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Constantin von Monakow

Constantin von Monakow

neuropathologist, neuropsychologist, philosopher

Neuropathologist, neuropsychologist, philosopher

(04.11.1853, Bobretsovo, Vologda Oblast - 19.10.1930, Zürich, Switzerland)


Constantin von Monakow was a Russian founder of the Switzerland Neurological Society who became one of the most influential neurologists of the 19th-20th century by pioneering the study of brain anatomy.

Constantin von Monakow was born in Bobretsovo (Vologda Oblast), Russia in 1853. He emigrated with his family to Germany and to Zürich, Switzerland, in 1866, where he earned a degree in medicine and neurology from the University of Zürich.

His ideas developed under a great influence of the Würzburg School of psychology.

The neurology of the time insisted on localization of psychological functions. Monakow, on the other hand, opposed to the theory, and developed an approach focused on the way in which falling out of psychological operations signified a zone of cerebral affection and not localization of psychical functions.

While still pursuing his medical studies, von Monakow came into personal contact with contemporary leading psychiatrists and neuroanatomists, and for a year was assistant to E.Hitzig (1838-1907), director of Burghölzli Psychiatric Clinic. Other decisive encounters were with W. Griesinger (1817-1875) and B. Gudden (1824-1886). Von Monakow laid the foundations of his work on neuropathology, neurophysiology and neuroanatomy during his year-long period as assistant in remote St Pirminsberg in the St Gall region. His monumental studies Gehirnpathologie (1897) and Die Lokalisation im Grosshirn und der Abbau der Funktionen durch kortikale Herde (1914) made Constantin von Monakow world famous, and Zürich became a world byword for the "Zürich Neurobiology school" or the "Monakow clinical-anatomical movement".

The localizing experiments of neuropsychiatrists such as Gudden and Hitzig interfered with mind-body separation. Comprehensive ideas were needed for their interpretation. In 1876 Monakow was initiated into brain research by Hitzig and by Gudden. Comprehensive ideas beyond the limits of the subject are typical of Monakow's works, starting from his dissertation where he discussed a parietal pain center. He created new terms. Monakow wanted to renew biology by exploring human rather than animal biology. Thus neurology and psychiatry became "neurobiology" and "neuropsychiatry".

Constantin von Monakow was a genius who in spite of political (emigration), family (break with his father), cultural (Russian mother tongue) difficulties and gross obstructions of his academic career achieved international recognition and praise for his very personal research.

Monakow belongs to the Neuropsychiatrists at the turn of the twentieth century who introduced highly efficient experimental methods into brain anatomy. We owe to him a number of discoveries and important details in the microscopical analysis of major brain pathways, to mention only the visual and auditory systems. Of special interest were his theory of brain localization and his original explanation of postapoplectic impairment of anatomically intact perifocal brain areas by diaschisis. Due to the close connection between basic research and clinical-pathological studies Monakow's Brain Research Institute in Zürich founded in 1891 became an attractive and well-regarded center of experimental neuroanatomy.

The Swiss Archives of Neurology and Psychiatry were established in 1917 by him. The main motivation was the growing need for an independent Swiss journal. While the papers were mainly Swiss authored, the Swiss Archives occupied a significant international position from the outset, as witness the regular contributions from well-known European neurologists.

Constantin von Monakow remained editor-in-chief until his death in 1930. Most of the famous (neuro-) scientific-philosophical works written during the last 15 years of his life were published in the Swiss Archives. The most outstanding volume was No 13 (1923), which contains 52 articles by the most renowned neurologists, psychiatrists, neuroanatomists and physiologists of that time as a festschrift for Constantin von Monakow's 70th birthday. Nearly all were papers with the more or less direct connection to von Monakow's work.

Until his death in 1930 his interest centered increasingly on ethical, philosophical and also religious issues, which he attempted to approach from a scientific, neurobiological perspective. Since the founding of Swiss Archives his contributions had been omnipresent and in number exceeded all the others.

In the history of Swiss neurology the founding of the Swiss Archives of Neurology and Psychiatry constituted a milestone: in the struggle for acceptance as an independent and officially recognized speciality neurology had taken a decisive step forward.

Monakow's open system of new ideas fully developed in 1928.

Monakow's ideas on cerebral and localization, particularly diaschisis and chronogenic localization, attracted little attention in the first years after publication. The late recognition of Monakow's work by most authors may also be due to the publication of his main work Die Lokalisation im Grosshirn und der Abbau der Funktionen durch kortikale Herde in 1914 when the First World War broke out, and to his intricate German style, defying attempts at translation into English, while Monakow's thoughts were too far ahead of his time, as his present success proves. A search covering in the last 20 years showed steadily increasing interest in diaschisis, and increasing citations of Monakow.

Constantin von Monakow presented his concept of diaschisis in his monograph Gehirnpathologie (2nd edition, 1905), and more extensively, in Die Lokalisation im Grosshirn und der Abbau der Funktionen durch kortikale Herde (1914). He defined diaschisis as a neurally transmitted, temporally and spatially restricted, functional disturbance in an area remote from the site of a primary brain lesion.

Over the last 15 years of his life Monakow shifted his emphasis to medical and philosophical concepts which were tightly intertwined.

Constantin von Monakow's main works:

  • Gehirnpathologie. Wien. 1896;
  • Die Lokalisation im Grosshirn und Abbau der Funktion durch kortikale Herde. Bergmann. Wiesbaden. 1914;
  • Schizophrenie und Plexus chorioidei (mit Kitabayashi). Schweizer Archiv. IV. S.363. 1919;
  • Die Syneidesis, das biologische Gewissen. Schweizer Archiv f. Neurologie und Psychiatrie. Bd. XX.1927;
  • Introduction biologique à l'étude de la neurology et de la psychopathologie. (C. de Monakow et R. Mourgue.) Alcan, Paris. 1928.

Towards the end of his fateful life Constantin von Monakow wrote an autobiography, "Vita mea", a "testament of my life, as it were".


Literature:
Gehirn und Gewissen. Psychobiologische Aufsätze von Constantin von Monakow. Mit einer biographischen Einführung von Mieczyslaw Minkowski. Morgarten Verlag, Conzett & Huber. Zurich. 1950; Schweizer Archiv f. Neurologie und Psychiatrie. Bd. 145. Verlag Bäbler. Bern. 1994; Schweizer Archiv f. Neurologie und Psychiatrie. Bd. 146. Verlag Bäbler. Bern. 1995; 100 Jahre Schweizerische Neurologische Gesellschaft. Herausgegeben von Claudio Bassetti und Marco Mumenthaler. Schwabe Verlag. Basel. 2008.

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