Carl Wernicke and the concept of 'elementary symptom'

Abstract

Examination of contemporary medical conference papers reveal that the German clinician, Carl Wernicke, conducted a unique on-going inquiry into psychiatric nosology. Wernicke was searching for what he called the 'elementary symptoms' of mental disorder, or, in other words, the single psychopathological feature, from which all others arose. From 1892 onwards, he postulated a variety of such 'elementary' symptoms. Wernicke's theory makes sense in terms of such categories as 'anxiety-psychosis' and 'hallucinosis'. His work contrasts with that of Kraepelin and also with modern diagnostic criteria. Neither Wernicke nor his followers pursued the theory of 'elementary symptoms', but an examination of his work sheds light on modern ideas about diagnosis.

Get full access to this article

View all access options for this article.

References

American Psychiatric Association , Diagnostic and Statistical Manual of Mental Disorders, 4th edn (Washington, DC: American Psychiatric Association, 1994).

Karl Bonhoeffer , 'Die Stellung Wernicke's in der modernen Psychiatrie ', Berliner klinische Wochenschrift, xlii (1905), 927-8.

E. Kraepelin , Psychiatrie, ein kurzes Lehrbuch für Studirende und Aerzte ( Leipzig: Abel, 1893 ).

Mario Lanczik and G. Keil , 'Carl Wernicke's localization theory and its significance for the development of scientific psychiatry', History of Psychiatry, ii ( 1991 ), 171-80.

K. Leonhard , Aufteilung der endogenen Psychosen (Berlin: Akademie, 1986).

Uwe Henrik Peters , 'Diagnostische Bilder, Phänomene und Kriterien in der Psychiatrie - eine Gegenüberstellung', Fortschritte der Neurologie Psychiatrie, lxii ( 1994), 137-6.

U.H. Peters , Zur Psychopathologie der Angstpsychosen. In: H. Heinrich and B. Bogerts , Angstsyndrome (Stuttgart, New York: Schattauer, 1988).

Carl Wernicke , discussion at the 59th convention of the Verein ostdeutscher Irrenärzte, Leubus, 19 June 1892, Allgemeine Zeitschrift für Psychiatne und psychisch-genchtliche Medizin (1893), 486-9.

C. Wernicke , Grundriss der Psychiatrie in klinischen Vorlesungen. Teil I und II ( Leipzig: Thieme, 1894, 1896).

10.

Carl Wernicke , description of a case, 60th convention of the Verein, Breslau, 26 November 1892, Allgemeine Zeitschrift für Psychiatne und psychisch-gerichtliche Medizin ( 1895a), 206.

11.

Carl Wernicke , remarks at the 62nd meeting of the Verein, Sorau, 25 June 1893, Allgemeine Zeitschrift für Psychiatrie und psychisch-gerichtliche Medizin (1895b), 207.

12.

Carl Wernicke , description of a case, 66th convention of the Verein, 24 November 1894, Allgemeine Zeitschrift für Psychiatrie und psychisch-gerichtliche Medizin (1895c), 1016-21.

13.

C. Wernicke , Krankenvorstellungen aus der psychiatnschen Klinik in Breslau. Heft I und II ( Breslau: Schletter'sche Buchhandlung, 1899,1900).

14.

World Health Organization , The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines (Geneva: World Health Organization, 1992).