# Popular Science Monthly/Volume 51/August 1897/Stones in the Head

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* STONES IN THE HEAD.
By Dr. A. CARTAZ.
IN all times painters have been fond of reproducing scenes of medical life, but the tendency has never been more marked than it was in the middle ages. Taking to the very life the oddest-seeming subjects, they have presented with the hands of masters the realistic pictures of the most various nervous troubles and pathological afflictions. On celebrated canvases may be seen, in attitudes of the most scrupulous exactness, the likenesses of great nervous affections like hysteria, malformations, clubfoot, and rickets. The great book of Charcot and Richer, Les démoniaques et les malades dans l'art (Demoniacs and Invalids in Art), has brought out into the light the large number of ancient works in which scenes of that kind are to be found. Yet they deal with only one special point in pathology.
A gentleman whose artistic erudition is equal to his medical knowledge. Dr. Henry Meige, has in his turn been gleaning in a rich field for observations, and has given us, in a series of remarkable studies in the New Iconography of the Salpêtrière, a sagacious and interesting critical estimate of the "painters of medicine." A recent memoir of his concerns pictures illustrating operations on the head.
We find these scenes of medical life most frequently reproduced, whether in a realistic or a satirical fashion, in the Flemish and Dutch schools. There are pictures giving a vivid image of a woman dying of hydropsy of the heart, as in Gerard Dow's celebrated canvas in the Louvre; of a young victim of anæmia, as in "The Patient" of Van Hoogstraaten, at Amsterdam; of a hysterical sufferer, as in "The Possessed" of Rubens, etc. But these pictures are most frequently figures of charlatans and really caricatures; subjects were abundant, for in that day, as in our own time, quacks and tooth-pullers were not idle. As in our fairs and parades, street operators and doctors and quacks of all sorts made display of their knowledge in public, and their address was not lacking in wit or warmth. Such scenes as these the Flemish painters strove especially to represent, castigating the quacks with their satirical pencils.
The pictures which we present to our readers repeat scenes from the operations for stone in the head. It may be asked. What was the operation which the painter intended to ridicule? There exist on the hairy part of the skin no such calculous products as are found in the canals of some of the glands or in some of the reservoirs of the organism, like the biliary vesicle or the bladder. We only know as tumors that might lend themselves ​to the operations of wandering quacks or mountebanks, such as the pictures represent, the sebaceous cyst or the common pimple, the caseous contents of which may possibly become chalky and hard like a stone. There are also pimples scattered over the forehead and the cranium which may be freed from their cores by a stroke or two of the bistoury. Large operations on the head were certainly known in those days; for trepanation, with which Hippocrates was acquainted, goes back, as any anthropologist will tell us, to prehistoric times. But our quacks could not have become skillful in such bold attempts; and if they had
Fig. 1.—"Stones in the Head." An engraving from the picture of Pierre Brueghel le Vieux, in the engravings room of the Amsterdam Museum. (Flemish school of the sixteenth century.)
only pimples to remove, there would have been no need of making a triumphant display of a stone or of piles of stones.
In his very judicious interpretation of these pictures. Dr. Henry Meige concludes that they relate to operations which were for the most part purely factitious and addressed to subjects of disordered minds. Instead of talking of bees in their bonnets, they said in the fifteenth and sixteenth centuries of persons a little off the balance that they had a stone in their head; and if one of such unfortunates happened to recover, they said, just as carelessly, that a stone had been taken out of his head.
When such a way of talking was current with the public, what is there to surprise one that the quacks of the period should be on the, lookout to make innocent and half-witted persons believe that they were masters of the surest process to cure them of ​their terrible infirmity? Do we not see in our own time patients persuaded that a snake is devouring their insides, that their skull is bored with a gimlet? Do we not see simple maniacs possessed by like ideas? Are there not neurasthenics who have a helmet weighing upon their head and compressing their brain?
Fig. 2.—"Stones in the Head." Picture by Jan Steen. Boijmans Museum, Rotterdam.
Have not hysterics their famous nail? And would not all these people of those times, less cultivated than in our time, however high their position may have been, be willing, in the paroxysms of their suffering, to submit to any operation that might be suggested in order to be delivered permanently? It was so formerly, and more especially in the era when sorcery had lost none of its prestige. It therefore seems logical to us to regard these operations, as Dr. Meige does, as pure deceptions of quacks; furthermore, we have the pictures to prove this.
Let us look, for example, at the painting of Brueghel le Vieux, in the Amsterdam Museum (Fig. 1). We are in a busy doctor's shop, where operations are performed without truce or mercy. Three surgeons are not too many to attend to the throng of patients. One rustic, already operated upon, looks slyly at his neighbor who is howling with pain and pushes away the assistants, while the operator is preparing, with formidable-looking forceps in his hands, to extract the troublesome stone. On the right, another operator, his head covered with a queer-looking long cap, is opening the incision through which deliverance is to come. In the background, an assistant is practicing upon a corpulent old fellow, while a fourth is trying to retain an unfortunate who is ​making for the door. These scenes of pain make no impression upon the monks, one of them prostrate and exhausted and carried by a good rustic who salutes the company with his fur cap, while another is exhibiting his affliction and asking for deliverance from it.
Another design, likewise by Brueghel le Vieux, is still more suggestive. It is a bald caricature, directly aimed against the quacks. The scene is not laid in a shop, but in the open air, with a staging put upon barrels, on which the operator (alone this time) exercises his wonderful talent. The crowd is gathering around him, presenting a curious series of types; some gaping with astonishment, some frightened, and others rejoicing as if at the approach of deliverance. One unfortunate has just passed through the hands of the operator; an assistant is applying a restorative liniment to the open wound, while the victim is gazing sadly at the pebble which is supposed to have been taken from his head. Another one is about to be placed in the fatal chair; the surgeon with his lantern carefully examines the offensive body. The patient howls, but a matron holds his head firmly. Another one is being brought up with a tumor larger than an orange on his head. Fig. 3.—"Stones in the Head." Picture by van Achen (van Bosch). Amsterdam Museum. (Dutch school of the sixteenth century.) Hidden under a stool is a confederate with a basket full of stones, ready to be passed at the proper moment, as the ball is passed to the juggler—and he is a confederate who can be relied upon, for his lips are closed by a padlock to secure his silence. The satirical intention of this curious picture has been marked by the painter himself in the little sketch outside of its lines on which he has placed his signature. It is a large egg containing an operator and his victim, with stones raining from the patient's head and falling out of the shell.
A like satirical intent may be found in Jan Steen's picture (Fig. 2), although the scene is treated less fancifully. The operator may have been a well-known man; he does not operate in a ​public place, but at home, in a comfortable Dutch interior; but he is not without skillful accomplices—the matron, his habitual assistant, with her cunning expression, and the urchin who laughs at the humbug of the thing, as he passes the pebbles which the crafty charlatan causes to roll over the neck of the suffering patient.
The scene represented in Jerome van Achen's picture (Fig. 3) would be considered less grotesque were it not for the fantastic dress and appearance of the operator; his robe, his cap, down to the curious stool he stands upon—all are extraordinary. The quiet figure of the patient is no less so. Surely, if any such stones had been taken from his head as the other doctor is showing to the assistants, it must have been with the aid of a local anaesthetic. He beams with as happy an expression as if a most grievous pain had just gone away from him by enchantment.
M. Meige has collected more than a dozen pictures representing these operations for stone in the head.—Translated for the Popular Science Monthly from La Nature.