Chapter 43 The development of neurology in the Low Countries

Abstract

This chapter reviews the development of neurology in the Low Countries. The development of the specialty of neurology in Belgium and the Netherlands is discussed. In the northern Netherlands, neurology has strong roots in psychiatry. In Belgium, on the contrary, neurology for a long time stayed within the realm of internal medicine. In the northern Netherlands, psychiatrists in the 19th and early 20th centuries produced many publications on neurological subjects, whereas physicians in internal medicine treated acute neurological disorders such as cerebrovascular disease, poliomyelitis, and meningitis from the beginning. The number of patients suffering from behavioral disturbances and movement disorders that primarily came to the attention of psychiatrists gradually declined pari passu with better understanding of the nature of the underlying disturbance of the central nervous system. In Belgium, the specialty of surgery expanded earlier and farther than elsewhere in the Low Countries. Several factors played a role. First, during the French and Napoleonic times in the southern Netherlands, no physicians and only military surgeons were trained for the campaigns and battles of the French armies. The early development of neurosurgery in Belgium originated mainly in the surgical departments, with neurologists participating, while in the Netherlands, neurosurgery was first performed in the neurological departments of Utrecht and Amsterdam. In both countries, neurosurgery and neurology were closely linked.