Medical Matters Muiris Houston "There is properly no history, only biography" - Ralph Waldo Emerson
Medicine and science are full of eponyms. About 8,000 medical eponyms are listed on www.whonamedit.com. Defined as the person or persons after whom a discovery, invention or institution is named, the use of eponyms has recently been challenged by some elements of the medical establishment.
In my experience patients love eponyms. Let's be honest, it is far easier to hold the attention of your average dinner party audience with the breathless announcement that you have just been discharged from hospital with Mallory-Weiss syndrome, rather than admit to having torn your gullet. Especially when the damage is likely to have been induced by excessive vomiting brought on by an ill-advised drinking binge.
Doctors generally like eponyms. For those engaged in medical research, there is the slim but ever-present chance that your name will be immortalised when you make a significant breakthrough in your area of expertise.
And for those of us who are happy to earn our crust closer to the clinical coalface, eponyms tax our medical school memory banks but inevitably lead to memorable malapropisms of the type that rarely emerge from a more functional explanation of disease.
There is an Irish eponymous link with one of the causes of sudden death in adolescents of which there was a cluster of cases last week. Prof Conor Ward was a consultant cardiologist at Our Lady's Hospital for Sick Children in Crumlin from 1958 until 1988.
He is the Ward in Ward-Romano syndrome. In 1962 he identified a particular heart arrhythmia in a six-year-old girl who presented with a history of loss of consciousness provoked by exercise.
The girl and other family members had a characteristic pattern on their electrocardiograms (ECGs) called a long QT interval. A Dr Romano responded to Ward's publication of his findings and eventually, in 1971, the condition was named Ward- Romano syndrome.
Because the long QT interval is a purely electrical finding, it cannot be identified at post mortem. But for the families of the four boys who died suddenly last week, and in whom no cardiac muscle abnormality is identified, the Ward-Romano syndrome may emerge as a possible cause.
The genetic abnormality associated with the condition was first identified in 1991. Testing became available in the Republic this year and the genetic abnormality of the family first found to have the cardiac problem has been labelled LQTS1.
In a lecture earlier this year, Prof Ward outlined the fascinating story of his and Dr Romano's discovery. But acknowledging the genetic breakthrough, he said: "Eponyms are not necessary when the cause of the condition has been identified." He then declared: "The present eponym is outdated," thus relinquishing his personal claim to fame.
A discussion paper in the British Medical Journal earlier this month asked the question: "Should eponyms be abandoned?"
Some doctors are of the view that they should. Arguing that eponyms do not reflect scientific discoveries, they said: "Use of eponyms without reflection or even knowledge of the person concerned causes other problems . . . eponyms usually refer to one person whereas scientific discoveries often reflect a group effort over time."
And those opposed to the continued use of eponyms also point out that some diseases have different eponyms in different countries, leading to avoidable confusion.
Dr Judith Whitworth of the Australian National University in Canberra disagrees: "Eponyms bring colour to medicine, they provide a convenient short hand for the profession and community alike and they embed medical traditions and culture in our history."
Pointing out that eponyms are practical and a form of medical shorthand, she asks: "Do we really want to speak of congenital cyanotic heart disease due to ventricular septal defect [ a hole in the heart], pulmonary stenosis [ a narrowed vessel], right ventricular hypertrophy [ thickening of a chamber] and aortic dextroposition [ displacement of the aorta] rather than Fallot's tetrology?"
I agree with her when she cautions against censoring eponyms. They tend to come and go of their own accord when they pass their natural expiry date. And she is absolutely correct when she notes that telling people what they must or must not say or write "is fraught with danger".
Perhaps the most powerful argument in favour of eponyms is that they support the balance between art and science in medicine, something that is recognised as increasingly important in the modern education of doctors.
But maybe the real reason I am in favour of retaining their use is that Houston's valve is the only eponym I could even remotely lay claim to. However, as it refers to the folds that encircle the inside of the rectum, I am secretly hoping that a namesake will soon make a breakthrough involving a more prosaic part of the human anatomy.
Dr Muiris Houston is pleased to hear from readers at mhouston@irish-times.ie but regrets he is unable to reply to individual medical queries.