The names of things (diseases) should be understandable, and be correct. And a brief looking at the naming of stuff in Medicine.

This portrait, all of you who have read my blogs, will immediately recognize that this person is Boerhaave, and not Benjamin Franklin (for example).

There is a funny history in medicine of naming various diseases/ processes either by the action that results in the finding or by the name of some person. I think from 1800-1950 the pinnacle of medical success is to have some finding named after you, like Boerhaave and Boerhaave syndrome (the rupture of the esophageal wall usually from forceful vomiting, which should be distinguished from another process named after two fellers: a Mallory- Weiss tear, a more gentle tear of the mucosa of the distal esophagus from vomiting.. I suspect Boerhaave may have preferred a more respectable disease to be named after him. So the height of acknowledgement in Medicine was to get something named after you.

As a version of this, the clever descriptions that are replete in musculoskeletal (MSK) imaging, which describe the activity that is associated with causing them, even if an antiquated activity. So there is Boxer's fracture which is fracture of the mid shaft of the fifth metacarpal, so people who in a drunken rage punch a wall get this fracture, and my favorite: gamekeeper's thumb, the chip fracture at the base of the proximal phalanx of the thumb because games keeper's, most of them employed in noble country estates in England, when they throttled a poor rabbit by flipping the creature over their thumb would sustain this injury. No other area of Radiology has more names of individuals associated with various individuals than in MSK radiology and intellectual snobs in MSK would quiz junior doctors on the various persons' names associated with various fractures. In my own areas, their were radiologists who did only GI (gastro-intestinal) radiology that would describe things that ended up being of no importance like cascade stomach on barium studies, or GU (genito-urinary) radiology, where there were so few things to know (up until 1985) ; renal stones, renal cysts, renal cancer, renal infection and renal obstruction, that they created odd impressive sounding, unpronounceable words, for things that were meaningless.

My opinion is that all of this wasted energy and time coming up with things that in the end meant nothing, reflected that up until the 1950's there really wasn't much to know in medicine, so there is a tendency to fill up the space of memory with a certain volume of material, much of which was nonsense.

In actuality I often think to myself when I try to remember what my password is for a journal or for Amazon, that there is more memory today involved with remembering usernames and passwords then necessary to know all of known medicine in 1880.

So my opinion, all of this self-aggrandizing of naming stuff in medicine should now focus on actually what is important:

what the medical process is, and what caused it

I, and everyone else already has to know 50 usernames and 50 passwords, we don't have to remember whose name is associated with ... a bent penis for example (Peyronie's disease).

This is why I came up with the terms Gadolinium Deposition DIsease, and Gadolinium Storage Condition, because those are actually the medical processes, and what caused them.

I do also see the dark humor in those complaining about those terms, but happy enough with Nephrogenic Systemic Fibrosis. The name neither confers what it is or what caused it.

the correct name would be:

Gadolinium Induced Systemic Fibrosis

Similarly, if in time ALS is correctly subdivided into the various etiologies they should be called as example:

Heavy Metal - ALS, and subcategorized as the actual heavy metal, such as Chromium- ALS. Gadolinium- ALS, etc.

This move to correct nomenclature has already been done in many areas in medicine, including with an area I am familiar with, contrast agent induced renal failure.

Up until maybe 1 decade ago we called it Contrast Induced Nephropathy (CIN) although I liked, and like still, very much the acronym, this has been changed and retweaked to :

Contrast Media Induced Acute Kidney Injury (CM- AKI).

With more medical knowledge always coming out, and more things that are actually important to remember, and also not to cause error in treatment, correct naming of medical processes is critical. We no longer have to know just a couple of things (as in the Seinfeld comedic piece: the circle and the tube. The circle being the stomach, the tube being the esophagus).. There are a considerable number of important things to know and remember, so there is no excess memory space to remember nonsense - like the 4 humours.

I am not the progenitor of correct naming, just one of the people on the bus realizing how critically important this is. We no longer wear powdered wigs and sit around in smoke-filled rooms in a Gentlemen's club trying to think up who deserves to have their name as the description for a disease, as if we are some sort of SAGEs. We must develop and continue the process of accurate, correct descriptions and names that actually describe what various processes are.

Richard Semelka, MD