By William J. Knaus, MD, Nicholas Caggiano, MD, and Matthew L. Iorio, MD
Confusion regarding the appropriate use of apostrophes in medical eponyms is pervasive in medicine. They are used to denote someone who had the disease (e.g., “Bennett’s fracture”), an occupation associated with the disease (e.g., “gamekeeper’s thumb”), or an homage to a description of the disease (e.g., “Dupuytren’s disease”). However, medical associations and journals, including our JHS, have required the discontinuation of the ‘s in eponyms1, despite being grammatically inconsistent.
In the case of Dupuytren’s disease, a common argument is that use of an apostrophe is incorrect because Dupuytren neither invented nor acquired the disease. However, this is a flawed interpretation of the relationship indicated by the apostrophe. As noted by Dirckx2, “the genitive is regularly used as an attributive modifier”. Meaning that, in addition to possession, the apostrophe allows one noun to describe another noun. Such as in Halley’s comet, which employs the usage of the adjectival form “of”, to denote which particular comet is in reference. Similarly, the frequently heard expression of “New Year’s day” demonstrates this usage as most would agree that a calendar itself is not in possession of a day. This is the synthetic genitive case, in comparison to the analytic genitive. To illustrate the comparison, Drickx’s expression of “a friend of my father’s” should sound redundant, as it includes both synthetic and analytic genitives. Although one can also correctly say a friend of my father or one of my father’s friends, the alternative is more common.
In French, the preposition de is used to assign possession as well as an “adjectival function”2. This is the case where palmar fibromatosis is commonly referred to as “Maladie de Dupuytren”, otherwise similar to the English language construct “of” in “the Circle of Willis” or the “Foramen of Monro”. However, the term “of” here serves the same purpose as the use of the apostrophe: the construct allows one noun to describe the other, as in “the disease as described by Dupuytren”.
Given this new understanding, it is clear that physicians have advocated for a grammatically inconsistent term, partly based on a misinterpretation of the language. Instead of trying to redesign the language, perhaps a more descriptive term, such as palmar fibromatosis, would serve better than the inconsistent eponym. The synthetic genitive (the grammatical construct which attributes possession to a noun) is an evolution of linguistics and is found throughout the English language. By dropping the ‘s, an eponym changes the subject from a noun to an adjective and, consequently, creates a syntax error.2 “Dupuytren’s disease” represents the accurate use of the synthetic genitive form of the eponym. The use of the apostrophe should be maintained to pay homage to those who described the phenomena as not only something grammatically useful, but as a contribution to the art of the English language.
- Iverson C, American Medical Association. AMA manual of style: a guide for authors and editors.10th ed. S.l. New York: JAMA & Archives Journals; Oxford University Press; 2007.
- Dirckx, JH. The synthetic genitive in medical eponyms: Is it doomed to extinction? Panace@. 2001;2(5):15-24.
This is a wonderful explanation and makes a lot of sense! I would be interested, especially given that the venue here is the JHS blog, to see a response or counterpoint from Dr. Graham or the editorial staff.