It’s time to retire the Eponym

It’s time to retire the Eponym

Eponym (n): A person after whom a discovery, invention, place, etc., is named or thought to be named.1

Although you might not have heard of the word “eponym”, you have certainly heard examples of them. If you’ve paid any attention to medicine (or even watched House, MD), you no doubt have heard of Alzheimer’s disease (discovered by Dr. Alois Alzheimer in 19062), Parkinson’s Disease (written about in 1817 in ‘Essay on the Shaking Palsy’ by James Parkinson), Hodgkin’s Lymphoma (described in 1832 by Dr. Thomas Hodgkin) or Down Syndrome (described in a rather crassly-named paper entitled “Observation of An Ethnic Classification of Idiots” by Dr. J. Langdon Down3). Eponyms are abounding in medicine.

However, I posit that eponyms, however ingrained in our discussion of medicine today, should not exist in today’s medical terminology.

For starters, eponyms don’t indicate any sort of functional information about the disease in question. To most people, “Lyme” is a disease that’s associated with ticks. However, to about 2,500 people, “Lyme” is their hometown in Connecticut4; this is, as you could probably guess, where Lyme Disease was first characterized in 1975. Sure, Lyme Disease is most commonly seen in the Northeastern United States (especially in Maryland, Delaware, Pennsylvania, New York, Connecticut, Rhode Island, and Massachusetts)5. But the term “Lyme Disease” does nothing to suggest that it’s carried by the bacterium Borrelia burgdorferi which is carried by the common deer tick Ixodes scapularis. Nothing about the letters L-Y-M-E indicates that it causes a stereotyped bull’s-eye rash, facial palsy, and swollen joints.

Sometimes eponyms cause confusions. The proper name for the intellectual impairment and characteristic facial appearance caused by three copies of the 21st chromosome in humans is “Down Syndrome”. That’s not a typo – it is not “Down’s Syndrome”6 (which I’ll admit, even I was subject to this assumption). As The Allusionist points out, the fact that Down Syndrome could be written in a few different ways (e.g. “Down”, “Down’s”, or “Downs’”) causes problems when searching for research articles about it7. Of course, if scientists used the unequivocal version of this disorder, Trisomy 21, there would be no problems with identification in the literature.

 

Eponyms represent a complexity to clinicians that might create a barrier to effective treatment. For instance, hearing “Cushing’s Disease” requires the memory that this means an elevated secretion of adrenocorticotropic hormone (ATCH)8. Surely, medical students would find it easier to focus on the specifics of what ATCH actually does, instead of memorizing the simple (meaningless) connection that it’s called “Cushing’s Disease”. On a patient’s chart, reading “elevated adrenocorticotropic hormone” immediately tells the physician what the main problem is, without having to remember back to medical school for the named connection.

During World War II, Nazi party scientists carried out human and non-human experiments, many of them unethical. However unethical these experiments may have been, these scientists did discover and characterize several diseases, disorders, procedures, and anatomical structures. One example is The Pernkopf Atlas of Human Anatomy, written by Eduard Pernkopf, the dean of the medical school at the University of Vienna in 1938 who was responsible for the removal of 153 Jewish staff members–some Nobel laureates9. This Atlas was hailed as “one of the most important anatomic atlases since the work of Vesalius”; unfortunately, he came about such detailed anatomical studies by dissection of many hundreds of people killed by the Gestapo. In fact, the illustrations in the first few editions were signed by Nazi party members who incorporated Swastikas and “SS” symbols in their signature. The fact that this Atlas (commonly used in anatomical education) is used at all represents a homage to an outmoded, outdated, inappropriate age of unscrupulous testing. [For more information, see “Eponyms and the Nazi Era: Time to Remember and Time for Change” in the Israeli Medical Association Journal, March 9th, 2007, 207-214]

In addition, Eponyms may represent a complication to patients as well. When I was in grade school, I was diagnosed with Osgood-Schlatter disease, or the inflammation of the bone directly beneath the tibial tubercle in the lower leg10. I remember going home and completely forgetting what the disease was called. If such esoteric names weren’t used, I might have been able to remember the name. Of course, this sort of disconnect is likely pronounced for people with a lower socioeconomic status and a lower education level, too.

However, I recognize that some Eponyms in science are so ingrained in our terminology that changing them poses too large a problem. For instance, most people don’t think about where the name “Fahrenheit” or “Celsius” come from, yet we use them in everyday conversation. It’s easy to forget that Volts are named after Alessandro Volta or Amperes are named for André-Marie Ampère11. Even a “Venn diagram” was named for John Venn, its creator. I recognize that some eponyms are so ubiquitous that the status of the eponym is no longer of just a name, but it now is the object it describes (temperature, voltage, current, a Venn diagram). These extremely common eponyms are inseparable from the inventor or discoverer who shares the same name.

In summary, eponyms represent a call to history that is unnecessary and ill-advised. It represents a complication for medical providers, researchers, and patients, and doesn’t provide any intrinsic information about the disease it’s describing. Of course, I recognize that the vernacular of “Parkinson’s Disorder” or “Down Syndrome” is unlikely to change; however, when new diseases are discovered, they should be named in a way that provides a description of the disease in question.

 

References:

(1) "Eponym". Oxford English Dictionary. Oxford, 2016. https://en.oxforddictionaries.com/definition/eponym.

(2) "Medical Eponyms". NCBI.NLM.NIH, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120137/.

(3) Down, Langdon. "OBSERVATIONS ON AN ETHNIC CLASSIFICATION OF IDIOTS". Nature, 1866. http://www.nature.com/scitable/content/Observations-on-an-ethnic-classification-of-idiots-16179.

(4) "DPH: A Brief History Of Lyme Disease In Connecticut". Ct.Gov, 2016. http://www.ct.gov/dph/cwp/view.asp?a=3138&q=388506.

(5) "Lyme Disease| Lyme Disease | CDC". Cdc.Gov, 2016. https://www.cdc.gov/lyme/.

(6) "What Is Down Syndrome? - National Down Syndrome Society". Ndss.Org, 2016. http://www.ndss.org/down-syndrome/what-is-down-syndrome/.

(7) Zaltzman, Helen. Allusionist 45: Eponyms II - Name That Disease. Podcast. The Allusionist, 2016. http://www.theallusionist.org/allusionist/name-that-disease.

(8) "Cushing Disease: Medlineplus Medical Encyclopedia". 2016. Medlineplus.Gov. https://medlineplus.gov/ency/article/000348.htm.

(9) "Eponyms And The Nazi Era: Time To Remember And Time For Change". 2007. The Israel Medical Association Journal. http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2007&month=03&page=207.

(10) "Osgood-Schlatter Disease - Mayo Clinic". 2016. Mayoclinic.Org. http://www.mayoclinic.org/diseases-conditions/osgood-schlatter-disease/basics/definition/con-20021911.

(11) "Shrapnel, Plimsoll, Joule, Boole: Eponyms In Science And Invention | Oxfordwords Blog". 2016. Oxfordwords Blog. http://blog.oxforddictionaries.com/2011/12/shrapnel-plimsoll-joule-boole/.

Dignity in Life

Dignity in Life

Follow Up Opinion: New Scientific Technique Yields 3-Parent Baby

Follow Up Opinion: New Scientific Technique Yields 3-Parent Baby

0