Triumph of eponyms in the theory of infective endocarditis: historical legacy or clinical reasonability?

Abstract

INTRODUCTION: For many years, there has been a discussion about the appropriateness of using medical eponyms (ME). On the one hand, some of them have already become potentially archaic and misleading. However, on the other hand, in the historical context and association with great scientists and clinicians, they provide emotional involvement in the process of memorizing complicated medical information and create a figurative image of the clinical picture, and in this sense their use can be reasonable, at least from positions of the pedagogical process.

АIM: To analyze historical and modern literature sources with the aim to determine the appropriateness of using ME in the scientific literature and clinical practice on an example of infective endocarditis (IE) as a disease with a large number of well-established ME.

The conducted analysis permitted to distinguish two groups of categories in the discussion of ME. Arguments in favor of refusing ME: (1) they lack precision the same eponym can denote somewhat different concepts, symptoms, diseases; (2) even an honored person was often not the first to describe a certain condition (thus, Osler nodes were not described by W. Osler, and Roth’s spots not by M. Roth); (3) some ME are difficult to memorize due to complex surnames, polysynthetic principle of the formation of the term (three surnames in an eponym is a usual case in medicine); (4) excessive ethnocentricity the predominance of surnames scientists published in certain countries, journals. Needless to say, there is certain subjectivity, tendency of the medical community to stereotyped thinking and an element of accidental in formation of ME. Arguments in favor of preserving ME: (1) they play a significant linguistic, cultural and educational role: being an important characteristic of language and traditions, they bring students closer to the history of medicine and the cultural context; medicine is a science that should strive to a place a human in the center of its interests, both as a patient and as a personality in history; (2) ME facilitates communication between colleagues; historical experience itself has preserved for us necessary, important, valuable ME, at the same time having eliminated a significant part of not very successful terms (thus, speaking about IE, examples of short-term life are the terms ‘Chernogubov’s disease’ and ‘Osler’s endocarditis’).

CONCLUSION: The modern scientific language is based on descriptive terminology. Nevertheless, the authors consider it premature to abandon ME as a phenomenon. The fact that ME preserved within a fairly long historical period and are currently widely used, among other things, in clinical recommendations and international classifications, have demonstrated the usefulness of ME. However, the approach to using ME in clinical practice and scientific publications should be reasonable and rest not only on the historical experience, but also on the current professional standards.

Keywords

eponym / infective endocarditis / diagnostic criteria / semiotics / medical terminology / Osler / Osler’s nodes / Libman / non-infectious endocarditis / Roth’s spots

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