The seventeenth century had seen a little interest in anatomy lessons conducted with the dissection of a human cadaver, and the occasional physician had earned themselves a portrait, such as that by Goya of Dr Arrieta, who saved the artist’s life in late 1819. But it wasn’t until the last quarter of the nineteenth century that medicine and surgery became popular themes in painting.
This reflected the rising role of medicine in society as a whole, when many patients left hospital in a better state than when they had been admitted, and surgical procedures didn’t have to be rushed, because the patient had been anaesthetised.
Portrait of Dr. Samuel D. Gross, generally known as The Gross Clinic, from 1875, is Thomas Eakins’ portrait of this eminent professor of surgery at work in a teaching theatre at Jefferson Medical College, Philadelphia. The operation, a conservative procedure to treat osteomyelitis of the femur, took place before the advent of aseptic technique, so instruments were clean but not sterile, and gloves and gowns weren’t worn. The patient, lying with their feet towards the viewer and their head under the anaesthetist’s mask, would have been receiving a general anaesthetic using ether or chloroform.
Gross stands near the middle of the painting, a scalpel held in his bloodied right fingers. Behind and to the left is the only woman in the painting: not a nurse, but apparently the patient’s distressed mother. Although there was interest in initial photos of this painting, when Eakins submitted it for exhibition the following year it was rejected as unsightly, and sent first to an Army hospital before returning to Jefferson Medical College.
Then in 1887 Henri Gervex became one of the early painters to depict medical and surgical procedures, in his Before the Operation. This work’s full title is Dr Péan Teaching His Discovery of the Compression of Blood Vessels at St Louis Hospital, and when exhibited at the Salon that year it was compared favourably with Rembrandt’s Anatomy Lesson of Dr. Nicolaes Tulp (1632).
Doctor Péan was apparently celebrated in Paris at the time, and Gervex invokes the aura of modern medicine, which was progressing in leaps and bounds. In the lower left corner are some surgical instruments to inspire awe. The patient, of course, is an attractive young woman, whose body is extensively exposed. Gervex couldn’t resist the opportunity.
In André Brouillet’s A Clinical Lesson at the Salpêtrière Hospital from the same year, an eminent neurologist Jean-Martin Charcot is demonstrating how he could hypnotise Marie “Blanche” Wittman, the ‘Queen of Hysterics’, into suffering hysterical collapse. Charcot and Wittman were a renowned partnership in this ‘act’, who performed in front of Sigmund Freud when he visited the hospital.
Jean Geoffroy’s Visiting Day at the Hospital from 1889 is perhaps the first painting of what we’d recognise as a modern hospital: it’s all about light, cleanliness, and the clinical. Like other Naturalist paintings of the time, it also fitted in very neatly with the French Third Republic’s image of modernising, by applying the latest developments of science to the improvement of life, and illness.
The boy’s father is clearly not rich, and he could never have afforded state-of-the-art care for his sick son. But this clinical atmosphere is not inhuman, as shown by the mother kissing her son in the next bed along. What the painting doesn’t reveal is that, in all likelihood, the boy in the foreground bed is dying of tuberculosis, a problem which even the Third Republic seemed powerless to prevent.
The hospital building shown in Luis Jiménez Aranda’s painting of Doctors’ Rounds in the Hospital Ward from the same year is not as modern, but its sheets are almost as white. Here, the large and august team of physicians, no doubt with their trainees too, is examining a patient’s chest during a ward round.
There’s a subtle detail here: the senior physician is bent down, with his left ear applied to the back of the patient’s chest. Today, that act of auscultation would be performed using a stethoscope, almost a badge of office for medical practitioners around the world. The stethoscope was still relatively novel in 1889: simple monaural tubes were first used by Laënnec in 1816, but the modern binaural design didn’t evolve until the late 1800s, and an older physician may still have preferred to apply their ear directly to the patient, as shown here.
Eakins’ experience with the reception of The Gross Clinic had perhaps discouraged him from painting in medical settings, but in 1889 students from the University of Pennsylvania School of Medicine persuaded him to accept a commission to paint their retiring professor of surgery, Dr. David Hayes Agnew. Eakins worked long hours to complete The Agnew Clinic (1889) in the three months allowed.
This fine painting shows how surgery had advanced in just fourteen years. Under the bright artificial light in the middle of the teaching theatre, the surgeon is performing a partial mastectomy. The patient is here shown at a more conventional angle, and no incisions are visible. The surgeons now wear gowns, although full asepsis with gloves, hats, etc., had yet to be introduced. A similar volatile liquid general anaesthetic is being used, administered via a mask.
The only woman present, apart from the patient, is now a nurse, Mary Clymer, although nurses had not yet developed specialist operating roles, and she’s dressed for the ward, not for handling instruments. The figure at the far right, on the edge of the canvas, is Eakins, allegedly painted by his wife, a fine artist in her own right.
Despite the care that Eakins had taken to avoid the problems of his previous painting, this work was rejected by the Society of American Artists, and brought about his resignation from that society in 1892.
Robert C. Hinckley’s Ether Day, or The First Operation with Ether, painted some time between 1882-93, recreates the scene on 16 October 1846 in what is now known as the Ether Dome in the Massachusetts General Hospital, Boston, MA. Here John Collins Warren is removing a tumour from the neck of a local printer, Edward G Abbott, who was anaesthetised using ether – its first recorded use for a general surgical procedure; I apologise for the poor quality of this image.
The medicalisation of life was incomplete without the medicalisation of death. Enrique Simonet’s unique painting of The Autopsy, also known as Anatomy of the Heart; She had a Heart! (1890), shows the largely exposed body of a young woman who had drowned herself. A well-dressed male pathologist stands by her head, holding in his left hand her heart, which he has apparently just removed. There are no spectators other than the viewer.
Anna Sahlstén’s Surgery in Hospital from about 1893 shows the dazzling whiteness of the modern hospital, with a smart professional nurse caring for a child patient in the background. On the wall is a large radiator for the hospital’s modern heating system, which replaced the old stoves seen in so many earlier images of hospital wards.
The wars of the nineteenth century brought together two innovations: the nursing revolution started by Florence Nightingale during the Crimean War, and some of the first official war artists who depicted the Franco-Prussian War of 1870-71. The most singular fusion of art and science occurred in the Great War (1914-18), with Henry Tonks, a former surgeon who had been a professional artist for more than a decade when he returned to medicine, and later became an official war artist too.
In 1915, Tonks was serving in the humble role of a medical orderly on the Marne, France, where he used his pastels to paint Saline Infusion: An incident in the British Red Cross Hospital, Arc-en-Barrois, 1915. Saline intravenous infusions were still relatively novel at that time, and war surgery was busy re-learning the lessons of the past.
Tonks was finally commissioned as a Lieutenant in the Royal Army Medical Corps in 1916, and then worked with the pioneer plastic and reconstructive surgeon Harold Gillies, documenting mutilating facial injuries in a unique and often harrowing series of pastels and sketches.
His most important war painting is that of An Advanced Dressing Station in France, 1918, which compares with John Singer Sargent’s Gassed (1919) in its near-documentary depiction of an ad hoc medical facility not far from the front line, and the apocalyptic vision of war.
For much of the final phase of the war, Sargent and Tonks travelled together and worked alongside one another. Gassed is a studio painting which Sargent composed from his notes and sketches made at this dressing station, and Tonks’ painting is a more literal depiction of conditions in the dressing station itself. Both were commissioned by the British government.