Altman, Lawrence K. "Experts Re-examine Dr. Reiter, His Syndrome and His Nazi Past," New
York Times, 7 March 2000, p. F7.
The ultimate tribute for doctors is to have an ailment, microbe, instrument or anatomical area
named after them, and medical journals and textbooks are sprinkled with hundreds of such
eponyms. Many are rewards for providing the first description of a disease or type of cell,
focusing new attention on a previously obscure condition or group of symptoms, or devising an
instrument adopted by others.
But occasionally a tribute proves embarrassing because of an inadequate search into medical
history or the background of the honoree. And new information can always change the picture.
A case in point is a common condition of unknown cause that affects the joints, eyes, urethra and
skin and known as Reiter's syndrome. It is named after a German doctor, Hans Conrad Reiter,
who reported a case in a military officer in 1916. The eponym was adopted in English language
journals in the early 1940s. But by then Dr. Reiter had become an early disciple of Hitler.
And now, new attention to his career shows that his involvement in Nazi atrocities was deeper
than previously known.
Two arthritis experts at the University of California at Los Angeles have added further evidence
of Dr. Reiter's role as a Nazi leader who helped plan and approve "human experiments" in
concentration camps. Writing in the current issue of The Journal of Clinical Rheumatology, Dr.
Daniel J. Wallace and Dr. Michael Weisman, renewed calls made over the last quarter of a
century to drop Dr. Reiter's name from the syndrome.
Dr. Reiter may have earned the highest marks for his teaching and service to the community, the
doctors said. But, they asked, "Should a war criminal be rewarded with eponymous distinction?"
The precise steps needed to get rid of an eponym are unclear and vary with who uses them. Many
eponyms disappear from usage over time as scientific advances clarify a condition. Some
specialties have committees that officially approve eponyms, but the one for the American
College of Rheumatology has been inactive for many years, Dr. Wallace said in an interview.
The numerous medical eponyms vary in usage by specialty, nationality and other factors. Some
are used widely.
Two of the most famous are Alzheimer's disease, a form of dementia named for Dr. Alois
Alzheimer, who described it in a medical journal in 1906, and Hodgkin's disease, a cancer of the
lymph system named for Dr. Thomas Hodgkin, the British physician who discovered it in 1832.
Two other famous eponyms involve the adrenal gland, which produces vital hormones.
Addison's disease, which describes adrenal insufficiency, is named after a British physician, Dr.
Thomas Addison, who described it in 1855. Cushing's syndrome is the opposite, resulting from
an overproduction of adrenal hormones, and is named for Dr. Harvey Cushing, an American,
who reported it in 1930.
Some doctors have been honored with more than one eponym. For example, the name of the 18th
century Czech scientist Jan Evangelista Purkinje is attached to certain cells in the brain and fibers
in the heart that he described.
Purkinje also showed, from experiments on himself, how one could see the blood vessels in the
back of the eye when light is focused on the white of the eye, a phenomenon known as Purkinje's
Doctors often prefer the simplicity of eponyms. For example, it is easier to say Reiter's syndrome
than subacute infectious polyarthritis with mucositis, or the many other tongue-twisting medical
terms for it.
Nationalism also plays a significant role in the use of eponyms because they often vary by
country. Dr. Reiter, for example, expressed displeasure that French doctors called it by another
name, Fiessinger-Leroy syndrome, after two French doctors who reported cases within weeks
after Dr. Reiter's report in 1916.
Some eponyms honor patients, like Lou Gehrig, who developed a previously known neurological
disease (amyotrophic lateral sclerosis). Others are named after patients who were among the first
in whom a condition was identified, like Christmas disease, a bleeding disorder also known as
hemophilia B that was found in a member of the Christmas family.
Other eponyms relate to geography. For example, Lyme disease is named for the Connecticut
town where a number of children suffered what was believed to be a new form of arthritis when
reported in the 1975. But Lyme disease is the same condition that European doctors reported
As fond as doctors are for using eponyms to honor their mentors and authors of significant earlier
papers, successive generations of doctors often do not know who they were, largely because
current interest in medical history is so lagging.
Authors often create eponyms and editors of peer reviewed journals and textbooks publish them
without fully checking the biographies of the honoree and without official sanction. But once
eponyms are established, editors are uncertain of their role in getting rid of them.
Dr. William J. Koopman, editor of the modern version of probably the first English language
arthritis textbook to list Reiter's syndrome, said in an interview that he was "at most vaguely
aware of" Dr. Reiter's past before his attention was called to the new report from Dr. Wallace
and Dr. Weisman. "It is not a simple matter to substitute" a new name for a well-established
eponym, and inertia plays a role, said Dr. Koopman, who also is chairman of the department of
medicine at the University of Alabama.
Also, when a doctor earns a degree of recognition for a scientific contribution, Dr. Koopman
said: "Do you drop the name because of something else they did? There's not a broad consensus
Dr. Reiter's name was first attached to the syndrome, at least in the English language, in an
arthritis textbook in 1941 and a journal article in 1942 by Dr. Walter Bauer and Dr. Ephraim P.
Engleman of the Massachusetts General Hospital in Boston.
Asked about the U.C.L.A. article, Dr. Engleman, now 88, said in an interview from his office in
San Francisco that he and Dr. Bauer named the syndrome "in deference to" Dr. Reiter "because
Reiter was the guy that we thought originally described it" in 1916.
But doctors had been describing the syndrome since at least the early1500s.
Doctors now use the eponym almost daily on rounds and it appears in virtually every medical
textbook, even health care books written for the public. Some texts also call Reiter's syndrome
reactive arthritis because doctors have learned that the joint inflammation seems to be an
immunologic reaction to a sexually transmitted infection or dysentery among people who have a
genetic predisposition to it.
Dr. Engleman also said that in 1942 he did not know about Dr. Reiter's Nazi involvement.
According to the new and earlier reports and interviews, Dr. Reiter was a vocal proponent of the
eugenics movements of the early 20th century who joined other professors to swear an oath of
allegiance to Hitler in1932. As president of the Reich Health Office in 1937, Dr. Reiter declared
a fundamental task of the Nazi health leadership was to stop further transmission of inferior
Dr. Engleman said that if he and Dr. Bauer had known about Dr. Reiter's Nazism, "we probably
wouldn't have called it Reiter's syndrome."
Dr. Wallace, the co-author of the new report, said that after treating Reiter's syndrome for more
than 20 years at Cedars Sinai Hospital in Los Angeles, he first learned about Dr. Reiter's past in a
book about Nazi medicine that a patient gave him two years ago. Dr. Wallace, who nearly
became a historian, was shocked that doctors would honor someone with such a past. So he
interviewed key sources and researched the eponym's history in medical and military libraries.
There, Dr. Wallace found evidence not reported in medical journals that Dr. Reiter reached the
pinnacles of power in Nazi Germany.
He found that Dr. Reiter had sanctioned "medical experiments" that killed thousands of
concentration camp prisoners, that he was included in a book of the top 5,000 Nazis and that he
was detained by American officials for two years after the war.
Dr. Reiter "devised orders, supervised medical atrocities and gave the stamp of approval for
them," Dr. Wallace and Dr. Weisman wrote.
Dr. Reiter played an important role in a number of decisions that involved medical experiments
in Nazi concentration camps. In one Reiter-approved vaccine "experiment," 250 prisoners at
Buchenwald died after they were purposely infected with rickettsia, a type of microbe. Dr. Reiter
represented Germany at the International Health Organization in Paris until 1945, and received
the Knights Cross Holders award from the quasi-military SS, the Nazi special police.
Dr. Reiter was not convicted of any crime. But that may have been partly because of the
difficulty obtaining proof: the two top-ranking Nazi doctors, with whom Dr. Reiter had planned
experiments at Buchenwald, committed suicide in 1945, according to the new report and other
After the war, Dr. Reiter continued publishing research papers and practiced medicine in Kassel.
He died at 88 in 1969. Dr. Reiter had achieved some recognition early in his career as a
microbiologist for a role in identifying a bacterium that causes a form of leptospirosis, which can
affect the liver.
Dr. Reiter also studied the spirochete bacterium, which causes syphilis, and his name is attached
to a strain that he helped identify as unusually severe.
Even if Dr. Reiter had not been a Nazi, it is not clear why he deserved having his name attached
to the arthritis syndrome. Dr. Reiter's report was not the first, and he drew a serious, erroneous
conclusion about his patient's diagnosis. Dr. Reiter initially concluded that the syndrome was
caused by a spirochete, which he found in the military officer's blood, and named it spirochetosis
But when the symptoms failed to respond to the then-standard anti-syphilis drugs, Dr. Reiter
abandoned his belief in a spirochetal cause and concluded that his patient had something else -
now known by his name.
In 1965, Dr. Verna Wright, a British rheumatologist, repeating a comment made 12 years earlier
in another scientific report, wrote: "Reiter's paper made a negligible, if not somewhat
misleading, contribution to the subject."
Acting on the U.C.L.A. letter, the Spondylitis Association of America, a patient advocacy group
that represents people with Reiter's syndrome, recently voted to call Reiter's syndrome reactive
arthritis. Editors and other medical leaders might follow its leadership.