Nazi link isn’t the only reason to abandon eponymous medical names

MPR reporter Lorna Benson provided an update yesterday on the long-running efforts of Mayo Clinic rheumatologist Eric Matteson to get a rare vascular disorder renamed.

The disorder is Wegener’s granulomatosis, which occurs when the immune system attacks and inflames blood vessels. Although first mentioned in the medical literature in the 1890s by a Scottish doctor, Wegner’s granulomatosis received its current name in the 1930s, when the German pathologist Friedrich Wegener (1907-1990) published a more complete description of it.

That eponymous name has stuck for some 75 years. But no longer. As Benson reports, three medical societies — the American College of Rheumatology, the European League Against Rheumatism and the American Society of Nephrology — have decided to change the name to granulomatosis with polyangiitis (Wegener’s). Eventually, once the medical community becomes familiar with the new term, the “(Wegener’s)” tag at the end will be dropped, too.

Matteson has been pushing for this change for several years, ever since he discovered, while researching an article on Wegener for The Lancet, that the pathologist had been a member of the Nazi party.

As Benson notes, “Wegener’s membership in the Nazi party may not have been particularly damning. In 1930s Germany it wasn’t unusual for physicians to join the Nazi party to keep their position in a public institution such as a hospital or a university.  But as Matteson and a German colleague dug deeper, they discovered that Wegener’s questionable political associations started even before his Nazi membership. In 1932 he joined the Sturmabteilung, also known as the ‘brown shirts,’ which terrorized Adolf Hitler’s opponents.”

And that wasn’t all:

After Germany began attacking and occupying its European neighbors, Matteson said, Wegener was transferred to Poland where he worked as a pathologist in the city of Lodz. His office was located close to the first organized ghetto where Jews and gypsies were confined.

As the city’s pathologist, Wegener performed autopsies on people who died in the ghetto. While there’s no evidence that Wegener ever participated in human experiments, Matteson said other members of his office did conduct such research. Records show that the health office participated in a Nazi embolism study that involved injecting oxygen into the bloodstreams of some prisoners.

“It is inconceivable that he could not have known what was going on there,” Matteson told Benson.

An end to eponymous names?

Matteson now argues that all eponymous medical names should be abandoned in favor of more scientifically descriptive names. To begin with, as he noted in a 2007 essay in BMJ, eponymous names do not reflect scientific discoveries:

A common flaw is that eponyms usually refer to one person whereas scientific discoveries often reflect a group effort over time. Behçet’s disease serves as an example: Hulushi Behçet recognised the disease in 1937, but Benedictos Adamantiades described a case of the disease in 1930. And what about all the other people who contributed? To acknowledge everyone who discovered facets of the disorder, we would have to name it Hippocrates-Janin-Neumann-Reis-Bluthe-Gilbert-Planner-Remenovsky-Weve-Shigeta-Pils-Grütz-Carol-Ruys-Samek-Fischer-Walter-Roman-Kumer-Adamantiades-Dascalopoulos-Matras-Whitwell-Nishimura-Blobner-Weekers-Reginster-Knapp- Behçet’s disease.

Such names also lack scientific accuracy. “Not surprisingly,” Matteson pointed out in his essay, “some [physicians] may remember the [eponymous name] while being unable to describe its meaning. In a systematic study, only 10 of 92 orthopaedic surgeons were able to give the correct description of Finkelstein’s test for diagnosing tendovaginitis.”

Furthermore, diseases can have different names in different countries. “For example,” wrote Matteson, “giant cell arteritis is known as Morbus Horton in Germany and maladie de Horton in France, but the term Horton’s disease is virtually unknown in the United States. Different ways of spelling add just another level of complexity. Should ankylosing spondylitis be known as Bechterew’s disease as in Germany or Bekhterew’s as in other countries?”

Then, of course, there’s the problem of eponymous names with unsavory connections. Wegener’s granulomatosis is not the only such case, as Matteson also noted in his essay. Another example is the arthritic disorder Reiter’s syndrome, named after convicted Nazi war criminal Dr. Hans Reiter (1881-1969). Its use has been in steady decline ever since a group of doctors began campaigning against it in 1977, and now it’s more commonly known as “reactive arthritis.” 

In fact, that’s what it’s called on the website of Matteson’s employer, the Mayo Clinic. Mayo hasn’t (yet) renamed Wegener’s granulomatosis.