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Everything you never wanted to know about eponym apostrophe s - the rule is not set in stone

Everything you never wanted to know about adding an “apostrophe s” (possessive form) with an eponym. 

AHDI (AAMT) came late to the game, starting in 1990, while The AMA Manual of Style started suggesting this in 1974, which was pretty much ignored except in scientific publications, until AAMT stuck their nose into it. 

There is still no “set in stone” rule. 

My philosophy:  If QA dings you for doing it, don’t do it.  Otherwise, I put them all in my expander with the “ ’s ” and never give it a second thought. 

Per AHDI (AAMT) Book of Style 3:  

8.2.7 Eponyms

“AHDI first advocated dropping the possessive form for eponyms in 1990.  We adopted this standard because it promotes consistency and clarity.  Likewise, The AMA Manual of Style and other industry resources have acknowledged this trend away from the possessive form.  It is important to note, however, that use of the possessive form is acceptable in environments where client or facility preference prevails.”

EXAMPLE:

Apgar score
Babinski sign
Down syndrome
Gram stain
Hodgkin lymphoma
Alzheimer disease
Lou Gehrig disease

When the noun following the eponym is omitted, the possessive form is preferred (See 8.2.9—Solitary Possessives).

EXAMPLE:

The patient reports a great deal of stress associated with caring for a parent with Alzheimer’s.
She was diagnosed with Hodgkin’s in early 2002.

The AMA Manual of Style

The AMA Manual of Style has a fairly lengthy discussion of the issue at section 13.2, beginning:  “There is continuing debate over the use of the possessive form; however, a transition toward the nonpossessive form may be gradually taking place, as illustrated by the change from Down’s to Down syndrome.”  They end their discussion with: “We recommend that the possessive form be omitted in eponymous terms.”

Some Background: 

"In 1974, the United States National Institute of Health called a conference to standardize the naming of diseases and disorders.  They recommended eliminating the possessive form ("The possessive form of an eponym should be discontinued, since the author neither had nor owned the disorder.").  Down syndrome is the accepted term in the USA, Canada and other countries, and the possessive form is used in the United Kingdom and other countries. 

There has been some discussion on how much the use of the term possessive case in lieu of genitive case has in decisions like this.  Phrases like Down’s syndrome or Hansen’s disease are classic examples of the objective genitive, which is used to classify or delimit the subject.  They have nothing to do with possession.  The possessive is merely one use of the genitive in English, albeit probably the most common use.  Possessive case is a bit of a misnomer.  The point being that this is not an instance of the “possessive” and calling it the “possessive case” can be misleading; as evidenced by this instance.  The argument that the inflection should be dropped because the named individual does not “own” or “have” the disease is not a valid one.  The conjecture was that there were no real grammarians at that 1974 conference.

The Chicago Manual of Style writes:  “The possessive forms Alzheimer’s, Down’s, Hodgkin’s, and the like, though rarely used in medical literature, may be preferred in a general context.”

But it seems to be a basic human need, the need to have rules; if no rule is discernible, someone’s bound to make one up.  “Down’s syndrome” has always seemed perfectly clear; “Down syndrome,” on the other hand, straightaway prompts the question “Is there an Up syndrome, too?”

In the case of medical terminology, there were for many hundreds of years no “rules” for doctors or medical writers to go by; doctors wrote what looked understandable, and acceptable, to them; hence the variable terminology.  But when laying down the rule, why opt to overturn centuries of traditional usage, unless there is a good reason for doing so?

The rule discussed is a rule of usage and not one of grammar.  Both Down’s syndrome and Down syndrome are grammatical, but the latter is the preferred usage according to the AMA published style guide.

Adding the “’s”  has the handy feature of allowing deletion of the syndrome or disease in informal or casual language.  For instance “He has Alzheimer’s ” sounds correct opposed to "He has Alzheimer.” However, it has been speculated that if everyone starts talking about it without the possessive, eventually "He has Alzheimer” will sound perfectly normal.  That’s how language works. 

So expect the AHDI Book of Style 4 – 5 – 6 (whenever) to remove the statement: “When the noun following the eponym is omitted, the possessive form is preferred” and go strictly with NO “APOSTROPHE  S” – Period. 

Your English lesion for today is now complete.  

Have a headache yet?