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Apostrophic illnesses

Q: I’m a physician who’s irritated by the increasing tendency for writers to omit the apostrophe in a disease named for a person, as in “Parkinson disease.” I resist this, and write “Parkinson’s disease,” which I think is correct.

A: You’re in an unfortunate position here. As a doctor, you’re caught between the recommended usage in the medical profession and standard usage everywhere else.

The AMA Manual of Style (10th ed.), for example, recommends dropping the ’s in such diseases, as does the 27th edition of Stedman’s Medical Dictionary.

Although Dorland’s Illustrated Medical Dictionary (30th ed.) says the ’s “is becoming increasingly less common,” it includes some diseases with the ending and some without to “reflect this ongoing change in usage.”

However, Merriam-Webster’s Medical Dictionary, which is intended for a broader audience, generally considers the ’s versions the usual forms, though it sometimes includes the stripped-down forms as acceptable variants.

As for common usage, the six standard dictionaries we’ve checked usually list only the ’s versions for these terms, though bare versions are sometimes given as acceptable or equal variants.

Merriam-Webster’s Collegiate Dictionary (11th ed.), for example, lists only “Parkinson’s” while The American Heritage Dictionary of the English Language (5th ed.) gives “Parkinson’s” as more common, but includes “Parkinson” as an acceptable variant.

The American Medical Association’s style guide acknowledges that the issue is still somewhat controversial, but says that the use of the ’s in medical eponyms, the technical term for things named after people, is a thing of the past.

“There is some continuing debate over the use of the possessive form for eponyms, but a transition toward the nonpossessive form has taken place,” the AMA guide says.

The AMA editors recommend dropping the ’s to represent “the adjectival and descriptive, rather than possessive, sense of eponyms” and to “promote clarity and consistence in scientific writing.”

We take issue here with the AMA editors. Technically, the ’s here is not possessive but genitive. As we’ve written before on our blog, genitives show associations and relationships much broader than ownership.

In a genitive construction like “last night’s mashed potatoes,” we’re not talking about ownership. The ’s here means “associated with” or “related to,” not “possessed by.”

Nevertheless, the misconception persists. The National Down Syndrome Society, in its Preferred Language Guide, gives this explanation for opposing the ’s:

“Down syndrome is named for the English physician John Langdon Down, who characterized the condition, but did not have it. An ‘apostrophe s’ connotes ownership or possession.”

In fact, the AMA stylebook cites the Down Syndrome Society’s language guide in support of its belief that a transition toward non-genitive eponyms has taken place:

“A major step toward preference for the nonpossessive form occurred when the National Down Syndrome Society advocated the use of Down syndrome, rather than Down’s syndrome, arguing that the syndrome does not actually belong to anyone.”

Other critics argue against medical eponyms whether they have apostrophes or not, saying the names may credit the wrong people or are out of date.

Victor A. McKusick, for example, says in Mendelian Inheritance in Man (11th ed.) that “often the person whose name is used was not the first to describe the condition … or did not describe the full syndrome as it has subsequently become known.”

Although “Down syndrome” is now more common than “Down’s syndrome” and standard dictionaries prefer the shorter form, most other medical eponyms still have the ’s in dictionary entries.

Of the 11 eponyms we’ve checked, “Alzheimer’s,” “Addison’s,” “Parkinson’s,” “Bright’s,” “Crohn’s,” “Hansen’s,” “Hodgkin’s,” and “Raynaud’s” diseases usually have the ’s. Only “Down,” “Munchhausen,” and “Tourette” syndromes are usually bare.

In fact, searches with Google’s Ngram viewer indicate that medical eponyms with ’s are overwhelmingly more popular in books than the stripped-down versions.

However, medical toponyms (diseases named after a place) don’t have apostrophes. For example, “Rocky Mountain spotted fever” or “Lyme disease” (named for Lyme, CT).

Note that the capitalized name in a medical eponym or toponym is traditionally followed by a lowercase generic term, as in “Lou Gehrig’s disease” or “West Nile virus.”

The old tradition of naming diseases or parts of the body for their discoverers dates back to the use of Latin medical terms.

An example is tuba Fallopii for the structures first described by the 16th-century anatomist Gabriele Falloppio, also known by his Latin name, Fallopius. Today we say “fallopian tubes,” which many standard dictionaries give with a lowercase “f.”

Since you are a physician, you may be interested in an excellent article we came across on the history of medical eponyms.

John H. Dirckx, a doctor who has written frequently about the language of medicine, says such terms “are cherished by most physicians who have a sense of history.”

Besides, he writes in a 2001 issue of the journal Panace@, they “are often embraced as a pleasant relief from polysyllabic terms derived from classical languages.”

They also have a “value as euphemisms,” he adds. A term like “Hansen’s disease,” for example, is a welcome replacement for “leprosy” and all that it conveys.

As for the ’s, he writes, “Some of the arguments offered by editors and others to justify exclusion of the genitive from eponyms are simply ludicrous.” (He mentions the objections we noted above, that the person didn’t have the disease or possess it.)

Such critics, Dr. Dirckx writes, “display ignorance of linguistics, a superficial and mechanistic view of language, disdain for tradition, and, sometimes, the arrogance of authority.”

He concludes, probably with tongue in cheek: “Will even the homely lay term Adam’s apple (nuez, prominentia laryngea) eventually come under the universal ban?”

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