At the early age of 26, Wernicke published the monograph that won him lasting fame. Its title was Der aphasische Symtomencomplex (The Aphasic Syndrome) and it appeared in 1874. The syndrome described by Wernicke was quite different from — and in many ways much more interesting than — that described a few years earlier by Paul Broca and which had become known as motor aphasia. Whereas the latter involved essentially a loss or defect in the expression of speech, the form of aphasia described by Wernicke was marked by a severe defect in the understanding of speech, and correspondingly became known as sensory aphasia. This term, however, is by no means totally appropriate as expressive disorders undoubtedly occur in Wernicke's aphasia, but they are disorders in word usage and word choice rather than disorders in the articulation or expression of speech. In severe cases, indeed, the patient's speech approximates to incomprehensible jargon. In such cases, it is the phonemic structure of language rather than its formulation and expression that is at fault.
Wernicke was further able to demonstrate that there are important differences between these two forms of aphasia, not only in clinical features but also in the site of the responsible lesions; whereas in Broca's aphasia the lesion as a rule involves the posterior portion of the left frontal lobe, Wernicke's aphasia is typically localized in the left temporal lobe, though bilateral lesions are not uncommon in cases in which the receptive loss is severe.
Wernicke's interest in aphasia was far from limited to its phenomenology and localization. He made a most creditable attempt to tie together anatomical and functional findings in order to produce a general theory of language and its disorders. This approach was well represented in the fact that his monograph bore the subtitle 'A psychological study on an anatomical basis'. By bringing together the cortical localizations of the two major speech areas, namely those of Broca and himself, Wernicke evolved what we should no doubt today describe as a flow diagram for language in the brain, and his theory provided a major stimulus to the discovery and understanding of new syndromes, for example his pupil Hugo Liepmann's work on apraxia and its relation to lesions of the corpus callosum.
Although the type of thinking exemplified by Wernicke and his pupils, with its strong emphasis on brain centres and the connections between them, went out of fashion between the two world wars, in modified form it has once again become a foundation stone in the work of many present-day investigators. (See also language areas in the brain; language: neuropsychology.)
Apart from his papers on aphasia, Wernicke wrote on a variety of neurological issues, and is still remembered for his description of a form of encephalopathy resulting from thiamine deficiency (common among alcoholics), which bears his name. He also wrote a textbook entitled Foundations of Psychiatry, which he himself regarded as his most important work, though it failed to achieve the popularity of Emil Kraepelin's textbook.
(Published 1987)
— Norman Geschwind/O. L. Zangwill
- Bibliography
- Eggert, G. H. (1977). Wernicke's Works on Aphasia: A Sourcebook and Review.
- Wernicke, C. (1895). Gesommelte Aufsätze und kritische Referate zur Pathologie des Nervensystems.
