The Art of Medicine: Over 2,000 Years of Images and Imagination

In his foreword to The Art of Medicine: Over 2,000 Years of Images and Imagination, Antony Gormley reminds the reader of the “pre-enlightenment idea of a Wunderkammer, or cabinet of curiosities … a collage of objects and images put together less to tell you what to think and what things were, than to incite your wonder and curiosity.” The Art of Medicine, by Julie Anderson, Emm Barnes, and Emma Shackleton, fulfills this objective by presenting selected treasures from the Wellcome Collection—photographs, drawings, etchings, lithographs, paintings, sculpture, artifacts, electron micrography, and other genres that document the history of medical progress and changing attitudes toward health and the human body. Whether through illustrations or “maps” of the human body executed by Renaissance anatomists or paintings that reflect medical practices of a particular era, the book is far-ranging in its coverage of visual images. It covers artistic treatments of health, the mind and body, anatomy, physiology, pathology, radiology, and medical, pharmaceutical, dental, and surgical treatment, all within chapters on specific beliefs and cultural traditions related to medicine and to the contributions of individual scientists who helped advance medical progress. But it is the art, rather than the authors’ text, that propels the book’s major premises.

In their introduction to the book, Ken Arnold and Simon Chaplin claim that, rather than “attempting to provide a comprehensive visual survey of medicine’s global history, or indeed even a systematic layout of Wellcome’s own museum and library, the approach here has instead been to let the material—the images, objects, and artworks take the lead.” Given the stated purpose of the book, one can argue that the high quality of the visual images contributes to its success and provides a mirror of human culture and history with all its quirks, eccentricities, and detours, as well as its monumental discoveries and achievements. We would argue, however, that in merely reflecting “the hectic variety of [Wellcome’s] collection that lent it its unique character,” the bookfalls short of its intended goal to stimulate “wonder and curiosity.” In order to incite curiosity, we believe a work of historic import must open the reader to questions stimulated by the authors’ interpretation of the subject matter; but the book’s inscrutable organization and its cursory references to historical facts and opinions deny any such stimulation. Too often, The Art of Medicine relies on common knowledge and generalized facts rather than analysis, comparison, and cross-reference.

Each chapter is divided into subsections. The first and most ambitious chapter, “Mapping the Body,” addresses the history of anatomical studies from a variety of cultures over a period of 600 years, including images from Asian and European medicine and a chronological summary of progress in the field of anatomy from the Middle Ages to the present. Although there is an implied geographical and cultural comparison, the authors do not follow that route in any depth. Other subsections focus on the geography of the body, such as the brain, the chest, the heart, etc. But the abrupt transitions between each—in one representative example, moving from anatomy to the physiology of pregnancy and embryos, then onto DNA, and then genetics—causes the authors’ perspective to blur. Their whimsical organization might be in the service of an unarticulated argument: Every hasty transition and subsection is relevant because the human body is a complex organism without an ostensibly logical explanation. The body is visible not only to the naked eye but also to the highly trained scientist who can interpret electron micrography—hence the book’s juxtaposition of scientifically primitive and sophisticated images. Or perhaps the author’s point is that the complexity of the human body is made clear only by contrasting contemporary forms of electronic “mapping” with ancient anatomical drawings, or by interrupting geographical examples with digressions into chronology. Although such implied premises are valid insofar as the book’s organization mirrors that of Wellcome’s collection, the text fails to take the reader on an inductive journey from example to idea.

The organization of the second chapter, “Medicine in our Lives,” is typical of the authors’ tendency to follow distracting detours. For example, the first two subsections, “Medicine and Belief” and “Memento Mori,” are logically connected in their focus on spirituality and mortality. However, the next subsection, “Traditional North American Medicine,” might be better suited to the third chapter, “Understanding Illness and Developing Cures.” Because the third chapter reviews a variety of “alternative” medical treatments, it would be a more logical location for images of First Nation medicine men. Similarly, the subsections “Physicians Taking the Pulse,” “Caricatures of Physicians,” “Hogarth’s Insights,” and “Medicine and Politics” are thematically related in their focus on the historical role of the physician, but they’re separated from each other by five consecutive and interruptive subsections—“Hospitals,” “Nurses,” “Childbirth,” “Dispensing Medicine,” and “Tonics and Curatives.” The authors might have avoided confusing the reader by combining the four sections pertaining to the role of the physician. Although the four sections discuss the art in greater detail than other chapters of the book, including an excellent series of examples of the physician as the object of satire, the significant connections between medical caricatures and medicine as metaphor are only superficially noted.

Less distracting but worth questioning is the placement of subsections that feature important contributors to medical progress: Andreas Vesalius and Jacques Gautier d’Agoty in the first chapter, Ambroise Paré in the fourth. These scientists and physicians merit a separate, chronologically organized chapter on men and women of science. It would also enhance these biographical vignettes to include some of the controversial questions associated with them. For example, scholars have questioned whether Vesalius or the artist Jan Stephen van Calcar executed the anatomical drawings usually credited to Vesalius, or whether the two men worked together. Similarly, Paré’s collection of drawings of the human body helped to document his use of empirical evidence at a time when a priori reasoning was preferred over the surgeon’s use of experimentation and observation. Considering the number of visual images in the book and its title, it is surprising that the authors do not examine the relationship between artists and physicians, which was so vital in the Renaissance.

The role of women in medicine is also given short shrift. No separate chapters are devoted exclusively to women in science. The third chapter rather lazily pairs images of nurses with a generalizing paragraph on the influence and impact of Florence Nightingale on nursing. The example has the effect of a gratuitous nod to women in the medical field, and the missed opportunity is unnerving.

Apart from the captions and descriptions accompanying images, The Art of Medicine features a narrative or descriptive piece in each subsection, usually just two or three paragraphs addressing the subject matter rather than the images of the section. Because of the brevity of these pieces, the reader is left with only general facts and history on the subject at hand, and there is little, if any, reference to specific historical examples. Analysis of the causes and consequences of significant discoveries is also missing. For example, in the subsection on childbirth in the second chapter “Medicine in our Lives,” the narrative avoids the mention of important milestones in making childbirth safer for women. The text makes no reference to the discoveries of Ignaz Semmelweis, which led to a decrease in puerperal sepsis in post-partum women. His empirically tested theories helped prevent infection in the maternity wards of European hospitals, thus making them safer for future childbearing women. It is not until the fourth chapter, “Treating with Surgery and Healing Wounds,” that any mention is made of Semmelweis’s contribution to safer childbirth practices. The problem of overly generalized text, then, appears to be one of faulty organization as well as misplaced emphasis and analysis.

Another type of omission detracts from the credibility of the authors’ use of examples. In a subsection of the fourth chapter titled “Pain and Relief,” the authors discuss the development of anesthesia and its use in pain reduction during surgery. Although English physicians Beddoes and Davy are named for their experimentation with nitrous oxide, and Simpson for his use of chloroform, an important experiment in American surgery is mentioned without names when the authors cite “a public demonstration in America” on the use of ether. Although this experiment, reported by Harvard professor Bigelow in 1846, was a significant breakthrough in the history of pain relief, and helped popularize the use of ether in surgery, the authors skim over the example without mentioning Bigelow. This oversight may reflect the authors’ expectation of a primarily British rather than American audience—the Wellcome Collection is, after all, a highly revered British institution—but the vague reference to American advances in anesthesia seems to underestimate the general reader’s curiosity about global scientific progress and desire for specificity.

The Art of Medicine deserves to be lauded for the variety and visual clarity of its images. The juxtaposition of ancient and modern, realistic and abstract, primitive and academic images reminds the reader of the numerous ways in which the body’s structure and functions have been represented over time. Magnetic resonance imaging, color-enhanced light microscopy, and digital artwork, for example, provide us with aesthetically fascinating examples unique to our era of sophisticated medical technology. The richness of the book’s images would be more powerful, however, with a more incisive analysis of the Wellcome Collection beyond matters of common knowledge and within the context of medical history. One wonders who the authors’ intended audience is. The general reader might enjoy the pictures, but would be frustrated by the book’s inconsistencies in organization; the reader with a background in science or art, already familiar with much of the material, would surely appreciate more substance in the text.