Friday, June 27, 2008

Excursions in Medical History: Brief Walk Through Medicine in Art

This coming August The Gross Clinic, painted by American master Thomas Eakins in 1875, will be exhibited at the Philadelphia Museum of Art until February of next year. Hat tip to Kathleen Stocker at A Repository for Bottled Monsters (a blog for the National Museum of Health and Medicine in D.C.) for the alert.

The New York Tribune described this masterpiece, which depicts American trauma surgeon Samuel D. Gross, as "one of the most powerful, horrible, yet fascinating pictures that has been painted anywhere in this century...but the more one praises it, the more one must condemn its admission to a gallery where men and women of weak nerves must be compelled to look at it, for not to look at it is impossible."

A lot of art depicting medical subjects is like this. It can be hard to look at and hard not to look at too. One of the scariest paintings I've ever seen is Sir Charles Bell's 1809 work depicting a patient suffering from tetanus. But there are other less gruesome examples throughout history, and I enjoy perusing them for the clues they provide about the history of medicine.

Here's the painter Goya getting some medicine from a doctor-friend (Self-Portrait with Dr. Arrieta, 1820).

In this painting on a Grecian urn from ca. 500 B.C., Achilles binds up Patroclus's wound from an arrow. With what? A swathe of linen? Would he have soaked it in something first, or applied a poultice?

Anatomic illustrations have a long and marvelous history, from Persian medicine centuries ago to Leonardo's famous drawings to today's med school anatomy "bible," the atlas illustrated by Netter. The National Library of Medicine has uploaded several pages from historic Persian, French, Dutch, German, Japanese, and Italian, anatomy books here and here for our perusal. Thanks, NLM!

Anatomy lessons were depicted by Dutch painters Mierevelt and Rembrandt, who portrayed Professor Nicolaes Tulp examining the flexor digitorum superficialis and Dr. Joan Deyman exploring the brain.

But to my mind Eakins' painting surpasses even these works by Rembrandt. There's something about The Gross Clinic that holds my attention - is it the way the light is striking Dr. Gross's forehead as well as the surgical field, or the way the "minor characters" have little stories of their own without distracting too much from the central focus of the painting? Is it the fact that here, clearly, the need for aseptic surgical techniques was unknown, whereas 14 years later, in 1889, when Eakins painted The Agnew Clinic, surgical gowns and sterilized instruments had become the norm, thanks to Lister? Looking through acts of medicine as portrayed by artists around the world (and throughout history) is like leafing through a family album, or trying to reconstruct stories for a family tree. It's nice to see how much we've grown...and humbling to realize how much farther we have to go.


Michael Leddy said...

What an amazing gallery — seeing surgery performed in street clothes really makes one think.

About Achilles and Patroclus: Patroclus too is a healer, having learned from Achilles. The scene of Achilles tending to Patroclus is not to be found in the Iliad, but there is a passage in book 11 in which Patroclus tends to the warrior Eurypylus:

Patroclus had him lie down, and with a knife
Cut from his thigh the barbed arrow.
He washed the wound off with warm water
And patted into it a bitter root
That he had rubbed between his hands,
An anodyne that took away the pain.
The bleeding stopped, and the wound was dry.

[Translation by Stanley Lombardo.]

Almost every wound in the poem is immediately fatal, so this one is an interesting exception — it adds to the depiction of Patroclus as a figure of great compassion and gentleness.

Resident Anesthesiologist Guy (RAG) said...

I love these kinds of pictures. It really lets you know where we've come from and how odd the training appeared to have been back then.

T. said...

Michael, thank you for this wonderful comment. In addition to the poetry, the medical details are much appreciated - Patroclus gave Eurypylus an ANESTHETIC (as well as a procoagulant, from the sound of it)! Very cool!

Rag - good to see ya! I am reliving my own residency orientation and beginnings as I peruse your blog...

Dragonfly said...

I love it!! Medical history is so fascinating....I wonder what aspect of what we are doing now will be looked at in 500 or even 50 years and shuddered at! Thanks for assembling all these.

T. said...

Dragonfly - thanks for stopping by!

I think NG tubes, mammograms, open heart surgery, and all manner of invasive things will be shuddered-over in the decades to come...I keep hoping I'll live to see the age of "tricorder" medicine, like in the Star Trek shows!