written by MATT FADHIL (edited by JONO CHENG)

Love them or hate them, you cannot escape eponyms in medicine. Skim down to the footnotes of any page in Talley’s and you’ll find random tidbits of information on the old German physician or wacky American surgeon who gave their name to the medical term that we know and cherish today. Signs and symptoms, diseases and syndromes, diagnostic criteria and surgical procedures, each named after famous or not-so-famous people from who knows when.

Behind every medical eponym is a story, a story about the namesake themselves or the journey each eponym has taken to end up with that namesake. Whether involving a doctor, a patient or someone entirely different, these stories are often a lot crazier than you might think.

Let’s now take a look at five very different examples of medical eponyms that have survived the test of time and the often surprising stories of how they came to be.

Scenario 01: Doctor coins anatomical discovery 

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Neuroanatomy is not everyone’s cup of tea, but if there is one thing everyone remembers, it’s the good ol’ Circle of Willis, the arterial anastomosis at the base of the brain. For that name, we can thank Dr Thomas Willis, a British anatomist from the 17th century. Willis, considered a founding father of neuroanatomy, was the first to accurately describe this intracranial arterial circle during his studies at Oxford, and the eponym was adopted by his colleagues not long after his death. Willis is also to thank for first numbering the 12 cranial nerves as we know them today, but the man was not all fun and games. He notoriously advocated for violently beating his psychiatric patients to cure them of their mania. Sounds like a lovely guy.

Scenario 02: Doctor describes disease

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Staying on the theme of neurology, the Brown-Séquard syndrome is as textbook as they come: three different patterns of neurological deficit at three different sites resulting from hemisection of the spinal cord. So who were the two doctors who gave us this elaborate name? Well, it was actually just the one, Charles-Édouard Brown-Séquard, an eccentric 19th Century Mauritian physician with a fearsome double-barrelled surname (AND first name)! Brown-Séquard published prolifically on the physiology of spinal pathways and their dysfunction in cord injury, and the neurological syndrome for which he’s most famous had gained his name even in his lifetime. At the time though, Brown-Séquard was just as famous for his forays into endocrinology: he was known to inject himself daily with the extract of dog and guinea pig testicles to ‘boost his energies’. Fortunately or otherwise, that particular medical regimen has not picked up his name.

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Scenario 03: Doctor pioneers diagnosis or management

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Surgical keen-beans out there would be familiar with the Whipple procedure, a notoriously-complex upper GI surgery that can last up to twelve hours. Performed typically for tumours of the head of the pancreas, the Whipple involves resection of the pancreatic head as well as the duodenum, gall bladder and distal common bile duct, with the remaining structures anastomosed to the jejunum. The procedure gains its name from Allen Oldfather (no joke, that is his actual name) Whipple, a 20th century American Professor of Surgery, who is remembered as a pioneer in the management of pancreatic disease and for his mentorship of a young Virginia Apgar (of Apgar Score fame). An equally fascinating curveball in this story is that Whipple did not give his name to Whipple’s disease, a malabsorptive disease caused by the bacterium tropheryma whipplei. Whipple’s disease was actually named after George Hoyt Whipple, a Nobel-prize winning American physician who was kicking around at exactly the same time. The two Whipples were even lifelong friends. 

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Scenario 04: Patient suffers from disease

If the term ‘spinocerebellar ataxia type 3’ doesn’t ring a bell, I really don’t blame you. It’s a rare autosomal dominant neurodegenerative disease that results in a progressive deterioration of motor control. Spinocerebellar ataxia type 3 also goes by the name Machado-Joseph disease (MJD), and boy oh boy is this a juicy eponym. For one thing, ‘Machado’ and ‘Joseph’ were not doctors but patients: William Machado and Antone Joseph, patriarchs of two Portuguese families who suffered from the hereditary disease and were studied by the first doctors to describe it. What’s even crazier is how the disease is distributed around the world. Though large clusters of MJD can be traced to areas where those two Portuguese families migrated, for reasons unclear, the highest prevalence of the disease is on Groote Eylandt, an island just north of Australia! In its community of Indigenous Australians, the rate of this otherwise extremely rare genetic disease is as high as 5%. 

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Scenario 05: Fictional character becomes associated with disease

Factitious disorder: a psychiatric disorder in which patients misrepresent, falsely claim or cause to themselves the symptoms of an illness or injury. It’s an uncomfortable diagnosis that you might have come across by the older name of Munchausen syndrome. So who was Munchausen? A clever psychiatrist? A particularly troublesome patient? Actually, neither.

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The name was coined by British physician Richard Asher in 1951 in reference to Baron Munchausen, a fictional German aristocrat made famous in a 1785 popular novel, Baron Munchausen’s Narratives of his Marvellous Travels and Campaigns in Russia. The book recounts the far-fetched, wildly exaggerated tales of a Baron in his adventures through Russia, fighting off giant fish, riding cannonballs and travelling to the Moon. This fictional character was in turn loosely based on a real-life Baron of the time, Hieronymus Carl Friedrich von Munchausen, who was said to be very much unhappy that his family name had been so appropriated. Imagine if the real-life Baron Munchausen knew that two centuries later, his name would stand in the history books alongside a little-understood, often-stigmatised psychiatric disorder. The poor Baron would be rolling in his grave.

References

  1. Bettencourt, C & Lima, M 2011, ‘Machado-Joseph Disease: from first descriptions to new perspectives’, Orphanet Journal of Rare Diseases, vol. 6, no. 1, p. 35, DOI:10.1186/1750-1172-6-35.
  2. Ferguson, RP & Thomas, D 2014, ‘Medical eponyms’, Journal of community hospital internal medicine perspectives, vol. 4, no. 3, p. 10.3402/jchimp.v4.25046, DOI:10.3402/jchimp.v4.25046.
  3. Tattersall, R & Turner, B 2000, ‘Brown-Séquard and his syndrome’, The Lancet, vol. 356, no. 9223, pp. 61-63, DOI:10.1016/s0140-6736(00)02441-7.
  4. Uston, C 2005, ‘NEUROwords Dr. Thomas Willis’ Famous Eponym: The Circle of Willis’, Journal of the History of the Neurosciences, vol. 14, no. 1, pp. 16-21, DOI:10.1080/096470490512553.
  5. Wysocki, WM, Komorowski, AL & Wysocki, A 2005, ‘[One name, two physicians. About Whipple’s procedure and Whipple’s disease]’, Przegl Lek, vol. 62, no. 2, pp. 139-40.

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