Moritz Romberg

Biographical Timeline

• Born November 11, 1795 in Meiningen, Duchy of Saxe-Meiningen, into a Jewish family
• 1812 – Entered medical studies at University of Berlin, newly founded in 1810; trained under Hufeland, Rudolphi, von Graefe, and Reil.
• 1817 – Graduated MD, University of Berlin with thesis De Rachitide Congenita (achondroplasia).
• 1818–1820 Study trip to Vienna, mentored by Johann Peter Frank (1745-1821), a pioneer in hygiene and spinal cord pathology; declared neurology his life’s focus.
• 1820 – Returned to Berlin as “Armenarzt” (physician to the poor); began autopsy-based neurological research at Charité; translated Andrew Marshall’s The Morbid Anatomy of the Brain into German.
• 1828 – Translated and annotated The Nervous System of the Human Body by Charles Bell (1774-1842), introducing British neurological concepts to Germany.
• 1830 – Qualified as Privatdozent in special pathology and therapy, University of Berlin, with a dissertation on cerebral haemorrhage.
• 1831 and 1837 – Director of the cholera hospital during the Berlin cholera epidemics.
• 1838 – Appointed extraordinary professor of pathology at the University of Berlin
• 1840–1846 Published Lehrbuch der Nervenkrankheiten des Menschen in three volumes, the first systematic neurology textbook; dedicated to Alexander von Humboldt.
• 1842–1864 Director of the Royal Outpatient Department for Internal Medicine, Charité, Berlin.
• 1845 – Appointed full professor; later awarded the title Geheime Medizinalrath (1851).
• 1853 – English translation of Lehrbuch by the Sydenham Society, titled A Manual of the Nervous Diseases of Man.
• 1864 – Retired after 44 years of medical service; celebrated widely in 1867 on the 50th anniversary of his doctorate.
• Died on June 16, 1873, Berlin aged 77, from chronic heart disease; buried in Friedrichwerder Cemetery (honorary grave)

I have selected the study of diseases of the nervous system for the object of my life and goal of my researches

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Medical Eponyms

Romberg’s Sign and Sensory Ataxia

Romberg immortalised his name with a clinical manoeuvre to identify proprioceptive deficits. In patients with tabes dorsalis, he noted:

Romberg Test

This simple observation became the Romberg test, a clinical test for sensory ataxia due to impaired proprioception, typically in tabes dorsalis (syphilitic neuropathy).

Romberg gave a detailed account of the pathognomonic phenomenon in his 1846 Lehrbuch

Early in the disease we find the sense of touch and muscular sense diminished… The feet feel numbed… The gait begins to be insecure… he puts down his feet with greater force… The individual keeps his eyes on his feet… If he is ordered to close his eyes while in the erect posture, he at once commences to totter and swing from side to side… It is now ten years since I pointed out this pathognomonic sign… in no case have I found it wanting.

Romberg 1846; 1: 794–801

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Howship-Romberg sign (1840, 1847)

Definition: Pain and paraesthesia along the inner thigh (medial aspect), often radiating to the knee, and pain on internal rotation of the hip—distributed along the obturator nerve. It is caused by compression of the obturator nerve in strangulated obturator hernia.

First noted by John Howship (1781–1841), the sign was further developed and given diagnostic significance by Romberg. Romberg described his findings of an obturator hernia and their clinical significance in 1847, published in 1848 as ‘Die Operation des eingeklemmten Bruches des eirunden Loches‘ emphasising the value of the nerve symptom in differential diagnosis:

Significance: This combined with intestinal obstruction symptoms provided a crucial clue for diagnosis in an era without imaging.

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Parry-Romberg syndrome (1825, 1846) (Romberg syndrome)

Parry-Romberg syndrome: rare disorder of progressive facial hemiatrophy. Slowly progressive atrophy of the soft tissues of one side of the face, associated with trigeminal neuralgia and involvement of the eyes and hair. Muscles, cartilage and the underlying bony structures may also be involved.

First described by Parry (1825) and elaborated by Romberg in 1846 as a “trophoneurosis”.

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Key Medical Contributions

Lehrbuch der Nervenkrankheiten (1840–1846)

Romberg’s three-volume textbook Lehrbuch der Nervenkrankheiten des Menschen was the first systematic neurology treatise, introducing physiological principles and nosology. He divided disorders into “sensitivity neuroses” and “motility neuroses,” and integrated pathology, clinical observation, and experimental findings. Dedicated to Alexander von Humboldt, it was translated into English in 1853 and remained a reference for decades.

Romberg’s writings catalogued an astonishing range of neurological phenomena, including:

• Cranial tuberculoma, cluster headache, restless legs syndrome, and autonomic disturbances.
• Pupillary changes in tertiary syphilis (before Douglas Argyll Robertson)
• Descriptions of trigeminal neuralgia, peripheral nerve lesions, cranial nerve palsies, and reflex disorders (including the cremasteric reflex).

Tabes Dorsalis and the Role of Proprioception

Romberg’s clinical acumen allowed him to separate locomotor ataxia (tabes dorsalis) from other paralyses. He recognized the compensatory role of vision in patients who had lost position sense and noted worsening instability when eyes were closed—decades before physiology elucidated dorsal column pathways. This insight marked the birth of modern neurophysiology applied to clinical practice.

Therapeutic Principles and Medical Ethics

Romberg advocated causal therapy whenever possible, condemned charlatanism and animal magnetism, and insisted on restraint in futile cases:

If it is not possible to cure the patient, let him die peacefully, close to his loved ones.

His pharmacological tools were limited to opiates, belladonna, mercury, iodine, and bleeding, but his rational approach prefigured modern medical ethics.

Influences and International Connections

Romberg was profoundly shaped by British and French medicine. He translated works by Andrew Marshall, Charles Bell, and François Magendie, and brought French techniques of auscultation and percussion to Berlin. This cosmopolitan outlook gave German neurology its first structured foundation.

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Controversies

Romberg was one of many physicians who incorrectly attributed the discovery of the function of the anterior and posterior roots of the spinal cord to Charles Bell, when in fact the finding was of François Magendie. Not backwards in coming forwards…

Romberg takes a swipe at his erstwhile colleagues in neurology…

The blame lies in a measure with the distinguished members of our profession who have been deterred by a fear that pathological investigations would fail to cope with the advanced state of physiological inquiry; in others, the fault is to be attributed to that mental indolence, which gives the preference to the easy path of tradition, and with foolish scepticism rejects everything that is new.

Romberg MH, 1840

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Major Publications

• Romberg MH. Thesis. De rachitide congenital. [Congenital Rickets] Karl August Platen, Berlin. 1817
• Romberg MH. Commentationes quaedam de cerebri haemorrhagia: quibus ad praelectiones suas de morbis nervorum. Berolini 1830
• Romberg MH. Lehrbuch der Nervenkrankheiten des Menschen. Berlin: Hirschwald. 1840-1846. [Vol I, Vol II, Vol III]
• Romberg MH. Tabes Dorsualis. In: Lehrbuch der Nervenkrankheiten des Menschen. Berlin. 1840; 1: 794-801.
• Romberg MH. Trophoneurosen. In: Klinische Ergebnisse. Forstner, Berlin, 1846: 75-81
• Romberg MH. Die Operation des eingeklemmten Bruches des eirunden Loches. Operatio hernia foraminis ovales incarceratae. In: Die operative Chirurgie. Dieffenbach JF 1848: 619-626
• Romberg MH. A manual of the nervous diseases of man. Volume I. Translation Sieveking EH 1853. Sydenham Society [Volume II]
• Romberg MH. Tabes Dorsalis. In: A Manual of the Nervous Diseases of Man. 1853; 2: 395–401.

Romberg translated two seminal neurology texts into German:

• Marshall A. The morbid anatomy of the brain in mania and hydrophobia 1814
• Bell C. An exposition of the natural system of the nerves of the human body [Bell’s physiologische und pathologische Untersuchungen des Nervensystems. Berlin, 1832]

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References

Biography

• Moritz Heinrich Romberg (1795-1873). JAMA. 1965;193(13):1119–1120.
• Schiffter R. Moritz Heinrich Romberg (1795-1873). J Neurol. 2010 Aug;257(8):1409-10.
• Housman B, Bellary SS, Walters A, Mirzayan N, Tubbs RS, Loukas M. Moritz Heinrich Romberg (1795-1873): Early founder of neurology. Clin Anat. 2014 Mar;27(2):147-9.
• Fresquet JL. Moritz Heinrich Romberg (1795-1873) Historia de la Medicina.
• Bibliography. Moritz Heinrich Romberg (1795-1873). World Cat Identities

Eponymous terms

• Lanska DJ, Goetz CG. Romberg’s sign: development, adoption, and adaptation in the 19th century. Neurology. 2000 Oct 24;55(8):1201-6.
• Yamashita K, Hayashi J, Tsunoda T. Howship-Romberg sign caused by an obturator granuloma. Am J Surg. 2004 Jun;187(6):775-6.
• Pearce JM. Romberg and his sign. Eur Neurol. 2005;53(4):210-3.
• Rastogi V et al. Abdominal Physical Signs and Medical Eponyms: Movements and Compression. Clin Med Res. 2018; 16(3-4): 76-82. 
• Beighton G, Wiedemann HR. The Person Behind the Syndrome. Springer. 1997: 147