Moritz Heinrich Romberg
Encyclopedia
Moritz Heinrich Romberg (1795 – 1873) was a Jewish physician from Berlin
Berlin
Berlin is the capital city of Germany and is one of the 16 states of Germany. With a population of 3.45 million people, Berlin is Germany's largest city. It is the second most populous city proper and the seventh most populous urban area in the European Union...

 who published his classic textbook in sections between 1840 and 1846; Edward Henry Sieveking
Edward Henry Sieveking
Edward Henry Sieveking was an English physician born in Bishopsgate, London. He studied medicine at the University of Berlin under eminent physiologist Johannes Peter Muller, and also at University College London and the University of Edinburgh, where he received his doctorate in 1841.For much of...

 translated it into English
English language
English is a West Germanic language that arose in the Anglo-Saxon kingdoms of England and spread into what was to become south-east Scotland under the influence of the Anglian medieval kingdom of Northumbria...

 in 1853.

He described what is now universally recognised as "Romberg's sign" in his original account of tabes dorsalis
Tabes dorsalis
Tabes dorsalis is a slow degeneration of the sensory neurons that carry afferent information. The degenerating nerves are in the dorsal columns of the spinal cord and carry information that help maintain a person's sense of position , vibration, and discriminative touch.-Cause:Tabes dorsalis is...

 (a disease caused by syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

 damaging the back of the spinal cord). He related early symptoms as: " 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..."

Romberg's sign he described (Pearce JMS. Romberg's Sign. J Neurology neurosurgery & Psychiatry 1993; 56 :51.) as:
"The gait
Gait
Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency...

 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."
Romberg had not observed this in other paralyses.

The unsteadiness with eyes closed (sensory ataxia
Sensory ataxia
Sensory ataxia is both a symptom and a sign in neurology. It is a form of ataxia caused not by cerebellar dysfunction but by loss of sensory input into the control of movement....

), relates to loss of sense of position in the legs and feet that are normally compensated for by the patient who uses vision to provide that information. But when the eyes are closed or in the dark, the loss of sense of position causes unsteadiness and sometimes falls, as Romberg described.

He was one of a tiny number of truly innovative neurologists in Europe who in the 1820-50 period introduced order and clinical observation and deduction into what was then an elementary discipline.

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