Development of the medical care for schoolchildren in The Netherlands 1796-1904 The foundations of the school medical service can be found at the end of the eighteenth century. In conformity with the ideas of the Enlightenment the middle class wanted their thoughts on virtue, education, health and social welfare put into practice. During the nineteenth century several laws on primary education were enacted that have been of importance to the medical and hygienical care of the schoolchild and its environment. In 1806 an Act on primary education was accepted that was operative until 1857. The most important change, however, was imposed by the Act of 1900 that introduced compulsory primary education. Improvement of the environment in which children were educated, was the main aim of nineteenth century physicians. They devoted themselves to the improvement of the school climate, light, air, ventilation, heat and school-desks and for the schoolchild more bodily exercise and gymnastics in combination with a reduction of lessons and homework. They argued for lessons in hygiene for pupils as well as for teachers, but got few results on these subjects. In the twentieth century the school physician made his entry into the school. From 1904 on physicians were appointed in an increasing number of municipalities. Their work became part of the municipal health services that were founded during these years.