Newsflash: ADHD Dates Back to 1798 (at least!)

Is ADHD a modern “invention,” created by computers, fast food, or even…Big Pharma? Recorded history says no. In fact, a recently discovered medical text from 1798 describes, in some detail, disorders of attention, including the observation that some are likely hereditary.

Physician Alexander Crichton (pictured right, at his Cambridge University graduation) provided the first known medical description of disorders of attention in his three-volume medical textbook. Moreover, “he certainly deserves credit for being the first to describe adults with attention disorders,” says ADHD expert Russell Barkley, Ph.D., writing a commentary about Crichton’s work and its modern relevancies in the February issue of The ADHD Report, a newsletter that follows research and trends in the field of attention disorders.

Until the discovery of Crichton’s three-volume textbook (by the two Washington University researchers who wrote a paper introducing it), most medical historians acknowledged physician George Still as providing the first description of symptoms of what we today call ADHD, in children.

Specifically, in his lectures before the Royal Society of Medicine and later writing for the medical journal Lancet in 1902, Still described 43 children in his clinical practice who had severe challenges with sustained attention and the “moral control of their behavior.” (As Dr. Barkley explains, Dr. Still used the latter phrase to mean “the regulation of behavior relative to the moral good of all. He saw this mental function as a conscious comparative process in which one evaluates both the present and likely future consequences of one’s actions for both one’s self and for others prior to choosing a course of action.”)

Both Still and Crichton shared the belief that disorders of attention can be inborn (heredity) or resulting from injury to or diseases affecting the nerves and brain, Barkley writes. “Also, I think it evident that neither Crichton or Still argued for an entirely social cause for disorders of attention,” he continues, “though Crichton discusses the possibility that early education of children can serve to enhance or retard their natural powers of attention.”

At the end of the ADHD Report article, Barkley details some historical milestones pertaining to ADHD in adults. (February’s issue also includes an article on “The Self-Management Approach to ADHD” as well as a summary of recent research findings. Note: A discounted subscription price for The ADHD Report is available for students and the family members of persons with ADHD.)

Meanwhile, for context, consider these other medical milestones (from the InfoPlease Medical Advances Timeline), with the addition of two important ADHD milestones in red.

1747
James Lind , a Scottish naval surgeon, discovers that citrus fruits prevent scurvy. He publishes his Treatise of the Scurvy in 1754, identifying the cure for this common and dangerous disease of sailors, although it takes another 40 years before an official Admiralty order dictates the supply of lemon juice to ships.

1796
Edward Jenner develops a method to protect people from smallpox by exposing them to the cowpox virus. In his famous experiment, he rubs pus from a dairymaid’s cowpox postule into scratches on the arm of his gardener’s 8-year-old son, and then exposes him to smallpox six weeks later (which he does not develop). The process becomes known as vaccination from the Latin vacca for cow. Vaccination with cowpox is made compulsory in Britain in 1853. Jenner is sometimes called the founding father of immunology.

1798
Alexander Crichton provides the first known description of disorders of attention in his three-volume medical textbook.

1870s
Louis Pasteur and Robert Koch establish the germ theory of disease. According to germ theory, a specific disease is caused by a specific organism. Before this discovery, most doctors believe diseases are caused by spontaneous generation. In fact, doctors would perform autopsies on people who died of infectious diseases and then care for living patients without washing their hands, not realizing that they were therefore transmitting the disease.

1906
Sir Frederick Gowland Hopkins suggests the existence of vitamins and concludes they are essential to health. Receives the 1929 Nobel Prize for Physiology or Medicine.

1953
James Watson and Francis Crick at Cambridge University describe the structure of the DNA molecule. Maurice Wilkins and Rosalind Franklin at King’s College in London are also studying DNA. (Wilkins in fact shares Franklin’s data with Watson and Crick without her knowledge.) Watson, Crick, and Wilkins share the Nobel Prize for Physiology or Medicine in 1962 (Franklin had died and the Nobel Prize only goes to living recipients).

1980
W.H.O. (World Health Organization) announces smallpox is eradicated.

1990
The first neuro-imaging study of adults with ADHD was conducted by Zametkin and colleagues. Using positron emission tomography to study the cerebral glucose metabolism of 25 adults who were currently hyperactive and had been so since childhood, they compared them to 50 normal control adults (Zametkin, Nordahl, Gross, King, Semple, Rumsey, Hamburger & Cohen, 1990) and found that the hyperactive adults manifested reduced metabolism globally and particularly in the premotor cortex and super prefrontal cortex — areas previously shown to be instrumental in the control of attention and motor activity. (from The ADHD Report, February 2009)