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