The history of neurology in Wisconsin: the early years, 1907-1957.

he history of neurology in Wisconsin is best appreciated by reviewing the early development of clinical neurology in Europe in the late 19th century , the practice of medicine in Wisconsin in the beginning of the 20th century, and finally the beginning and growth of neurology in Wisconsin in the 20th century. Brief biographies of the pioneers of neuropsychiatry at the University of Wisconsin and the work they did give insight to the final separation of neurology from psychiatry. The Development of Neurology in Europe Modern medicine evolved in Europe in the late 18th and early 19th centuries. The techniques of clinical examination developed gradually, with Leopold Auenbrugger introducing percussion in 1761, and Rene Theophile Laennec adding auscul-tation in 1819. 1 Clinical neurology developed much later, in the latter part of the 19th century. Rapid advances in clinical neurology were preceded by fundamental discoveries in the physiology of the nervous system by Bell, Magendie, and Hall; in neuroanatomy by Remak, Golgi, and Cajal; and later with descriptions of neuropathology of certain disorders by Virchow, Alzheimer, and Speilmeyer. 2 During the second half of the 19th century, three schools of neu-rology spearheaded the birth of this field. The neurological examination of a patient that we use today was developed between 1870 and 1900, and elaborated on in the early 20th century. 3 Prior to 1870, observation of gait, expression, movement disorders, palpation of limbs, and gross testing for presence or absence of sensation completed the neurological examination. In 1875, Jean Charcot included the testing of deep tendon reflexes and added routine ophthalmoscopic examination to the neurological exam. By 1890, the neurological examination was divided into mental, motor, sensory, and reflex examinations. Gowers introduced the testing of coordination in the late 1890s, and Babinski added his famous sign in 1896. Vibration and position sense and their relationship to the posterior columns of the spinal cord described by Rydel and Seiffer were added in 1903. Complex sensation testing (two point discrimination, tactile and weight discrimination) was added shortly after. 3 Descriptions of neurological lesions and disease flowed from Europe to America, and clinical syndromes were described in meticulous detail. Heinrich Quincke developed the needle and the technique of lumbar puncture in 1891. Then Probster introduced elec-tromyography in 1928, and Hans Berger, professor of Psychiatry in Jena, developed electroencephalog-raphy in 1929. 2 Neurology as a special discipline was recognized when The National Hospital for …