This article explores the photographic physiognomy of Victorian asylum superintendent Hugh Welch Diamond. Through close readings of Diamond’s photographs as well as commentary published by Diamond and Dr John Conolly, the author argues that Diamond expanded the meaning of the word physiognomy to include metonymic traits such as clothing and hairstyle. Diamond used physiognomy for both diagnostic and therapeutic purposes, and he staged his photographs to maximize their efficacy for both, creating a mediated mirror through which his patients viewed themselves. Through photographic physiognomy, Diamond tried to change the nature of asylum practice, using images of his patients to nurture them to health without physical restraints.