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Wernicke, Carl

Carl Wernicke

1848-1905
German neuroanatomist, pathologist, and psychiatrist who made fundamental discoveries about brain function.

Carl Wernicke was an influential member of the nineteenth-century German school of neuropsychiatry, which viewed all mental illnesses as resulting from defects in brain physiology. A practicing clinical neuropsychiatrist, Wernicke also made major discoveries in brain anatomy and pathology. He believed that abnormalities could be localized to specific regions of the cerebral cortex and thus could be used to determine the functions of these regions. Wernicke was one of the first to conceive of brain function as dependent on neural pathways that connected different regions of the brain, with each region contributing a relatively simple sensory-motor activity. At the time, most scientists conceived of the brain as functioning as a single organ. Wernicke also helped demonstrate dominance by either the right or left hemispheres of the cerebrum.

Wernicke was born in 1848 in the German town of Tarnowitz in Upper Silesia, in what is now Tarnowskie Gory, Poland. He earned his medical degree at the University of Breslau in 1870 and stayed on to work with Heinrich Neumann. Wernicke also spent six months studying with Theodor Meynert in Vienna. He earned his psychiatry qualification in 1875 and moved to Berlin, where he spent three years at the Charité Hospital as assistant to Karl Westphal, before starting a private practice in Berlin. With his mentors, Meynert and Westphal, Wernicke continued the neuropsychiatric tradition begun by Wilhelm Griesinger.

Describes Wernicke's aphasia

In 1873, Wernicke studied a patient who had suffered a stroke. Although the man was able to speak and his hearing was unimpaired, he could barely understand what was said to him. Nor could he understand written words. After he died, Wernicke found a lesion in the rear parietal/temporal region of the patient's left brain hemisphere. Wernicke concluded that this region, which is close to the auditory region of the brain, was involved in speech comprehension. Wernicke named the syndrome sensory aphasia , although now it is usually called Wernicke's aphasia. The affected region of the brain is known as Wernicke's area. The syndrome is sometimes called fluent aphasia since the victim is capable of speech; however words may be misused and the speech may be disordered or even without content. For this reason, scientists now believe that Wernicke's area may be involved in semantic processing, and it is sometimes called the receptive language area.

Wernicke published The Aphasic Symptom Complex in 1874 when he was 26. In this work, he developed many of his ideas about brain localization, and he related different types of aphasia to specific damaged regions of the brain. In contrast to Wernicke's aphasia, motor aphasia involves damage to the part of the brain known as Broca's area. With this syndrome, a patient understands speech, but cannot speak himself. Wernicke postulated that Broca's area and Wernicke's area were connected, and he predicted that damage to this connection would cause conduction aphasia, a syndrome wherein a patient could both speak and understand language, but would misuse words and could not repeat words. Wernicke's prediction turned out to be correct. Two of Wernicke's early aphasia papers were published in English in 1994.

Describes Wernicke's encephalopathy

The three volumes of Wernicke's comprehensive work, Textbook of Brain Disorders, appeared between 1881 and 1883. In this work, based on careful case studies, Wernicke attempted to relate all known neurological diseases to specific regions of the brain. The volumes included many of Wernicke's original observations on brain anatomy, pathology, and clinical manifestations. Based on his observations, he predicted the symptoms that would result from blockage of the posterior inferior cerebellar artery. Again, his hypothesis was later confirmed. In the second volume, Wernicke described for the first time a syndrome resulting from the ingestion of sulfuric acid, which caused specific mental and motor abnormalities and paralysis of muscles in the eyes. He called this syndrome acute hemorrhagic superior polioencephalitis. It now is called Wernicke's encephalopathy and is known to be caused by a nutritional thiamine deficiency.

In 1885, Wernicke became an associate professor of neurology and psychiatry at the University of Breslau. Five years later, he was awarded the department chair. Wernicke's clinical studies were published as Grundriss der Psychiatrie in klinischen Vorlesungen in 1894, with a second edition in 1906, and as Krankenvorstellungen aus der psychiatrischen Klinik in Breslau, in the years 1899-1900. Between 1897 and 1903, Wernicke published the three-part Atlas des Gehirns on neuroanatomy and pathology. His last work on aphasia appeared in 1903 and was translated into English in 1908.

Wernicke moved to the University of Halle in 1904 as a full professor. The following year, he died in Dörrberg im Geratal, Germany, of injuries suffered in a bicycling accident. Wernicke's research laid the foundation for the Wernicke-Geschwind model of language, which predicted the neural pathways involved in simple language tasks, such as reading a word aloud.

Margaret Alic

Further Reading

Bynum, William F. "Wernicke, Carl." In Dictionary of Scientific Biography, edited by Charles Coulston Gillispie. Vol.14. New York: Charles Scribner's Sons, 1970.

Lanczik, M., and G. Keil. "Carl Wernicke's Localization Theory and its Significance for the Development of Scientific Psychiatry." History of Psychiatry 2 (1991): 171-180.

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Wernicke, Carl

WERNICKE, CARL

(b. Tarnowitz [now Tarnowskie Gory], Upper Silesia, Germany [now Poland], 15 May 1848; d. Dörrberg im Geratal, Germany, 15 June 1905), neuropsychiatry, neuroanatomy.

After receiving a medical degree from the University of Breslau in 1870, Wernicke worked there under heinrich Neumann, qualifying in psychiatry in 1875. During this period he spent six months in Vienna with Theodor Meynert and from 1876 to 1878 was Karl Westphal’s assistant in the psychiatric and neurologic clinic at the Charité Hospital in Berlin. He then established a private neuropsychiatric practice in Berlin 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 Halle as full professor. He died a year later from injuries received in a bicycling accident.

Wernicke and his teachers Meynert and Westphal were part of the prominent tradition of nineteenth-century German neuropsychiatry stemming from Wilhelm Griesinger. These neuropsychiatrists made no distinction between diseases of the “mind” and diseases of the “brain.” As Griesinger had announced, “Mental diseases are affections of the brain.” Accordingly, Wernicke called his tirst major work, Der aphasische symptomencomplex (1874), a “pychological study on an anatomical basis.” In that monograph he developed his concept of cerebral localization, fully described sensory aphasia (Wernicke’s aphasia) for the first time, and located the lesion causing this condition in the posterior portion of the first left temporal convolution. Wernicke’s work also helped to establish firmly the notion of right and left cerebral dominance.

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 also first described (II, 229–242) a condition he called acute hemorrhagic superior polioencephalitis. Since renamed Wernicke’s encephalopathy, the syndrome is manifested by particular disturbances of consciousness and gait and paralysis of the eye muscles. Wernicke’s encephalopathy is frequently seen in chronic alcoholics, but it is also observed in other pathologic states. His original description was in case of sulfuric acid ingestion.

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 Vorlesungan (1894; 2nd ed., 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 von Leyden and Felix Klemperer, Die deutsche Klinik am Eingange des 20. Jahrunderts.

Wernick excelled in careful neuropsychiatric description of patents, but he contended that psychiatry was not sufficiently developed to demarcate specific psychiatric syndromes. This attitude brought him into conflict with Emil Kraepelin, the great psychiatric nosologist of the period.

BIBLIOGRAPHY

I. Original Works. Most of Wernicke’s major publications are mentioned in the text. Others include “Das Urwindungssystem des menchlichen Gehirns ,” in Archiv für Psychiatrie, 6 (1876), 298–326; “Ueber das Bewusstsein,” in Allgemeine Zeitschrift für Psychiatrie, 35 (1879), 420–431; and “Die neueren Arbeiten über Aphasie,” in Fortschritte der Medizin, 3 (1885), 824–830, and 4 (1886), 371–377, 463–482. Many of Wernicke’s collected papers on neuropathology were published as Gesammelte Aufsätze und kritische refer ate zur pathologie des Nervensystems (Berlin, 1893).

Wernicke’s 1903 summary of aphasia was translated into English in A. Church, ed., Dieases of the Nervous System (New York–London, 1908), 265–324.

II. Secondary Literature. The best general treatment of Wernicke is the article by Karl Kleist in Kur Kolle, ed., Grosse Nervenärzte, II (Stuttgart, 1959), 106–128. There are also short biographical essays by Kurt Goldstein in Webb Haymaker, ed., Founders of Neurology (Springfield, III., 1953), 406–409; and by H. Liepmann in Theodor Kirchhoff, ed., Deutsche Irrenärzte, II (Berlin, 1924). Other articles on Wernicke include H. Liepmann, “Über Wernickes Einfluss auf die klinische psychiatrie,” in Monatschrifte für Psychiatrie und Neurologie, 30 (1911), 1–37; P. Schröder, “Die Lehren Wernickes in ihrer Bedeutung für die heutige Psychiatrie,” in Zeitschrift für die gesamte Neurologie und Psychiatrie, 165 (1939), 38–47; and O. M. Marx, “nineteenth-Century Medical Psychology. Theoretical Problems in the Work of Griesinger, Meynert, and Wernicke,” in Isis, 61 (1970), 355–370.

There is a good concise treatment of nineteenth-century German neuropsychiatry in Erwin H. Ackerknecht, A Short History of Psychiatry (2nd ed., New York, 1968), 60–71; and several references to Wernicke’s work in Lawrence C. McHenry, Jr., Garrison’s History of Neurology(Springfield, III.,1969), 358–361.

William F. Bynum

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