Insane people were often at one time, outwardly as well as inwardly, unlike what they were at another—the change from better to worse, or from worse to better, in the madness having a necessary tendency to produce alterations of appearance externally.
 Wilkie Collins, The Woman in White (1859). copy citation

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Author Wilkie Collins
Source The Woman in White
Topic appearance madness
Date 1859
Language English
Reference
Note
Weblink http://www.gutenberg.org/files/583/583-h/583-h.htm

Context

“On receiving his inmate again, the proprietor of the Asylum acknowledged that he had observed some curious personal changes in her. Such changes no doubt were not without precedent in his experience of persons mentally afflicted. Insane people were often at one time, outwardly as well as inwardly, unlike what they were at another—the change from better to worse, or from worse to better, in the madness having a necessary tendency to produce alterations of appearance externally. He allowed for these, and he allowed also for the modification in the form of Anne Catherick's delusion, which was reflected no doubt in her manner and expression. But he was still perplexed at times by certain differences between his patient before she had escaped and his patient since she had been brought back.” source