PROF. DR. HULUSİ BEHÇET: AN EPONYM WHO İS REFERRED TO
PROF. DR. HULUSİ BEHÇET: BİR HASTALIĞA İSMİ VERİLEN KİŞİ
Selda Pelin Kartal Durmazlar1 Ahmet Akgul2
Anahtar kelimeler: Hulusi Behçet, Behçet hastalığı
Key words: Hulusi Behçet, Behçet's disease
An eponym is defined as a person after whom a discovery, invention, institution, etc is named or thought to be named. Although scientific discoveries often reflect a group effort over time, they usually refer to one person. 1,2 The man behind the eponym of "Behçet's disease" is Prof. Hulusi Behçet who recognized the disease as a "triple symptom complex" and was honored by international dermatologic societies with the disease name dedicated to him.3-8 Prof. Hulusi Behcet was one of the rare dermatologists honored on a stamp.9 Currently ,World Health Organisation Standard/ICD-10 is Behcet's disease.
Hulusi Behçet (1889-1948) was a great scientist and the first professor in Turkey. He had been interested in syphilis, leishmaniosis ( Oriental Sore) and first described "the nail sign" appearing by the removal of the crust of an Oriental Sore. In 1923, he described the etiologic agents of "gale cereal" in Turkey. In 1933 he described the dermatitis of fig (dermatitis figus carcia). In 1935, he was honored for his studies on mycosis.3 The disease, currently known all over the world as "Behçet disease", "Behçet syndrome", "Behçet's triad", "Tri-symptom Behçet" or "Morbus Behçet" was first recognized by Hulusi Behçet with a patient in 1924.3-8 This patient, who had been examined because of eye disturbances, recurrent oral and genital ulcers both in Istanbul and Vienna for 40 years, was given several diagnoses. Some doctors thought of tuberculosis or syphilis while some other doctors said a microorganism which was not present in Europe might have caused the disease. Hulusi Behçet, who continued to examine the patient after his loss of vision, thought that the causative agent was a virus. In the next several years he met two more patients with similar to that was seen in the previous patient. Hulusi Behçet thought the symptoms of these three patients were the symptoms of a new disease and reported his ideas on this topic firstly in 1936, in the Journal of Skin and Venereal Diseases and in Dermatologische Wochenschrift in 1937. In the same year at the meeting of the Society of Paris Dermatylogy he declared that several factors may cause the etiology of the disease. 3-8,10 On 13 September 1947, international dermatologic societies came together in Zurich and named the disease as "Morbus Behçet".3-8
In the recent literatüre, a group of authors renamed the disease as "Adamantiades-Behcet disease" and the chapter written by one of those authors in a well-known dermatology book covers this title".11-13 It is clear that several authors before Hulusi Behçet described one or several individual findings of this disorder. Among these physicians, for example, Hippocrates in the fifth century BC reported some individual symptoms attributed to an originally endemic and epidemic disease. But, due to sporadic appereance of the disease in the course of time, the disease became less significant and was forgotten. There were also other physicians who described one or several individual findings of this disorder, for example, Janin (1772), Reis (1906), Blüthe (1908), Gilbert (1920, 1921, 1923), Planner and Remenowsky (1922), Weve (1923), Shigeta (1924), Adamantiades (1930), Dascalopoulos (1932), Whitwell (1934), Nishimura (1936), Blobner (1937) and probably many others remained still unnamed reported several individual findings of this unique disorder. 4-8,10,14-26 If the disease is renamed as "Adamantiades-Behcet disease", what about all the other people who contrubuted? Besides, the case report by Adamantiades in 1930 focused on recurrent hypopyon uveitis, not triple symptom complex.10 In the following decade, Adamantiades published several further papers, after the acceptance of the eponym "Behçet", he insistently concentrated again on "relapsing iritis with hypopyon" in 1946, 1953 and 1958.10,27-29 That was because Dr. Adamantiades thought that he found a distinct entity. By the great work which the Editor Hasan Yazıcı brought us today the English translation of the original work of Behçet, the article can be reached.7 From his study, we can clearly understand that Hulusi Behçet demonstrated the lesions of the mouth, the genitalia and the eye together. Unlike Adamantiades, Behçet did not concantrate on the signs related his speciality only.
Dr. Adamantiades was also a great scientist, an ophthalmologist at that times and he was one of the members of the group of scientists to be remembered. However, he even himself did not know that he was describing a case of so-called Behçet's disease even after the worlwide recognition of Behçet's disease. There are many historical publications with evidence-based articles on this topic which are available in English literatüre.4-8,10,14-25
Prof. Dr. Hulusi Behçet deserves to have the disease named after him, because he was the first modern author to group the various ophthalmic, dermatological, and orogenital lesions together as a syndrome.30 Moreover, eponyms for diseases mostly have been attributed to contemporary scientist. We should remember that, use of a medical eponym needs a global uniformity in scientific publications. We should not change the deeply rooted eponyms according to our personal feelings.