Facial Signs As Predictors and Reflectors of Disease
Certain diseases alter the expression or appearance of the face because the disease
process is related to the development or physiology of the face and affects its structure or behavior or both.
Some medical text books teach medical students how to recognize signs in the face that indicate particular diseases.
These facial signs of disease can be changes in the features of the face or alterations of the movements and expressions that the face produces.
Facial signs of disease can both predict what diseases the person might develop and reflect symptomatically the disease process.
The topics of the face as a predictor and a reflector of disease are discussed below.
The ancient Chinese physiognomists believed that each face could predict its owner's future.
In some respects, this view is confirmed by evidence that certain facial characteristics are related to the kinds of diseases
that one is likely to develop later in life.
For example, consider the two types of facial profile described by Enlow,
the brachycephalic (A. in the table at the right) with a shorter, concave profile, wider eyes, protruding chin, and small nose
versus the dolichocephalic (B. in the table) with a longer, convex profile, receeding chin and forehead, and a larger, protruding nose.
Patients who develop certain gastrointestinal medical symptoms are more likely to have an ulcer
if they are dolichocephalic versus a gall bladder problem if they are brachycephalic.
This association between the face and disease illustrates that if someone develops these symptoms, their face predicts the nature of their illness.
These Enlow types may also be related to whether a person is susceptible to depression versus schizophrenia.
Some research studies show that certain facial anomalies, such as ears with attached lobes, hair whorls, and widely spaced eyes,
are related to mental disorders, such as schizophrenia, and to physical characters, such as clumsiness.
There is some evidence that structural asymmetries of the face predict hyperactivity and schizophrenia and susceptibility to infectious diseases.
Certain facial expressions and behaviors, including glaring and certain anger expressions, correspond to personality types
(Type A, in the A/B typology) and predict susceptibility to cardiovascular disease.
Facial signs are often used to diagnose the presence of certain diseases. One of the most obvious relationships between facial signs and disease is the case of genetic and congenital diseases. Specific genetic abnormalities cause such diseases as Down's Syndrome, Lesch-Nyhan, and DeLange syndrome, and produce specific patterns of facial abnormalities. Congenital diseases such as cretinism, fetal alcohol syndrome, and hydrocephaly also produce facial signs of their presence. Many infectious diseases can be diagnosed from facial signs. A body of research findings show that the behaviors of the face differ when the person is mentally disturbed, and can differ according to the type of psychological diagnosis.
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