Etikettarkiv: stanley finger

ADHD historik Del 3: Sir George Frederick Still


Sir George Frederick Still (1868-1941) Den Brittiska pediatrikens fader.

Englands förste professor i barnmedicin presenterade den 4, 6 och 11 Mars 1902 sina sedermera berömda föreläsningar för the Royal College of Physicians in London, under namnet “Goulstonian lectures” som handlade om ‘some abnormal psychical conditions in children’, Föreläsningarna publicerades samma år i the Lancet. Han beskrev 43 barn som hade mycket allvarliga problem med att upprätthålla en kontinuerlig uppmärksamhet, att disciplinera sig själva och att inte bli ständigt överemotionella, aggressiva eller passionerat upptagna med något för situationen olämpligt.


Still skrev: “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.” Alltså ett problem som verkade utgå från barnens oförmåga att styra energin i sin egna uppmärksamhet, trotts att barnen i övrigt hade välfungerande intellekt
Och drog slutsatsen att:“there is a defect of moral consciousness which cannot be accounted for by any fault of environment” När Still talade om moralkontroll vilket var dåtidens begrepp grundat i läror från William James så refererade han snarare till den tidigares begreppsanvändning. Still avsåg med moralkontroll egentligen:“the control of action in conformity with the idea of the good of all” Alltså förmågan att agera för allas bästa.


”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 to 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 Frederick Still beskrev självfallet inte adhd enligt dagens terminologi men många historiker inom fältet anser att de beskrivna barnens svårigheter sannolikt skulle betraktas som adhd i dag med den samsjuklighet som ofta följer med.

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 e?ects. 1798.

Some abnormal psychical conditions in children: the Goulstonian lectures”. The Lancet’, 1902;1:1008-1012

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.

Palmer, E. D., and Finger, S. 2001. An early description of ADHD(Inattention Subtype): Dr. Alexander Crichton and the ”MentalRestlessness” (1798). Child Psychology and Psychiatry Reviews, 6, 66-73.

Ett stort tack till

Ph.D. Russell Barkley för reflektioner och material.

Samt ett stort tack till Professor Stan Finger vid Washington universitetet i St Louis, för kloka och välgenomarbetade artiklar med exemplariska hänvisningar.Det känns tryggt att skriva till en av världens mest kunniga professorer inom neurovetenskaplig historik sent en fredagskväll och en kvart senare få svar från en professor som skriver Cheers och verkar allmänt glad samtidigt som han lämnar distinkta hänvisningar och snabbt erbjuder sig att skicka behövda referenser.

Snacka om bedårande skönt avslappnad kunnighet, med en djup kärlek till kallet. Hatten av, även bocken bugar.

ADHD historik på Svenska

ADHD historia Del 1 Alexander Crichton

ADHD historia Del 2 Alexander Crichton

ADHD historia Del 3 Sir George Frederick Still

ADHD historia Del 4 Charles Bradley 1937 – Benzedrine

English

Links to Part 1 in the history of ADHD: Alexander Crichton
Links to part 2 in the history of ADHD Sir George Frederick Still

Gerorge Still som barn

English: The History of ADHD: 1798, Alexander Crichton

Part 1 of the ADHD history
The earliest well documented description of ADHD and ADD

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 efects. In the chapter ”Attention”, Crichton described a ”mental restlessness”.

The book

“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.

Dr Crichton described all the essential features of the inattentive
subtype of attention deficit hyperactivity disorder which were almost entirely consistent with the criteria for the inattentive subtype as portrayed in DSM-IV (APA,2000) (Palmer & Finger, 2001).

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 e?ects. 1798.
Some abnormal psychical conditions in children: the Goulstonian lectures”. The Lancet’, 1902;1:1008-1012
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.
Palmer, E. D., and Finger, S. 2001. An early description of ADHD(Inattention Subtype): Dr. Alexander Crichton and the ”MentalRestlessness” (1798). Child Psychology and Psychiatry Reviews, 6, 66-73.

Many Thanks to:

Professor Russell Barkley for material and kind advice.
Professor Stanley Finger; at Washington University in St. Louis.

Sir George Frederick Still in the history of ADHD

The History of British Pediatrics.

ADHD historik på Svenska

ADHD historia Del 1 Alexander Crichton

ADHD historia Del 2 Alexander Crichton

ADHD historia Del 3 Sir George Frederick Still

ADHD historia Del 4 Charles Bradley 1937 – Benzedrine

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