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Hugh Welch Diamond
Richard Lansdown introduces Hugh Welch Diamond,one ofthe fathers
of medical photography, whose imagesofthe insane both reflected and
challenged prevailingideas about visually recording insanity.
PhotograpMadness
www.h i storytoday.com
Left: Hugh Weich Diamond in 1856. Above: one of hisphotographs
of an inmate ofthe Springfieid asyiumin Tooting, south London.
One ofthe gems ofthe Royal Society ofMedicine's library is the
Diamond(Collection, a set of 22 photographstaken by Hugh Welch
Diamond
(c. 1809-86), a physician and founder member ofwhat is now the
Royal Photographic Society. Theearliest British medical
photographer, he was thefirst ever to take pictures of a wide range
ofinmates in an asylum, images that were exhibitedin the first
exhibition of photographs held at theRoyal Society of Arts in 1852.
His work chimedwith the then fashionable view that one
coulddiagnose mental illness from the face, a practicewhich
hitherto had relied on drawings and paint-ings which he took to
what was seen then as newheights: The Cornbill Magazine oí \S(>\
spoke of'I he dawn of a new day ... The faithful register ofthe
camera ... will now render ... an actualscience." Diamond, however,
went beyond diag-nosis; he put forward views on the therapeuticuse
of images. Although much of what his photo-graphs stood for has
passed, along withphrenology, his work remains as a landmark ofits
time.
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Hugh Welch Diamond
The early years.Diamond was born at Goudhurst in Kent in
about1809, the son of William Diamond, who claimed tocome from
Huguenot stock. At one time a surgeon inthe East India Gompany,
William later becamekeeper of a mad house, opened in London in
1820on the site of what is now St Paneras Station, Thefamily lived
over the shop and both Hugh and hiseldest son. Warren Hastings
Diamond, followedin William's footsteps.
For unknown reasons Hugh attendedNorwich Grammar School
beforeembarking on his medical training.Details about his studies
are sketchy.At the time the medical structurewas split into three
orders: physi-cians (the élite of whom wereuniversity educated);
surgeons(who were apprenticed likeany other craftsmen ofthetime);
and apothecaries who,following the ApothecariesAct of 1815, could
providemedical advice andprescribe drugs, Hughserved a five-year
appren-ticeship in his father'sasylum. When the West KentDispensary
opened in 1830he was appointed to theadministrative post of
resi-dent apothecary with a salaryof £60 per annum. Ninemonths
later he set up in privatepractice near Soho Square,London, where
in 1832 he wasfaced with the cholera epidemic. Hegained his
membership ofthe RoyalGollege of Surgeons in 1834 (the sameyear he
was elected a fellow of the Society ofAntiquaries), However, the
college has norecords of him as he was not, as is sometimesclaimed,
a fellow. Further evidence suggests a link withSt Bartholomew's
Hospital (Barts), where he probablyobserved patients and attended
occasional lectures. In1842 he began studying mental illness at
BethlemHospital under Sir George Tuthill, He also, it
seems,acquired a medical doctorate in Kiel, the German citythat
belonged to the King of Denmark, with a thesison insanity, though
no trace of this can be found inrecords there. Nevertheless, in
1848 he was MrDiamond and in 1849 he was Dr Diamond, At
theinaugural meeting ofthe Photographic Society in1853 he is listed
as H, Diamond Esq, M,D,
Ideas about insanityDiamond lived through and observed the
rapidincrease in the number of asylums which took place inthe 19th
century. In 1774, when the Act of Parliamentfor Regulating
Madhouses in England and Wales cameinto force, there were 16
metropolitan licensedmadhouses. By 1819 there were 40, but still
the totalnumber of inmates in the asylums of England and
Another of Diamond'sphotographs from theSpringfield series.
France combined amounted to only a few hundred.By the late 1890s
the figure had reached the hundredsof thousands.
It was not just that there was an increasing aware-ness of a
need to cater for the insane; asylums werealso convenient places
for shutting away members ofthe family. In his 1830 publication An
InquiryConcerning the Indications of Insanity, with Suggestions
for the Better Protection and Care ofthe Insane JohnGonolly
(1794-1866), the first chair of medi-
cine at the newly founded University ofLondon, notes: 'Let no
one imagine that
even now it is impossible or difficult toeffect the seclusion of
an eccentric
man; or easy for him, when onceconfined, to regain his
liberty,'
Gonolly also observed, 'Duringthe term allotted to medicalstudy,
the student never sees acase of insanity, except bysome rare
accident. Whilstevery hospital is open, everylunatic asylum is
closed tohim,' Diamond, of course,had doors opened via
hisfather.
Diamond wouldundoubtedly have heard ofand observed the methods
ofdealing with the insane thatprevailed into the 19th
century in many institutions:not only the need to beat and
chain at least the wilder inmates,who were seen as no more
than
animals, but also of how efficaciousit was to make patients
vomit or to
take their blood. He would probablyalso have known of the newer
approach
of electric shocks. The first ElectricalDispensary in London had
been founded in
1793 and treated 3,274 patients in its first year,allegedly
curing 1,401 and'relieving' 1,232,
The association between human mental and phys-ical dispositions
can be traced back to Aristotle andthe four humours. By the
mid-18th century philo-sophical thinking about the treatment of
madness inthis area was gathering apace, William Battie's A
Trea-tise on Madness published in 1758 had shifted theemphasis
towards a need to observe and then managethe individual patient,
who would often get betterwhen purging and bleeding ceased, Thomas
Reid's AnInquiry into the Human Mind, on the Principles ofCommon
Sense, published in 1764, argued that the keyto understanding
insanity was the direct study ofmind in action by means of
introspection andanalysis, Reid predicted that there would be
an'anatomy ofthe mind' as indispensable as the anatomyof the body.
This view was supported by JohnGregory's 1765 plea to consider the
mental and phys-ical relationship: 'the Mind and Body are so
intimatelyconnected,,, that the constitution of either,
examinedapart, can never be thoroughly understood,'
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Hugh Welch Diamond
Diamond would also have heard ofthe sweepingchanges that took
place coincidentally with the FrenchRevolution, when the chains,
the cruelty and theneglect ofthe madhouse were, to some
extent,replaced by more benign approaches.The French physician
PhillipePinel's Traite médico-philosophique sur
l'aliénationmentale: ou la maniepublished in 1801 (and inFnglish as
Treatise onInsanity in 1806) hadanenormous influence onboth French
and Anglo-American doctors duringthe 19th century. Thiswas not
simply becausePinel advocated theremoval of chains frompatients, he
alsoattempted to apply seien- •tifie principles to psychi-atric
observations ratherthan merely speculating.His gathering of
practicalfacts formed the largest body ofits kind to date, based on
observa-tions of up to 800 patients in the BicètreHospital, Paris.
He also stressed mental over physicalcauses of insanity and his
preferred 'moral' methodof treatment was directed as much at the
emotionsas the intellect.
In Britain, too, a series ot House of CommonsSelect Committees
and Parliamentary Enquiries from1807 to 1839 marked a shift from
the notion oflunatics as animals to one in which they were seen
ashumans, many of whom could be cured. But there
were still those who argued for an approach to aeti-ology based
on the state ofthe body rather than themind. Writing in 1828, one
doctor noted:
Some ...have suffered their attention tobe led astray by
psycbological
disquisitions... tbey contend wemay penetrate tbat internal
disorganization wbence theaberration originates...Tben tbe
science ofreasoning or logic being tbeproper remedy, a cure willbe
tbus effected... Istrongly deprecate theimpression that none
butpbilosopbers can cureintellectual derangement... Tbe attempt at
treatingan insane person in tbismanner would end inaggravation
ofthe
patient's state.
Diamond at SpringfieldIn 1849 Diamond was
appointed medical superintendentofthe women's department ofthe
Surrey
CCounty Lunatic Asylum where he was in charge of 400pauper
patients. He had originally applied in 1848 tooversee the men's
section but a Mr Snape was thepreferred candidate. Evidence of
Diamond's lifestylein this role is suggested by records relating to
MrSnape. The latter enjoyed gifts of coal and candles aswell as
produce from the asylum's farm to supple-ment his income of £350
per annum. Snape wasable to support his wife, three children and
an
An engraving after aphotograph by
Diamond,entitled'ReiigiousMeianchoiy'and pubiishedin the Medical
Times andGazette, 1858.
A douche for the treatmentof the insane, from Cases ofMental
Disease with Practical
Observations on theMedical Treatment byAlexander
Morison,1828.
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Hugh Welch Diamond
unmarried female family member and to keep afootman, a lady's
maid, a governess and a nurse.
The Springfield inmates were, to a large extent,those whose
prognosis was not good; the curablewere sent to St Luke's or to
Bethlem. Many went toand from the local workhouses, as Diamond
himselfnoted: 'It frequently happens that an inmate who isa little
troublesome in the workhouse is threatenedto be sent back to the
Asylum ... They are oftenreturned to us as sane in their minds as
at the timeof their discharge'.
His approach to treatment can be inferred from hiswriting to the
Commissioners in Lunacy in 1854 tothe effect that: 'In a properly
constructed building,with a sufficient number of suitable
attendants,restraint is never necessary, never justifiable
andalways injurious in all cases of lunacy whatever.'
However, while chains had largely been discardedwhen Springfield
opened in 1840 and while there wasan emphasis on moral therapy,
socialisation andlabour, inmates were still subjected to cold baths
andshowers, isolation and the rotating chair (which wasspun around
until the patient vomited). Diamond'smedical superintendent's
duties included 'To bleed,cup and perform all surgical operations
and to readprayers morning and evening.'
Picturing madnessTo understand Diamond's photography one
mustconsider the notion of photographic objectivity andsee how it
meshes with prevailing ideas of physiog-nomy and psychiatry.
In Essays on the Anatomy of Expression in Painting(1806) the
physician Charles Bell (1774-1842) argued
that the key to diagnosis is in the face: the mad man isan
outrageous maniac, little more than a savageanimal and so lacks
some essential human quality inthe face. To Bell, eyebrows and eye
muscles, whichdenote the mind, were inactive in the faces
oftheinsane. With fixed eyes and a raging mouth. Bell's madman
became a grotesque stereotype. Pinel's Treatise onInsanity ofthe
same year incltided two plates, the firstcomparing the skulls of
normal and idiotic patients,the second depicting a maniac and an
idiot.
The French artist Théodore Géricault (1791-1824)produced
portraits often patients at the Salpêtrièrebetween 1821 and 1824,
some of which have becomewell-known portraits in their own right.
They werecommissioned in 1820 by Etienne Jean Georget, afollower of
Pinel, who maintained that direct observa-tion ofthe insane is
essential if one is to understandtheir physiognomy. Géricault
himself, however,claimed that he could not distinguish between
thediagnosed insane and an average person.
In the second edition of his Outlines of lectures onMental
Diseases {1826) the Scottish physicianAlexander Morison (1779-1866)
included 13 engrav-ings based on those from the Salpêtrière, with a
noteto the effect that: 'The appearance ofthe face, it is
wellknown, is intimately connected with, and dependentupon, the
state ofthe mind.'
Alongside this was the development of phrenology,a form of
physiognomy created around 1800 by theGerman physicians Franz
Joseph Gall and JohannSpurzheim, which became hugely popular. As
aschoolboy. Gall had noticed that one of his classmates,who had a
remarkably good memory, also hadprotruding eyes and from this
simple observation
A rotary machine in whichthe chair was spun until thepatient
vomited, fromCases of Mental Diseasewith Practical Observationson
the Medical Treatment,1828.
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Hugh Weich Diamond
came the idea that the brain was a jigsaw of separate'organs'
occupying specific cortical areas. Since anorgan's size governed
the exercise of its functions andsince the contours ofthe head
signified the contoursof the brain configuration, so a reading of
the skullcould give information on personality.
Diamond's interest in photography started remark-ably early: he
made his first photographic print, of astrip of lace and two
feathers, on April 8th, 1839, onlythree months after William Fox
Talbot had announcedto the world his negative-positive process.
Throughhis contact with others Diamond made a significant,albeit
indirect, contribution to the development ofphotographic
techniques, since it was he who taughtphotography to Frederick
Scott Archer, a formerpatient from his general practice days.
Archer went onto invent the wet plate collodion process,
whichproduced results of much improved detail andreduced exposure
times ftom minutes to seconds,arguably the greatest contribution to
the developmentof photography within the first 20 years of its
exis-tence. Archer shared his method with Diamond in1850, before it
was made known to the general publicthe following year.
Once at Springfield he put his skill to good use,photographing
patients. It appears that despite themove towards greater privacy
for patients in the early19th century, the question of asking their
permissionto take or display their pictures did not arise.
Although the method of photography that he usedenabled Diamond
to employ shorter exposure timesthan had been available in the
1830s it was still neces-sary to ensure that the sitter remained
still for up to aminute or two and it is noticeable that his images
wereall of people in repose and not moving. There aresome
similarities here to the portraits of Diamond'sfriend Lewis
Carroll.
Philippe Pinelreleasing lunatics fromthe Bicêtre asylum inParis
in 1793, byCharles Louis LucienMuiler, C.I 840-50.Right: a page
fromPinel's1801 Traitémédico-philosophiquesur l'aliénationmentale;
ou ia manie,showing the crania andheads of the insane.
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Hugh Weich Diamond
In May 1856 Diamond presented a paper to theRoyal Society
entitled On the Application of Photog-raphy to the Physiognomy and
Mental Phenomena ofInsanity. The paper proposed three medical uses
ofphotography. First was recording the physiognomy:
The Photographer secures with unerring accuracy theexternal
phenomena of each passion, as the really certainindication of
internal deivngement, and exhibits to theeye the well known
sympathy which exists between thediseased brain and organs and
features ofthe body.
Second was photographs as an aid to treatment, aradical idea. He
described a woman with delu-sions who thought she was a queen, so
heshowed her photographs ofthe severalother patients who imagined
themselvesto be queens and royal personages, 'thefirst decided step
in her gradualimprovement'.
He noted also that simplyshowing a patient her photographcould
be therapeutic. 'In verymany cases they are examinedwith much
pleasure and interest.'It seems that the photograph as ameans of
increasing self-esteemhad found its place.
He referred also to an image ofa young woman 'tormented
bysuicidal monomania', which hadbeen described by the French
jour-nalist Ernest Lacan thus:
And yet what sadness, how manycomplaints, how many
disappointments areto be found in those eyes.... How much
bitter-ness and restrained grief how many swallowedsobs, are in
this mouth, whose smile must have beenso graceful in the past.
The third use of medical photography proposed byDiamond was the
identification of patients in case ofreadmission. He regarded
photographs as more usefulthan written notes in recalling the
essential character-istics of his patients.
Wider impactDiamond's work aroused considerable interest in
themedical as well as the photographic world.T.N. Brushfield ofthe
Ghester (bounty LunaticAsylum confirmed the therapeutic value of
images,reporting in 1857:
Patients are very much gratified at seeing their ownportraits...
Last week a patient begged for a portrait ofherself that she might
send to her son, who was inIreland, to show how much better she
was.
In his papers On the Physiognomy of Insanity in theMedical Times
and Gazette in 1858 and 1859, JohnGonoUy argued that there was a
readily identifiable facefor every type of madness. Diamond's
photographs did
The Madwoman or theObsession of Envy, byTheodore
Gericauit,1819-22.
not easily lend themselves to reproduction and soGonolly used
lithographs based on them, sometimesnot totally faithfully.
Nevertheless he was aware of theirshortcomings. 'There is so
singular a fidelity in a wellexecuted photograph that the
impression of very recentmuscular agitation in the face seems to be
caught by theprocess, which the engraver's art can scarcely
preserve'.
Gonolly also added case notes from which one cangain some
inkling of Diamond's medical approach. Inone sequence we see four
stages in the progress ofonepatient, suftering from puerperal
depression. Thesecond portrait was taken eight days after the
first, the
third four to five weeks later and the fourth two orthree months
after that, on her discharge.
In The Expression ofthe Emotions inMan and Animals ( 1872)
f)arwin, greatly
influenced by Gharles Bell, presented anevolutionary account of
the face of
insanity. Darwin saw expressions ashaving evolved, like other
parts ofthe human body, arguing that eventhe most human of human
charac-teristics, facial expressions, werederived from animals. He
focusedon the insane because 'they areliable to the strongest
passions,and give uncontrolled vent tothem'. It was one ofthe
firstscientific books to be publishedwith photographs.
A key figure in compiling thisbook was James Grichton Browne
(1840-1938), one ofthe most distin-guished psychiatrists of the
19th
century. Himself a photographer, hemust have been aware of
Diamond's
work. He sent Darwin 41 photographs ofhis patients, many of them
annotated. Darwin
reproduced only one in his book, perhapsbecause, like Gericauit,
he could not see how thepeople portrayed as insane differed from
thoseperceived as normal.
Springfield and the aftermathDiamond resigned from the Surrey
asylum position in1858. The reason is often glossed over and the
story isnot happy. In April 1856 his colleague Mr Snape wasstruck
by a patient. Snape ordered that he be given ahalf hour cold shower
bath, which involved an esti-mated 618 gallons of cold water being
poured overhim. This was followed by the administration of'agood
dose of tartar emetic'. A few minutes later thepatient had a fit
and died.
Snape argued that the patient had died of adiseased heart and
ordered Diamond's son. Warren,recently qualified as a surgeon, to
remove the heart atthe post-mortem. Snape saw fatty
degeneration;Diamond Senior saw a healthy heart and thought thatthe
shower and emetic had caused the death. Snapewas eventually charged
with manslaughter and it wasthen revealed that Diamond had, on his
own initiative,kept the heart for a day or so, shown it to
othermedical men and then burnt it. After trial at the Old
Hi
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Hugh Weich Diamond
Bailey Snape was acquitted in July 1856, exoneratedbut
financially ruined. The Committee of Visitorsthen wrote their
report on the incident, castigatingDiamond who had 'made himself
liable to severereprehension'. Diamond resigned and set up his
ownprivate asylum for female patients in Twickenham.
Diamond's asylum seems generally to have cateredfor a small
upmarket clientele. Many patients weredescribed in the census
returns as'lady'or'of inde-pendent means'. Resident, at various
times, was thedaughter of a field marshal and of a barrister, a
fellowof a ('ambridge college and 'a mad peer'. On the otherhand,
there was also the widow of a warehouseman,the wife of a grocer and
the widow of a haberdasher.
Diamond stopped exhibiting photographs when heopened the
Twickenham asylum. He had received hisfirst adverse review of his
portraits. The PhotographicNews of February 4th, 1859 said that
such photo-graphs'ought to adorn the walls ofthe physician'sstudy
but certainly not the walls of a public exhibition... (they) are
perfectly hideous'.
While this could hardly have pleased him it ismore likely that
he stopped photographing hispatients when he moved from a public
hospital withhundreds of inmates to a private one with only
ahandful. As the Richmond and Twickenham Times ofJune 26th, 1886
pointed out: 'That which was allow-able in a public institution
would not be so in aprivate establishment.'
Lingering visionsIf neither Géricault nor Darwin could really
see thedift"erence between the images of the insane andthose ofthe
average person, how can we explain theviews of Diamond and others?
Simon Cross arguesthat each historical period has its own
understandingofwhat madness is and, consequently, what sort
otrepresentational identity it is given at any one timeand
according to who is defining it. One sees whatone wants to see and
the followers of physiognomy,lacking other supports for diagnosis,
grasped at whatthey could. Despite the hopes ofthe Cornhitl
maga-zine, the strength of Diamond's manipulated and
iMadness depicted in theAnatomy and Philosophy ofExpression as
Connectedwiththe Fine Arts byCharles Bell, 1844.
Twickenham House,Diamond's private asylum,by Rosa Wallis, 1887.
Thepainting shows the musicroom where some of thepatients
slept.
Staged photographs was, as the hi.storian SharronaPearl has
pointed out, precisely that they were notexact reproductions; they
were reproductions madeby a photographer, who could emphasise
physiog-nomically meaningful symbols, including theclothing, hair
and liodies of his patients, not onlytheir faces.
As a professional psychologist and amateurphotographer, I like
to contemplate the link betweenDiamond and Darwin, between
photography, psychi-atry and psychology. We no longer respect
phrenology,today the MRl scan tells us more about the brain thanthe
photograph, but we can look back to Diamondwith gratitude.
Richard Lansdown was Head ofthe Psychology Department atGreat
Ormond Street Hospital, London from 1971 tol994.
Further Reading J. Browne Darwin and the Face of Madness.W.F.
Bynum, R. Porter & M. Sheperd [edsl The Anatomy ofMadness Vol
1. (Tavistock Press, 1985); A. Burrows & I. Schu-macher,
Portraits ofthe insane: The Case of Dr Diamond(Quartet Books,
1990); S. Cross, Mediating Madness (PaigraveMacmillan, 2010); S.L.
Gllman (ed). The Face of Madness(Brunner/Mazel, 1976); R. Hunter
& I. MacAlpine, ThreeHundred Years of Psychiatry (Oxford
University Press, 1970);S. Pearl, Through a Mediated Mirror: The
Photographic Phys-iognomy of Dr Hugh Welch Diamond'in History of
Photog-raphy, 33,288-305,2009; A. Scull, The Most Solitary of
Afflic-tions: Madness and Society in Britain 1700-1900 (Yale
Univer-sity Press, 1993).
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