In the Lecture Theater
In the Lecture Theater
Reflex and Diagnosis in Carl Wernicke’s Krankenvorstellungen
Chapter two shows how the reshaping of the medical landscape after Bismarck's insurance reforms in 1883 opened up space for a challenge to the localization project. Though Carl Wernicke made his name as a neuropsychiatrist, he became increasingly skeptical of the claim that discrete brain centers were responsible for discrete functions. This chapter examines Wernicke's clinical work in Breslau. Wernicke originally constructed his clinical demonstrations (Krankenvorstellungen) following the principles of neuropsychiatric localization, but the variety and complexity of the patient material led him to sideline that project. Drawing instead on Duchenne de Boulogne's “anatomy of the living,” Wernicke began to present disease as the complex interaction of numerous nervous elements, and re-shifted the goals of his patient examination from the identification of a single lesion to the close description and interpretation of the patient's pathology. Wernicke's reflex practice showed itself to be resistant to the localization project for which it had been first deployed.
Keywords: Carl Wernicke, neuropsychiatry, clinical demonstrations, interpretation, breslau, anatomy of the living, somatopsyche
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