ADHD - An Illustrated historical overview

States of explosiveness T homas Smith Clouston (1840–1915) was a notable Scottish psychiatrist of the late 19 th century who wrote prolifically on the nature of mental illness and theories of treatment. For most of his career, he served as physician superinten- dent at the Edinburgh Royal Asylum . In 1899, Clouston published a remarkable article on states of over-excitability and mental explosiveness, in which he described cases of impulsive children with learning problems. He outlined a therapy consisting of individual dietary and so- cial treatments, including environmental improvements, and a pharmacological intervention consisting of carefully dosed grains of potassium bromide. “I do not advocate bromide treatment alone […] I think milk will be found the sheet anchor in dieting all such neurotic children. Environment too, fresh air, suitable amusements, companionship, control, employment must be looked to, and the schoolmaster must be regarded for the time as an aid to treat- ment and so under the doctor´s order.” T.S. Clouston, 1899.