Medicine: Art and Science

The scientific revolution has granted us many advantages in life. And nowhere is this better seen than in medicine. Before the scientific revolution, the concept of medical treatment mostly consisted of various herbal remedies, leeches and the occasional horrific amputation without anesthetic. With the advent of the scientific method, doctors have been able to apply rigorous standards to identify the efficacy of treatments. As well as this we have been able to keep records and data to show how diseases and their frequency have changed over time. This will often afford insights into the causes of diseases. But disease existed long before the scientific revolution and before epidemiological data. Is there any way to get an idea of rates of disease in times before this? Strangely enough, to answer this question we can turn to the history of Western art. Why is this? Well, the function of art and how that has changed can offer us some insights.

Art was not always a medium for self-expression or for passing commentary on the human condition or socio-political realities. What we know as art used to be a profession just like any else. Something that people did to pay the bills rather than to achieve self-actualization. This is because their role was to depict reality for posterity. By this architecture, landscape or importantly, portraits. What this means is that we have a body of artistic work that, with the aid of a sharp clinical eye, will allow us to diagnose medical problems retrospectively through history from these faithful depictions of each artists patron.

Some examples of this follow. One of the things that can be seen is the depiction of incidental depictions of medical conditions in pieces of art. One such example is the famous painting An Experiment on a Bird in the Air Pump (1768) by Joseph Wright. Here is one of the figures off to the right, a disruption of the skin can be seen. When looked under closer detail the particular distribution and form of the rash are diagnostic of dermatomyositis. This painting record was created more than one-hundred years before this disease would first be identified and described in 1891.

Further examples can be seen in Caravaggio’s The Crucifixion of Saint Andrew (1607) in which an old, lean female figure possesses a neck lump consistent with the goiter of hypothyroidism. This is consistent with her apparently low socio-economic status within which a cause of hypothyroidism, iodine deficiency, was rampant. This same condition can be seen in a figure in Gentileschi’s Judith and her Maidservant (1613) in which one of the character depicted, who was based on a self-portrait of the artist, also demonstrates the characteristic neck welling.

However, it is not just the models and subjects of paintings that can be seen to suffer from medical conditions. Rembrandt, who was a regular and ruthlessly honest self-portraitist demonstrates his own afflictions through his depictions of himself. One of his later portraits is a veritable treasure trove of clinical signs. The lumpy skin lesions that speckle his face are suggestive of inflammatory dermatitis, the bulbous nose with thickened, rough skin belies rhinophyma and the bulging temporal artery may be a suggestion of temporal arteritis. Rembrandt is also thought to have suffered from stereo-blindness, or the inability for both eyes to work together to form a single image. This is often an ailment of artists who are taught to visualize their subject through a single eye in order to more readily portray a three-dimensional scene in two-dimensions. The clue to this is in the fact that only ever one eye appears to be directed at the viewer, whilst the other is looking elsewhere.

The writing, however, is not always so clear on the wall. Sometimes it is not what is depicted that suggests pathology, but how it is depicted. This takes a bit more detective work, but the inferences are there to be made.

Degas, who is famous for his impressionist portrayals of pedestrian scenes, such as ballerinas at rehearsal and people engaged in their daily activities within their own home is thought to have suffered from a degree of central visual loss. This inference can be made by comparing the work from his earlier career to that of his later. Earlier on, his palate and the transitions between object were much smoother and natural. Whereas later the contrast was harder and the details less defined. It is possible that these paintings all looked similar to Degas, who because of his failing vision, was not able to make the distinctions. This may have led to some of the idiosyncratic aesthetic value of his work which demonstrates the perversity of the relationship between poor health and art.

Diagnostics from art, however, are not limited to art from a previous era, insights can still be gained from modern art, although they often are more telling of the artist’s internal experience than perhaps their physical ailments.

Jean-Michel Basquiat was a young artist and contemporary of Andy Warhol in New York during the height of pop-art. Basquiat screamed to fame in his young twenties, becoming one of the most dominant popular artists of his time. Tragically, however, as is often the case of those who have fame thrust upon them at a young age, his life was cut too short and he died at the age of just twenty-seven. Some of his later work may have given observers an insight into his mental state. When analyzed retrospectively, the specter of death is quite prominent. The themes he painted for took a turn of the darker and the phrase “Die, Die, Die” became a recurring motif.

Whilst this might all be academic now, there are some lessons useful for medicine to be taken from this. Even in the age of CT scans and MRI, it is still important to have a sharp clinical eye for the symptoms. You never know, you might spot something somewhere unexpected.