Triple-view Photographs as Medical Records *

Photography has been used as a means of recording medical and scientific facts concerning the appearance of patients for some sixty years. A good photograph as part of a case record is serviceable not only for identification and the portrayal of specific lesions, but as an indicator of the health status, nutritional condition, and mental alertness of the individual at the time of examination. Portraits taken at intervals under standard conditions may tell a story of significance. Front, three-quarter, profile, and back views are equally simple to take but not equally useful in all materials. A sharp profile is best if the problem be that of the comparison of two photographs or a direct comparison of a person and a photograph. Nutritional changes do not greatly modify the profile and it lends itself to measurements such as physical anthropologists frequently make. On the other hand, front views are much better than are profiles for purposes of memory identifications; the profile may look strange while the front view seems very familiar. Curiously, passport pictures are ordinarily front views, whereas they should be profiles for accurate matching. Standard police practice prescribes a front view and the right profile, but authorities agree that the most favorable position for recognition is the three-quarter face, because the nose stands out distinctly and one ear is visible. In clinical and scientific medicine interests other than those mentioned are usually more important, but at the same time the examiner must decide what view or views shall be made. Ideally several pictures should be taken, but such a procedure requires a considerable expenditure of time, makes the photographic recording too prominent a part of the total examination, introduces the possibility of annoying the patient, presents added problems of filing, and has the disadvantage of being rather expensive. An approach to the ideal of several pictures (without the enumerated disadvantages) may be achieved through using a doublemirror unit and a miniature or other camera, thus taking three views of the patient in a single photographic exposure.