From Guises of Desire by Hilda Reilly
"She complained of not being able to recognize people. Normally, she said, she had been able to recognize faces without having to make any deliberate effort; now she was obliged to do laborious ‘recognizing work’ and had to say to herself ‘this person’s nose is such-and-such, his hair is such-and-such, so he must be so-and-so’. All the people she saw seemed like wax figures without any connection with her."
From The Case History of Bertha Pappenheim (Anna O.) by Josef Breuer
One of the visual disorders afflicting Bertha Pappenheim for a short period was the inability to recognise faces. Instances of patients suffering from this condition are recorded from the mid-19th century on but there is no indication that Bertha's own doctor, Josef Breuer, was familiar with it. Indeed, the way he describes her symptom suggests that he considered it rather as an idiosyncrasy unique to Bertha, merely another behavioural oddity which bolstered the diagnosis of hysteria.
The first known account dates from 1844. For a long time it was believed to be part of a more complex visual disorder and it wasn't until a century later that it was isolated as a condition in its own right and given a name - prosopagnosia.
Prosopagnosia is much more than a matter of not being able to put a name to a face. It involves not being able to recognise the identity of the person owning the face. So, for example, you might meet a former teacher in the street and not remember his name. If you realise that the person used to be your history teacher whose name momentarily escapes you, you are not suffering from prosopagnosia. If, on the other hand, you have no idea who he is until he speaks and you then realise that it's the same voice which bored you with information about people and events long gone, it's more likely to be due to prosopagnosia. If the face also strikes you as being an amorphous blob, pretty well indistinguishable from the multitude of other faces in the street, it's definitely prosopagnosia.
Prosopagnosia can be either congenital or acquired, in which case it results from damage to the associated, highly specific, part of the brain. In Bertha's case, such damage could have been caused by seizures of temporal lobe epilepsy, a diagnosis which could equally account for a number of her other symptoms.
People are now much more familiar with prosopagnosia, largely thanks to The Man Who Mistook His Wife for a Hat by Oliver Sacks. It would be interesting to know what Sacks would make of Bertha Pappenheim's case. I'm sure the account he would come up with would be very different from that put together by Josef Breuer.