Sir George Frederick Still (1868-1941) The father of British pediatrics.
England’s first professor in child medicine presented on 4th, 6th and 11th March 1902 a series of three lectures to the Royal College of Physicians 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.
one of the first to describe the nature of ADHD and related disorders.
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.