Founded on the practice of dissection and its accompanying document, the anatomical illustration, formal study of the body has always been an interdisciplinary endeavour, involving scientific methods of systematic examination and artistic techniques of production.
Some of the earliest known examples are those produced by Leonardo da Vinci (1452–1519), which are characterised by an acute graphic precision, fragmentation, and lack of social or emotional context — features that seem to capture the scientific ideal of objectivity, and have since become recognisable conventions of those images of the body constructed as medical.
Leonardo’s anatomical notebooks, however, were lost after his death, and this influence was not fully realised until their rediscovery at the turn of the nineteenth-century.
The intervening years saw the flourishing, across Europe, of the illustrated anatomy — a genre of a printed book often lavishly produced, and conceived around images of both the internal and external workings of human physiology.
Although highly varied in style, these volumes unified the visions of science, religion, and art concerning the wonders of creation and mysteries of death and, with a varied audience, their content functioned in multiple ways: as instruction manuals for surgeons, as educational material for the cultural elite, as art in their aesthetic allure, and as spiritual and emotional musings on mortality and the afterlife.
This integrated approach to the study of the body, and its understanding of medical knowledge as part of a diverse social and cultural fabric, was to dominate the next two centuries. It was not until the late eighteenth-century that anatomical illustration began to develop an impassive, literal appearance, as the nascent discipline of pathology, with its need to classify diseases and to examine their effects on specific types of tissue, began to demand images that explored afflicted body parts in singular detail.
Ever increasing numbers of medical students meant there were also changes in the format of publications, since the luxurious, folio volumes of the past were no longer practical.
Their need was rather for smaller and cheaper editions, that could be “lugged around in a satchel and propped against a cadaver on the mortuary table”. Such influences meant that the typical nineteenth-century illustrated anatomy was an intricately rendered display of discrete body parts, with no environmental or social context, and no intentional ethical sentiment — a style exemplified by Henry Gray’s ‘Anatomy, Descriptive and Surgical’ (1858), in which the physically, emotionally, and mentally integrated being of Renaissance humanism becomes “a collage of tissues” viewed with the pragmatic detachment of the medical gaze (Barnett, p. 27).
The discovery of photography at this point in the history of medical images would seem to offer a means of advancing the tendency towards an impartial, objectified idea of the body, since the automated eye of the camera is an apparently neutral observer, free from the flaws and prejudices that affect the human endeavour of handmade illustration.
However, as Richard Barnett points out, this view of photography was always an erroneous one, since from its earliest years the camera had been used to stage deceptions and record untruths — spirit photographs being a well-known example (p. 34). Rather than merely being a tool for recording visual data, the photograph was more accurately a forum in which empirical enquiry, imagination, and aesthetics could interact and combine in novel ways.
Like the illustrated anatomy, medical photographs emerged from a complex of scientific, artistic, and religious influences and aims. Their function as medical data and information is validated by the camera’s capacity to accurately record; yet at the same time the production techniques of portraiture — the use of pose, props, facial expression, and dress, as well as aesthetic manipulations such as lighting and framing — are always evident.
I want to contend that this artistic aspect made early medical photographs not only a means of documenting different types of affliction, but also a way of considering the nature of suffering, and offering reflections on mortality. As a site of such spiritual musing, early medical photography is more closely aligned with the multifunctionality of the first anatomical images, and recovers a metaphysical significance that had all but disappeared from scientific illustrations of the body.
The pervasive matter of disease and bodily torment is what urges the artistic interpretation of medical subjects towards religious themes and concepts: specifically the figure of the martyr, it being the traditional icon of physical desecration and suffering in Christian history and mythology, and thus in Western cultures in general.
This article will demonstrate visual correspondences between early medical photographs and antecedent representations of martyred saints in painting and ecclesiastical imagery, which may be consciously or unconsciously constructed by their makers.
By drawing this association, medical photographs attach the spiritual significance of Christian art — its faith in a realm beyond the material, and its meditations on the Divine — to the ostensibly scientific image. Most pertinently, it forwards the idea that physical anguish has a potentially positive aspect of being a path to transcendental exultation and communion with God.
While religious art is an explicitly visual source for this thematic thread in medical photographs, another influence can be identified in the cluster of martyr novels that emerged around mid-nineteenth-century.
These bestselling titles — some of whose authors, including Charles Kingsley, Nicholas Wiseman, and John Henry Newman, were also prominent churchmen — had already brought the figure of the martyr and her or his attainment of supernal grace through earthly immolation to the surface of the popular imagination.
This made it an expedient model for photographic interpretations of injury and disease. What is especially interesting about these texts is that they are grounded in history and the empirical evidence of contemporary archaeological discovery concerning the early development of Christianity.
As such, their narratives evolve from a blend of scientific research and creative invention that parallels the dual documentary and aesthetic properties of the photograph, as well as the integrated outlook of the early illustrated anatomy.
That the martyr narrative and the medical photograph also share a prevalent interest in the morbid or damaged body makes for an especially strong alignment, and it is in the martyr narrative’s devoutly inspired attitude of compassion and reverence towards bodily suffering that the medical photograph finds a moral framework for studying and presenting sickly states of being.
The camera’s capacity to embrace multiple functions is reflected in the first medical photographs to appear in the 1840s, which present a return to the expansive interests of the early illustrated anatomy. Typical subjects were scenes of doctors and surgeons at work, dissections performed in crowded amphitheatres, and studies of individual patients.
Where the nineteenth-century anatomical illustration had largely become a means of elucidating the internal mechanics of the body, the early medical photograph reinstates a more holistic understanding of disease, incorporating the practical, emotional, and moral impact of illness through its depiction of whole persons within a social context, as opposed to the isolated, objectified body parts of pathological anatomy.
What we see conveyed in the early medical photography — particularly the portrait of the patient — is not only the visual quantification of different pathological conditions, but also an insistent sense of the individual subject’s suffering as they negotiate an uncomfortable limbo between the pain of a broken body and the fear of death.
This state of suspension between life and death is one manifestation of an inherent ambiguity that the damaged body shares with the properties of the photograph, and which mobilizes both as agents of the horrific — in its uncanny expression, as well as in the sense of the abject.
Defined by Julia Kristeva, the abject pertains to those processes and products of the body that simultaneously determine and threaten the boundaries of the self, many of which are especially evident in sickness.
