The history of ADHD 1798 - 1902

with kind permission from P-O

http://adhd-npf.blogspot.com/2008/10/history-of-adhd-1902-sir-george.html

The earliest well documented description of adhd and the adhd history

===18th century===

In 1798, a Scottish-born physician and author, Sir Alexander Crichton (1763-1856), described what seems to be a similar mental state much like the inattentive subtype of ADHD, in his book An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. In the chapter "Attention", Crichton described a "mental restlessness".

“The incapacity of attending with a necessary degree of constancy to any one object, almost always arises from an unnatural or morbid sensibility of the nerves, by which means this faculty is incessantly withdrawn from one impression to another. It may be either born with a person or it may be the effect of accidental diseases.

When born with a person it becomes evident at a very early period of life, and has a very bad effect, inasmuch as it renders him incapable of attending with constancy to any one object of education. But it seldom is in so great a degree as totally to impede all instruction; and what is very fortunate, it is generally diminished with age." p. 271

Crichton further observed:

"In this disease of attention, if it can with propriety be called so every impression seems to agitate the person, and gives him or her an unnatural degree of mental restlessness. People walking up and down the room, a slight noise, in the same, the mowing a, the shutting a door suddenly, a flight excess of heat or of cold, to much light or to little light, all destroy constant attention in such patients. Inasmuch as it is easily is exited by every impression.” p 272

Crichton’s noted: ‘they have a particular name for the state of their nerves, which is expressive enough of their feelings. They say they have the fidgets" p 272

Dr. Crichton suggested that these children needed special educational intervention and noted that it was obvious that they had a problem attending even how hard they did try.

"Every public teacher must have observed that there are many to whom the dryness and difficulties of the Latin and Greek grammars are so disgusting that neither the terrors of the rod, nor the indulgence of any kind intreaty can cause them to give their attention to them." p. 278

Alexander Crichton was almost two centuries ahead of his time in his observations of what is now known as the Inattention subtype of ADHD. He wrote about the salient features of this disorder, including attentional problems, restlessness, early onset, and how it can affect schooling, without any of the moralism introduced by George Still and later authors of the subject.

Sir George Frederick Still (1868-1941) The father of British pediatrics.

Englands first professor in child medicine presented on 4th, 6th and 11th March 1902 a series of three lectures to the Royal Society of Medicine in London, under the name “Goulstonian lectures” on ‘some abnormal psychical conditions in children’, which were published later the same year in the Lancet. He described 43 children who had serious problems with sustained attention and self-regulation, who were often aggressive, defiant, resistant to discipline, excessively emotional or passionate, who showed little inhibitory volition, had serious problems with sustained attention and could not learn from the consequences of their actions; though their intellect was normal.

He wrote “I would point out that a notable feature in many of these cases of moral defect without general impairment of intellect is a quite abnormal incapacity for sustained attention.

He concluded:“there is a defect of moral consciousness which cannot be accounted for by any fault of environment” When Still was talking about Moral Control, he was referring to it as William James had did before him, but to Still, the moral control of behavior meant “the control of action in conformity with the idea of the good of all”

"Another boy, aged 6 years, with marked moral defect was unable to keep his attention even to a game for more than a very short time, and as might be expected, the failure of attention was very noticeable at school, with the result that in some cases the child was backward in school attainments, although in manner and ordinary conversation he appeared as bright and intelligent as any child could be. These considerations on the nature of the defect may appear too speculative to have any practical value, but I venture to think that they have some basis in clinical fact, and my reason for bringing them forward in this connexion is to emphasise the possibility that other morbid conditions beside defect of moral consciousness may be responsible for defect of moral control.”

George Still certainly did not use the current terminology for this disorder, but many historians of ADHD have inferred that the children he described in his series of three published lectures to the Royal College of Physicians would likely have qualified for the current disorder of ADHD combined type, among other disorders.

References:

Alexander Crichton : An inquiry into the nature and origin of mental derangement : comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. 1798.

Russell A. Barkley: The Relevance of the Still Lectures to Attention Deficit Hyperactivity Disorder A Commentary. 2006; 10; 137 J Atten Disord.

George F. Still Some Abnormal Psychical Conditions in Children: Excerpts From Three Lectures 2006; 10; 126 J Atten Disord.

UNDER CONSTRUCTION

Misc

1845

In 1845, Dr. Heinrich Hoffmann (a German physician and poet who wrote books on medicine and psychiatry) became interested in writing for children when he couldn’t find any suitable books to read to his 3-year-old son. The result was a book of poems, complete with illustrations, about children and their undesirable behaviours. “Die Geschichte vom Zappel-Philipp” (The Story of Fidgety Philip) in Der Struwwelpeter was a description of a little boy who could be interpreted as having attention deficit hyperactivity disorder, or as merely a moral fable to amuse young children and encourage them to behave properly. The book was translated to englidhs by Mark Twain.

Dr. Heinrich Hoffman wrote a story which and gave a staggeringly accurate, and yet entertaining description of a young boy who by some is believed would be diagnosed with ADD ADHD today.

The book was unique in paying attention to children and their characteristics - something completely innovative at the time. An example of his work included

“Let me see if Philip can be a little gentleman; let me see if he is able to sit

still for once at table.” Thus spoke, in earnest tone, the father to his son;

and the mother looked very grave to see Philip so misbehave. But Philip he did

not mind; his father who was so kind … See the naughty, restless child, growing

still more rude and wild, till his chair falls over quite. Philip screams with

all his might, catches at the cloth, but then, that makes matters worse again.

Down upon the ground they fall, glasses, bread, knives forks and all … Poor Papa

and poor Mamma look quite cross, and wonder how they shall make their dinner

now.”

First appeareance of "hyperactivity" is said to be in .... by Oxford .. but one can very easily find earlier descriptions...