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December 27, 1995

Picturing Health and Illness: Images of Identity and Difference

JAMA. 1995;274(24):1967. doi:10.1001/jama.1995.03530240077047

"It is amazing how complete is the delusion that beauty is goodness," wrote Tolstoy in the late 19th century. Soon thereafter, social scientists in the United States provided fresh evidence for the accuracy of Tolstoy's observation when they made frequent diagnoses of intellectual defectiveness solely on the basis of an unattractive appearance. In his famous 1914 study of the Kallikak family, psychologist Henry H. Goddard confidently described children "with drooping jaws and the unmistakable look of the feebleminded,"1 and in the same year sociologist Edward Alsworth Ross looked at all the "hirsute, lowbrowed, big faced" immigrants with their "sugarloaf heads, moon-faces, slit mouths, lantern jaws, and goose bill noses" and concluded that "the physiognomy of certain groups unmistakably proclaims inferiority of type."2

Of course, these absurdly subjective claims emanated from the "soft" sciences, those marked by a seemingly endless and subjective debate over the nature and distribution of

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