Venery, the spinal cord, and tabes dorsalis before Romberg: the contribution of Ernst Horn

Abstract

Usually Heinrich Romberg is credited with having established tabes dorsalis as a clinicopathological entity in the 1840s. But Romberg's teacher, Ernst Horn (1774 to 1848), had inspired five different students to write their doctoral dissertations on the same subject. These five theses, published between 1817 and 1827, as well as M. Steinthal's most comprehensive later description, were triggered by Horn's observation of the lower spinal cord atrophy which he found in one of his tabetic patients at autopsy. The dissertations are analyzed together with the prior literature reflected in them as it deals with the spinal cord. Discussions of the putative influence of the spinal cord on the vagaries of male sexual function, and vice versa, began with "consumption of the backbone", referred to in the Hippocratic corpus. "Venery"--if not veneral disease as we understand it--was thought throughout the centuries to be the prime cause of tabes. One may presume that the rising concern with public health and with national aims--a kind of "moral rearmament"--caused the subject to be so vigorously pursued by members of the young medical generation in early 19th-century Germany.