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The birth of dermatology in the Netherlands In his historical essay on the origin of the specialism of Dermatology in the Netherlands, Berend Mesander (1926-2000) points out that, until the 19th century, patients with skin and venereal diseases were treated by barber-surgeons and quacks.[1] Doctores medicinae, professionals with a university education, focused on internal medicine. They might have been interested in theoretical aspects of skin and venereal diseases, but generally considered these ailments far beneath them, particularly disdaining the crude practice of treatment with ointments, bandages and fumigation. Qualified doctors entered the scene if the barber surgeon requested their assistance to prescribe internal medication. Starting at the end of the 19th century, the origin of medical specialisms is on the one hand related to the emergence of new knowledge (e.g. microbiology) and new techniques (e.g. the use of anaesthetics), and on the other to the increase of wealth, prosperity and life expectancy. Dermatology, or to be more precise Dermato-venereology, was one of the first specialisms to emerge. The first chair in dermatology was established at the University of Amsterdam in 1867. It took a further 50 years before another university, Groningen, found room for another. Chairs at Utrecht and at Leiden were soon to follow. Early interest in dermatology focused on patients with infectious diseases of the skin, such as scabies, favus, syphilis and erysipelas. The first Dutch dermatologists were mostly autodidacts: general practitioners and health officers who had gleaned knowledge of skin and venereal diseases through self-study, practical experience and visits to well-known dermatological centers outside the Netherlands, such as the Unna clinic in Hamburg. Some dermatologists were trained in Amsterdam, the only Dutch academic dermatology center in those days. By 1900 dermatology had been established as a specialism in all major cities of the Netherlands: Amsterdam, Rotterdam, the Hague, Groningen and Utrecht. Nevertheless, setting up a dermatological practice remained a challenge. General practitioners did not easily surrender their position to newcomers. Many believed they had sufficient knowledge to treat patients themselves, perhaps taking this view as much for financial as for professional reasons. Dermatologist-urologist (!) Lucas Maillette de Buy Wenniger (1875-1934) accentuated the tension between traditional practitioners and the new specialists, when he wrote to his fiancée in 1902: “I’m beginning to understand what having a specialism essentially means: it means doing just one thing and knowing something about that thing, of which colleagues shamefully know absolutely nothing.” Ultimately, the universities played only a marginal role in the rise of dermatology as a separate specialism. According to Jan Roelof Prakken (1897-1982), the same could not be said for the NVDV, established in 1896[2]. Interestingly, the society’s 1896 memorandum of association does not explicitly describe venereology. The proposed line was the study of dermatology and venereology, but originally substantial attention was paid to diseases of the urogenital system. Urology was thus specifically considered part of the society’s field of study. This was confirmed by P.H. Schoonheid’s demonstration held in 1905 on modern diagnostics with new cystoscopes and separators, and by a thesis on the urine of those suffering from dermatoses, published in 1908 by M.E. Polano, father to the later dermatology professor M.K. Polano. The situation changed in 1910, when the urologists left the society en masse to establish their own. At the society’s general meeting, the president announced 16 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:39 Pagina 16