A Hole in the Head

by Charles G Gross

  14. Gross and Mishkin, 1977.

  15. E.g., Hamilton and Tieman, 1973; Lehman and Spencer, 1973; Storandt, 1974; Corballis, Milner, and Morgan, 1971; Bradshaw, Nettleton, and Patterson, 1973.

  16. Blakemore, 1973a.

  17. Critical reviews of the dyslexia literature are in Money, 1962, particularly articles by Money, Saunders, and Benton; Critchley, 1970; and Benton, 1975.

  18. Money, 1962; Shankweiler, 1963. The importance of mirror-image confusion to dyslexia is supported by the fact that specific dyslexia is apparently absent among Japanese children, and there are no mirror forms in Kana script, which is used for learning to read in Japan (Makita, 1968).

  19. Schmitt and Worden, 1974; Kinsbourne, 1976; Dimond and Beaumont, 1974; Harnard et al., 1977.

  20. The situation in left-handed people is not just the opposite of right-handed people. Some have language in the left hemisphere and visuospatial functions in the right, just like right-handers. Others are the reverse of right-handers in having language in the right hemisphere and visuospatial functions in the left. A third group of left-handers has both language and nonlanguage perceptual functions in each hemisphere. This heterogeneity of localization of function in left-handers probably reflects the fact that people are left-handed for several different reasons, such as heredity or some slight early trauma to the left hemisphere. See references in note 11 and Hecaen and Sauquet, 1971.

  21. Indirect support for this possibility is the finding that right-handed people can read mirror-reversed words in their left visual field (projecting to their right hemisphere) more easily than in their right visual field (Harcum and Finkel, 1963).

  22. E.g., Symmes and Rapoport, 1972.

  23. Money, 1962; Shankweiler, 1963; Symmes and Rapoport, 1972.

  24. Wölfflin, 1941; Gaffron, 1950; Oppe, 1944; Shapiro, 1970; Arnheim, 1974.

  25. Wölfflin, 1941.

  26. Gaffron, 1950.

  27. Gaffron, 1950.

  28. Swartz and Hewitt, 1970.

  29. Ross, 1966; Gordon and Gardner, 1974.

  30. Wölfflin, 1941; Gaffron, 1950; Arnheim, 1974.

  31. Objects appear closer: e.g., Adair and Bartley, 1958; clearer: Dallenbach, 1923; Burke and Dallenbach, 1924; heavier: Levy, 1976.

  32. Kinsbourne, 1974; Gur, 1975.

  33. McManus and Humphrey, 1973.

  34. Jensen, 1952a, 1952b.

  35. Leonardo da Vinci, 1970. Why did Leonardo da Vinci mirror-write? Mirror-writing is common when a person either writes with two hands simultaneously or with the nonpreferred hand, particularly without looking. This is presumably because if the muscles of the nonpreferred hand make the same movements as those normally made by the corresponding muscles of the preferred hand, the result will be mirror-writing. Perhaps Leonardo was taught with his right hand, and, because he was a left-hander, mirror-writing was the natural tendency when using his preferred left hand. Leonardo was hardly one to let convention alter his natural inclinations when writing notes to himself. The suggestion that his mirror-writing was a secret code hardly gives much credit to him or his contemporaries. In any case, as Luigi Boldetti showed, Leonardo “protected” many of his inventions by introducing an intentional error into his plans, such as an extra cogwheel or an unnecessary ratchet (see Calder, 1970).

  36. Gilbert and Bakan, 1973; Ellis and Shepherd, 1975; Young and Ellis, 1976.

  37. Wölfflin, 1941; Arnheim, 1974; Swartz and Hewitt, 1970.

  38. Dean, 1946.

  39. Gaffron, 1950.

  40. Buswell, 1935; Hess, 1965; Noton and Stark, 1971; Yarbus, 1967.

  41. Landauer, 1969. Landauer asked undergraduates and professional artists for their preferences for one of four possible orientations of abstract paintings made by artists in the United States. Only 35% of the preferences were veridical.

  42. Rollenhagen and Olsen, 2000; Baylis and Driver, 2001; Gross, 1978; Holmes and Gross, 1984.

  43. Gross, 1978; Holmes and Gross, 1984.

  44. van Zoest et al. 2006.

  45. Biederman and Cooper, 1991; Fiser and Biederman, 2001.

  46. West, 1997.

  47. Wolff and Lundberg, 2002.

  48. McManus, 2002.

  49. Coren, 1992.

  7

  REMBRANDT’S THE ANATOMY LESSON OF DR. JOAN DEIJMAN

  Rembrandt van Rijn’s striking painting of a human brain being dissected by a headless figure, The Anatomy Lesson of Dr. Deijman (1657), may be the most famous portrayal of a neuroscience procedure (figure 7.1). It represents a curious combination of two genres of European painting: the group portrait and the historical painting, in this case an account of a public dissection. Such dissections served both educational and entertainment functions in seventeenth-century Holland.

  The great popularity of group portraits was a unique Dutch phenomenon.1 In sixteenth-and seventeenth-century Holland, there was no sovereign monarch or royal court and thus no royal patronage of the arts.2 Furthermore, due to the rise of Calvinism, the Church no longer supported the arts. Thus, the principal large commissions available to artists were group portraits of the members of trading associations, hunting clubs, and guilds or other civil institutions. As the subjects were usually the organization officers or “board of regents,” these group portraits are often termed “regents’ portraits.” The Night Watch (1642), one of the most famous of Rembrandt’s masterpieces, was such a commissioned group portrait of a company of Civic Guards in which the amount of money each subject contributed determined his prominence in the painting.3

  Figure 7.1

  Rembrandt, The Anatomy Lesson of Dr. Joan Deijman (surviving fragment of original), 1656. Amsterdams Historisch Museum.

  One type of regents’ portrait was the “anatomy lesson,” a group portrait of the leading members of a surgical guild (or, more specifically, those members who contributed to the cost of the painting).4 Before Rembrandt, the figures in these paintings were usually gathered rather stiffly and artificially around a skeleton, skull, or body being autopsied (figure 7.2). In Rembrandt’s hands, however, the “anatomy lesson” developed beyond a group portrait to become a more or less accurate account of a significant historical event in the life of the bourgeois Dutch community, namely the public dissection of an executed criminal.

  PUBLIC DISSECTIONS AS THEATER

  The spectacle of public dissections in front of large audiences of both medical professionals and laymen began in the early Renaissance medical schools of Italy and had become common throughout the continent by the middle of the sixteenth century.5 In Holland, they were an elaborately regulated public ritual in the major cities. Since each city usually authorized only one such public dissection each year, it became a major event in the Dutch social, educational, and entertainment calendar; it went on for three to five days following the execution.6

  The dissections were conducted by a leading surgeon in the community who had been appointed the city praelector chirurgic et anatomie. They were held in the winter to retard putrefaction of the bodies and were conducted in special anatomical theaters that held 200 to 500 spectators (see figure 7.3).7 The affairs were evening events, illuminated by scented candles and often accompanied by flute music. The rival professional groups, the physicians and surgeons, sat separately from each other and from the lay public. Everyone was charged admission. The proceeds were used not only to pay the fee of the praelector but also for food, drink, and tobacco at the major banquet of the Guild of Surgeons. The banquet was followed by a torchlight parade.8

  Figure 7.2

  N. Eliasz, The Anatomy Lesson of Dr. Johan Fonteijn, 1626. Amsterdams Historisch Museum.

  Figure 7.3

  W. Swanenburgh (1581–1612) after J. C. Woudanus (ca. 1570–1615), The Anatomical Theater in Leiden, 1610. Amsterdam, Rijksmuseum. Rembrandt’s drawing of a human skeleton riding a skeleton horse, Skeleton Rider (ca. 1655, Darmstadt Museum) is believed to be of the skeleton in the upper right, or possibly of a similar exhibit reported in the anatomical the
ater in Amsterdam. The drawing, in turn, is thought to be closely related to Rembrandt’s The “Polish” Rider, ca. 1655. New York, Frick (Held, 1991).

  In ordinances of 1605 and 1625 regulating the dissections in Amsterdam, the audience was explicitly forbidden from talking or laughing during the dissections. They could ask questions as long as they were of a “decent and serious nature.” Body parts such as the heart, kidney, and liver (the membra naturalia) were passed among the audience but stiff fines were in place to ensure their return.9 At least until the seventeenth century only male bodies were used.

  These rare dissections were particularly valuable for the physicians and surgeons in the audience since anatomy was then viewed as the fundamental basis of medicine and surgery. In addition, contemporary accounts stress the educational value of the dissections for the general audience, for example, in demonstrating “the secrets of nature revealed by God.” They also continued the hoary practice of discouraging crime by mutilation of the criminal’s body after death. Finally, they were also very good theater.10

  Some historians have emphasized the more general scientific, artistic, and cultural roles of the anatomical theaters.11 At that time, Holland, unlike Britain, France, and Italy, had neither scientific societies nor scientific journals. Thus the anatomical theaters served as important venues for scientists to meet and discuss their work. Lectures on medical and other topics were routinely scheduled there. The anatomical theaters usually included attached libraries, museums (“natural history cabinets”), and even botanical gardens. Major paintings were exhibited, particularly, of course, “anatomy lessons.”

  THE ANATOMY LESSON OF DR. NICOLAES TULP

  Rembrandt painted two anatomy lesson group portraits, both of members of the Surgeons’ Guild of Amsterdam. The first, painted in 1632, was The Anatomy Lesson of Dr. Nicolaes Tulp (figure 7.4). It was commissioned by Tulp, the city praelector, and paid for by those portrayed in it (except for Aris Kint, the cadaver, who had been hanged for robbery with violence).12 Although in the form of the usual group portrait, it was actually a strikingly original artistic triumph. For the first time, Rembrandt dramatically emphasized the dissection rather than just the dramatis personae. The lecture dissection is shown as the dramatic event it must have been. The portraits do not look “pasted on” as was usually the case before (figure 7.2); rather they are portrayed as individuals, with considerable variation in how and how much each is paying attention to the dissection.

  Figure 7.4

  Rembrandt, The Anatomy Lesson of Dr. Nicolaes Tulp, 1632. The Hague, Mauritshuis Museum.

  In spite of its artistic superiority, the painting was typical of previous “anatomy lessons” in deviating considerably from an accurate account of the real event.13 At the actual dissection, the guild members, other than the lecturer and perhaps his assistant, would have been in the front rows of the audience rather than on the stage around the lecturer. Tulp is shown starting by dissecting an arm when, in fact, the body cavity was always opened first and the limbs were usually not reached until the second day. Finally, Rembrandt’s rendering of the anatomy of the arm is rather distorted and inaccurate.

  The painting was Rembrandt’s first group portrait and it was an immediate success. It established him as a major portrait painter, leading to many portrait commissions. In fact, medical professionals were “among the most faithful of Rembrandt’s patrons throughout his life.”14

  The fame of The Anatomy Lesson of Dr. Nicolaes Tulp went beyond the world of art history. As was first pointed out by the English critic John Berger, it was the model for the picture of the murdered Che Guevara that sprung from the first pages of newspapers around the world: the Christlike figure lying half-naked and surrounded by Bolivian officers and soldiers, the commanding officer mimicking the stance of Dr. Tulp.15

  THE ANATOMY LESSON OF DR. JOAN DEIJMAN

  Twenty-four years later, Rembrandt painted his second and final anatomy lesson. Now the praelector was Dr. Joan Deijman, Tulp’s immediate successor. This painting, originally measuring 245 by 300 centimeters, was badly damaged in a fire in the eighteenth century and only the central portion (113 x 135 cm) of the lower half survived. This fragment then disappeared and was rediscovered in England in the nineteenth century, and badly slashed in the twentieth.16

  After the painting was completed, Rembrandt made a sketch of it for the design of its frame. On the basis of this sketch, of contemporary accounts of the intact painting, and of Rembrandt’s other portraits, the original painting has been reconstructed (figure 7.5).17 Whereas the original consisted of the portraits of eight spectators in addition to Dr. Deijman, his assistant, and the cadaver, in the fragment only the cadaver, the assistant, and a headless Dr. Deijman survive (figure 7.1). The body was that of Joris Fonteijn, who had just been hanged for his “habitual criminality.”

  The portrait is a more accurate account of the standard public dissection than Rembrandt’s earlier painting. The dissection of the viscera has been completed first and Deijman has removed the top of the skull (which his assistant is holding), has flapped back the dura, and is presumably about to start the usual next step, horizontal sections of the cerebrum. It is not clear whether Rembrandt actually sketched this or any other brain dissection from life. However, the view of the brain and the flapped-back tissue is virtually identical to plate 67:2 of Andreas Vesalius in his On the Fabric of the Human Body (1543),18 even in regard to the expression of the mouth. It is thus almost certain that Rembrandt depended heavily on this Vesalius figure, whether or not he also made his own observations.

  The overall design of the painting also seems to have been influenced by the famous title page of Vesalius’s great work.19 In the center of that woodcut, Vesalius is shown dissecting a human corpse in front of a Palladium-like stage.20 Although most of Rembrandt’s other multiperson paintings are asymmetrical, the principal features of this painting, the body and the dissector, are placed in its very center. (Even Christ does not usually get this treatment in Rembrandt.) The stagelike structure with which Rembrandt surrounds his picture may also be derived from the stage in the background of the Vesalius frontispiece; there does not seem to have been a similar stage in the Amsterdam anatomical theater.

  Figure 7.5

  Rembrandt, The Anatomy Lesson of Dr. Joan Deijman, computer montage reconstruction by N. Middelkoop and T. Wolzak (Middelkoop, 1994) Amsterdams Historisch Museum. The missing portraits are taken from other Rembrandt paintings.

  Artistically, Dr. Deijman is considered an even greater masterpiece than Dr. Tulp.21 The radically foreshortened body is particularly dramatic, leading the viewer’s eye from the confronting feet, across the open viscera to the brain and the scalpel. (This arrangement of the body is considered to be derived from Montegna’s Dead Christ in Milan.) The eyes are just enough in shadow to threaten to stare directly at the viewer. The blackish toes and lips, the yellow skin tone, and the rigor mortis are all of a reality never before seen in an “anatomy lesson.” When the great English painter and critic Sir Joshua Reynolds saw the full original in 1781 he commented, “There is something sublime in the character of the head which reminds me of Michael Angelo; the whole is finely painted, the colouring much like Titian.”22

  Today, the original functions of “anatomy lesson” paintings are fulfilled by group photographs usually posed in front of the organization’s building or meeting place. The lay functions of the public dissection, namely entertainment, voyeurism, and education, are largely carried out by television.

  POSTSCRIPT

  This article as originally published did not have the space to deal with three other aspects of the “anatomy lesson” paintings of Rembrandt. The first is who were Drs. Tulp and Deijman, the second is how accurate are the dissections shown in the anatomy lessons, and the third is who were the subjects of the dissections.

  DR. TULP AND DR. DEIJMAN

  If Dr. Nicolaes Tulp (1593–1674), born as Claes Piterszoon, had not been immortalized by Rembrandt
, he would still be a paragraph or two in a (large) history of European medicine.23 His major work was the four-volume Observationum Medicarum (1641 and new editions continued until 1739). It was primarily a set of over 200 cases covering what today are a variety of specialties. It was called the “Book of Monsters” because many of the cases were quite bizarre. It included illustrations and descriptions of some of the strange animals that the Dutch East India Company was bringing home. One of these seems to have been the first ape ever brought back to Europe and described (figure 7.6).24

  Among the significant observations that medical historians have mined from this work were the first description of spina bifida (a developmental spine disorder) and of “cluster headache” (a brief recurrent unilateral pain involving the temples, neck, and eye), and cases of contralateral hemiplegia and posttraumatic amnesia and of a variety of gastrointestinal and urological disorders. His anatomical discoveries include a valve of the intestines known as “the valve of Tulpus” and the first description of human lacteal vessels. Tulp was a man of this time: Hippocrates and Galen were quoted much more often than any contemporary sources.

  In seventeenth-century Holland physicians were supposed to teach and guide the lower-class surgeons and not do any actual surgery themselves. However, Tulp described several successful trephinations for head injury, which he appears to have carried out himself.

  Tulp became successful and wealthy and entered politics, eventually holding the post of burgomaster (like a mayor) four times. Curiously, in the 1980s a fitness report on the first Dutch settlers on Manhattan Island, signed by Tulp, was found in the archives of the Dutch colony in the New York public library.25

  Dr. Johannes Deijman (1620–1666) succeeded Tulp as the Amsterdam praelector chirurgic et anatomie in charge of public dissections. He does not seem to have published anything.