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Carl Wernicke (1848–1905) J Neurol (2003) 250:1390–1391 DOI 10.1007/s00415-003-0250-x PIONEERS IN NEUROLOGY Frank Pillmann Carl Wernicke (1848–1905) Carl Wernicke was born into mod- [2]. The success of his book created est circumstances. He studied med- an opportunity for Wernicke to join icine in Breslau, now Wroclaw the department of psychiatry and (Poland). In 1871, Wernicke entered nervous diseases of the Berlin Char- the municipal “Allerheiligen” Hos- ité Hospital under Karl Westphal. In pital of Breslau where he served in 1878, Wernicke’s academic career the psychiatric department as assis- was severely disturbed as he entered tant to Heinrich Neumann, extraor- into conflict with the hospital ad- dinary professor of Psychiatry at ministration. He lost Westphal’s Breslau University. He was excited support and had to retreat to private by the fascinating findings of the neurological practice in the follow- up-and-coming neurosciences; for ing years. example, the linking of disordered During this time,Wernicke’s pro- language to the third anterior gyrus ductivity did not cease. He pub- by Paul Broca in 1865 and the dis- lished a variety of neurological pa- covery of the excitability of the cor- pers, including a description of the tex by Hitzig and Fritsch in 1870 [4]. hemianopic pupillary response and Wernicke managed to obtain a leave wrote the well-received “Textbook of absence to visit Theodor Meynert of brain diseases” [8]. It was this in Vienna,who had just begun to es- textbook that contained the de- Carl Wernicke (1848–1905) tablish his fame as the principal au- scription of “Pseudoencephalitic thority in neuropsychiatry. haemorrhagica superior” based on Within a few months of return- the examination of 3 cases – later ing to Breslau, Wernicke designed called Wernicke’s encephalopathy. an extended theory of aphasia. He He pioneered sterile ventricular collected a number of supporting puncture and external CSF drainage cases on the wards of the Allerheili- for the treatment of hydrocephalus Received: 5 August 2003 gen Hospital and, in 1874, he pub- [1] and,in 1882,he reported the first Accepted: 6 August 2003 lished a monograph of 72 pages: case of surgical treatment of a pa- “The Aphasia Symptom Complex” tient with a brain abscess [10]. [7]. Virtually overnight, Wernicke When Neumann died, Wernicke ౧ Dr. med. F.Pillmann ( ) assumed a leading role in aphasia succeeded him as Head of the Bres- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie research. The important point was lau Psychiatric Hospital and as Pro- Martin-Luther-Universität not the identification of just another fessor of Psychiatry in 1885. Soon, Halle-Wittenberg cerebral localisation. Rather, it was he set up a laboratory and began to 06097 Halle, Germany Wernicke’s general approach of ex- fight for the funding of a neurologi- Tel.: +49-345/557-4560 Fax. +49-345/557-3500 plaining higher cognitive functions cal outpatient clinic, which was fi- E-Mail: by the interaction of spatially dis- nally opened in 1889 [3]. The assis- JON 1250 [email protected] tributed, but interconnected centres tant in charge of the outpatient 1391 clinic was Ludwig Mann. In 1889, continuously set the Breslau author- References Wernicke had characterised the ities at odds against him. In the typical posture and gait in cerebral course of this conflict, Wernicke 1. Aschoff A, Kremer P,Hashemi B, hemiplegia in a short article [9], but first had to give up his position as Kunze S (1999) The scientific history of hydrocephalus and its treatment. he left it to Mann to publish an in- director of the clinic and later he Neurosurg Rev 22:67–93 depth analysis of what is now was denied the right to use patients 2. Graves RE (1997) The legacy of the known as the “Wernicke-Mann” for teaching purposes. Wernicke-Lichtheim model. J Hist type of hemiplegia in 1895 [5]. In Relief came in 1904 when Wer- Neurosci 6:3–20 3. Kiejna A, Wojtowicz M (1999) Zur the 1890s, Wernicke embarked on a nicke was offered the chair of psy- Geschichte der Psychiatrischen und project to design a photographic at- chiatry and nervous diseases at Nervenklinik in Breslau. Stiftung zur las of stained brain slices. For years, Halle University. Within the subse- Förderung der psychischen Gesund- he and his assistants devoted a great quent 14 months,Wernicke initiated heit, Wroclaw 4. Lanczik M, Keil G (1991) Carl Wer- deal of time and effort handling the the use of brain puncture for the di- nicke’s localization theory and its immense technical problems of pro- agnosis and localisation of brain tu- significance for the development of ducing, staining and photographi- mours and,thus,continued a neuro- scientific psychiatry. Hist Psychiatry cally reproducing whole-brain surgical tradition started by his 2:171–180 slices. In 1903, the last of three vol- predecessor Eduard Hitzig. He also 5. Mann L (1896) Klinische und anatomische Beiträge zur Lehre von umes was finally completed. recruited assistants for histological der spinalen Hemiplegie. Dtsch Z In Breslau (and later in Halle), and pathophysiological studies and Nervenheilk 10:1–66 Wernicke had many important initiated psychopathological re- 6. Pillmann F,Marneros A (2001) Carl pupils who later made their careers search [6]. Tragically, these activi- Wernicke – Wirkung und Nach- wirkung. Fortschr Neurol Psychiatr in neurology or psychiatry. The list ties came to an abrupt end when 69:488–494 includes Otfried Foerster, Karl Bon- Wernicke had a severe accident on a 7. Wernicke C (1874) Der aphasische hoeffer, Hugo Liepmann, Karl Heil- bicycle trip into the forest of Symptomencomplex. Cohn & Weigert, bronner and Karl Kleist. During Thuringia. He died the next day on Breslau 8. Wernicke C (1881–1883) Lehrbuch der these years, Wernicke became in- 15 June 1905 at the age of 58. Gehirnkrankheiten für Ärzte und creasingly devoted to the concept of Driven by a fervent “need for Studierende,Vol. 1–3. Cassel placing psychiatry on a neurobio- causality” and with talents for both 9. Wernicke C (1889) Zur Kenntnis der logical foundation.Towards this end conceptualisation and observation, cerebralen Hemiplegie. Berl klin he published a textbook, Outline of Wernicke was among the most out- Wschr 26:969–970 10. Wernicke C, Hahn E (1882) Idiopathi- Psychiatry, in successive parts from standing and influential neuro-psy- scher Abscess des Occipitallappens, 1894 to 1900. chiatrists of the 19th Century. In durch Trepanation entleert. Archiv für In the handling of the political addition to his numerous contribu- pathologische Anatomie und Physiolo- affairs of the clinic Wernicke was tions to both clinical neurology and gie und für klinische Medicin (Vir- less fortunate. There were long- psychiatry, his network view of chows Archiv) 87:335–344 standing conflicts of interest be- brain function (in some ways, be- tween the municipal authorities and fore his time) foreshadowed today’s the royal university.Wernicke,in his connectionist concepts. harsh and uncompromising way, .
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