Journal : Canada Lancet; vol. xxii.
Toronto : Dudley & Burns, 1890.
Description : page 168.
Subject : clinical photography.
Since the introduction of simple forms of photography, renewed efforts have been made by physicians and other scientific workers to adapt this art to practical use in medicine. The introduction of composite photography was an advance in proving the manner in which certain marked characteristics grow in different types of individuals. Instantaneous plates, cleverly arranged, have been made to show the curious gaits of different forms of nervous ailments. But photography as a whole, has been a rather disappointing agent in medicine ; it has done but little of what is expected of it, and in many cases and attempts it has proved a misleading guide. At Norristown, in the State Hospital for the Insane, photography has been used to catch the lineaments of the various types of insanity ; the method in which the work is done may be of interest to the readers of the LANCET.
A gallery convenient to the wards was fitted up and typical patients were selected from among the eight hundred insane men collected in the institution. The patients were brought to the gallery with as little previous knowledge of what was going to happen as possible ; this was done to avoid exciting them or giving them time to "fix up;" every thing being wanted as near the reality as possible. They were given a chair and were allowed to assume their own positions ; no instructions whatever as to position or posing, being given. Wherever the patient noticed this lack of instruction he attributed it to the amateurishness of his photographers. In this way many interesting characteristics were brought out ; the moods in which they happened to be were expressed ; the expression of the face was given ; the general physique and costume of each class could be studied. All this went to make up the tout ensemble which gave to each patient an indescribable finish, different and yet adhering to a certain type. This effect was facilitated by the rapidity with which the pictures were taken. The camera was already focussed ; the light arranged ; no head-rest was adjusted, for the exposure was short ; care being taken only that the chair in which the patient sat should not be moved.
By using the same chair always in the same position, with the same light and the camera invariably the same distance from the sitter, this could be done ; it also served to show the comparative height and breadth of each patient in this way, the space between the top of the sitter's head and the upper edge of the photograph represents the varying heights and the amount of background revealed on each side shows the comparative breadths. In this way two hundred and fifty interesting photographs were obtained in a short time.
The method has been still further broadened by Dr. Chase, chief resident male physician, so that now all new patients are photographed on admission and the faces of all the older patients are gradually being added to the collection, so that the whole eight hundred are now included. This album serves a number of purposes ; it shows the condition of the patient at a certain period ; it serves as a reminder in recalling the cases of dead or discharged inmates, and in cases of escape it affords a very efficient means of identification. When Dr. Chase completes this work, it will throw light on a very interesting and important point ; that is, to what degree the faces of the insane express their malady ; whether it would be possible to diagnose or classify them by such means. Moreover it will add another interesting advance in medicine and photography to the annals which yearly fill our journals.