People stop playing for many reasons but I doubt that a lack of realism is one of them. Item names are just labels to help distinguish between different quality levels. It wouldn't change the game to just use numbers, like weapon 1, helmet 5, to identify the 83 items in each category of spells, weapons and armor but that's not how anyone does it in role playing games. Jeff probably had to stretch his imagination to come up with enough different names when putting the game together. Look at the crafting list for higher-end heal spells and you get the impression some of this was done late at night after some long days
The graphics are just there for decoration, like the interface skin. It's actually one image for every 10 different normal critters, not 1 per 15. At the start there were even fewer images. What we have now is the upgraded graphics package. I'd guess that most players don't even notice the graphics after a couple hours of playing, so changing them is just not important. If you ask players what they'd like to see changed in the game I don't think the graphics or item names would even come up.