The specialists whose research triggered the renaming of Wegener’s granulomatosis have encouraged colleagues to continue rooting out Nazi-associated and other problematic medical terms, arguing there may be a case for removing all disease eponyms.
Initially named after German pathologist Dr Friedrich Wegener, the systemic disorder was renamed granulomatosis with polyangiitis a decade ago after research was published in The Lancet outlining Dr Wegener’s links with the Nazi party.
According to the 2006 article, he joined the Nazis eight months before Hitler’s rise to power in 1932, rising to a high rank in the party and carrying out autopsies on victims of the transports in Poland during WWII.
Polish government records also revealed that Dr. Wegener had been accused of war crimes, with his name appearing on a war criminals registry card together and being forwarded to the UN War Crimes Commission, the article said.
But nearly 20 years on, strong reasons remain for doctors of all specialties to examine the eponyms they use closely, say the authors, rheumatologist Professor Eric Matteson and nephrologist Professor Alexander Woywodt.
And it is already taking place, with work underway across the multiple specialties to replace other disease eponyms, they write in a new paper for Rheumatology (link here).
A notable example they give is Clara cells in the lung, renamed club cells following recognition that Dr Max Clara, after whom the cell was named, based his work on a sample obtained “from a prisoner executed by the Nazi ‘justice system’”.
Others in various stages of rebranding include:
- Asperger syndrome, replaced with Autism spectrum disorder
- Beck-Ibrahim disease, replaced with Congenital cutaneous candidiasis
- Cauchois-Eppinger-Frugoni syndrome, replaced with portal vein thrombosis
- Hallervorden-Spatz disease, replaced with Pantothenate kinase-associated neurodegeneration
- Reiter’s syndrome, replaced with reactive arthritis
- Seitelberger disease, replaced with infantile neuroaxonal dystrophy
Given the inherent issues associated with any eponym, it may be time to replace them all more descriptive medical terminology, the pair argued.
This was already taking place in some fields outside medicine, with recent moves to rename some birds named after problematic figures, they noted.
Nevertheless, there was some nuance to the subject, which remained a topic of live debate, the authors stressed (see their list of pros and cons below).
“We have previously argued that all eponyms should be abandoned in favour of a more factual nomenclature and others have agreed with our view,” they wrote.
“However, we also accept different views on this topic… in particular the thought that some eponyms honour victims, not perpetrators of atrocities.”
“We also accept the notion that even those eponyms that are linked to atrocities can be used as opportunities for teaching akin to the brass ‘stumbling stones’ plaques used in Germany to commemorate victims of Nazi atrocities.”
But all in all, the pair stood by their earlier work.
They concluded: “We had no personal agenda with Wegener or his colleagues, nor did we actively seek out this topic.”
“Instead, we thought it our professional responsibility to find out what happened and describe the events in a fair and factual manner.”
“We would encourage future generations of physicians and surgeons to scrutinise the eponyms they use, ask questions, and investigate their biographies.”
|Reasons in favour||Reasons against|
|Different eponyms are in use for the same condition||Practical issues with replacing the eponym in textbooks, databases etc. given the fact that there are around 8000 eponyms in use currently many of whom are deeply embedded in clinical use|
|Many discoveries are made by teams or through contributions from multiple individuals working independently from each other and some eponyms honour the wrong person entirely||Eponyms linked to unacceptable behaviour are part of our shared history of medicine and renaming amounts to censoring|
|Eponyms may be linked to behaviour that is felt to be unacceptable||Some eponyms are linked to victims, not perpetrators, of atrocity|
|Eponyms are not informative when compared with descriptive nomenclature||Eponyms are idiosyncratic but part of the culture and tradition of medicine|
|Norms and standards evolve over time and a prolonged debate and discussion around the use of an eponym may be impractical||Standards for renaming are impossible to establish|