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|archived= |quote=There is also increasing evidence that neonatal cortical function is far greater than previously thought and some suggestion that short-term behavior may be affected by prior painful stimuli. |pubmedID= |pubmedCID= |DOI= |doi=3627897
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→Conclusion: Improve citation.
[[File:Paul_flechsig_perscheid_1906.jpg|thumb|Flechsig in 1906]]'''{{FULLPAGENAME}}''' ({{LifeData|birth=1847-06-29|birthplace=Zwickau|birthcountry=Kingdom of Saxony|death=1929-07-22|deathplace=Leipzig|deathcountry=Germany}}) was an eminent nineteenth-century German neuroanatomist, psychiatrist and neuropathologist.
Professor Flechsig had an interest in myelinogenesis — the development of the myelin sheaths for nerves.<ref name="myelogenesis2024">{{REFweb
|url=https://en.wikipedia.org/wiki/Myelinogenesis
|title=Myelinogenesis
|publisher=Wikipedia
|accessdate=2024-01-07
}}</ref> The myelin acts as an insulator to allow the electrical impulses to travel through the nerves.<ref name="myelogenesis2024" />
Flechsig (1872) observed that the myelin sheath is not yet formed in newborn babies,<ref>{{REFjournal
|last=Flechsig
|init=PPE |author-link= |last2= |init2= |author2-link=Paul Emil Flechsig
|url=https://zenodo.org/records/1428540
|title=Developmental (Myelogenetic) Localisation of the Cerebral Cortex in the Human Subject
|journal=Lancet
|date=1901-10-19
|pages=1027-9
|accessdate=2204-01-07}}</ref> which he reported in 1876.<ref>{{REFbook |last=Flechsig |first=Paul Emil |init=PE |author-link=Paul Emil Flechsig |year=1876 |title=Die Leitungsbahnen im Gehirn und Rückenmark des Menschen auf Grund entwicklungsgeschichtlicher Untersuchungen |trans-title=The pathways in the human brain and spinal cord based on developmental studies |language=German |url=https://ia903406.us.archive.org/9/items/bub_gb_0UxvjrYgAJQC/bub_gb_0UxvjrYgAJQC.pdf |location=Leipzig |accessdate=2024-01-12 |format=PDF }}</ref> so Unfortunately, he came to the unfounded conclusion that the newborn cannot feel [[pain]].<ref>{{REFjournal
|last=Cope
|init=DK
|author-link=
|url=
|title=Neonatal pain: The evolution of an idea.
|journal=The American Association of Anesthesiologists Newsletter
|date=1998-09
|accessdate=2024-01-06
}}</ref> So great was his reputation and influence that his views were accepted without question, even though empirical studies had not been carried out. Surgical As a result, surgical operations were have been carried out on infants without pain medicationfor more than 100 years. {{PUB}}* {{REFbook |last=Flechsig |first=Paul Emil |init=PE |author-link=Paul Emil Flechsig |year=1927 |title=Meine Myelogenetische Hirnlehre: Mit Biographischer Einleitung |trans-title=My myelogenetic brain theory: With a biographical introduction |language=German |url=https://books.google.com/books?hl=en&lr=&id=FiyEBwAAQBAJ&oi=fnd&pg=PA1&dq=Paul+Emil+Flechsig&ots=vHHjZ2xluC&sig=TDbWc5mxl1zJdy-jTstO48oznrQ#v=onepage&q=Paul%20Emil%20Flechsig&f=false |scope= |ISBN=978-3-662-32788-3 |accessdate=2024-01-08 }} Professor Flechsig published numerous books, articles, and other publications in German on a wide variety of subjects. In accordance with IntactiWiki policy they will not be listed here.
==Flechsig's views are disproved==
It was not until a century later that medical science started to question his views. Talbert et al. (1976) measured the rise in cortisol and cortisone in [[circumcised]] infants and found an increase in "stress".<ref>{{REFjournal
|last=Talbert
|first=
|etal=no
|title=Adrenal Cortical Response to Circumcision in the Neonate
|journal=Obstet Gynecol
|date=1976
|pubmedCID=
|accessdate=2024-01-07
}}</ref> Gunnar et al. (1981) also examined serum cortisol and behavior after neonatal [[circumcision]]. They reported "striking increases in serum cortisol concentrations" after unanesthetized non-therapeutic [[circumcision]].<ref name="gunnar1981">{{REFjournal
|last=Gunnar
|first=
|etal=no
|title=The effects of circumcision on serum cortisol and behavior
|journal=Psychoneuroendocrinology
|location=
[[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) published a magisterial article in the ''New England Journal of Medicine'' that conclusively settled the issue. The authors stated:
<blockquote>
Numerous lines of evidence suggest that even in the human fetus, pain pathways as well as cortical and subcortical centers necessary for pain perception are well developed late in gestation, and the neurochemical systems now known to be associated with pain transmission and modulation are intact and functional. Physiologic responses to painful stimuli have been well documented in neonates of various gestational ages and are reflected in hormonal, metabolic, and cardiorespiratory changes similar to but greater than those observed in adult subjects. Other responses in newborn infants are suggestive of integrated emotional and behavioral responses to pain and are retained in memory long enough to modify subsequent behavior patterns.<ref>{{REFjournal
==Conclusion==
Flechsig's error condemned millions of infant girls and boys undergoing surgery to acute [[pain]], [[trauma]] , and [[shock]] for more than over a century and that practice is still persists ongoing today. Open For example, open heart surgery on infants was done without anesthesia until 1987.<ref>{{REFweb
|url=https://www.newsweek.com/when-doctors-start-using-anesthesia-babies-medics-thought-they-couldnt-feel-pain-1625350
|title=When Did Doctors Start Using Anesthesia on Babies? Medics Thought They Couldn't Feel Pain
|last=Lea
|first=Robert
|init=R
|publisher=Newsweek
|date=2021-09-02
}}</ref> The [[AAP]] belatedly acknowledged the need for anesthesia in 1987.<ref>{{REFjournal
|last=Committee on Fetus and Newborn
|last2=Committee on Drugs
|last3=Section on Anesthesiology
|last4=Section on Surgery
|etal=no
|title=Neonatal anesthesia
|journal=Pediatrics
|date=1987
|volume=80
|issue=3
|page=446
|url=https://www.cirp.org/library/pain/aap/
|accessdate=2024-01-07
}}</ref> Boys may have suffered more than girls because of the practice of non-therapeutic neonatal [[circumcision]], including the after effects of [[PTSD]] and behavior changes.<ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> and [[PTSD]].
{{LINKS}}
* {{REFweb
|title=Paul Flechsig
|publisher=Wikipedia
|accessdate=2024-01-07
}}
|url=https://www.uniklinikum-leipzig.de/einrichtungen/pfi
|title=Paul-Flechsig-Institut – Zentrum für Neuropathologie und Hirnforschung
|publisher=University of Leipzig
|accessdate=2024-01-07
}}
|url=http://www.whonamedit.com/doctor.cfm/3146.html
|title=Paul Flechsig
|publisher=Who Named It
|accessdate=2024-01-07
}}
{{REF}}
{{DEFAULTSORT:Flechsig, Paul Emil}}
[[Category:Person]]
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[[Category:Physician]]
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[[Category:Pain]]
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[[Category:Germany]]