Sir Alexander Crichton (18th Century)

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Portrait of Sir Alexander Crichton

The earliest known symptoms were described by Sir Alexander Crichton, pictured above, who was born on December 2, 1763 in Edinburg, Scotland (Palmer & Finger, 2001). He not only received his doctor of medicine degree from Leyden University in the Netherlands, but also earned a degree from the Royal College of Physicians in London, in 1791 (Palmer et al., 2001).

The Inquiry, 1798
Crichton’s main area of interest was the human mind, specifically the causes and effects of mental disorders. His interest can be seen through his published work, Inquiry, in 1798 (Palmer et al., 2001.) He addressed the idea of attention deficits in the second chapter of Book II in the Inquiry. This chapter, On Attention and its Diseases, discuss matters of how the mind and brain interact through nerves to perceive situations, to capture our attention.  In his book he differentiates between natural inattentiveness individuals experience versus abnormal forms of inattention.

The Early History of ADHD. This is an image of what became a well known publication of Crichton’s, known as “Inquiry” (1798), bring attention to inattentive symptoms.

Crichton and Inattention
Crichton was able to identify two different types of attention defects, “a morbid diminution of its power or energy” and “the incapacity of attending with a necessary constancy to any one object” (Palmer et al., 2001). These aspects were believed to be caused by physical conditions in the environment, and due to exhaustion of the mind, specifically nerves in the brain.  Through observing his patients, Crichton noted symptoms similar to characteristics listed in the criteria for the Impulsive-Hyperactive subtype of ADHD. His focus seemed to be on the manifestation of this “inattention” in young children, and observing the effects of environmental stimuli and other factors throughout the development of the child.

Through his observations, Dr. Crichton described symptoms of inattentiveness as “mental restlessness, or the fidgets” (Palmer et al., 2001). Although hyperactivity is not explicitly mentioned, the characteristics Crichton described seem to follow those listed in the current criteria for ADHD relating to inattention.

Impact
Crichton provided evidence for what would be later labeled as ADHD. Through addressing these characteristics in the Inquiry, and speculating the potential causes of inattentive behavior in people, it also led him to study the impact it had on individuals. Crichton began to take into consideration how inattentiveness varies in age, specifically with children and how it would affect them in school (Palmer et al., 2001). By addressing these deficits in attention and recognizing the impacts it had on individuals, it slowly attracted a greater emphasis to be made on diagnosing, what is known today as, ADHD.

 

 

References:

Harlow, C.H. Portrait of Sir Alexander Crichton.[Online Image]. Retrieved November 15, 2012 from http://publishing.cdlib.org/ucpressebooks/view?docId=ft638nb3db&chunk.id=d0e15318&toc.depth=100&brand=ucpress

Palmer, E. & Finger, S. (2001). An early description of ADHD (Inattentive subtype): Dr. Alexander Crichton and “Mental Restlessness”. Child Psychology & Psychiatry Review, 6(2), 66-73. doi: 10.1017/S1360641701002507

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