Moritz Heinrich Romberg

Moritz Heinrich Romberg (1795-1873)

Moritz Heinrich Romberg (1795-1873) was a German neurologist.

Leading German neurologist of the nineteenth century and the author of the first modern classification of neurological disorders – Lehrbuch der Nervenkrankheiten des Menschen, published in three volumes between 1840 and 1846. Sieveking translated into English in 1853 [A manual of the nervous diseases of man].

Romberg described the physiology of neurological function and constructed a now outdated nosology of nervous system disorders first real attempt to systematise neurological disease.


Biography

  • Born 11th November 1795 Meiningen (Thüringen)
  • 1817 – MD, University of Berlin – Thesis on ‘congenital rickets’ with comprehensive description of achondroplasia
  • 1820 – Postgraduate training in Vienna with Johann Peter Frank (1745 – 1821). Frank was a German physician and public health pioneer recognised for his contributions in spinal cord disease and was responsible for directing Romberg’s career towards neurology
  • 1821 – Physician to the poor, Berlin.
  • 1830 and 1836 – Leading role during the Berlin cholera epidemics.
  • 1845 – Chair of Medicine and directorship of the Royal Policlinic Institute at the Friedrich Wilhelm University, Berlin.
  • Died on 16th June 1873, Berlin of heart disease.

Key Medical Attributions

In Lehrbuch der Nervenkrankheiten des Menschen 1840-1846 Romberg drew prevailing neurological theories together and presented a systematic and ordered approach to neurology. He combined pathophysiological features with clinical observations and treatment strategies. Of note he dichotomised disorders into ‘Neuroses of Sensibility’ (sensory or afferent disorders) and ‘Neuroses of Motility‘ (motor or efferent disorders).

Romberg gives an unmistakable description of Argyll Robertson pupils prior to the eponymous description by Douglas Argyll Robertson.

Other contributions to medicine span the areas of epilepsy and achondroplasia while further clinical descriptions include pupillary abnormalities in tertiary syphilis and the cremasteric reflex.

Romberg gives a thorough account of the muscular weakness, tabetic gait, urinary frequency, retention and incontinence and the constricting girdle pains associated with tabes dorsalis. In particular he provides an account of sensory ataxia (Romberg sign)

Romberg original description

Early in the disease we find the sense of touch and muscular sense diminished, while the sensibility of the skin is unaltered in reference to temperature and painful impressions. The feet feel numbed in standing, walking or lying down, and the patient has the sensation as if they were covered in fur; the resistance of the ground is not felt … The gait begins to be insecure . . . he puts down his feet with greater force . . . The individual keeps his eyes on his feet to prevent his movements from becoming still more unsteady. 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; the insecurity of his gait also exhibits itself more in the dark. It is now ten years since I pointed out this pathognomonic sign, and it is a symptom which I have not observed in other paralyses, nor in uncomplicated amaurosis . . in no case have I found it wanting

Romberg translated two seminal neurology texts into German:


Medical Eponyms

  • Romberg Sign (Romberg test)
  • Parry-Romberg syndrome (Romberg syndrome)
  • Howship–Romberg sign: inner thigh pain on internal rotation of the hip along the distribution of the obturator nerve. Caused by compression of the obturator nerve. Associated with strangulated obturator hernia. Named with English surgeon John Howship (1781-1841)

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]


Major Publications

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


References


eponymictionary CTA 2

eponym

the person behind the name

Posted by Dr Mike Cadogan

Emergency physician with a passion for medical informatics and medical education/textbooks. Asynchronous learning #FOAMed evangelist | @sandnsurf | + Mike Cadogan | LinkedIn

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