- Wernicke's aphasia
- Wernicke's centre
- Wernicke's cramp
- Wernicke's dementia
- Wernicke's disease
- Wernicke's pupillary reaction
- Wernicke-Korsakoff disease
- Wernicke-Mann hemiplegia
Biography of Carl Wernicke
Karl Wernicke was born in the small town of Tarnowitz in Upper Silesia, which was then a part of Prussia, where his father was a civil servant. He studied medicine at the University of Breslau (Wroclaw), mainly as a student of Heinrich Neumann (1814-1884) at the Allerheiligenhospital. He completed his basic medical education being conferred doctor of medicine at Breslau in 1870, before undergoing specialist training in psychiatry as Neumann’s assistant. While with Neumann he had the opportunity to spend six months in Vienna with Theodor Hermann Meynert (1833-1892). Meynert influenced him greatly and Meynert was virtually the only name Wernicke mentioned in his lectures and only his portrait hung on the wall in Wernicke's clinic. He was habilitated for psychiatry at Breslau in 1875, at Berlin in 1876. From 1876 to 1878 he was 1st assistant in the clinic for psychiatry and nervous diseases under Karl Westphal (1833-1890) at the Berlin Charité. In 1878 established a private neuropsychiatric practice in Berlin, practicing until 1885, when he became associate professor of neurology and psychiatry at Breslau. He obtained the chair at Breslau in 1890 and in 1904 went to the same tenure at Halle. He died a year later from injuries received in an accident while riding a bicycle in the Thuringian forest.
In 1877 he observed that lesions that were relatively limited to the 6th nucleus resulted in paralysis of conjugate glaze to the side of the lesion and he was the first to postulate a centre for conjugate gaze in the pontal tegmentum. This work made him internationally famous.
Wernicke was only 26 years of age when he, in 1874, published "Der aphasische Symptomenkompleks" in which he first described sensory aphasia, localised at the temporal lobes, as well as alexia and agraphia. In his book Wernicke tried to relate the various aphasias to impaired psychic processes in different regions of the brain. He also demonstrated the dominance of one hemisphere in brain function in these studies.
Between 1881 and 1883 Wernicke published his three-volume Lehrbuch der Gehirnkrankheiten. This comprehensive survey included a number of original anatomical, pathological, and clinical observations, such as the subsequently confirmed postulation of the symptoms resulting from occlusion of the posterior inferior cerebellar artery. Wernicke’s original description of encephalopathy was in a case of sulphuric acid ingestion. He was aware of a toxic factor being important in its aetiology, but he did not realise that this was nutritional.
Wernicke aimed at a natural system for the classification of mental disorders, chiefly based on the anatomy and pathology of the nervous system. His pattern of thought was based on the concept that psychiatric diseases were caused by disturbances of the associative system. It was, in other words, a sort of localisation doctrine. Wernicke did not believe in specific psychiatric disease entities, and he was an ardent adversary of Emil Kraepelin (1856-1926), considering the latter's classification as not being sufficiently scientific. The concepts developed by Wernicke in his "Grundriss der Psychiatrie" later occasioned Karl Jaspers to term Wernicke a "brain mythologist". But then - who reads Jaspers these days?
In his later work Wernicke remained concerned both with brain anatomy and pathology and with clinical neuropsychiatry. With four collaborators he published the three-part Atlas des Gehirns between 1897 and 1903. His clinical studies are contained principally in Grundriss der Psychiatrie in klinischen Vorlesungen (1894; 2nd. Edition, 1906) and in Krankenvorstellungen aus der psychiatrischen Klinik in Breslau (1899-1900). Wernicke also continued to write on aphasia; his last summary of this “symptom complex” appeared in 1903 in the multivolume system of medicine edited by Ernst Viktor von Leyden (1832-1910) and Felix Klemperer (1866-1932), Die deutsche Klinik am Eingang des 20. Jahrhunderts.
Wernicke was a taciturn and reserved man, not easy to deal with. He was close to his older co-workers, particularly Ernst Storch, whom he held i great esteem. He had not much contact with his younger pupils, but his way of examining patients and his demonstrations were so lucid and stimulating that those who had the good fortune to attend his clinics were deeply influenced in their further consideration of neurological and psychiatric problems. His influence can be seen in the work of a whole generation of German psychiatrists.
With Georg Theodor Ziehen (1862-1950) he founded the journal Monatsschrift für Psychiatrie und Neurologie in 1897.
- Der aphasische Symptomencomplex. Eine psychologische Studie auf anatomischer Basis. Breslau, 1874.
- Erkrankungen der inneren Kapsel. Ein Beitrag zur Diagnose der Herderkrankungen. Breslau, 1875.
- Das Urwindungssystem des menschlichen Gehirns.
Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1876, 6: 298-326.
- Ueber das Bewusstsein.
Allgemeine Zeitschrift für Psychiatrie, Berlin, 1879, 35: 420-431.
- Ueber den wissenschaftlichen Standpunkt in der Psychiatrie.
Kassel, 1880. Lecture at the 53rd Naturforscher-Versammlung zu Danzig.
- Lehrbuch der Gehirnkrankheiten für Aerzte und Studirende.
3 volumes, Kassel und Berlin, Fischer, 1881-1883.
- Gesammelte Abhandlungen.
Arbeiten aus der psychiatrischen Klinik in Breslau Heft 1 und 2.
- Die neueren Arbeiten über Aphasia.
Fortschritte der Medizin, Berlin, 1885, 3: 824-830; and 1886, 4: 371-377, 463-482.
- Zweck und Ziel der psychiatrischen Kliniken.
Klinisches Jahrbuch, Berlin, 1889, 1: 218-223.
- Gesammelte Aufsätze und kritische Referate zur Pathologie des Nervensystems. Berlin, 1893.
- Atlas des Gehirns.
2 parts, Breslau, Schletter, 1897 and 1903. Published with support from the Königliche Akademie der Wissenschaften Abt. 1.
- Grundriss der Psychiatrie in klinischen Vorlesungen.
Leipzig, G. Thieme, 1894-1900; 2nd edition, 1906; translated into English.
- Krankenvorstellungen aus der psychiatrischen Klinik in Breslau.
Breslau, Schletter, 1899-1900.
Also in Psychiatrische Abhandlungen,. Heft 10, pp 13-14.
- Über die Klassifikation der Psychosen. Breslau, 1899.
- Hugo Liepmann (1863-1925) in Theodor Kirchhoff, editor, Deutsche Irrenärzte, Berlin 1924, 2: 238.
- Kurt Goldstein in Webb Haymaker, editor, Founders of Neurology. Springfield, Illinois, 1953: 406-409.
- Karl Kleist, in Kurt Kolle, editor: Grosse Nervenärzte, II. Stuttgart, 1959: 106-128. On Wernicke's work
- P. Schröder:
Die Lehren Wernickes in ihrer Bedeutung für die heutige Psychiatrie.
Zeitschrift für die gesamte Neurologie und Psychiatrie, Berlin, 1939, 165: 38-47.
- O. M. Marx:
Nineteenth-Century Medical Psychology. Theoretical Problems in the Work of Griesinger, Meynert and Wernicke.
Isis, 1970, 61: 355-370.
- Erwin H. Ackerkkencht:
A Short History of Psychiatry.
2nd edition, New York, 1968: 60-71.
On nineteenth-century German neuropsychiatry.
- Lawrence C. McHenry Jr.:
Garrison’s History of Neurology.
Springfield, Illinois, 1969: 358-364.
With several references to Wernicke’s work. Obituaries:
- Ernst Siemerling, in Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1905, 40: 1016-1019.
- Georg Theodor Ziehen, in Monatsschrift für Psychiatrie und Neurologie, 1905, 18: 1-4.