Y. Keynan and D. Rimar • Vol 10 • April 2008 256 Reiter’s syndrome is an eponym used to denote the combina- tion of three symptoms – arthritis, urethritis and conjunctivitis – occurring during or after episodes of diarrhea or urethritis. We believe that the eponym should be deleted from the medical literature and replaced by the term reactive arthritis, as sug- gested previously, for several reasons. Firstly, the triad described in this syndrome is too restrictive of the concept of reactive arthritis, which encompasses a great deal more and can be pres- ent even in the absence of all three components. Second, a more descriptive term than an eponym is preferred. Third, Reiter was not the first to describe the syndrome. Finally, and most important, is the moral issue. Despite this reasoning the term Reiter syndrome is still being used and there are few instances where it is mentioned with disfavor. The syndrome was probably recognized as far back as the time of Hippocrates. Sir Benjamin Brodie describes this syn- drome in five patients with the triad of urethritis, arthritis and conjunctivitis, in a book published in 1818. In 1916, two French investigators, Noel Fiessinger and Edgar LeRoy, described four patients with arthritis, urethritis and conjunctivitis in the Bulletin of the Medical Society of Paris. This article appeared eight days prior to the report of Reiter. The authors named it the “conjunctival, urethral, synovial syndrome.” This association of arthritis, conjunctivitis and non-gonococcal urethritis was published in 1916 in the German Medical Weekly. The author was Reiter. Reiter did not actually recognize that the arthritis and conjunctivitis were related to the dysentery and mistakenly attributed the disease to a spirochete infection, naming it Spirochaetosis arthritica, speculating that it may have been transmitted by biting flies or mosquitoes [1]. Although he was not the first to describe the syndrome and despite the fact that he associated it with a spirochetal pathogen, the eponym ‘Reiter's syndrome” gained popularity. Hans Conrad Julius Reiter, born in 1881 in Leipzig, received his medical degree in 1906. He joined the Nazi Party on 31 August 1931. He was appointed Minister of Hygiene in the District of Mecklenburg/Lübeck and subsequently directed the Department of Health. After 1933, he was promoted to the position of president of the German Health Ministry and was involved in the activities of the Nazi Racial Hygiene Program. He was ministerially responsible for the "euthanasia" and forced sterilization programs, whose victims numbered in the hundreds of thousands. The documents relating to charges against Reiter and the investigation of these charges during the Nuremberg Trials between 1945 and 1947 were obtained and published by Wallace and Weisman [2,3]. Among the charges against Reiter is active participation in experiments related to involuntary steriliza- tion and euthanasia. In addition, according to documentation presented by Iglesias-Gammara and co-authors [1], he helped de- sign one of the sixty “overtly criminal” research projects – that of vaccinating Buchenwald concentration camp inmates with typhus, resulting in hundreds of deaths [2,3]. Wallace and Weisman, in a letter to the International Committee of Rheumatology Medical Editors and the American College of Rheumatology, suggested that the term Reiter’s syndrome be changed to reactive arthritis in all publications. The efforts of Wallace and Weisman bore fruit and the rate of the unqualified use of the Reiter eponym in medical publications in the English language declined from 57% in 1998 to 34% in 2003, but was not eliminated [4]. In 2003, Dan Caspi, head of the Israeli Rheumatology Society at that time, called for the substitu- tion of the eponym Reiter syndrome by the more appropriate Abstract Reiter’s syndrome is an eponym used to denote the triad of arthritis, urethritis and conjunctivitis. This syndrome is named after Hans Conrad Julius Reiter, who was involved in the activities of the Nazi Racial Hygiene Program related to involuntary sterilization, euthanasia and criminal research projects. Reiter defamed the entire medical profession and it was therefore suggested that the term Reiter’s syndrome be changed to reactive arthritis. We undertook to investigate the use of the eponym Reiter syndrome in medical literature, medical schools in Israel and medical textbooks, compared to the term reactive arthritis, by searching Medline between the years 2003 and 2007, 14 current medical textbooks, curricula of the four medical schools in Israel, and computerized patient fle systems in Israel. We found a decline in the use of the eponym in articles published between 2003 (18%) and 2007 (9%); however, most textbooks (13/14) still use it. Two of the four medical schools in Israel continue to use the eponym. The eponym appears in the computerized patient fles of all four healthcare providers in Israel. We hold that the continued use of the eponym Reiter syndrome in medical textbooks, medical schools and computerized patients fles in Israel is honoring an abomination and is inconsistent with medical principles. Awareness is still lacking and we suggest deleting the Reiter syndrome eponym from use, and replacing it with the more appropriate term – reactive arthritis. IMAJ 2008;10:256–258 For Editorial see page 296 Reactive Arthritis – The Appropriate Name Yoav Keynan MD and Doron Rimar MD Department of Medicine, Lady Davis Carmel Medical Center, and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel Key words: reactive arthritis, urethritis, conjunctivitis, eponym, Reiter syndrome Perspective