The Pioneers of Neurology in South America

Dr. Allegri and Dr. Serrano say neurology was born on the continent toward the end of the 19th century. Image courtesy of Dr. Ricardo F. Allegri

The history of neurology in South America has its roots in 1885, when the Hospital San Roque de Buenos Aires initiated its Nervous Diseases Service. Its first director was Dr. José María Ramos Mejía, a writer, sociologist, scientist, and outstanding public citizen. In 1887, only 5 years after Dr. Jean-Martin Charcot was awarded the chief of neurology position at the famous Hôpital de la Salpêtrière in Paris, Dr. Ramos Mejía became the first professor of neurology in South America, at the Universidad de Buenos Aires.

Three others — Dr. Christofredo Jakob, a German neuropathologist; Dr. José A. Estévez, a skilled clinician; and Dr. José Ingenieros, a sociologist — collaborated with him to develop the field in Argentina.

In 1892, Dr. Augusto Orrego Luco, who was trained in France by Dr. Charcot, took over as professor of nervous diseases at the Universidad de Chile, Santiago. He was the most prominent figure in Chilean neurology during the second half of the 19th century, and was nicknamed the Charcot of America. In 1907 the department of neurology was taken over by his disciple, Dr. Joaquín Luco Arriagada (who was trained by Dr. Joseph Babinski).

In Brazil, the discipline emerged in 1912 when the school of medicine at the Universidade do Rio de Janeiro created its first department of neurology. Its first full professor, Dr. Antõnio Austregésilo Rodrígues de Lima, was a politician, writer, and skilled physician; he is considered the father of Brazilian neurology.

Prof. Dr. Enjolras Vampré Image: Arq. Neuro-Psiquiatr. vol.43 no.4 São Paulo dez. 1985 Creative Commons License

The São Paulo School of Neurology was founded in 1925, when Dr. Enjolras Vampré was appointed head of the department of psychiatry and neurology. Dr. Vampré, who also was trained at Salpêtrière, is considered the founder of the neurology in São Paulo.

In 1925, Chilean doctor Luco Arriagada created the Hospital del Salvador Servicio de Neurología in Santiago. In 1932 the Sociedad de Neurología, Psiquiatría y Neurocirugía de Chile was founded. When Dr. Arriagada retired, Dr. Lea Plaza was made chair of neurology at the University of Chile, and Dr. Jorge Oyarzun became chief of neurology at the Hospital del Salvador.

In 1925, Uruguay also took an important step with the creation of the department of neurologic diseases at the School of Medicine of Montevideo, with Dr. Américo Ricaldoni as its chairman. In 1927, the Uruguayan government created the Instituto de Neurología de Montevideo (the first neurologic institute in Latin America), with Dr. Ricaldoni as its designated director.

Peru's nascent field of neurology began in 1935 with Dr. Julio Oscar Trelles Montes, who was trained in Paris by Dr. Jean Lhermitte. Dr. Trelles is considered the father of Peruvian neurology. In 1937, he founded the Revista de Neuropsiquiatría, and 1 year later, the Sociedad de Neuropsiquiatría y Medicina Legal. In 1940, he was made professor of neuropathology at the school of medicine at Universidad Nacional Mayor de San Marcos. By this time, Dr. Trelles was also tending to the Refugio de Incurables in Lima, which was later renamed Hospital Santo Toribio de Mogrovejo. Almost every neurologist in Peru studied at this hospital in some capacity under Dr. Trelles's 30-year directorship.

In Uruguay at the beginning of 1937, Dr. Alejandro Schroeder, who was trained in Germany, was appointed director of the Institute of Neurology in Montevideo. After Dr. Schroeder's tenure there, the institute, which was renamed Instituto de Neurología Prof. Dr. Américo Ricaldoni, has been ranked among the top in South America. In 1939 the Sociedad de Neurología y Neurocirugia de Montevideo opened with Dr. Schroeder as its first president.

In Venezuela, neurology began when Dr. Pedro B. Castro returned from Paris in 1936, where he had been trained by Prof. Georges Charles Guillain at Salpêtrière. In 1938, Dr. Castro took over as a neurology consultant at Hospital Vargas, Caracas. In 1940, the Universidad Central de Venezuela created its first department of neurology and psychiatry and named Dr. Castro its chairman.

Chilean neurology was invigorated in 1939 when Dr. Alfonso Asenjo Gómez, who was trained in the United States by Dr. Walter Dandy and in Germany by Dr. Wilhelm Tönnis, created the Hospital del Salvador's service of neurosurgery.

Arquivos de neuro-psiquiatria (Impresso) / Academia Brasileira de Neurologia.-- Vol.1, no.1 (1943) -- São Paulo ISSN 0004-282X

In Buenos Aires in 1941, Dr. Vicente Dimitri was designated professor of neurology at the University of Buenos Aires. With Dr. Dimitri, neurology in Argentina came into its own.

In 1943, Dr. Adherbal Tolosa, Dr. Paulino Longo, and Dr. Oswaldo Lange created the Arquivos de Neuropsiquiatria in São Paulo under the direction of Dr. Lange. This journal remains foremost in neurosciences in Latin America; its articles are accessible in Index Medicus, World Health Organization, Bireme, Lilacs, and Latindex.

In 1944, Dr. Deolindo Augusto de Nunes Couto took over as chairman of the department of neurology at Universidade Federal do Rio de Janeiro and consolidated activity in neurology in Brazil. In 1946, he founded the Instituto de Neurología da Universidade Federal do Rio de Janeiro, which carried out extensive research in neurology, neurophysiology, and neurosurgery. This institute, later renamed Instituto de Neurología Deolindo Couto da Universidade Federal do Rio de Janeiro, became the international face of Brazilian neurology.

In Argentina, Dr. Jose Pereyra-Kafer became chairman of the Hospital Ramos Mejía Neurology Service (formerly Hospital San Roque) in Buenos Aires, and then took over as professor of neurology at the University of Buenos Aires. The Sociedad Neurológica Argentina (SNA) was founded in 1957. In 1953, the Instituto de Neurocirugía e Investigaciones Cerebrales of Chile opened, and for the following 34 years, it was directed by Dr. Asenjo.

Dr. Andrés Rosselli Quijano, who trained in the United States with Dr. Raymond Adams, Dr. Maurice Victor, and Dr. C. Miller Fisher, founded a neurology unit in 1956 that was annexed to the neurosurgery department at Hospital Militar Central de Bogotá. The Sociedad Neurológica de Colombia was formed in 1963.

In 1953 the Archivos Venezolanos de Psiquiatria y Neurologia was created. Neurology and psychiatry became independent specialties in 1959 under Dr. Castro, the first chairman and founder of the new department of neurology at the Universidad de Venezuela. The quarterly Pan- American Congress was conceived within the framework of the WFN. The first open conference was held in October 1963, in Lima, Peru, chaired by Dr. J. Oscar Trelles, the country's prime minister.

In conclusion, neurology in South America emerged toward the end of the 19th century, following the origin of the specialty in Europe and its official baptism with Charcot at Salpêtrière in Paris. The first steps took place almost simultaneously in five countries: Argentina, Brazil, Uruguay, Chile, and Peru. In the other countries, the development of neurology took place later in the 20th century. ■

(At time of publication, September 2008) DR. ALLEGRI and DR. SERRANO work at Servicios de Neurología & Neuropsicología and Centro de Estudios Médicos e Investigaciones Clínicas, Buenos Aires.

Adapted from a journal article published by Dr. Allegri in the Journal of the Neurological Sciences (J. Neurol. Sci. 2008 Aug 15;271: 29-33).