“Female patient suffering from erotomania, 1843.”

Science is a bit like Doubting Thomas—it has to see the evidence before believing it. And sometimes even then it is just theories about what was or was not seen.

Way back in the early 1800s, many scientists thought it an idea to use visual representation, through illustrations and engraving, to help codify the system of identifying say, organs, bones, types of disease, and even mental illness. For example, a drawing of someone suffering from buboes caused by the pox would help diagnose a patient with similar buboes also caused by the pox. It was a logical, well-intended, and noble idea, one that helped create the many books on anatomy and disease which progressed the development of medicine from the 1700s on—most notably Gray’s Anatomy in 1858.

The physician and alienist, Sir Alexander Morison (1779—1866) pioneered the documentation of psychiatric illness during the early to mid-1800s. An “alienist” is the archaic term for a psychiatrist or psychologist. Morrison was inspecting physician at the Surrey Asylum and Bethlehem Hospital. He excelled in the diagnosis and treatment of those poor unfortunate people who suffered from mental illness. He was a wise and kindly old gent, who wrote two texts of great importance on psychiatric illness—Outlines of Lectures on Mental Diseases (1826), and Cases of Mental Disease, with Practical Observations on the Medical Treatment (1828). But these were but a warm-up for his illustrated volume The Physiognomy of Mental Diseases in 1840.

The Physiognomy of Mental Diseases contained descriptions of the various types of mental illness, case studies of various patients from a selection of England’s psychiatric hospitals, and some possible treatments. At the time, psychiatric care was going through a much-needed overhaul, with patients being treated as suffering from a (possibly) curable disease rather than being written-off as possessed by demons or just too fucked-up to no longer defined as human and dumped in bedlam where they were often exhibited to the amusement of the paying public. Morrison devised (whether by himself or in collaboration is unclear) the idea of illustrating his book on The Physiognomy of Mental Diseases with a series of portrait engravings of the patients whose case studies he was describing. It was a very useful idea.

However, it does suggest that mental illness can always be identified through a patient’s facial expressions—as if there are certain universal physical attributes that define all types of mental illness. Moreover, such drawings were open to possible caricature with artists exaggerating certain facial tics or expressions which may or may not be relevant. Morrison’s approach was valued until the 1850s, when the photograph was deemed to be the more scientific and reliable choice for documenting mental illness by his successor at the Surrey Asylum, the physician and pioneering photographer Hugh Welch Diamond.
 

 

Portrait of 20-year-old female mental patient.

 

 
More engravings from ‘The Physiognomy of Mental Diseases,’ after the jump…

 
Among the early pioneers of photography in the 1800s was a middle-aged English doctor called Hugh Welch Diamond, who believed photography could be used in the diagnosis and treatment of the mentally ill. Diamond first established his medical career with a private practice in Soho, London, before specializing in psychiatry and becoming Resident Superintendent of the Female Department at the Surrey County Lunatic Asylum in 1848—a position he held until 1858. Diamond was an early adopter of photography, taking his first portraits just three months after Henry Fox Talbot licensed his “salt print” process for producing “photogenic drawings.” As a follower of “physiognomics”—a popular science based on the theory that disease (and character) could be discerned from an individual’s features or physiognomy—Diamond believed photography could be used as a curative therapy.

In documenting madness, Diamond was following on from his predecessor at Surrey County, Sir Alexander Morison who had produced a book of illustrations by various artists depicting patients at the asylum called The Physiognomy of Mental Diseases in 1838. Diamond believed the book was not scientific as the drawings were mainly illustrative interpretations of what the artist saw and could therefore veer towards caricature. He believed that the camera was the only way in which doctors could document illness without taint of prejudice:

The Metaphysician and Moralist, the Physician and Physiologist will approach such an inquiry with their peculiar views, definitions and classifications—The Photographer needs in many cases no aid from any language of his own, but prefers to listen, with the picture before him, to the silent but telling language of nature.

Between 1848-58, Diamond photographed the women patients at Surrey County, taking their portraits against a curtained wall or canvas screen. He became convinced he was able to diagnose a patient’s mental illness from their photographic portrait and then use the image as a therapeutic cure to sanity—the idea being the patient would be able to recognize the sickness in their features. As evidence of this, he cited his success with one patient who he had used the process on:

Her subsequent amusement in seeing the portraits and her frequent conversation about them was the first decided step in her gradual improvement, and about four months ago she was discharged perfectly cured, and laughed heartily at her former imaginations…

Convinced he had found a possible cure to mental illness, Diamond presented a paper “On the Application of Photography to the Physiognomic and Mental Phenomena of Insanity” to the Royal Society of Medicine in May 1856, in which he explained his theories. While many scientists and doctors saw the merit in Diamond’s propositions, they were eventually dismissed as “pseudo-science,” “snake oil” and “quackery.” However, the belief in physiognomy as a form of scientific empiricism was developed by police detective, biometrics researcher and inventor of the mugshot, Alphonse Bertillon, who devised a system of anthropometry for classifying criminals. This was later dropped in favor of fingerprinting and later DNA.

Diamond’s ideas on the diagnostic and curative nature of photography have long been discredited, however, he is now best remembered as a pioneer of psychiatric photography.

During his time at Surrey County, Diamond was able to document most of the female patients as the asylum was a public institution, which meant the patients had no rights to privacy. It’s interesting to note that when he left Surrey for a privately run asylum in Twickenham, Diamond was not permitted to take patients’ portraits. The following is a selection of Diamond’s portraits of the patients at Surrey County Asylum, more can be seen here. Alas, I was unable to find details to the identities of the sitters or their illnesses.
 

 

 

 
More portraits after the jump…