THE idea that a certain type of face indicates a tendency to certain diseases is not only widely diffused in the medical profession, but among the public at large, as is shown by the frequent occurrence of such phrases as “consumptive-looking,” and “apoplectic-looking.” With a view to ascertaining how far these generally-entertained ideas are true, and of substituting for mere personal impressions the test of exact and unprejudiced investigation, the authors of this paper have made a number of observations by the method of composite portraiture, already described by Mr. Gallon in NATURE. The countenance which is supposed to indicate a tendency to phthisis or consumption, is one of the best marked and most commonly recognised. The authors have begun with this disease, and at present have limited themselves to it. A large number of portraits of phthisical I atients were first taken, and were then grouped into composites, clinical facts being first taken as guides for grouping. Thus, cases of advanced disease were grouped first, but they gave no result beyond that of well-marked emaciation. Cases grouped according to the rapidity of their course also yielded no characteristic type, nor was anything very definite at first obtained from those in whom the hereditary taint was strong, but on further investigation this last group of hereditary cases was found to fall into two main divisions, not separated by any abrupt line of demarcation. In the first division the faces were broad, with coarse, blunted, and thickened features; while in the second the faces were thin, narrow, ovoid, with thin, softened, and narrow features. These two groups correspond to the two types well recognised by physicians as strumous and tubercular. On comparing the phthisical with nonphthisical cases, however, it was found that the percentage of narrow ovoids was almost exactly the same in the phthisical and non-phthisical patients. Although the authors do not say so, we may perhaps be justified in regarding these two types of face as possibly racial. Their results lend no countenance to the belief that any special type of face predominates among phthisical patients, nor to the generally entertained opinion that the narrow ovoid tubercular face is more common in phthisis than in other diseases. Whether it is more common than among the rest of the healthy population, they cannot at present say. In comparing composites, both of the broad faces and of the narrow ovoid faces in phthisical and non-phthisical patients, they found that in each case the phthisical patients presented a more delicate form of each type, with finer features, a lighter lower jaw, and an altogether narrower face. Although their conclusions seem to indicate that there is no foundation for the belief that persons possessing certain physical characteristics are especially liable to tubercular disease, yet it may hereafter be proved that some, explanation of the doctrine may be found in the course of the disease when it attacks such persons.
"An Inquiry into the Physiognomy of Phthisis, by the Method of Composite Portraiture." By Francis Gallon, F.R.S., and F. A. Mahomed, M.D.