On tetany: 19th century research activity in the Vienna Medical School

Helmut GRÖGER <helmut.groeger@univie.ac.at>
Institute for the History of Medicine, Vienna, Austria

Salomon Levi Steinheim (1789-1866) and Jean Baptiste-Hippolyte Dance (1797-1832) were the first to describe the clinical symptoms of tetany; Francois Remy Lucien Corvisart (1824-1882) coined the term tetany. It was Armand Trousseau (1801-1867) who actually discovered the phenomenon that was named after him. In the German-speaking area it was mainly a paper by Franz Riegel (1843-1904) and a study by Wilhelm Erb (1840-1921) about electrical hyperexcitability which paved the way; this observation had also been mentioned by Moritz Benedikt (1835-1920). The detailed study of tetany in the Vienna Medical School was started by Franz Chvostek the elder (1835-1884); in his venie docendi he was the first to deal with electrotherapy and since 1876 he had published a number of case studies on this disease. It was he who discovered mechanical hyperexcitability, a most significant means to diagnose latent tetany. Chvostek's Sign (twitching of the respective facial side after percussing the facial nerve) is based on this discovery. Nathan Weiss (1851-1883)--although he submitted his venia docendi on the subject of internal medicine--nevertheless dealt only with questions of neuropathology. He was appointed Head of the Department of Electrotherapy and Neuropathology at the General Hospital in Vienna. In 1880 he reported about a fatal case of tetany. Weiss was the first to do respective systematic studies of the spine including medulla oblongata and the stem ganglia, where he discovered changes in the anterior cells of the spinal medulla as well as in the motor nuclei of the oblongata. As early as 1881, i.e., before the discovery of the epithelial bodies, Weiss found a causal relationship between tetany and strumectomy.

The most detailed work on tetany was carried out by Lothar Frankl-Hochwart (1862-1914). At the Medical Department of Hermann Nothnagel (1841-1905), he was in charge of an Outpatient Unit for Neurology and Electrotherapy which was run parallel to the Outpatient Unit for Neurology at the Department of Psychiatry under Theodor Meynert (1833-1892). In 1887 Frankl published a paper on electrical and mechanical excitability of nerves and muscles affected by tetany. As a result of further experimental and clinical studies, Frankl published a monograph, Tetany, in 1891. It was the first comprehensive monograph dealing with this disease; further editions and contributions in manuals were published. Frankl-Hochwart--since 1891 he had been recipient of a venia docendi in the field of neuropathology--pleaded for neurology as an independent discipline and favoured establishing a separate department. He was also the co-founder of the Society of German Neurologists. Under Frankl's influence, Hermann Schlesinger (1866-1934) and Rudolf Jaksch (1855-1947) at the Nothnagel Medical Department also focused on tetany. Although at the Medical Department of Otto Kahler (1849-1939) there was interest in neuropathological issues--same as at Nothnagel's--it was Franz Chvostek the younger (1864-1944) who did the studies on tetany. As evident, tetany research in the Vienna Medical School at the outgoing 19th century was widely spread, reaching out to internal medicine but focusing mostly on neuropathology; this discipline was about to gain independence and, particularly as far as tetany research was concerned, supplied valuable contributions.

Session VIII -- Poster Session 2
Saturday, 16 June 2001, 9:00 - 9:30 am

Sixth Annual Meeting of the International Society for the History of the Neurosciences (ISHN) and
Eighth Meeting of the European Club for the History of Neurology (ECHN)

Cologne, Germany