HISTORICAL BACKGROUND 19Establishment of the National
Institute of Neurological
Diseases and Blindness
The oldest neurological society in the world, the American Neurological
Association (ANA), was founded in 1875 with a strong grounding in
European neurology.^1 The term “neuropsychiatry” first originated in the
late nineteenth century but was not extensively used in the United States
until World War I, when the Division of Neurology and Psychiatry with
in the Army Surgeon General’s Office was established in 1917.^2 Although
it consisted mostly of psychiatrists, the division was directed by a neu
rologist and was strongly dominated by members of the ANA. At the
time, psychiatrists were seen as experienced hospital administrators
who treated psychoses but who had little training in organic diseases of
the nervous system, while neurologists exhibited the opposite pattern.^3
Neither had much experience treating psychoneuroses and, as a result,
both were united under the broad label of “neuropsychiatry” and pro
vided with the supplementary training that each specialty group lacked
to treat the most pressing problem at the time: war neuroses. The use
of the term “neuropsychiatry” declined after the 1930s, however, and
was not revived until World War II.
By WWII, clinical neurologists’ lack of emphasis on treating organic,
neurological diseases solidified their reputation as diagnosticians un
interested in neurological treatment. With the rise of psychiatry and
its emphasis on mental disorders resulting from emotional tensions due
to interpersonal, social, and cultural maladjustments, neurological per
spectives were also increasingly seen as unnecessary and perhaps even
detrimental.^4 During WWII, the administrative positions of all armed
services’ neuropsychiatric divisions were filled by psychiatrists, not