocate you. SI long meant Societe Internationale, the body responsible for standard units of measurement worldwide (except USA!). the the diabetic people decided to appropriate it for Satiety Index, now thankfully ignored!