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Wilhelm Heinrich Erb
German neurologist, born November 30, 1840, Winnweiler, Pfalz); died 1921.
Associated eponyms:
Duchenne-Erb paralysis
A disturbance caused by nerve lesion of plexus brachialis during birth, manifested as flaccid paralysis of a group of muscles of shoulder and upper arm involving cervical roots of 4th, 5th, and 6th cervical nerves.
Erb's dystrophy
A slowly progressing, juvenile form of muscular dystrophy, affecting each sex equally.
Erb's phemomenon
Increased electrical irritability of motor nerves in tetany (Erb’s sign III).
Erb's point
The point on the side of the neck 2 to 3 cm above the clavicle and in front of the transverse process of the sixth cervical vertebra.
Erb's reflex
So-called biceps femoris reflex.
Erb's signs or symptoms
1. Loss of the knee jerk as an early sign of tabes dorsalis; 2. Absent dilatation of pupil by painful irritation of the skin in tabes dorsalis; 3. Increased electrical irritability of motor nerves in tetany.
Erb's test
The test of reaction of degeneration.
Erb-Charcot paralysis
A rare syndrome consisting of spinal syphilis with paraesthesia, spastic weakness, and tiredness of the legs associated with pain, sphincter disorders, exaggerated deep reflexes, muscle atrophy, sensory disorders, and paraplegia.
Erb-Goldflam syndrome
Syndrome characterized by ptosis, strabismus, occasionally by complete ophthalmoplegia externa, weakness of masticatory muscles, dysphagia, dysphonia, and general muscular exhaustion after slight activity.
Erb-Westphal symptom
The most important reflex anomaly seen in tabes dorsalis.
Huntington's chorea
A rare disease of the central nervous system characterized by progressive dementia with grimacing, gesticulation, ataxic movements, finger twitching, dysarthria, speech disorders and other bizarre involuntary movements.
Jolly's myasthenic reaction
A test for distinguishing between Lambert-Eton syndrome and myasthenia gravis pseudoparalytica, or Erb-Goldflam syndrome.
Landouzy-Dejerine syndrome
A hereditary from of progressive muscular dystrophy with atrophic changes in the muscles of the face and scapulohumeral group.
Minkowski-Chauffard disease
Congenital haemolytical anaemia presenting with spherocytosis, splenomegaly and varying degrees of anaemia and ikterus.
Nievergelt's syndrome
A rare, inheritable bone disease characterized by deformities of the radius, ulna, tibia, and fibula.
Touraine-Solente-Golé syndrome
Osteodermopathic syndrome characterized by so-called "bull-dog scalp" lesions, clubbing of the digits; elephantiasis of long bones, enormously large hands and feet; periosteal lesions, fatigability, etc.
Biography:
Of the many German neurologists who flourished during the later 1800's, the most significant figure was Wilhelm Heinrich Erb. Primarily known for the advances he made in identifying, classifying, and treating the muscular dystrophies, many of which still bear his name, Erb also pioneered in the use of electricity in the diagnosis and treatment of nervous disorders. He was the first clinician to use the reflex hammer routinely in examinations. Erb was to Germany what Jean-Martin Charcot (1825-1893) was to France, and William Richard Gowers (1845-1915) to England. For half a century he ruled over German neurology with an imperial hand.
Wilhelm Heinrich Erb was born in Winweiler, in the Bavarian Palatinate, the son of a forester. He was 17 years old when he was entered as a medical student at Heidelberg. He also studied in Erlangen and Munich. He was an assistant to Ludwig von Buhl (1816-1880) in Munich for a brief period of time, and for several years at Nikolaus Friedreich’s (1825-1882) clinic in Heidelberg.
Erb received his doctor’s degree at Heidelberg in 1864. Already one year later, in the autumn of 1865, he was habilitated. The same year became Privatdozent for internal medicine in Heidelberg, and in 1869 was appointed Dozent (lecturer).
In 1880 Erb was appointed to a chair in special pathology at the University of Leipzig, where he also became head of the polyclinic, but returned to Heidelberg to assume the same positions there. He remained in Heidelberg for most of his life, succeeding his teacher Nikolaus Friedreich in 1883.
The man
Erb had the appearance of a cultured gentleman; he was always immaculately dressed and kept his professorial beard trimmed to the last hair. There was an air of detachment about him, neither he nor anyone else in that rigid hierarchy forgot that he was the Herr Geheimrat (Sir Privy Counsellor). He was punctual to the minute, and always on the alert.
Erb was also noted for his benevolence, as reflected, considering the period, in the equal care he gave all patients – peasant or aristocrat – in his large international practice. The title Seine Excellenz was conferred on him by the local reigning prince, the Grand Duke of Baden. His 70th birthday was an occasion for a special town and gown celebration in Heidelberg, where fighting fraternities in full fig and torch parades for academic worthies presented nothing unusual. His statue of bronze was unveiled in the park near the Akademisches Krankenhaus, and a street named after him.
In his later years Erb was a broken man; two of his four sons had died, and a third was killed at the front on the first day of World War I. Erb's end came quietly. On the way home from listening to Beethoven’s Eroica he caught a cold, and a few days later, bronchopneumonia claimed him.
Research
Erb's first research chiefly concerned the fields of toxicology, histology, and therapeutics. His interest later turned to neurology, where he was to become one of the giants. He investigated the effect of electric current on the human organism. He popularised electrodiagnostics in neurology and demonstrated increased motor nerve irritability in tetanus.
He made early observations relating to syphilis and tabes dorsalis. In his works on tabes dorsalis he repeatedly sought to find the association between this disease and syphilis. Besides these fields he has left research material on poliomyelitis, claudication intermittens, various brain tumours, and the progressive muscular atrophy.
Among his most important writings are Handbuch über die Elektrotherapie and a dissertation on the spinal paralysis.
O Lord
Erb was an excellent teacher although something of a martinet with a short temper. On such occasions his language was not that customarily heard in academic circles – a holdover from his youth with helping his father, a forester. One of his sayings to his students, who included Ernst Julius Remak (1849-1911) and Max Nonne (1861-1959), was «Pray every morning before you get out of bed – ‘O Lord let me not idle my life away today.’»
Bibliography:
A bibliography of Erb’s work comprises 273 publications altogether.
- Die Pikrinsäure, ihre physiologischen und therapeutischen Wirkungen. Doctoral thesis, Heidelberg, 1864.
- Über die Agoniesteigerung der Körperwärme bei Krankheiten des Zentralnervensystems.
Deutsches Archiv für klinische Medizin, 1/2,1865
- Zur Entwicklungsgeschichte der roten Blutkörperchen.
Habilitation thesis, 1865. [Virchows] Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, Berlin, 1864, 34: 138 - 194,
- Ein Fall von Fazialparalyse. Verhandlungen des naturhistorisch-medizinischen Vereins zu Heidelberg, Band IV, 1867.
- Zur Kasuistik der Nerven - und Muskelkrankheiten (Bleiparalyse und Accesoriuslähmung). Deutsches Archiv für klinische Medizin, Band IV, 1868
- Über die Anwendung der Elektrizität in der inneren Medizin.
[Volkmanns] Sammlung klinischer Vorträge, Leipzig, 1872, 46. 38 pages.
- Handbuch der Krankheiten der cerebrospinalen Nerven. 1874.
- Ein Fall von Bleilähmung.
Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1875, Bd. V.
- Handbuch der Krankheiten des Rückenmarks und verlängerten Marks. 1876.
- Krankheiten des Rückenmarks und seiner Hüllen. In Hugo Wilhelm von Ziemssen, et al: Handbuch der speciellen Pathologie und Therapie. Volume 11, 2; Leipzig 1876; 2nd edition, 1878.
- Krankheiten der peripheren cerebrospinalen Nerven. In Hugo Wilhelm von Ziemssen, et al: Handbuch der speciellen Pathologie und Therapie. Volume 11, 2A; Leipzig, 1876; 2nd edition, 1878.
- Über die neuere Entwicklung der Nervenpathologie und ihre Bedeutung für den medizinischen Unterricht.
Inaugural address in Leipzig, 16.6.1880.
- Elektrotherapie. In: Hugo Wilhelm von Ziemssen, et al: Handbuch der speciellen Pathologie und Therapie, volume 3; Leipzig, 1882.
- Handbuch der Elektrotherapie. Leipzig 1882.
This work on electrotherapy contains first descriptions of several nervous disorders and was written while Erb was professor of neurology at the University of Heidelberg, a post he held for some twenty-seven years.
- Die Thomsensche Krankheit (Myotonia congenita). 1886.
- Dystrophia muscularis pregressiva. Leipzig, Breitkopf, 1890. 32 pages.
[Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1890, N.F. 2.
- Dystrophia musculorum progressiva. Klinische und pathologisch anatomische studien.
Deutsche Zeitschrift für Nervenheilkunde, 1891, 1: 13, 173.
- Die Ätiologie der Tabes.
[Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1892.
- Über die wachsende Nervosität unserer Zeit.
Heidelberg, 1894.
- Die Therapie der Tabes.
[Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1896.
- Winterkuren im Hochgebirge.
[Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1900.
- Bemerkungen zur Balneologie und physikalisch-diätetischen Behandlung der Nervenleiden.
[Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1891.
- Paralysis agitans. Deutsche Klinik, Berlin, volume 6, 1.
- Tabes dorsalis.
Deutsche Klinik, Berlin, Volume 6, 1. Leipzig and Vienna, 1906.
- Gesammelte Abhandlungen, 1864-1910.
2 volumes; Leipzig 1910.
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