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Paul Emil Flechsig

Born 1847
Died 1929

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German neurologist, born June 29, 1847, Zwickau, Saxony; died July 22, 1929.

Biography of Paul Emil Flechsig

Paul Emil Flechsig was the son of Emil Flechsig, deacon (Pastor) of the Protestant church of St. Mary in Zwickau. His father, a friend of Robert Schumann. was a cultured man and much concerned with local social welfare. His mother, Ferdinande Richter, came from a wealthy family.

Flechsig graduated from the Gymnasium in Zwickau and then studied medicine at Leipzig from Easter time 1865 to June 1870, when he obtained his doctorate, aged only 23. His dissertation was Bemerkungen über Meningitis luetica . .. In Leipzig he came under the influence of the brothers Ernst Heinrich Weber (1795-1878) and Eduard Friedrich Wilhelm Weber (1806-1871) in anatomy, and in Physiology by Carl Friedrich Wilhelm Ludwig (1816-1895). Ludwig was especially impressed by Flechsig’s histological work, and he encouraged and advised him in it. His histology teacher was Franz Schweigger-Seidel (1834-1871).

Following graduation, Flechsig served two years as a surgeon in the Franco-Prussian War 1870-1871. On demobilization he returned to Leipzig, and on January 1, 1872 he became assistant to Ernst Leberecht Wagner (1829-1888) of the Institute of Pathology in the University of Leipzig, and also worked at the medical polyclinic

Into the brain
Flechsig was impressed by Theodor Hermann Meynert's (1833-1892) contribution on the structure of the mammalian brain which had just appeared in Salomon Stricker's (1834-1898) Handbuch der Lehre von den Geweben des Menschen und der Thiere. He prepared a set of brain sections from the human newborn, premature, full-term, and early postnatal infants. He discovered that axons in different parts receive their myelin sheath at different stages of growth, and he could observe the chronological sequence of this process.

Already in 1872 he presented a preliminary report of his findings at a national meeting in Leipzig, the 45. Versammlung Deutscher Naturforscher und Aerzte

Although Flechsig contributed to the clinical and pathological study of hysteria, epilepsy, neurosyphilis, and chorea, his fame is due mainly to his technique of myelogenesis for the examination of the brain.

A career
On October 1, 1873 he was appointed head of the department of histology at the Institute of Physiology under Carl Ludwig. Here he devoted all his time to research and benefited greatly from the facilities available and the contact with many outstanding German and foreign physiologists.

By 1875 Flechsig was university lecturer – Privatdocent. During the next few years he studied primary systemic disorders of the spinal cord, the course of the medial lemniscus, and the myelogenesis of the internal capsule, which he subdivided into anterior limb, posterior limb, and knee.

In 1877 Flechsig became professor extraordinarius in the new chair of psychiatry. Having, however, rather scanty knowledge of psychiatry, he obtained several years' leave of absence. He then studied psychiatry at some of the most important lunatic asylums in Germany and abroad, including a stay in Paris where he visited Jean-Martin Charcot (1825-1893).

Flechsig led the establishment of the new university lunatic asylum at Leipzig, the Irrenklinik. Here he spent the rest of his working life, from the opening on May 2, 1882, and attracted many pupils and visitors. He was rather a stern figure who said it is the duty of a professor to think «other than others». He intensely disliked socialism.

In the summer of 1884 Flechsig was appointed ordinarius of psychiatry and from 1894 to 1895 he was rector of the University of Leipzig. In 1901, along with the elder Wilhelm His (1831-1904), he helped to found the International Brain Commission, which planned to unify nomenclature, standardize methods, collect material, and encourage research in neuroanatomy. He was made an honorary member of the University of Dorpat in 1903, received the honorary D. Sc. of Oxford in 1904, and became honorary doctor of his alma mater in 1909.

More research
Flechsig’s monumental work on the pyramidal tract – in which for the first time he traced its origin to the cerebral cortex – appeared in parts in 1877 and 1878. It is the first clear account of the upper motor neurone, and the now familiar division of the internal capsule into knee and limbs is his.

In 1893 Flechsig embarked on the study of myelogenesis in the hemispheres and supplemented his myelogenetic findings with clinical observations and data from degeneration experiments. He outlined the auditory radiation and could list twelve cortical areas that are myelinated – and therefore functional before birth – as well as twenty-four in which myelinisation occurs after birth; these he arranged chronologically according to the time of myalinisation.

Flechsig evolved a map of cortical function that appeared in a report of 1904 to the Central Committee for Brain Research. Flechsig's conclusions evoked considerable argument, especially from Leonardo Nianchi concerning frontal lobe function and Oskar Vogt (1870-1959) on the techniques of myelogenesis. It is now clear that although Flechsig made many errors and ignored the work of others with which his results did not agree, he nevertheless stimulated much beneficial discussion and research.

Flechsig was a true Vogtländer, with a thick neck, a large barrel-shaped trunk, and short legs. He wore a broad-brimmed hat and a velvet cloak with large glass buttons, resembling therefore, it was said by some, his psychiatric patients.

The man
Flechsig had a cyclothymic personality, almost bordering on a true manic-depressive state. Years of intense activity – when he worked ceaselessly and poured out ideas, encouragement and inspiration – alternated with years when he was irritable, arrogant, intolerant, and tyrannical and suffered from severe depression. Nevertheless his students and followers venerated him, and Richard Arwed Pfeifer (1877-1957) records that «his guidance was full of spirit and during discussion of various problems his whole youth was awakened.» He was devoted to his work and had little time for anything else until late in life. He liked to mix with aristocrats, monarchs, and politicians, in part because of their interest in his work and in part because of his need for extramural research funds.

At the age of seventy-four, Flechsig retired from his official duties at the University of Leipzig where he had spent more than fifty years. Oskar Vogt relates that he had grown so accustomed to his cottage in the garden behind the clinic, forgetting that it belonged to the University, that he refused to budge from it and had to be evicted. Nonetheless he continued to work as "ein Forscher aus Leidenschaft", stimulating those around him to the very end.

Flechsig married Auguste Hauff in 1870. After her death in 1922 he married Irene Colditz, who was thirty years younger than he; she was able to interest him in social events during the closing years of his life.

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