CONTRIBUTORS'
SECTION
PEDIATRIC HISTORY
ERNSTMORO (1874-1951)
Dick Hoefnagel, M.D., and Dieter Lüders,M.D. The Department of Pediatrics, Boston City Hospital
I i AS EIISTE TBIMENON― was the title of a
lecture given by Ernst Moro (Fig. 1)
on May 7, 1918, before a meeting of the Society of Natural History and Medicine in Heidelberg; in this lecture the speaker discussed some features peculiar to the first
3 months of an infant's life.1 At tile end of it, “¿almostas an afterthought,―2 Moro
described what he called “¿asmall observa tion―:
\Vhen a young infant is placed on the examining
table and one taps with the hands on both sides
of the pillow there follows a peculiar motor re
flex: both arms are symmetrically extended and
then approach each other again with slight shak
ing movements. A similar series of movements is described i@y the legs. The reflex is at its clearest in the first weeks of life. After a few months it becomes less evident and finally disappears en
tirely. It is rarely elicitable after the first three
months; only in prematures can it exist somewhat
longer. . . . Undoubtedly the phenomenon is re lated to the startle of the infant. Less understand Ill)le, however, remains the peculiar movement fol lowing tile extension of the limbs, because it lacks
any purposefulness in contrast with all defensive reflexes.
This description, clear and concise, of the reflex that came to bear his name, and that
has been used ever since as a useful sign
in tile evaluation of tile newborn and young
infant, was followed by speculative remarks
on its nature. Although tile initial extensor
phase of the phenomenon, in Moro's opin ion, was clearly related to a startle re sponse, it was tile second phase, where
arms and legs are brought back to their resting position while describing an “¿em brace,― which led Moro to the thought that the reflex is part of the organism's instinct to seek protection. Moro considered
Ftc. 1. Ernst Moro. ( Reproduced from the Annales
Nestle, 1960, with permission of the Nestle Corn pany, Frankfurt aM.)
the reflex, therefore, as an atavistic phe nomenon related to the behavior seen in young mammals, who, because of their
limited independent mobility in early life, have to be carried by the mother. To il lustrate this concept, Moro published a
drawing of an orangutan carrying her young (Fig. 2). He also noted the tendency of the reflex to disappear gradually in nor
mal full-term infants shortly after the third
month of life and its persistence for a
6-44 ERNST MORO
Fic. 2. The illustrations used by Moro for his article “¿Daserste Trimenon.― (Reproduced with permis
sion of the J. F. Lehmann Verlag, München.)
and in infants with damage to the central
nervous system. Much has been written
about the neurophysiological meaning of this reflex; this work has been ably re viewed by Mitchell.2
Ernst Moro was born on December 8, 1874, the youngest of eight children, at Laibach in the Austrian-Hungarian mon archy.3 He planned to study botany, but changed his mind and enrolled as a medi cal student at the University of Graz. His progress was rapid, and even before his graduation lle was appointed assistant to Theodor Escherich, Professor of Pediatrics. Moro soon joined his superior in studies of the intestinal flora of infants and children, Eschericll's main interest. In 1900, he pub lished his findings on a new organism, an acidophilic svmbiont of Lactobacillus bi fldus.4
In 1901 Moro followed Escherich to Vienna and later worked under von Pfaund ler in Graz and Munich. During these years his steady work was productive of many important contributions to the field of child
with old tuberculin, Moro described a modification of it. The “¿Morotest―up to this day, refers in many countries to a per cutaneous skin test in which an ointment of old tuberculin and lanolinC is rubbed into tile skin; in later years @sloroconsidered
this skin test his most important contribu
tion.
In 1911 Moro replaced Emil Feer as Head of Pediatrics at Germany's oldest uni
versity, Heidelberg; the Kinderklinik was
housed in the Luisenheilanstalt, named after its principal benefactress, the Grand Duchess Louisa of Baden. The years that followed, with the exception of those of the first world war, were years of great ac tivity tllat soon gave Heidelberg its place among the leading child healtil centers of Europe. Among Moro's many outstanding assistants were men like Franz Lust, Ernst Freudenberg, Paul Gyorgy, \Valter Keller, and Alfred Adam. 1's@Iuchfundamental work was done by Moro and his fellow workers in such fields as vitamin and calcium me
CONTRIBUTORS' SECTION 645
tion of diarrhea. He reasoned that whereas in normal infants the upper small intestine
is practically sterile, increased peristalsis
leading to diarrhea might well occur be
cause of invasion and multiplication of bac teria, not necessarily virulent and often sim ply saprophytic, from the large intestine and lower ileum into the upper segments of the
small intestine.
Moro's lifelong personal interest in dis
eases of the skin in children and his great knowledge of immunology and allergy led, toward the end of his scientific career, to publication of an important and pioneering
monograph on seborrheic dermatitis and
atopic eczema.7
And what about Moro the man? He had
a quick and orderly mind and many artistic
qualities. He was basically a morphologist; he preferred to see and not imagine things. His lasting interest in skin diseases is a good illustration of this quality. His inter
ests in calligraphy and painting belong in
the same category, even though the latter was mainly restricted to copying the old masters. Moro did not have the dictatorial
qualities of the caricature of the old Ger
man professor. He was accessible and
friendly to his colleagues, especially to
those whom he liked. He was sensitive and
suffered from scientific-political currents against him, not unusual at that time in
German pediatric-academic circles. His lec tures were outstanding and given in the true tradition of the classical clinical lec tures of the German or French school. His
diagnostic acumen was equally unique,
based on intuitive insight and deductive power: an experience that remained unfor
gettable to those who had the privilege to have been associated with him.
In 1936, because if ill health and the political upheavals in his country of adop tion, Moro, although only 62 years old, resigned from his post. He spent his re maining years in Heidelberg, where he died on April 17, 1951. His solitude was shared by his devoted wife and daughter.
In the fall of 1960, at the one hundredth
year celebration of the “¿Luisenheilanstalt― in Heidelberg, the new children's hospital
for tuberculous children was named after and dedicated to Ernst Moro, in lasting
recognition of his scientific and human qualities.
REFERENCES
1. Moro, E. : Das erste Trimenon. München.Med. Wschr., 65:1147, 1918.
2. Mitchell, R. G. : The Moro reflex. Cereb. Palsy
Bull., 2:135, 1960.
3. Seidler, E. : Pädiatrie in Heidelberg. Ann.
Nestle, October, 1960.
4. Moro, E.: Uber den Bacillus acidophilusn.
spec. Em Beitrag zur Kenntnis der normalen
Darmbacterien des Sauglings. Jahrb. Kinder
heilk., 52:38, 1900.
5. Moro, E. : Karottensuppe bei Ernahrungsstör ungen der Säuglinge.München.Med. Wschr., 55:1637, 1908.
6. Moro, E. : Uber eine diagnostisch verwertbare Reaktion der Haut auf Einreibung mit Tuberkulinsalbe. München. Med. Wschr., 55:216, 1908.
7. Moro, E. : Ekzema Infantum und Dermatitis Seborrhoides: Klinik und Pathogenese. J.
Springer, Berlin, 1932.
Acknowledgment
1962;29;643
Pediatrics
Dick Hoefnagel and Dieter Lüders
ERNST MORO (1874-1951)
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ERNST MORO (1874-1951)
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