Sander L. Gilman, The Face of Madness.
New York: Brunner/Mazel 1976; pp. 17-24.
An Asylum on a large scale supplies instances of delirium with raving fury and spitefulness, or delirium accompanied with an appearance of gaiety and pleasure in some cases, and with constant dejection and despondency in others, or imbecility of all the faculties, with a stupid look and general weakness, and the Photographer catches in a moment the permanent cloud, or the passing storm or sunshine of the soul, and thus enables the metaphysician to witness and trace out the connexion between the visible and invisible in one important branch of his researches into the Philosophy of the human mind.
The father of clinical photography, Hugh W. Diamond produced the first photographic images of mental disease while he was Resident Superintendent of the Female Department at the Surrey County Lunatic Asylum, a position he held from 1848 to 1858. It was within this population that he used his camera for a dual purpose, with his patients serving as either passive subjects or as objective participants. As his subjects, Diamond was interested in the physiognomics of their behavior and he probably intended to arrange them into a phenotypic atlas. It is also quite likely he intended to improve upon the nosology of his predecessor at Surrey, Sir Alexander Morison. In a letter to Henry Fox Talbot written in 1852, Diamond distanced himself from Morison's work:
The enclosed pray do not look at as photographs critically but such as they are, they are most accurate & useful. Sir A Morrison’s delineations of the insane instead of being truthful are perfect characatures.
With over 100 plates of artists' drawings, Morison's 1838 edition of The Physiognomy of Mental Diseases was a lavish production that showcased the sweep of positivism in psychiatry which began with Philippe Pinel and his protege, Jean Etienne Esquirol, at the Salpêtrière in Paris after the turn of the century. In 1838 Esquirol also published an atlas which he titled, Des maladies mentales considérées sous le rapport médical, hygiénique et médico-légal and which was equally expansive, comprising 27 plates engraved by Tardieu. It is also notable that 1838 was the year both men were honored for their work in establishing asylums and procedures for the humane treatment of the insane, Morison with a knighthood and Esquirol with the codification of his reforms (Law of 1838).
In this short essay, Diamond is advocating for a photographic physiognomy and contrasts it to the artist renderings that illustrate the works of his peers:
M. Esquirol has described in a striking and accurate manner the aspect of the countenance peculiar to that stage of dementia which is characterized by confirmed incoherence, a chronic mania (of which I exhibit two illustrative portraits) but those who never witness this exhibition of human suffering, either in the original or in the copy drawn to the life, can hardly imagine this peculiar state of mental prostration —
— Photography, as is evident from the portraits which illustrate this paper, confirms and extends this description, and that to such a degree as warrants the conclusion that the permanent records thus furnished are at once the most concise and the most comprehensive.
Because he was a prolific essayist, it is a mystery why Dr. Diamond never organized his thoughts and passion for clinical photography into a book. This paper, first published by Sander Gilman in 1976, can be read as an outline for a Diamond nosology and a proposal for a second function for the camera which engages the patient as an objective participant in the healing process. Diamond believed that a mental patient who participated in capturing a series of photographic images of his sickness could subsequently derive a therapeutic separation from that sickness. The case he gives as an example is of a 20 year old woman who was delusional, thinking she was a queen:
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—
So passionate was his advocacy of photography, Dr. Diamond was led to believe in its curative power. Arguably, the program he proposed for using a camera to treat delusional ideation is the first historical example of a psychodynamic regimen. There was considerable experimentation with the use of hypnosis for treating the insane, especially at Salpêtrière under the administration of Charcot. Féré and Binet experimented with the effects of magnets in the 1880s and Luys with other substances which he placed on the end of a wand and touched to the skin, but again these men were all treating the hysteric who had been hypnotised. Not until the work of Freud and his "talking cure" would there emerge a comparable psychodynamic technique out of the positivism that propelled nineteenth century psychiatric medicine. It could also be argued that Freud got his ideas from Diamond although there is no historical evidence that this is true. However, the similarities between a passive, listening analyst as posited by Freud and the clinical photographer as described by Diamond is remarkable:
—The Metaphysician and Moralist, the Physician and Physiologist will approach such an inquiry [into the phenomena of insanity] with their peculiar views, definitions and classifications—The Photographer, on the other hand, 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—
A Diamond atlas would have been a remarkable event in the history of photography and medicine. Gernsheim refers to a portfolio that he published in 1852 in parts but is now lost. However, its shape can be imagined from an 1858 work written by John Conolly for The Medical Times and Gazette and republished by Sander Gilman along with reproductions both of Diamond's photographs and of the lithographic drawings of the photos which Conolly used to illustrate his articles. Conolly titled his series Case Studies from The Physiognomy of Insanity, and it is reasonable to assume that he is referring specifically to the lost portfolio, both the images and text. How much Conolly borrowed from Diamond beyond the use of the photographs is unclear, he stints with only one line of credit even though he is obviously drawing from Diamond's records.
Examples of Hugh Diamond calotypes are extremely rare. Perhaps his strongest image illustrates the cover of The Face of Madness showing an old woman holding a bird. This image is owned by the Getty and can be viewed by clicking here »».