Death and Dying

Chapter 9 (“Death and Dying”) concerns a number of issues related to the end of life: the age-old question of what happens to one after death, the litany of problems encountered in old age, the mixed benefits of defying death, and the long history of assisted dying. These weighty issues and others are addressed in a series of compelling works that celebrate dying in the presence of friends and family, both glorify and demonize death in battle, and question the value of ICU care that suspends patients in a web of tubes and wires simply to create a kind of purgatory between life and death.

Genetics

Chapter 8 (“Genetics”) chronicles an aspect of medicine whose history covers less than two centuries. The modern science of genetics traces its origin only as far back as the work of Gregor Mendel, published in 1866 C.E. The images included in this chapter depict genetic disorders ranging from Down syndrome to Cri-du-Chat syndrome. They also illustrate the high price in genetic defects paid by royal families for excessive inbreeding, since the time of Egypt’s 18th dynasty. The chapter’s final work, a portrait of Henrietta Lacks, speaks to the chromosomal theory of the pathogenesis of cancer, one first clearly enunciated by Theodor Boveri in 1914 C.E.

Public Health

Chapter 5 (“Public Health”) contains 21 works of art that tell the story of efforts by societies throughout the ages to protect the health of their citizens. Of the measures instituted, some of the oldest and the most important with regard to impact on life expectancy, disability, and quality of life have been ones concerned with provision of a clean water supply and proper waste management. Numerous works featured in this chapter speak to the dire consequences of poor sanitation, insect-borne infections, pollution, and plagues, such as the Black Death, leprosy, tuberculosis, syphilis, influenza, and AIDS. They also tout the miracle of immunizations, while decrying the medical profession’s inability to lighten society’s addiction burden or substantially improve the care provided to incarcerated patients.

Surgery

Although surgery’s history is nearly as old as the human species, the practice as we know it today did not exist before the 19th century C.E. Chapter 4 (“Surgery”) transports the reader through art across 40,000 years of surgical history, stretching from trephination performed during the Cro-Magnon era to the miraculous transplant surgeries of today. Concepts covered by the artworks include barber-surgeons, “laudable pus,” carbolic acid-decontamination of operative fields, the ancient origin of general anesthesia, antiseptic surgical practice, the control of puerperal fever, Caesarian section, and surgical subspecialists in the ancient world. These are accompanied by portraits of some of the greatest figures in the pre-modern history of surgery, including Joseph Lister, William T. Morton, Samuel T. Gross, and Ignaz Semmelweis.

Therapeutics

Chapter 3 (“Therapeutics”) contains a series of works that reflect the long history of medical treatments, beginning with therapeutic rituals and progressing to modern intensive care. Whereas there is a current tendency to think of drug therapy as a recent innovation, written records of the use of salicylates, cannabis, mandrake, and opioids in ancient Egypt, Greece, and China attest to the fact that some of the earliest physicians gave patients drugs that were both effective and surprisingly modern. For over 1500 years, however, these were less important than interventions directed at correcting humoral disproportions. Some of this chapter’s most engaging works depict the bleeding, purging, cupping, and burning that were performed in an effort to achieve a proper balance between the various corporal humors. Also depicted in stunning works are the roles played by nurses, hospitals, and quacks in the evolution of medical practice.

Nutrition

Chapter 1 (“Nutrition”) features works of art depicting patients with nutritional disorders. Examples of both overnutrition and undernutrition are included. The final work considered is one by Johann J. Hasselhorst, titled Dissection of a Young Woman, in which an 18-year-old suicide victim is being dissected by a male surgeon to determine the ideal measurements of the female form. Her ideal from is contrasted earlier in the chapter with that of subjects, such as the Venus of Willendorf (a Paleolithic statuette discovered in the village of Willendorf, Austria in 1908 C.E.), with various forms of morbid obesity, and others, such as the Starving Buddha (a 2nd century B.C.E. bronze statue located in the Lahore Museum), that depict Kwashiorkor, cretinism, scurvy, pellagra, and other ravages of undernutrition.

Diagnostics

Chapter 2 (“Diagnostics”) traces the evaluation of the patient as depicted in art from the earliest times to the present. Although ancient physicians had none of the vast array of sophisticated laboratory tests that are now so important in diagnosing diseases, little has actually changed in the initial evaluation of the patient for over 4000 years. In fact, the principles underlying today’s concept of a proper medical history and physical examination were clearly articulated by the Egyptians in medical papyri produced as early as 1950 B.C.E. The works featured in this chapter transport the reader from some of the earliest records of how to take a medical history, perform a proper physical examination, and examine clinical specimens such as blood and urine to employing the imaging techniques of the modern era.

Military Medicine

Chapter 7 (“Military Medicine”) illustrates war’s long history of functioning as a pragmatic training ground for physicians, especially surgeons, was well as a giant field trial for developing, testing, and refining medical advances. The images included in this chapter transport the reader from the first aid stations of imperial Rome to the ligatures of Ambrose Paré, the “flying ambulances” Dominique Jean Larrey introduced during the Napoleonic Wars, Florence Nightingale’s implementation of the principles of proper sanitation in her hospital at Scutari during the Crimean War, the advent of reconstructive surgery in Germany just prior to the outbreak of World War I, the evolving concept of the post-traumatic stress disorder, and the war crimes committed by German and Japanese physicians during World War II.

Mental Health

Chapter 6 (“Mental Health”) contains works that speak to psychiatry’s long struggle to attain the professional status of the other branches of the healing arts. These works tell the story of a discipline that has struggled to understand and manage diseases of the mind, based on concepts ranging from the work of malicious spirits to humoral dyscrasias, demonic possession, lunar influences and “rocks in the head.” Past treatments, no less than those of the present, have, of necessity, focused on alleviating symptoms rather than preventing or curing the underlying disorders. As the works featured in this chapter demonstrate, much progress has been made in the area of mental health over the course of many centuries, although substantially less than that achieved by the other branches of the healing arts.

Artists as Patients

Although artists reveal much about themselves in their works, rarely do they give even a glimpse into their medical histories. The following self-portraits are notable exceptions. They reflect the disorders with which eleven artists struggled and yet only vaguely understood. Chapter 10 (“Artists as Patients”) considers the disorders reflected in self-portraits of eleven artists—Dürer, Rembrandt, Goya, van Gogh, Munch, Toulouse-Lautrec, Klee, Ket, Kahlo, John Bellany, and Dr. Muhammad Asim Khan. Each portrait is an autobiography of sorts, which arouses a host of deep, vague, generalized reminiscences of what it means to be a patient, and how tenuous one’s hold on health is, regardless of one’s accomplishments.