Should eponyms be abandoned?

No
Judith A Whitworth, director John Curtin School of Medical Research, Australian National University, Canberra ACT 0200, Australia director@ cs!r"anu"edu"au Medicine has been enthusiastic in naming tests, symptoms, and diseases after their discovers. Alexander Woywodt and Eric Matteson argue that eponyms are no longer appropriate, but Judith A Whitworth believes they remain a useful reflection of medical history So!e years a#o, fillin# in ti!e bet$een candidates in a clinical e%a!ination, & $as chattin# to a collea#ue about e'ony!s" (is vie$ $as that e'ony!s $ere not 'articularly useful and he recalled an encounter $ith a youn# $o!an stru##lin# in a si!ilar e%a!ination" She couldn)t find the ly!'h nodes and see!ed unfa!iliar $ith 'ul!onary auscultation" To bolster her s'irits, he as*ed her $ho discovered +och)s bacillus" She beca!e even !ore an%ious and lost for $ords" My collea#ue hel'fully as*ed, ,-ho $rote Mendelssohn)s Spring Song., and she burst into tears" Si!ilarly, & recall a friend co!in# out of a fine arts e%a!ination and as*in# $ho desi#ned the /iffel To$er" & understand there $as a lon# line of 'eo'le ha''y to ar#ue that e'ony!s be abolished, and fe$ 're'ared to ta*e the contrary vie$" This & can only ascribe to the $ell *no$n hu!an 'ro'ensity to en oy tiltin# at $ind!ills" /'ony!s are here to stay" /'ony!s are every$here and there are lots of the!01233 $hen & last loo*ed at $hona!edit"co!"4 They are heard on the street as $ell as in the $ard" They are in te%tboo*s, in the !ass !edia, on the $eb, 'al! 'ilots, and in the -orld (ealth 5r#ani6ation)s latest revision of the international classification of diseases"2 They are so $idely used and reco#nised that their eradication, even if it $ere desirable, $ould ta*e a 'ur#e of !onu!ental 'ro'ortion and effort" -hy bother. /'ony!s brin# colour to !edicine, they 'rovide a convenient short hand for the 'rofession and the co!!unity ali*e, and they e!bed !edical traditions and culture in our history" The use of e'ony!s in !edicine, as in other areas, is often rando!, inconsistent, idiosyncratic, confused, and heavily influenced by local #eo#ra'hy and culture" This is 'art of their beauty" 7or e%a!'le, 8lu!!er9:inson syndro!e in the United States ;and Australia<, 8aterson9+elly)s syndro!e in the United +in#do!, and -aldenstro!9+ ellber# syndro!e in Scandinavia all describe sidero'enic dys'ha#ia"= There are even differences $ithin countries" 7or e%a!'le, cholecysto#ra'hy $as *no$n as such in Melbourne but called the >raha! test in Sydney"= /'ony!s are often 'ractical and a for! of !edical shorthand" ?o $e really $ant to s'ea* of con#enital cyanotic heart disease due to ventricular se'tal defect, 'ul!onary stenosis, ri#ht ventricular hy'ertro'hy, and aortic de%tro'osition rather than 7allot)s tetralo#y. 5r hereditary disorder of renal tubular function $ith vita!in ? resistant renal ric*ets, #lycosuria, a!inoaciduria, and hy'er'hos'haturia for 7anconi syndro!e. 5r violent !uscular er*s of the face, shoulders, and e%tre!ities $ith s'as!odic #runtin#, e%'losive noises, or co'rolalia instead of Tourette)s syndro!e.

No need for censoring

/'ony!s are not si!'ly rooted in the 'ast" They co!e and #o" Richard @ri#ht, Tho!as (od#*in, and Tho!as Addison, #iants of 43th century !edicine, $ere conte!'oraries at >uy)s (os'ital" (od#*in)s disease and Addison)s disease are $ell *no$n to 'ractitioners and 'ublic ali*e" @ri#ht)s disease $as $idely used as an e'ony! for #lo!erulone'hritis ;althou#h Ste$art Ca!eron sho$ed one of @ri#ht)s cases $as in fact a!yloidA< but $ith i!'roved understandin# of the diverse aetiolo#y, 'atholo#y, and clinical courses of various for!s of ne'hritis, it has fallen fro! favour" Si!ilarly, the e'ony!ous !on#olis! has disa''eared fro! conte!'orary use and been re'laced by ?o$n)s syndro!e" As $e co!e to understand !ore of the basis of diseases, current usa#e $ill chan#e" There is no need to le#islate a#ainst e'ony!s" They #o of their o$n accord $hen they 'ass their use9by date" &n these ;better< days of codified evidence, a''eal to authority is the last resort, but here it is the best evidence $e have" To learn it is necessary to understand history" Much is !ade of the ar#u!ent that to use the na!e of so!eone $ho $as vile is to celebrate the! ina''ro'riately" @ut history is $hat ha''ened, not $hat $e or the revisionists $ish had ha''ened" -e re!e!ber the na!es of tyrants and des'ise the!, not celebrate the!" Tellin# 'eo'le $hat they !ust or !ust not say or $rite is frau#ht $ith dan#er" Rather it should be left to individuals to deter!ine if there are 'eo'le $hose na!e they ,do not care to recall, ;Don Quixote, Cervantes<" Si!'ly $ithdra$in# the e'ony!ous ter! for the $ic*ed fe$ is not a $ay for$ard" -ho $ould deter!ine acce'tability. -ould 'olitical vie$s or !arital infidelity or ta% avoidance disBualify so!eone. -ould the heinous behaviour need to be 'roved in a court of la$ or !erely ru!oured. -ould historicity 'revail so that other ti!es and custo!s beco!e irrelevant. &t is all or nothin# for e'ony!s" >iven they are no$ dee'ly e!bedded in our culture, abolishin# the! is unrealistic" Si!ilarly, if $e abolish the! in !edicine, can $e still use the! in the sciences that enable !edicine. ?o $e #et rid of Ava#adro)s nu!ber, @oyle)s la$, the oule, the *elvin, the hert6. /'ony!s are $idely used in conte!'orary life" &n !any cases their use is so $ides'read that they are not al$ays reco#nised as e'ony!s" Should $e abolish the cardi#an because he $as a bully $hose inco!'etence led to a !onu!ental folly and over a hundred unnecessary deaths ;not his o$n< in the char#e of the Ci#ht @ri#ade. Should $e instead s'ea* of a front o'enin# s$eater. -hat $ill $e call the sand$ich, sideburns, diesel, or chauvinis!. &n the $ords of the A!erican 'hiloso'her Ral'h -aldo /!erson, ,There is 'ro'erly no history, only bio#ra'hy", /'ony!s are here to stay"

Co!'etin# interestsD

References 1. -ho na!ed it. "$$$"$hona!edit"co! 2. -orld (ealth 5r#ani6ation" &nternational statistical classification of diseases and related health 'roble!s" "$$$"$ho"intEclassificationsEa''sEicdEicd40online =" 7ir*in >@, -hit$orth JA, eds" ?ictionary of !edical e'ony!s" CanforthD 8arthenon, 4321" A" Ca!eron JS, @ec*er /C" Richard @ri#ht and observations in renal histolo#y" Guys Hosp Rep 43FAG44=D4H3914"IMedlineJ