Abstract
Behold the hands, how they promise, conjure, appeal, menace, pray, supplicate, refuse, beckon, interrogate, admire, confess, cringe, instruct, command, mock, and what not besides, with a variation and multiplication of variation which makes the tongue envious – Michel de Montaigne
Introduction
During the Renaissance the desire to produce lifelike portrayals of the body prompted artists to become knowledgeable about anatomy and the inter-relationships between the various parts of the human body. The collaboration between science and art produced images of the body that combined medical knowledge and artistic illustrations giving the bases for remarkable drawings and sculptures. Indeed, the pre-Renaissance schematic and conventional hand portraits led to anatomically correct and more realistic hand depictions by the Renaissance painters who gave representation of the hand a vibrant new significance. Some artists became intensely interested in the study of human anatomy including hands to capture their static and dynamic complexity. Therefore, the art of that period is a suitable venue in which to explore the existence of congenital deformities or medical illness in the drawings, paintings and sculptures.
Retrospective investigations may try to shed light on the reasons why the artists included anatomical variations or diseases in a painting, and although the discussion is only speculative there is great interest in health professionals in understanding the underlying meaning. Often no written historical document can actually confirm the intention of the painters in depicting the disease. Medical deduction from artists’ work presents intriguing challenges covering: artistic convention, hallmark of the artist’s school, intentional true or inadvertent depiction, underlying symbolic/religious meaning or iconographical attributes.
Among the several diseases that have been sparsely depicted, a decade ago the attention of the medical literature and of the readers of the Journal of the Royal Society of Medicine has been attracted by figures depicted in some 16th and 17th century Renaissance art by Flemish and Italian painters, where the hand has been depicted with unusual representations or real deformities involving the fifth finger.1–3 Therefore, we conducted a systematic review among the works of the major Italian Renaissance artists. We have recognised further cases and tried to contribute to the discussion with the aim of answering some unsolved questions.
The painters
A closer look at the anatomical details revealed a particular fashion in depicting the fifth finger of the hand in nine major Italian Renaissance artists (Figures 1 to 4).
(a) Details of The Mystical Marriage of St. Catherine (date unknown), by Bernardino di Betto better known as ‘Pinturicchio’ (from the Pinacoteca Vaticana [Vatican City, Vatican]); (b) Detail of Madonna and Child with St. John the Baptist (1486), by ‘Pinturicchio’ (from the Museo Diocesano del Duomo di Città di Castello [Perugia, Italy]); (c) Detail of The Virgin and Child with Saint Jerome (1475–1480), by ‘Pinturicchio’ (from the Fine Arts Musem [Boston, MA, United States]); (d) Detail of The Virgin and Child with goldfinch and Sts. John the Baptist, Paul, Peter, and Sebastian (date unknown), by ‘Pinturicchio’ (from private collection); (e) Details of The Virgin and Child with Two Angels (1475–1480) by ‘Pinturicchio’ (from private collection); (f) Detail of Madonna and Child with Saints (1497), by ‘Pinturicchio’ (from the Dome of Spoleto [Italy]); (g) Detail of The annunciation (1500–1501), by ‘Pinturicchio’ (from the Baglioni’s Chapel, Collegiate church of Santa Maria Maggiore [Spello, Italy]); (h) Detail of Adoration of the Child with St. Jerome (1488–1490), by ‘Pinturicchio’ (from the Della Rovere Chapel or the Chapel of the Nativity, Basilica of Santa Maria del Popolo [Rome, Italy]); (i) Detail of The resurrection (1492–1494), by ‘Pinturicchio’ (from the Borgia Apartments in the Apostolic Palace in the Vatican [Vatican City, Vatican]); (j) Detail of Madonna with the blessing child (1480), by ‘Pinturicchio’ (from the National Gallery [London, UK]); (k) Detail of Virgin and child (date unknown), by ‘Pinturicchio’ (from private collection); (l) Details of Aeneas Piccolomini Introduces Eleonora of Portugal to Frederick III (1502–1508), by ‘Pinturicchio’ (from the Museum of Opera of the Dome [Siena, Italy]); (m) Details of Madonna of the Peace (1490), by ‘Pinturicchio’ (from Pinacoteca civica Tacchi-Venturi, [San Severino Marche, Italy]). (a) Details of Madonna between St John the Baptist and St Sebastian (1493), by Pietro di Cristoforo Vannucci also known as Pietro Perugino (from the Galleria degli Uffizi [Florence, Italy]); (b) Detail of The Archangel Raphael with Tobias (1496–1500), by Pietro Perugino (from the National Gallery [London, UK]); (c) Detail of Madonna between St John the Baptist and St Sebastian (1493), by Pietro Perugino (from the Galleria degli Uffizi [Florence, Italy]); (d) Details of Madonna Enthroned with Saints Catherine and Rose of Alexandria and two angels (1489–92), by Pietro Perugino (from private collection); (e) Details of Madonna of Loreto (1507), by Pietro Perugino (from the Victoria and Albert Museum [London, UK] [Poland]); (f) Detail of Corciano Alterpiece (1513), by Pietro Perugino (from the Church of Saint Mary [Corciano, Italy]); (g) Detail of Madonna and Child (1465), by Giovanni Bellini (from the Kimbell Art Museum [Fort Worth, TX, United States]); (h) Detail of Madonna and Child (1490–1500), by Giovanni Bellini (from the Indianapolis Museum of Art [Indianapolis, IN, United States]); (i) Detail of Madonna with Blessing Child (1510), by Giovanni Bellini (from the Pinacoteca di Brera [Milan, Italy]); (j) Detail of Madonna and Child (1460–1470), by Giovanni Bellini (from private collection [Italy]); (k) Detail of Madonna with the Thumb (1460–1465), by Giovanni Bellini (from the Venetian Academy [Venice, Italy]).
Bernardino di Betto also known as ‘Pinturicchio’ (little painter) because of his small stature (1452–1513), Domenico Bigordi also known as Ghirlandaio (1449–1494), Paolo di Dono or Paolo Doni also known as Paolo Uccello (1397–1475), Timoteo Viti (1469–1523), Giovanni Santi (1433–1494) who was Raphael Sanzio’s father, Alessandro di Mariano di Vanni Filipepi also known as Sandro Botticelli (1445–1510), Piero di Benedetto de’ Franceschi also known as Piero della Francesca (1416/1417–1492), Pietro di Cristoforo Vannucci also known as Pietro Perugino (1448–1523), Giovanni Bellini (1433–1516) were all renowned draftsmen, artists and painters and recognised masters of the Renaissance period. These painters should be added to the lists of artists who used an unphysiological presentation while depicting the fifth finger of the hand collected by Hijmans and Dequeker 1 (Dirk Bouts, 1410–1475), by Fras 2 (Gerard David, 1455–1523) and by Johnson 3 (Filippo Lippi, 1406–1469; Hans Memling, 1430–1494; Cosimo Roselli, 1439–1507 and Luca Signorelli, 1445–1523).
The depiction of the fifth finger
In their paper Hijmans and Dequeker tried to argue their hypothesis in favour of the depiction of camptodactyly by Dirk Bouts and tried to differentiate these canvases from other representations of the period in which similar deformities including the little finger were portrayed. 1 Indeed, throughout the manuscript the Dutch and Belgium authors elegantly excluded other diseases including rheumatologic disorders (polyarticular nodular osteoarthritis and rheumatoid arthritis) and different finger deformities (clinodactyly, claw-hand deformity, arachnodactyly). 1 A master of painting like Bouts who had a strong reputation for attention to detail and whose style is renowned for clarity of form would have left little to chance in his works and it is doubted by the authors that he included the abnormal details by accident. In addition, Hijmans and Dequeker 1 having failed to note similar anomalies in other contemporary artists’ works rejected ‘mannerism’ as the answer.1,3 They conclude their investigation arguing that their observations indicate that the same individual had been the common factor in five separate representations. Letters questioning this hypothesis were published in the JRSM claiming further cases of fifth finger deformities including camptodactyly in the same period were depicted by several artists2,3 and discrediting the diagnosis of camptodactyly made by Hijmans and Dequeker 1 based on the observation of Bouts’ works. Fras concluded that because of the many painters who adopted the same fashion in depicting the fifth finger as resembling the effect of camptodactyly or similar finger deformities, it may be presumed that Bouts had observed a hallmark convention that was very common in that period rather than representing a specific hand disorder. 2 On the same wavelength Johnson argued that to imbue and to idealise the delicacy and the grace of the hand depiction, some members of the Netherlandish and Italian Renaissance movements in using this unnatural depiction of the fifth finger may simply have been following an artistic trend of that period. 3
Discussion
No other artistic movement has contributed more to development of art as a conundrum of science, physiology and anatomy than the Renaissance. After centuries of depiction of human figures in profile lacking appropriate shading with no real depth or perspective, the Renaissance revolution reintroduced in the art some aspect of the Greek and Roman cultures leading to an increasing interest in knowledge about the human body form and function along with innovations in mathematics and science. The artists became able to represent human body shape in its static position and dynamic movements and the renewed Greek–Roman influence drove them towards the representation of the ideal beauty. To obtain ideal figures with perfect proportions and harmonious shapes, the Renaissance artists often used technical tricks such as small proportions or deformities that were imperceptible at first sight. Two major examples of these Renaissance hallmarks are shown by Michelangelo in his ‘David’ and in his ‘Pietà’. In the first case, the head and the hands were oversized compared to the rest of the body to symbolise his ability to act and his intelligence/smartness. In the second statue, the arms and the hands of the Virgins were sculpted with larger dimensions than those of Jesus Christ to include the body of Christ in a harmonic pyramid within the virtual boundary of the Virgin and her dress.
The present investigation could confirm the presence of this trend among the major Renaissance painters also regarding the depiction of the hand. Many of the artists’ models are unknown (Figures 1 to 4), save for a few known individuals and even less so the subject of oft-repeated themes such as the Madonna and child. Anyway, it seems unlikely that so many painters whose combined artistic lives span over a century and whose creations were made in very different cities, including Perugia, Urbino, Florence, Siena and Rome were dependent on one and the same genetic pool of models, or that this small pool of models was used for different periods of the artists’ life. Even repeated facial characteristics by the same artist in paintings, at different times, of the Madonna cannot be taken as a conclusive indicator of the use of the same model. And it seems that even the most fertile imagination could not envisage that Europe during the Renaissance period was drastically populated with hand- or finger-deformed people.
During the 15th and 16th centuries, two different schools of painters emerged: those who were following the ‘representation’ and those who were searching the ‘description’ of the reality.4,5 Apparently all the visual art movements including painting and theatre distinguished a ‘representative’ method from a ‘descriptive’ method of interpreting reality giving birth to two different schools of thought. The first one would modify, trim and summarise reality as it strived to represent ‘beauty’. The second described reality as it is, including pain and deformity, to depict the human condition. To summarise: on one side there was an aspiration towards beauty and magnificence, (that was the philosophy of the Catholic area of thought); on the other side there was the idea that factual representation was paramount (that was a feature of the Dutch school and a future basis of Calvinistic doctrine). Although the aforementioned distinction can be applied to all of the figures of the manuscript, there is a further subgrouping that is required. The posture of the hand usually hides the meaning of ‘sense’ that usually expressed or indicated the meaning of the work. Therefore, the analyses should be conducted painting by painting. There are some paintings that showed clearly finger deformities resembling camptodactyly, whereas some leave the observer more sceptical because in a sense the work would be devalued, diminishing the underlying spiritual and theological concepts. Indeed, images ‘e’, ‘g’, ‘h’, ‘l’ and ‘m’ of Figure 1, image ‘k’ of Figure 2, images ‘g’, ‘l’ and ‘o’ of Figure 3 and images ‘f’, ‘g’ and ‘j’ of Figure 4 may be classified as resembling camptodactyly, while its diagnosis should be excluded in all the other images because such gestures seem to represent a hallmark feature intended to give some elegance to the hand and grace to sacred subjects.
(a) Details of The Virgin and Child with Sts Jerome and Gregory the great (1502–1508), by Bernardino di Betto better known as ‘Pinturicchio’ (from the Louvre Museum [Paris, France]); (b) Detail of Madonna and Child (1490), by ‘Pinturicchio’ (from the Gardner Museum [Boston, MA, United States]); (c) Detail of The Virgin and Child with the Infant Saint John the Baptist (1490–1500), by ‘Pinturicchio’ (from the Poldi-Pezzoli Museum [Milan, Italy]); (d) Detail of Madonna with Writing Child and St. Jerome (1480), by ‘Pinturicchio’ (from the Gemäldegalerie [Berlin, Germany]); (e) Details of Madonna with blessing Child (1490) by ‘Pinturicchio’ (from the Museum of Warsaw [Poland]); (f) Detail of Virgin with Child (date unknown), by ‘Pinturicchio’ (from the Ashmolean Museum [Oxford, UK]); (g) Detail of Madonna with the Blessing Child (1492–1493), by ‘Pinturicchio’ (from private collection); (h) Detail of Madonna and Child (1480–1513), by ‘Pinturicchio’ (from Pinacoteca Vaticana [Vatican City, Vatican]); (i) Detail of Madonna enthroned with the Saints (1407–1408), by ‘Pinturicchio’ (from the Saint Andrew’s Church [Spello, Italy]); (j) Detail of Madonna of the milk (1492), by ‘Pinturicchio’ (from the Sarah Campbell Blaffer Foundation, [Houston, TX, United States]); (k) Detail of The Adoration of the Shepherds (1501), by ‘Pinturicchio’ (from the Baglioni’s Chapel, Collegiate church of Santa Maria Maggiore [Spello, Italy]); (l) Detail of Madonna and Child before a landscape (date unknown), by ‘Pinturicchio’ (from the Museo Colección Particular [Madrid, Spain]). (a) Detail of Madonna (1473), by Domenico Bigordi also known as Ghirlandaio (unknown location); (b) Detail of The Virgin and the Child (1480–1490), by Domenico Ghirlandaio (from the National Gallery [London, UK]); (c) Detail of Madonna and Child (1470), by Domenico Ghirlandaio (from the National Gallery of Art [Washington, DC, United States]); (d) Detail of Madonna and Child (1450–1460), by Paolo di Dono or Paolo Doni also known as Paolo Uccello (unknown location); (e) Detail of Saint Margareth of Antiochio (1510), by Timoteo Viti (from Museo Accademia Carrara [Bergamo, Italy]); (f) Details of Madonna and Child with the Sts. Clare, Bonaventure, Francis, Ursula and the Virgins (date unknown), by Timoteo Viti (from Monastero delle Clarisse Church of Saint Clare [Italy]); (g) Detail of The Annunciation (date unknown), by Giovanni Santi (from Casa Santi [Urbino, Italy]); (h) Detail of Visitation (date unknown), by Giovanni Santi (from Church of Santa Maria Nuova [Fano, Italy]); (i) Detail of Christ supported by two angels (1490), by Giovanni Santi (from the Museum of Fine Arts [Budapest, Hungary]); (j) Detail of Madonna with Enthroned Child and Saints (1484), by Giovanni Santi (from the Altarpiece of pieve di Santa Sofia [Italy]); (k) Detail of The Virgin Adoring the Sleeping Christ Child (1490), by Alessandro di Mariano di Vanni Filipepi also known as Sandro Botticelli (from the National Gallery of Scotland [Edinburgh, Scotland]); (l) Detail of Portrait of a Young Man (1482–1485), by Sandro Botticelli (from the National Gallery of Art [Washington, DC, United States]); (m) Detail of Virgin and Child with Six Angels and the Baptist (1485), by Sandro Botticelli (from the Borghese Gallery [Rome, Italy]); (n) Detail of Madonna of the Pomegranate (1487), by Sandro Botticelli (from the Galleria degli Uffizi [Florence, Italy]); (o) Detail of Virgin and Child with the Infant St. John the Baptist (1490–1500), by Sandro Botticelli (from the São Paulo Museum of Art [San Paulo, Brasil]); (p) Detail of Madonna of Senigallia (1474), by Piero di Benedetto de’ Franceschi also known as Piero della Francesca (from the National Gallery of Marche in the Ducal Palace of Urbino [Urbino, Italy]).
Therefore, although some of the paintings included in our systematic review show human figures with the hand depicted as resembling camptodactyly involving the fifth finger, it is most likely that all the aforementioned artists in their career merged attributes from various models to create an idealised beauty of the hand. Their ability and artistic skills in drawing anatomy would have been enhanced by the anatomical studies and dissections of that time. This may explain how they could depict physical features without requiring the presence of models.