Diagnosis, Drawing, and Doctors in the Renaissance.

Back to the long posts. This was originally meant to be just about Leonardo and anatomy, but as I’m also teaching a course on the body in art, it seems logical to include some of that material too.  The stuff on diligentia and drawing has been presented in various conference papers.

Just as we get ill today, so too did renaissance artists. Just as we like to diagnose ourselves, for better or worse, so did artists in renaissance Italy. A wonderful drawing (1) by the German artist Albrecht Dὕrer has come down to us; it is nothing less than the artist’s self-diagnosis, a visual note to his physician. The inscription on the drawing reads: Do der gelb fleck ist und mit dem finger drawff do ist mir we"  (This is the yellow spot and when I press my finger on it, it hurts). Some years earlier on a harrowing drawing of the Dead Christ (2), Dὕrer annotated the sheet to say that it was made “during my illness.” In the words of Pamela H. Smith:

1.Albrecht Durer, Self-Portrait during Illness, 1512-15, Kunsthalle, Bremen, coloured pen drawing, 127 x 117 mm	2.Albrecht Durer, Head of the Dead Christ, 1503, graphite on paper. “These two faces I made in awe (?) during my illness.”

“Artisans such as Durer, dependent upon their body and their senses for their livelihood, might focus particularly on their body. Durer recorded his own bodily state, once by providing an annotated drawing indicating with his finger where he had pain. This drawing has been read as a self-aware statement of his own melancholic nature, but could just as well be the correspondence between patient and physician. During another illness, Durer drew a vivid portrait of a dead Christ and then noted his own bodily state on the drawing thus linking his own bodily condition to the moment of his artistic production. The patient-centred “subjective” components of early medicine reinforced the bodily dimensions of artisanal knowledge and epistemology.”[1]

3. Jacopo Pontormo, Detail of the Deposition showing self-portrait, Cappella Capponi, Santa Felicità, Florence, 1528, oil on wood, 313 x 192 cm	4.Jacopo Pontormo, Detail of sheet of studies for San Lorenzo, figures for “The Deluge”, c. 1546, Red chalk on paper, 419 x 216 mm (whole sheet) Galleria degli Uffizi, Florence

Back in Italy we hear of a complaining Jacopo Pontormo whose self-portrait appears in his celebrated Deposition (3); he tells us he suffered from diarrhoea, and what I imagine would have been the renaissance equivalent of pyloric spasms, during his painting of the frescoes in San Lorenzo, now known only through a series of remarkable drawings. (4) Anatomical realism fused with morbid fantasy is my description of these. Recently Philip Sohm reproduced pages of Pontormo’s diary,, which contain figures that he thought resembled somebody suffering from “intestinal cramps”, a condition that he believed characterised many of Pontormo’s figures with their agonised, writhing bodies.”[2] Pontormo’s diary, written in the last two years of the artist’s life is fascinating reading. It is a compendium of notes on painting, self-diagnosis, dietary habits and weather reports. You can read selections from it here.  bodies.”

5. Leonardo da Vinci, Self-Portrait, c. 1512, Royal Library, Turin, Red chalk on paper, 333 x 213 mm.	6. Leonardo da Vinci, Anatomical Studies, The surface muscles of the neck and shoulder, Royal 1508-10, Library, Windsor Castle, pen and brown ink (two shades), with wash modelling over traces of black chalk, 292 x 199 mm.

But what of Leonardo (5) I hear you ask? With his profound knowledge of the human body, isn’t he the artist who helps us to understand the intersection of medicine and art in the renaissance?

Obviously, we have Leonardo’s many beautiful and detailed drawings (6) of the human body, as well some interesting textual comments and narratives pertaining to these. One of the most interesting of these is a famous, and from our modern perspective, grisly story about the artist during a brief trip to Florence between 1507-8. There, he tells us that he waited for a man of over a 100 years, a centenarian, to die so he could dissect him and discover the medical cause of his death.

“And this old man, a few hours before his death told me that he was over as hundred years old and that he felt nothing wrong with his body other than weakness. And thus, while sitting on a bed in the hospital of Santa Maria Nuova in Florence (8), without any movement or other sign of mishap, he passed out of this life. And I made an anatomy of him in order to show the cause of so sweet a death. This I found to be a fainting away through lack of blood to the artery which nourished the heart, and other parts below it, which I found very dry; thin and withered. This anatomy I described very diligently and with great ease because of the absence of fat and humours which greatly hinder the recognition of the parts. The other anatomy was on a child of two years in which I found everything contrary to that of the old man.”

7. University of Milan, formerly Ca’ Granda Hospital.	8. Hospital of Santa Maria Nuova, Florence.

One scholar, Monica Azzolini, has argued that the description conforms to post-mortem procedures in renaissance Italy, rather than conveying the idea that Leonardo performed the dissection in secret, on his own. Azzolini saw no difference between medical practice in Florentine and Milanese hospitals and that Leonardo would have been familiar with both. This specific case of the centenarian has also been connected with the methods used by physicians in “documenting their autopsies” in fifteenth-century Italy.

[3] What is emerging through this scholarship is the question of what part medical knowledge played in artistic practice and techniques. According to Azzolini, drawings were made of dissections, fiat designum and these were meant to be kept on the premises of some hospitals.[4] One such institution was the Ca’ Granda (7) in Milan, a new building established by the Sforza family in 1456, now the site of the University of Milan. The Ca’ Granda must have been an institution that Leonardo knew as well as the older Brolo hospital. Sadly, none of these hospital drawings have been preserved, although attempts have been made to connect some of Leonardo’s extant drawings with the dissections and autopsies carried out at both hospitals in Milan, although there is no concrete proof of such involvement on Da Vinci’s part. Attitudes towards the problem of dissection in renaissance Italy have shifted with this new wave of scholarship, which does not see these operations as predominantly secretive, but sanctioned by ruling authorities such as the Medici in Florence and the Sforza in Milan.

It has to be said that this fresh, and extremely useful scholarship, is difficult to reconcile with the image of Leonardo the artist- anatomist cutting up the body in private, indulging his genius far from the suspicious eyes of authority. Leonardo himself seems to have conspired in this view with his description of what the aspiring medical-artist should be prepared to endure if he was to be successful in his endeavours. It is a wonderful evocation of the secret world of anatomy, but one wonders if Leonardo had his tongue slightly up his cheek here with his description of the art of anatomy carried out in the small hours.

“But though possessed of an interest in the subject you may perhaps be deterred by natural repugnance, or if this does not restrain you than perhaps by the fear of passing the night hours in the company of these corpses, quartered and flayed, and horrible to behold.”

9. Unknown artist, etching after drawing by Polidoro di Caravaggio, in Ashmoleon Museum, Oxford, date unknown.

At the same time Leonardo seems to be deadly serious, carrying out his researches during what Kenneth Keele calls the “long, distasteful hours of adventurous dissection and patient drawing.”[5] Something of this nocturnal practice is caught in a little-known drawing (9), probably by Polidoro di Caravaggio, but once attributed to Michelangelo by its owner Sir Thomas Lawrence. It does seem almost a caricature with its mannerist distortions and such gruesome details as planting a candle in the chest of the cadaver. There doesn’t seem to be much artistic skill visible here, either in the technique or in the subject matter, so it seems good idea to disassociate it from Michelangelo.

10. Frontispiece to Realdo Columbo’s De Re Anatomia, 1559.

We know that Michelangelo had a sophisticated knowledge of anatomy and nearly collaborated with the surgeon Realdo Colombo on an anatomical treatise. It has been conjectured that a figure on the right of the frontispiece (10) to Columbo’s De Re Anatomica of 1569 is none other than Michelangelo himself, although another artist is drawing the body, not Michelangelo. I can’t remember the name of the scholar who advanced this theory, but he believed that the putto or child holding the group of quill pens, whilst tugging at “Michelangelo’s” hand, was exhorting the great man to take up the pen and draw the human body, presumably because the sitting artist doesn’t seem to be making a good fist of it- he hasn’t even started drawing the body.

11. Leonardo da Vinci, Anatomical Studies, dissection of the hand, Royal Library, Windsor Castle, c. 1508-10, pen and brown ink (three shades), with wash modelling over traces of black chalk.

The role of the artist’s pen near the dissecting hand of the anatomist is important here because there are parallels between the hand of the surgeon who holds the knife and the artist’s which holds the pen. As Leonardo says:

“And if this does not deter you then perhaps you may lack the skill in drawing essential for such representation and even if you possess this skill, it may not be combined with a knowledge of perspective, while if it so combined you may not be versed in the methods of geometrical demonstration, or the methods of estimating the forces and power of the muscles; or you may be found wanting in patience so that you will not be diligent.” (11)

12. Frontispiece to Julius Casserius’s Tabulae Anatomicae, 1627.

In the above passage Leonardo uses the word “diligent”, and sometimes diligence was personified as a figure, “Diligentia.” Wielding a knife, Diligence sometimes sits next to Anatomia, a woman with a mirror and skull symbolising the science of the body. This idea is present in seventeenth-century anatomical illustrations (12), where Diligentia is contrasted with Ingenium (13), which refers more to the imagination, and innate ability rather than external practice, though both are necessary for the anatomical-artist. However, it remains to be seen how diligence in both an artistic and medical sense became united in the artistic and medical culture of quattrocento Italy.

13. Detail of Casserius showing personifications of Diligence, Anatomy and Ingenium.

One wonders how Leonardo’s diligentia would have been used in the context of anatomies and dissections performed in Milanese hospitals like Ca’ Granda and the Brolo, establishments in the city where he produced most of his anatomical illustrations, except for the brief sojourn in Florence mentioned above. Azzolini’s scenario of Leonardo attending dissections by surgeons and medics at these Milanese hospitals, while exchanging notes across the operating table is an attractive one, but it’s difficult to sustain given Leonardo’s extraordinary single-mindedness when drawing the body. Jonathan Sawday is probably accurate when he points out that Leonardo’s “rapacious consumption of bodies in the proto-gothic ambience of his nocturnal studio” did not really contribute to a contemporary understanding of the human body, so why should his drawings be located in the medical practice of Milanese hospitals.[6] It may be the case- though it is by no means an irrefutable fact- that Leonardo could have learnt from anatomists such as Fazio Cardano, and his son Girolamo. Even if we accept that some of these late anatomical designs reflect aspects of contemporary medical knowledge, there remains the problem that Leonardo’s extant anatomical drawings though, as Martin Kemp puts it, almost as good as viewing a dissection, yet really aren’t the result of viewing “a formal autopsy.”[7]

14.Leonardo da Vinci, The muscles of the shoulder, Royal Library, Windsor Castle, c. 1508-10, pen and brown ink (three shades) with wash modelling over black chalk.

Azzolini clearly wants to put Leonardo back amongst the doctors, right in the operating theatre; and as she notes, autopsies and dissections in renaissance Milan “required the presence of an artist.” While there is no concrete evidence that Leonardo visited the Ca’ Granda, she believes that the artist entered the Brolo- at the back of Milan Cathedral- as a reference to it exists in Leonardo’s writings. Part of her argument here- based upon the veteran Leonardo scholar, Carlo Pedretti- is that Leonardo didn’t set down his drawings and notes on the centenarian until he returned to Milan from Florence on 12^th September, 1508. Her assumption is that Leonardo’s description of the centenarian, who probably died from a coronary occlusion, reflects knowledge of the way “fifteenth-century physicians described their autopsies.”[8]

Admittedly, Leonardo must have had the chance to meet medical experts in Milan, and outside that city there is a documented association with Marcantonio della Torre, a professor of anatomy at Pavia. However, Marcantonio, a staunch follower of Galen, may not have believed in the validity of anatomical drawings at all. Galen thought it was better to actually watch an anatomy rather than try to understand one from the point of view of drawings. As Kemp points out, exposure, either “directly or indirectly” to Galen’s ideas may have solidified Leonardo’s resistance to those accounts of the human body that rejected the value of visual illustration.[9] Leonardo ultimately evolved a method of drawing and annotating the body that dispensed with all the time-consuming written description that could never rival the visual-textual configuration of Leonardo’s late anatomical drawings.(14)

15. Leonardo da Vinci, superficial muscles of the arms, Royal Library, Windsor Castle, c. 1508-10, pen and brown ink (three shades) with wash modelling over black chalk.

For some reason when looking at some of Leonardo’s anatomical drawings which show cross-sections of the body and emaciated old men  (15) on the same sheet, the idea of a renaissance patient popped into my mind. I don’t know why; perhaps it was the result of looking at Durer’s agonising diagnostic drawing or reading about Pontormo’s ailments; or maybe it was because Smith’s “patient- centred subjectivity” had wedged somewhere in my brain. In the case of Dὕrer, he’s his own patient although we assume that he showed this drawing to a physician; in the case of Pontormo, the artist comes across as a hypochondriac, someone who turns illness into a performance much like his contorted figures in his drawings. Leonardo’s drawings obviously function at more advanced levels than diagnosis, or examples of “patient-centred subjectivity.” The description of his encounter with the centenarian might put us in mind of a doctor-patient relationship, but it would be an incorrect interpretation. Renaissance artists weren’t doctors, and in the case of Leonardo, he cautioned against placing too much trust in their judgments, the “destroyers of life.” Drawings could be medically indicative, but for Leonardo, diligentia, the skill that the artist-anatomist needed, helped to put the whole man before the viewer, not create a diagnostic framework supported by knowledge of medical procedure in renaissance hospitals. That is probably what these individuals who appear in his anatomical sheets represent: they help us complete the circle; they help us to recognise the connection between the living and anatomized body, rather than conveying a “patient-centred subjectivity.”

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[1] Pamela H. Smith, The Body of the Artisan: Art and Experience in the Scientific Revolution, (Chicago, 2004), 145.

[2] Philip Sohm, The Artist Grows Old: The Aging of Art and Artists in Italy 1500-1800, (New Haven, 2007), 107-127

[3] Monica Azzolini, “Leonardo da Vinci’s Anatomical Studies in Milan: A Re-examination of Sites and Sources” in Visualizing Medieval Medicine and Natural History, 1200-1550, (eds), Jean A. Givens, Karen M. Reeds, Alain Touwaide, (London, 2006), pp. 147-176.

[4] Azzolini, “Leonardo da Vinci’s Anatomical Studies in Milan”, 162.

[5] Kenneth Keele, “Leonardo’s Influence on Renaissance Anatomy”, Medical History, 157, 1972, 360-370, 369.

[6] Jonathan Sawday, The Body Emblazoned, 111.

[7] Martin Kemp, “Dissection and Divinity in Leonardo’s Late Anatomies”, Journal of the Warburg and Courtauld Institutes, Vol. 35, (1972), 200-225, 203.

[8] Azzolini, “Leonardo da Vinci’s Anatomical Studies in Milan”, 163.

[9] Kemp, “Dissection and Divinity”, 215.

 

Sources consulted.

Monica Azzolini, “Leonardo da Vinci’s Anatomical Studies in Milan: A Re-examination of Sites and Sources” in Visualizing Medieval Medicine and Natural History, 1200-1550, (eds), Jean A. Givens, Karen M. Reeds, Alain Touwaide, (London, 2006).

Kenneth Keele, “Leonardo’s Influence on Renaissance Anatomy”, Medical History, 157, 1972, 360-370. available here.

Martin Kemp, “Dissection and Divinity in Leonardo’s Late Anatomies”, Journal of the Warburg and Courtauld Institutes, Vol. 35, (1972), 200-225.

Jonathan Sawday, The Body Emblazoned: Dissection and the Human Body in Renaissance Culture, (New York, 1995).

Pamela H. Smith, The Body of the Artisan: Art and Experience in the Scientific Revolution, (Chicago, 2004).

Philip Sohm, The Artist Grows Old: The Aging of Art and Artists in Italy 1500-1800, (New Haven, 2007).

Comments

[HNiyazi]

Many thanks for this superlative post David. It's an extremely fascinating topic for scholars spanning both art history and the history of medicine.

It may also be worth adding the role of prints in the Renaissance in dispersing this type of knowledge - something which I hope to cover soon in the review of the Art Institute of Chicago's catalogue of their astounding prints collection (published recently by Yale Press)

Also an astounding resource (in addition to the ones you have cited) is the 'The Body Within - Art, Medicine and Visualization' by Brill's - a bit pricey - but a must read for someone interested in this topic.

Kind Regards, and looking forward to more of these detailed explorations. Each time we put in this much effort - we push the standard of art history blogging a degree higher. Bravo!

H

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