Moving beyond eponyms: the case for biological and clinically descriptive disease names

The use of eponyms in medical terminology has been a long-standing tradition, usually serving to honor the individuals who first described a disease or discovered its characteristics. However, as the understanding of diseases has advanced, the drawbacks of eponyms became apparent. Learning eponyms is challenging for students and patients, yet using eponyms is often the most practical option.

The case against eponyms

1. Lack of descriptive clarity. Eponyms do not intrinsically convey any meaningful information about the disease itself. For instance, "Lou Gehrig disease" does not provide insights into disease pathology, symptoms, or affected populations. In contrast, in a descriptive name like “amyotrophic lateral sclerosis,” “amyotrophic” is derived from Greek, meaning "without muscle nourishment," and reflects the characteristic muscle wasting seen in the disease; "lateral" refers to the areas in the spinal cord where the nerve cells that control muscles are located; and "sclerosis," meaning hardening or scarring, describes the degeneration of neurons in these regions. Descriptive names can facilitate better understanding and communication among healthcare professionals and patients alike (Woywodt and Matteson 2007).
2. Ethical considerations. Some eponyms are linked to historical figures who are now considered controversial, unethical, or worse. For example, "Wegener granulomatosis" was named after Friedrich Wegener, who had associations with Nazi war crimes. The transition to "granulomatosis with polyangiitis" reflects a move towards ethical integrity in medical nomenclature (Garlapati and Qurie et al 2022) as well as biological terminology.
3. Global standardization and communication. In an increasingly interconnected world, standardized terminology is essential. Eponyms may be understood inconsistently in different parts of the world and even by different investigators in one country, leading to confusion. Descriptive names provide a universal language that enhances the accuracy of medical records and leads to the proper selection of patients for clinical trials, valid interpretation of research, and accurate formulation of clinical guidelines (Goetz 2000). This consistency is essential for effective global health communication and collaboration.
4. Educational value. Although eponyms can provide historical context, they often lack educational value in terms of understanding the disease. Descriptive names offer immediate insights into the disease's nature, facilitating learning and improving diagnostic accuracy. For instance, "autoimmune thyroiditis" clearly describes an autoimmune condition affecting the thyroid gland, whereas "Hashimoto disease" requires additional explanation (Teive et al 2016).

The benefits of descriptive disease names

1. Enhanced diagnostic precision. Descriptive names reflect the underlying pathology, symptoms, and affected systems, aiding in more accurate and timely diagnoses. For example, "granulomatosis with polyangiitis" describes a disease characterized by granulomas and inflammation of multiple blood vessels, providing clear diagnostic criteria (Jennette and Falk 2007).
2. Improved patient communication. Patients can better understand their conditions when the names are descriptive. This understanding can enhance patient engagement, compliance with treatment plans, and overall outcomes. Descriptive names demystify medical terminology, making it more accessible to non-specialists.
3. Facilitation of research and treatment development. Clear, descriptive names can streamline research efforts by providing specific, unambiguous terminology. This can accelerate the development of targeted therapies and improve the precision of clinical trials. For example, using "amyotrophic lateral sclerosis" instead of "Lou Gehrig disease" emphasizes the disease's nature and aids in global research collaboration (Brown and Al-Chalabi 2017).

Conclusion

There are good reasons for freeing the medical vocabulary from eponyms, yet there is room for exceptions. Certain eponyms are so deeply embedded in medical discourse and are so well known to the public that they are best left alone. Similarly, some eponyms are associated with disorders that are so complex in their clinical and biological manifestations that they cannot be described with reasonable brevity. A word of caution is also in order. Substituting acronyms for what they stand for and referring to diseases by obscure gene names are often as problematic as using eponyms.

References

Brown RH, Al-Chalabi A. Amyotrophic lateral sclerosis. N Engl J Med 2017;377(2):162-72. PMID 28700839

Goetz CG. The history of Parkinson's disease: early clinical descriptions and neurological therapies. Cold Spring Harb Perspect Med 2011;1(1):a008862. PMID 22229124

Garlapati P, Qurie A. Granulomatosis with polyangiitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2022. PMID 32491759

Jennette JC, Falk RJ. Nosology of primary vasculitis. Curr Opin Rheumatol 2007;19(1):10-6. PMID 17143090

Teive HA, Lima PM, Germiniani FM, Munhoz RP. What's in a name? Problems, facts and controversies regarding neurological eponyms. Arq Neuropsiquiatr 2016;74(5):423-5. PMID 27191240

Woywodt A, Matteson E. Should eponyms be abandoned? Yes. BMJ 2007;335(7617):424. PMID 17762033

MedLink acknowledges the use of ChatGPT-4, an Artificial Intelligence chatbot, in drafting this blog entry.

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