Extract from Phillipe Pinel's 'A Treatise on Insanity' (1801)

Here, Pinel compares the perceived physiognomies of an idiot and a maniac. These extracts are courtesy of Sander L. Gilman's Seeing the Insane. References to the 'proportions of Apollo' allude to the perceived ideal facial proportions as determined by classical sculpture.

On first view of this idiot (lowest image), what appears most striking is the extremely disproportionate extent of the face, compared with the diminutive size of the cranium. No traits of animation are visible in his physiognomy. Every line indicates the most absolute stupidity. Between the height of the head and that of the whole stature, there is a very great disproportion. The cranium is greatly depressed both at the crown and at the temples. His looks are heavy and his mouth wide open. The whole extent of his knowledge is confined to three or four confused ideas, and that of his speech to as many inarticulate sounds. His capacity is so defective, that he can scarcely guide the food to his mouth; and his insensibility so great, that he is incapable of attending to the common calls of nature. His step is feeble, heavy and tottering. His disinclination to motion is excessive. He is totally insensible to the natural propensity for reproduction - a passion so strong even in the Cretin, and which gives him a deep consciousness of his existence. This equivocal being, who seems to have been placed by nature on the very confines of humanity, is the son of a farmer, and was brought to the hospital de Bicetre about two years ago. He appears to have been impressed from his infancy with the above characters of fatuity...

... The ancient artists, who were equally remarkable for the delicacy of their touch and their acuteness of observation, could not fail to discover those proportions of the head which are the essential constituents of beauty. They have, consequently, divided those of Apollo into four parts by horizontal planes at equal distances. One of those parts begins at the roots of the hair on the forehead, and extends to the crown. The form of the head of the maniac (uppermost image) varies no more than well-proportioned heads in general from this standard, since the whole height of his head is twenty-three centimetres. Subtracting one from the other, we obtain a remainder of six centimetres, which, compared with the whole height, gives a proportion very nearly approaching that of one to four, as in the head of Apollo. The height of the head of the idiot, on the contrary, is eighteen centimetres, and his face fifteen. On subtraction we have a distance of three centimetres, which is only one sixth of the height, and which shews how much the vault of the cranium is flattened, and, consequently, its capacity diminished. This diminution is still more strikingly apparent if we examine the human skull in another point of view. In well formed heads, a horizontal section of the cranium made in the direction of the squamous margin of the temporal bones, gives an irregular ellipsis of such a form, that the double ordinate passing at the anterior portion of those bones, is much shorter than that passing through the posterior part. The head of the maniac approaches in those respects to the proper proportions, for the posterior double ordinate is longer by two centimetres than the anterior. On the contrary, those two lines are about equal in the head of the idiot, as I have ascertained by a caliber compass; so that the section of this cranium would give a figure very nearly approaching that of a regular ellipsis.