Tuesday, February 10, 2015

Diagnosis through Art

There is an unusual hand condition called Dupuytren's contracture that affects an estimated 3 percent of white men over the age of 40, and a lesser number of somewhat older women.  It has a strong genetic correlation, and its effects vary by patient.

The essence of the condition is a tightening of the inside tissue, usually of the ring and/or baby fingers, that makes it more difficult over time to straighten the hand.  There are various treatments, the first a surgery devised by a French doctor, Baron Guillame Dupuytren, who described and named the disease in the early 19th century.

Dupuytren's in History

Not all medical symptoms are documented in careful notes preserved down the centuries.  So it was with Dupuytren's.  At some point, doctors began calling it the "papal benediction," based on its resemblance to historical depictions of European saints.

Below is a modern medical guide's illustration of the papal benediction, aka Dupuytren's disease, in its advanced stages:

There were no photographs in the years before the condition was described, and now many doctors and people with Dupuytren's look at the images that do remain -- mostly religious art -- and see it that it has a long history.  

It seems clear that artists were familiar with the condition and were depicting it long before it had a name.  Once you start looking, you see it everywhere.

A few examples are below:

St. Peter at St. Peter's Basilica, Rome

St. Nicholas at Melisende Psalter, Jerusalem

St. Patrick near Saul, Ireland

St. Francis of Assisi, from the workshop of Rubens

St. Sebastian, on the left, (with St. Appollonia right) by Bici di Neri

St. Benedict of Nursia by El Greco

St. James the Minor by El Greco


As genetically passed conditions go, Dupuytren's is not particularly scary.  It seems not to have inhibited the careers of playwright Samuel Beckett or Ronald Reagan.

The video below suggests it can be treated successfully even for a major classical pianist.

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