Are Medical Eponyms Obsolete?
”What’s in a name? That which we call a rose by any other name would smell just as sweet.”
William Shakespeare, Romeo and Juliet, Act 2, Scene 2
Maybe Australian gynecological anatomist Dr. Kristin Small and gynecologist Dr. Nisha Khot are on to something really important. They have recently issued a call to rename hundreds of body parts and multiple surgical procedures named after “old men, kings and gods.” According to them, these eponyms are completely irrelevant and dangerously misogynistic. They teach their students to replace them with more practical, descriptive and neutral terminology. According to the Daily Mail, Dr. Small is simply tired of everything medical being named after “dead dudes.” You can read about her passionate crusade at https://www.dailymail.co.uk/news/article-8537393/Sexist-body-terms-like-Adams-apple-no-longer-used-doctor-says.html.1So what are we talking about? One prominent example these trailblazers cite is the term “Adam’s apple” as a description of excessive laryngeal cartilage. Apparently, this phrase was first found in the 1662 English translation of the text Anatomia by Thomas Bartholin (1616-1680), a Danish physician. The term likely refers to a popular story that Adam, the first man according to Judeo-Christian theology, eventually expired when an apple (the “forbidden fruit”) became lodged in his throat. The anatomical revisionists would prefer that this structure be called a “laryngeal prominence.” In fact, they are a wee bit late, since the latter terminology already appeared in a popular text of its day, the Basle Nomina Anatomica in 1895. Apparently, 126 years later, “laryngeal prominence” has not yet obliterated the highly objectionable “Adam’s apple.”
Another phrase which has drawn their ire is “Achilles tendon.” Of course, this structure is the fibrous tendon which connects several calf muscles to the calcaneus (heel bone). Apparently, this phrase was first used by the Dutch anatomist and surgeon Philip Verheyen (1648-1710) in his 1693 textbook Corporis Humani Anatomia. The anatomist was almost certainly making reference to the mythological account of Achilles being held by the heel by his mother, Thetis, when she dipped him in the River Styx as a baby to render his body invulnerable. In so doing, she left his heel susceptible to injury. The anatomical revisionists would have us drop Achilles tendon for either calcaneal tendon or heel cord.
Some other terms which might be endangered include: Eustachian tube (so named in honor of the sixteenth-century Italian anatomist Bartolomeo Eustachi), fallopian tubes (named in honor of the sixteenth-century Italian anatomist Gabriele Falloppio), and Bartholin glands (named after their first describer, seventeenth-century Danish anatomist Caspar Bartholin the Younger). Instead, we are urged to utilize these terms: pharyngotympanic tube, uterine tubes, and greater vestibular glands, respectively.
All this got me thinking about some terms we might eliminate in dermatology. The first to go has to be the dilated pore of Winer. Let’s replace it with “really big nasal pore.” Another one that irks me is Mucha-Habermann disease. It is also known only as Habermann disease. I lay awake at night wondering if Mucha should be there, or not? And we already have a perfectly pragmatic, easy-to-remember name: pityriasis lichenoides et varioliformis acuta. Hailey-Hailey disease needs to be totally replaced by chronic benign familial pemphigus–even though the juxtaposition of the words “benign” and “pemphigus” is slightly misleading. Why should we use the name Behcet’s syndrome? Dr. Behcet published his research on this disorder in 1936, but the main components of the entity were actually first documented by Planner and Remenovsky in 1922 in the Archiv für Dermatologie und Syphilis. Rather than renaming this disease with a triple eponym, we should hold a national contest to come up with a new, concise, neutral appellation! Finally, although described in Wikipedia as “the father of modern academic dermatology” and “the most influential dermatologist of the last 100 years,” we must vow to jettison the terminology Fitzpatrick Skin Type. Let’s all agree to exclusively use the term “skin photophenotype.” Believe me, there are many, many more suggestions I could make….As you can tell from my tone, I find the movement currently spearheaded by Small and Khot to be slightly narrow-minded and misguided. I really don’t think that medical eponyms are born from malevolent intent of any kind, let alone being racist or misogynist. Mostly, naming an anatomical structure, a disease, or a specific procedure after prominent scientists who discovered or explained it or after famous patients who popularized it (e.g. Lou Gehrig’s disease, Tommy John surgery) honors individuals. It helps tell a story of how this entity came to be, if one only takes the time to look it up. Many eponyms are so deeply ingrained in medicine and popular culture that their names provide a convenient shorthand for both physicians and patients. Case in point: use the term Hodgkin’s Disease (with or without the apostrophe s), and the majority of medical providers and many laymen know precisely what it is.
When you consider historical precedent, widespread prevalence, and ease of use, I think eponyms are here to stay. Even if well-intentioned, to purge medicine of eponyms would be a massive, time-consuming and incredibly costly endeavor. Is this realistic? Is it even worth it? Truly humanitarian acts should supersede a kind of “cancel culture” witch hunt in medicine. In the time spent to be interviewed by the Daily Mail about the evils of eponyms, perhaps these Australian doctors might have better spent their efforts by providing pro bono care for one or more disadvantaged individuals.
Reference
Ferri L. New push to RENAME body parts like the Adam’s apple and Achilles’ tendon because they are ‘irrelevant and misogynistic.’ DailyMail.com. 2020 July 19. Accessed 2022 Jan 11.
