Carl Wernicke

Biography

• Born May 15, 1848 in Tarnowitz, Silesia (Prussia)
• 1870 – Medical degree, University of Breslau; served in Franco-Prussian War
• 1871–1874 – Worked with Theodor Meynert in Vienna
• 1874 – Published Der aphasische Symptomencomplex, identifying receptive aphasia (Wernicke’s aphasia)
• 1876 – First assistant under Karl Westphal (1833–1890) at the Berlin Charité practising neuropsychiatry
• 1885 – Appointed Professor at University of Breslau
• 1890 – Published Lehrbuch der Gehirnkrankheiten (Textbook of Brain Diseases)
• 1897 – Founded the journal Monatsschrift für Psychiatrie und Neurologie with Theodor Ziehen (1862-1950)
• 1904 – Moved to Chair of Psychiatry at University of Halle
• Died June 15, 1905 following a bicycle accident in Thüringerwald, aged 57

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Medical Eponyms

Wernicke’s area

Wernicke identified the posterior superior temporal gyrus of the dominant hemisphere as essential for language comprehension. Damage to this region results in fluent but nonsensical speech, now termed Wernicke’s aphasia.

Definition: Posterior part of the superior temporal gyrus, left hemisphere
Function: Comprehension of spoken and written language
Damage: Results in fluent aphasia with impaired understanding

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Wernicke’s aphasia (1874)

Wernicke’s aphasia is the classical “receptive aphasia”, in distinction to the “expressive aphasia” of Broca, although this terminology is problematic since there are concurrent “expressive” problems in Wernicke’s aphasia (and “receptive” problems in Broca’s aphasia).

Symptoms: Fluent speech, paraphasias, neologisms, poor comprehension
Contrast: Differs from Broca’s aphasia (non-fluent, preserved comprehension)

• Wernicke C. Der aphasische Symptomencomplex: eine psychologische Studie auf anatomischer Basis [The aphasic symptom complex: a psychological study from an anatomical basis] 1874

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Wernicke encephalopathy (Wernicke syndrome) (1881)

A neurologic syndrome caused by thiamine deficiency (often associated with chronic alcoholism), presenting with ophthalmoplegia, ataxia, and confusion. He described the syndrome post-mortem in 1881.

Constellation of nystagmus, ophthalmoplegia, cerebellar signs, neuropathy, and inability to record new information (“loss of recent memory”) as a result of thiamine deficiency (secondary to alcoholism and/or starvation).

Anatomical changes include bilateral pinhead-sized haemorrhages in the mamillary bodies and in the periventricular and periaqueductal grey matter. [aka Wernicke disease; Wernicke syndrome; polioencephalitis hemorrhagica superior; Meynert amentia, Gayet disease, Gayet-Wernicke syndrome]

Triad: Ophthalmoplegia, ataxia, mental confusion
Etiology: Thiamine (B1) deficiency
Legacy: Forms part of the Wernicke–Korsakoff syndrome

• Wernicke C. Die acute, hämorrhagische Polioencephalitis superior. In: Lehrbuch der Gehirnkrankheiten. 1881; II(47): 229-242

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Wernicke hemianopic pupil (1883)

Absence of the pupillary light reflex when light is shone into the blind half of the retina in homonymous hemianopia.
Localizing Value: Indicates a lesion in the optic tract anterior to where pupillary fibers branch off to the pretectal area.
Clinical Insight: If the lesion is posterior to this point, the reflex is preserved despite visual loss.

• Wernicke C. Über hemiopische Pupillenreaktion. Fortschritte der Medizin, 1883; 1: 49–53

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Wernicke’s cramp (1904)

A rare form of painful local muscle cramp precipitated by precipitated by anxiety or fear. Described by Wernicke in a lecture-demonstration in 1904

• Wernicke C. Ein Fall von Crampus-Neurose. Berliner klinische Wochenschrift, 1904; 41: 1121-1124.

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Connectionist Theory

Wernicke proposed that complex cognitive functions arise from the dynamic interaction of localized brain regions via white matter tracts — pioneering the connectionist model.

Major Publications

• Wernicke C. Lehrbuch der Gehirnkrankheiten. 1881. [Band II, Band III]
• Duchenne GB, Wernicke C. Physiologie der Bewegungen nach electrischen Versuchen und klinischen Beobachtungen. 1885
• Wernicke K. Ueber hemiopische Pupillenreaction. Fortschr Med 1883;1:49–53
• Wernicke C. Gesammelte Aufsätze und kritische Referate zur Pathologie des Nervensystems. 1893
• Wernicke C. Outline of psychiatry in clinical lectures [24 lecture reprints]. The alienist and neurologist. 1899; XX (2-4). 1900; XXI(1-2). 1902; XXIII(2-4). 1903; XXIV(1-2).
• Wernicke C. Grundriss der Psychiatrie in klinischen Vorlesungen. 1900

References

Biography

• Siemerling E. Carl Wernicke. Archiv für Psychiatrie und Nervenkrankheiten, 1905; 40(3): 1016-1019.
• Pillmann F. Carl Wernicke (1848-1905). J Neurol. 2003 Nov;250(11):1390-1
• Braun B. Carl Wernicke (1848–1905) und die „Wernicke-Kleist-Leonhard Schule“. Beziehungen zur „Erlanger Schule“ der Psychiatrie [Carl Wernicke (1848-1905) and the “Wernicke-Kleist-Leonhard school”. Connections to “Erlangen School” of psychiatry]. Fortschr Neurol Psychiatr. 2020 Oct;88(10):652-660. 
• Fresquet JL. Karl Wernicke (1848-1904). Historia de la Medicina
• Carl Wernicke (1848-1905). BNF
• Name: Carl vs Karl. Google ngram

Eponymous terms

• Binder JR. The Wernicke area: Modern evidence and a reinterpretation. Neurology. 2015 Dec 15;85(24):2170-5.
• Javed K, Reddy V, Das JM, Wroten M. Neuroanatomy, Wernicke Area. 2023 Jul 24. In: StatPearls [Internet].