Moritz Heinrich Romberg
Biography of Moritz Heinrich Romberg
Moritz Romberg studied and qualified in medicine in Berlin, obtaining his doctorate in 1817 with a thesis on rachitis, in which he gave his now classic description of achondroplasia, or “congenital rickets”. He obtained postgraduate experience in Vienna, where he became a close friend of Johann Peter Frank (1745-1821), a pioneer in the study of diseases of the spinal cord, and also a humanitarian and founder of modern public hygiene. Frank's influence on Romberg was considerable and lasting, and he was responsible for his career being directed towards neurology.
After his return from Vienna, Romberg in 1820 became medical officer to the indigent in Berlin. He was habilitated for Privatdozent of special pathology and therapy in Berlin in 1830. This was the first ever post in this speciality and Romberg thus has the distinction of being the first clinical neurologist. During the cholera epidemics in Berlin in 1831 and 1837 he worked unselfishly in charge of the cholera hospitals. In 1838 he was appointed ausserordentlicher professor of his speciality, and in 1840 was entrusted with the leadership of the university policlinic. In 1845 he was elevated to the chair of special pathology and therapy and directorship of the Royal Policlinic. He then gave up his position as physician to the poor, in order to concentrate on teaching and scientific work.
Romberg derived much of his background from contemporary English neuroanatomy and neuropathology in translating Andrew Marshall’s (1742-1813) The Morbid Anatomy of the Brain in Mania and Hydrophobia, With the Pathology of These Two Diseases (London, Longman & Co, 1815) into German in 1820, and, more significantly, Sir Charles Bell’s (1774-1842) The Nervous System of the Human Body (London, Longman & Co, 1830) in 1832. He was conscious of the importance of having brought Bell’s great landmark in neurology to the German-speaking world, stating: “The researches of Sir Charles Bell fill me with enthusiasm, and in 1831 I translated his great work and made known to my professional brethren in Germany his investigations which will ever serve as models of scientific inquiry.”
Romberg was the first physician in history to give particular attention to altered structure related to clinical manifestations – the neurology, as we know it today. His clinic was always well attended. He taught "propaedeutic clinic”, introducing practical demonstrations and emphasising the importance of a careful physical examination to ensure a correct diagnosis. In this teaching he used patients from his private and indigent practice.
Romberg’s most important work was in the field of neuropathology, where his major contribution was the description of the eponymous physical sign, which indicates dysfunction of the posterior columns of the spinal cord. He was the founder of the teaching of neuralgia ciliaris.
He was a widely known, very popular and highly respected teacher, always intent on closing personal relations with his students.
His own three-volume textbook, Lehrbuch der Nervenkrankheiten des Menschen ["A Manual of the Nervous Diseases of Man"], written during the years 1840-1846 while he was director of the University Hospital in Berlin, became a classic in its own right. It is a milestone because it was the first systematic textbook in neurology, and for the first time compiled the existing knowledge of the physiology of the nervous system, giving structure to material that had hitherto been scattered, in such a way that a far more precise picture than before emerged of various groups of diseases, making possible a more directed therapy. It is the foundation for all later works in this special branch of pathology. In it he described the sign for tabes dorsalis, a disease for which he tried to find a rational treatment. In the preface to this book he castigated his predecessors for the inadequacy of their contributions: "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."
In 1851 Romberg became medical privy councillor. He died from chronic heart disease on June 16, 1873 at the age of 78 years.
Romberg published frequently in Casper’s Wochenschrift für die gesammte Heilkunde (Berlin) of which he was co publisher from 1833.
"Every social group has its own type of health and disease, determined by the mode of living. They are different for the courtiers and noblemen, for the soldiers and scholars. The artisans have various diseases peculiar to them, some of which have been specially investigated by physicians. The diseases caused by the poverty of the people and by the lack of the goods of life, however, are exceedingly numerous that in a brief address they can only be discussed in outline."
The People's Misery: Mother of Diseases. Translated by Henry E. Sigerist.
An address delivered by Johann Peter Frank in 1790.
We thank Fritz-Dieter Söhn for correcting the title of Casper's Journal.
- Johann Peter Frank:
System einer vollständigen medicinischen Polizey.
9 volumes. Mannheim, Tübingen, Wien, 1779-1827.
First systematic treatise on public hygiene. In his classic work, Frank, the "Father of Public Hygiene", considered the ruler of a state to stand in the relation of a father to his children. among his duties being the safeguarding of the people's health and the preservation of a healthy race by appropriate laws. The last two volumes were edited by Georg Christian Gotthelf Voigt (1790-1866). The Johns Hopkins Press, Baltimore, published selections from an English translation, with introduction by Erna Lesky, in 1976. Works by Romberg:
- De rachitide congenita.
Doctoral dissertation, Berlin, Carl August Platen, 1817. English translation published by the Sydenham Society, London, 1853.
- Commentationes quaedem de cerebri haemorrhagia.
Habilitation text, Berlin, 1830.
- Bemerkungen über die asiatische Cholera. Berlin, 1832.
- Bericht über die Choleraepidemia des Jahres 1837.
- Lehrbuch der Nervenkrankheiten des Menschen.
Berlin, Duncker, 1840-1846. 2nd edition, 1851; 3rd edition (unfinished), 1857, 1 volume.
Also under the title of Pathologie und Therapie der Senisbilitäts- und Motilitätsneurosen.
English translation: A Manual of the Nervous Diseases of Man. 2 volumes. London, Sydenham Society, 1853. Translated and edited by Sir Edward Henry Sieveking (1816-1904)
- Neuralgiae nervi quinti specimen.
Academic inauguration address, Berlin, 1840.
- Bell's physiologische und pathologische Untersuchungen des Nervensystems. Berlin, 1832, 1836.
- De paralysi respiratoria. Berlin, 1845.
- Klinische Ergebnisse. Berlin, Förstner, 1846.
The part Trophoneurosen, describing facial hemiatrophy, or Parry-Romberg syndrome, is on pages 75-81.
- Klinische Wahrbehmungen und Beobachtungen, etc.
2 volumes, Berlin, 1851.
On Romberg’s experiences in the university policlinic, and the results of his many years as director of this institution. Published by his nephew, Eduard Heinrich Henoch (1820-1910).
- Pathologie und Therapie der Senisbilität- und Motilitätneurosen.
Title of the third edition of his Lehrbuch der Nervenkrankheiten des Menschen. See above.