Himanshu Chaudhary and Katie Silaj

Do you know what a Magnolia tree and the Pythagorean Theorem have in common? They are both eponyms, which are terms derived from people’s names (Strous & Edelman, 2007). Eponyms are often used to honor someone’s achievements, however, sometimes the person rewarded with a finding named after them was not actually the one to discover it in the first place. For example, the Magnolia tree was named in the 1700s by Linnaeus, a Swedish botanist, to honor Pierre Magnol, a French botanist (Govindarajan et al., 1993). While this is the term used to introduce the tree to Europeans, this plant has been native to Asia and North America long before its European discovery and has been known by several other names. Similarly, the Pythagorean Theorem, which you may recall being taught in Geometry, is often accredited to Pythagoras, a Greek philosopher. However, historical evidence suggests that other cultures were aware of this theorem as many as 2,700 years before Pythagoras was born (see Argarwal, 2020). These examples illustrate the ethnocentrism of scientific nomenclatures.

While many eponyms are decades, centuries, or even millennia old, more eponyms are added to the scientific literature each year. From Parkinson’s Disease to Fallopian tubes, some have estimated that there are more than 8,000 eponyms that have been used to name physical signs and symptoms, parts of the body, behaviors, cysts, diseases, and other medical phenomena in the medical field alone (Ferguson & Thomas, 2014). Though eponyms have been a common practice throughout human history, they have become increasingly more controversial in recent years. Considering both the ethical and practical considerations when using eponyms, should they continue to be used in education?

What is Unethical about Eponyms?

With so many eponyms in the medical literature, it is not a simple task to replace them all. However, eponyms that are a result of harmful and unethical research practices should be discarded, especially when other more practical terms exist. For example, reactive arthritis is more well-known as Reiter’s disease and is named after Hans Conrad Julius Reiter, a German bacteriologist, hygienist, and member of the Nazi party who lectured students on “racial hygiene” in universities (Strous & Edelman, 2007). Reiter is also responsible for approving sterilization programs and the purposeful infection of inmates in Nazi concentration camps (Woywodt et al., 2010). Despite all of this, Reiter was given multiple international awards and has several eponyms associated with him. Continuing to use his name to communicate with patients and other medical professionals is disrespectful, unethical, and impractical when reactive arthritis better describes the condition being discussed.

Another problem associated with using eponyms to name scientific phenomena is that often the name chosen does not acknowledge everyone who contributed to the discovery, but instead favors one or two people who perhaps had the opportunity to publish in a popular journal or had more power or influence than other contributors (Woywodt & Matteson, 2007). For example, Behçet’s disease was named to recognize Hulushi Behçet’s discovery of the disease in 1937, but other scientists such as Benedictos Adamantiades, Hippocrates, and several others noted cases of the disease much earlier. Additionally, one’s culture or language may give them an unfair advantage in the world of scientific eminence if they belong to a dominant group (Werneck & Batagália, 2011). Japanese eponyms are much more common than Chinese or Indian ones (Chen & Chen, 1994), perhaps due to Japan embracing Western medical practices earlier on than China and India, whose societies were more deeply rooted in ancient indigenous medical practices. There is plenty of evidence to demonstrate the ethical issues related to eponyms in science. Next, we explore pragmatic issues that eponyms introduce to the scientific nomenclature.

Are Eponyms Efficacious? 

Along with disturbing ethical concerns, there are some practical concerns with using eponyms. A medical disorder may be given a name that could refer to multiple scientists, and as a result, multiple disorders (Werneck & Batagália, 2011). For example, Pick’s syndrome could be referring to one of three disorders (i.e., the pick cell, Pick’s disease, and Pick’s pericarditis), all of which are associated with different scientists named Pick (i.e., Ludwig Pick, Arnold Pick, and Friedel Pick). Eponyms can cause confusion and miscommunication and, in some cases, misdiagnoses. Waseem and colleagues (2005) conducted a survey of orthopedic surgeons to investigate whether they could identify a photograph of Finkelstein’s test, a test of the hand used to diagnose de Quervain’s disease. Surprisingly, 90.4% of surgeons surveyed reported using the test in their practice, but only 10.7% correctly identified the proper method. The reason behind so many experts misidentifying Finkelstein’s test originates with Leao (1958) who incorrectly referred to Eichhoff’s maneuver as Finkelstein’s test. Such confusion on the part of professionals can be quite costly and shows that even when using unique eponyms, they are often used incorrectly. If more descriptive names were used to describe medical terms, they would be less likely to get mixed up as the names labeling the phenomena would be semantically related to them (e.g., reactive arthritis as opposed to Reiter’s disease).

Another practical issue related to eponym use is inconsistencies between publications regarding the use of the possessive form (e.g., Down syndrome versus Down’s syndrome; Jana et al., 2009). A much larger issue for scientific communication occurs when the same disorder is referred to as a completely different name in other languages or countries (e.g., Grave’s disease is also known as Flajani’s disease and Basedow’s disease; Berghammer, 2006). Inconsistent naming of disorders becomes confusing and has motivated some scholars to speak out in favor of changing this nomenclature. Some have suggested using more descriptive terminology, while others have called for an eponym-descriptive name hybrid. Before taking a firm stance on the best way to name medical phenomena going forward, we must consider the effects that eponyms may have on learning and memory compared to more descriptive terms.

Are Eponyms Good for Learning?

Medical terminology is often regarded as one of the most difficult specialized languages to learn due to needing to memorize and understand long words with unfamiliar spellings, such as “hysterosaplingooophorectomy” (Abdullah, 2013). Some scholars have argued that eponyms act as a shorthand that facilitates the learning of complex medical jargon, while others believe more descriptive terms would make learning medical terminology more accessible as they could act as an informative label for the information being learned (Ferguson & Thomas, 2014). While there are strong arguments on either side of this issue, we speculate that descriptive names may be more appropriate in certain contexts and more beneficial for learning in the long run than eponyms. Though little is known about the efficacy of eponyms from a learning and memory perspective, a recent study examining students’ knowledge of and perspectives on chemical eponyms found that students who majored in teaching chemistry had greater knowledge of and preference for eponyms compared to those whose majors were in other domains (Slabin & Kratiski, 2017). Thus, motivation and experience may play a role in the ability to learn eponyms.

In another survey of neurology trainees, 86% of respondents agreed or strongly agreed with the statement “Eponyms may credit morally questionable historical figures” (Zheng & Gold, 2020). With so many experts aware of the unethical nature of many eponyms, as well as several strong arguments that the nomenclature may be impractical, it is now time to further investigate the efficacy of eponym use from a cognitive lens. Considering the difficulty people tend to have remembering proper names (Abrams & Davis, 2017), we expect that descriptive terms would be more easily learned and recalled than eponyms; however, more work is needed to support this assumption.

So what do we do?

Veering from the status quo of naming discoveries may seem like a daunting task, especially with such a large number and variety of existing eponyms in the literature. Change often occurs incrementally, so by recognizing the issues involved with using eponyms, we can take a step forward towards improving the current nomenclature. One option may be to use a combination of eponyms and descriptive names, such as Alzheimer’s Senile Dementia, in an effort to recognize the familiarity of the term “Alzheimer’s” for many, while providing semantic context for those who are less familiar. While no solution will be perfect, future research should investigate more ethical and practical ways to refer to scientific phenomena and explore the most effective ways to communicate scientific information in the medical field and in the classroom.

References

Abdullah, G. M. A. (2013). Strategies and approaches for teaching and learning medical terminology. International Journal of English and Education, 2(2), 225-240.

Abrams, L., & Davis, D. K. (2017). Competitors or teammates: how proper names influence each other. Current Directions in Psychological Science, 26(1), 87-93.

Argarwal, R. P. (2020). Pythagorean theorem before and after Pythagoras. Advanced Studies in Contemporary Mathematics, 30(3), 357-389.

Berghammer, G. (2006). Translation and the language (s) of medicine: Keys to producing a successful German-English translation. The Write Stuff, 15(2), 40-44.

Chen, T. S., & Chen, P. S. (1994). Japanese eponyms: Successful adoption of Western medicine. Journal of the Royal Society of Medicine, 87(8), 461.

Ferguson, R. P., & Thomas, D. (2014). Medical eponyms. Journal of Community Hospital Internal Medicine Perspectives, 4(3), 25046.

Govindarajan, G., Rao, S. S., Vaiyapuri, S., & Rao, M. S. (1993). Scientific history and theeducational significance of eponyms in science instruction. Journal of Instructional Psychology, 20(4), 340.

Jana, N., Barik, S., & Arora, N. (2009). Current use of medical eponyms–a need for global uniformity in scientific publications. BMC Medical Research Methodology, 9(1), 1-5.

Leao, L. (1958). De Quervain’s disease: A clinical and anatomical study. JBJS, 40(5), 1063-1070.

O’Flynn, C. (2020). Epo-Nots: Issues with non-traditional eponyms. Journal of Communication in Healthcare, 13(3), 201-204.

Slabin, U. & Krasitski, V. (2017). For humanization and historicism: How well university students know and what they think about chemical eponyms. Journal of Baltic Science Education, 16(2), 250-265.

Strous, R. D., & Edelman, M. C. (2007). Eponyms and the Nazi era: Time to remember and time for change. Medicine and Holocaust, 9, 207-214.

Waseem, M., Khan, M., Hussain, N., Giannoudis, P. V., Fischer, J., & Smith, R. M. (2005). Eponyms: Errors in clinical practice and scientific writing. Acta Orthop. Belg., 71, 1-8.

Werneck, A. L., & Batigália, F. (2011). Anatomical eponyms in cardiology from the 60 to the XXI century. Rev Bras Cir Cardiovasc, 26(1), 98-106.

Woywodt, A., Lefrak, S., & Matteson, E. (2010). Tainted eponyms in medicine: the “Clara” cell joins the list. European Respiratory Journal, 36, 706-708.

Woywodt, A., & Matteson, E. (2007). Should eponyms be abandoned? Yes. Bmj, 335(7617), 424.

Zheng, J., & Gold, C. A. (2020). Eponyms are here to stay: Usage in the literature and among current neurology trainees. Neurology, 94(6), 257-264.