Des Spence portraits a rather outdated and stark view of modern medicine in his piece; “Medical heresy: ditch the eponyms”1. We agree that, in general, eponyms are redundant, but many have already been replaced; for example Rieter’s syndrome by reactive arthritis and Wegener’s granulomatosis by granulomatosis with polyangiitis. Some eponyms still have a role as shorthand for complex abnormality and therefore have a role in teaching e.g. Colles’ fracture or Fallot’s tetralogy?
Dr Spence’s colleague’s ‘Hop test’ may be of value in the diagnosis of acute appendicitis, but does not appear to have been subject to ‘Evidence-based’ investigation. In contrast, Rovsing’s sign (pressure over the descending colon in the left lower quadrant, causing pain in the right lower abdomen in acute appendicitis – old central European reference provided2) has at least been scrutinised with respect to validity.
Surely Dr Spence still believes that talking with patients and a focussed examination is the bedrock of clinical practice. Otherwise, uncontrolled over-investigation with blood tests, ultrasound, CT and MR will become reality3.
The forthcoming 13th edition of Macleod’s Clinical Examination (given an eponymous title in 1995 on the retiral of Dr John Macleod) will have referenced ‘Evidence-based Examination’ points to emphasis the value of certain examination techniques and, of course, many fewer eponyms.
Editors of Macleod’s Clinical Examination
Graham Douglas
Fiona Nicol
Colin Robertson
1. Des Spence. Medical heresy: ditch the eponyms. [From the Frontline] BMJ 2012; 344: e2503
2. N. T. Rovsing: Indirektes Hervorrufen des typischen Schmerzes an McBurney's Punkt. Ein Beitrag zur diagnostik der Appendicitis und
Typhlitis. Zentralblatt für Chirurgie, Leipzig, 1907, 34: 1257-1259.
3. McGee S. Evidence based Physical Diagnosis. 2nd edition. Saunders/Elsevier 2007 p577
Competing interests:
Editors of Macleod's Clinical Examination
Rapid Response:
Re: Medical heresy: ditch the eponyms
EVIDENCE-BASED EXAMINATION MUST BE THE FUTURE
Des Spence portraits a rather outdated and stark view of modern medicine in his piece; “Medical heresy: ditch the eponyms”1. We agree that, in general, eponyms are redundant, but many have already been replaced; for example Rieter’s syndrome by reactive arthritis and Wegener’s granulomatosis by granulomatosis with polyangiitis. Some eponyms still have a role as shorthand for complex abnormality and therefore have a role in teaching e.g. Colles’ fracture or Fallot’s tetralogy?
Dr Spence’s colleague’s ‘Hop test’ may be of value in the diagnosis of acute appendicitis, but does not appear to have been subject to ‘Evidence-based’ investigation. In contrast, Rovsing’s sign (pressure over the descending colon in the left lower quadrant, causing pain in the right lower abdomen in acute appendicitis – old central European reference provided2) has at least been scrutinised with respect to validity.
Surely Dr Spence still believes that talking with patients and a focussed examination is the bedrock of clinical practice. Otherwise, uncontrolled over-investigation with blood tests, ultrasound, CT and MR will become reality3.
The forthcoming 13th edition of Macleod’s Clinical Examination (given an eponymous title in 1995 on the retiral of Dr John Macleod) will have referenced ‘Evidence-based Examination’ points to emphasis the value of certain examination techniques and, of course, many fewer eponyms.
Editors of Macleod’s Clinical Examination
Graham Douglas
Fiona Nicol
Colin Robertson
1. Des Spence. Medical heresy: ditch the eponyms. [From the Frontline] BMJ 2012; 344: e2503
2. N. T. Rovsing: Indirektes Hervorrufen des typischen Schmerzes an McBurney's Punkt. Ein Beitrag zur diagnostik der Appendicitis und
Typhlitis. Zentralblatt für Chirurgie, Leipzig, 1907, 34: 1257-1259.
3. McGee S. Evidence based Physical Diagnosis. 2nd edition. Saunders/Elsevier 2007 p577
Competing interests: Editors of Macleod's Clinical Examination