Sunday, December 30, 2012

The End of an Eponym

It's interesting when medicine and history intersect (at least I think it's interesting).  Here's a quick history lesson that I recently encountered.

An eponym is a medical term named after a person.  Some of these are familiar to just about everyone.  For example, most people are familiar with Alzheimer's disease and Down Syndrome.  Others are much less familiar, such as Castleman's disease.  Eponyms are the bane of existence for many first year anatomy students- trying to remember where Hesselbach's Triangle is, for example.

One fairly common eponymous disease is Reiter's Syndrome.  I've seen it several times.  It is an arthritis that occurs in reaction to a bacterial infections, usually food poisoning or a sexually transmitted infection such as chlamydia.  As I've mentioned a few times recently, I'm in the process of studying for my internal medicine board recertification.  I recently completed the Rheumatology module.  When reading the section about Reiter's Syndrome, I saw that it was always mentioned as "reactive seronegative arthritis, formerly known as Reiter's Syndrome."

I thought that was a bit weird.  Eponyms are annoying in that they are yet another term to memorize, but I've never seen one apparently being retracted.  About two seconds of Googling told me why.

Hans Conrad Reiter was a German physician born in 1881.  During his time in the army in World War I, he described a case of arthritis in a gentleman with a sexually transmitted infection.  This classic triad of arthritis, uveitis and non-gonococcal urethritis eventually became know as Reiter's Syndrome.  Following the war, he became a professor in Berlin and was, by all accounts, quite a popular teacher.

However, there is a much darker side.  Reiter was a eugenicist.  He believed that certain people and races carried "inferior" genes, and the removal of these genes from society would create a stronger human race.  It's not surprising that he became a vocal supporter of Adolf Hitler.  His support of Hitler led to a nice career trajectory.  Eventually, he became a member of the SS.

It gets worse.  He planned and carried out hideous experiments at Buchenwald, leading to the deaths of hundreds.  He sanctioned forced sterilization and euthanasia.  His own testimony at Nuremberg is damning, but he was not imprisoned, possibly in exchange for supplying the Allies with intelligence.  He died at the ripe old age of 88, living out the long, peaceful life that he had denied to so many others.

His war crimes started to come to light in 1977, and a campaign started to change the name from Reiter's  Syndrome to reactive arthritis.  The wheels of the medical community turn at a glacial speed, however, and it took until 2009 for the name change to become official.

So, it's the end of an eponym.  Eponyms are meant to honor- we need to make sure that those they honor are deserving of the accolades.

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