The diagnosis of art: Sir George Savile, 8th Baronet – the ears have it?
Authors: Neil Hughes, Manoj Ramachandran, Jeffrey K Aronson
Journal: Journal of the Royal Society of Medicine (2008)

The bust of Sir George Savile (1726–1784) by Joseph Nollekens (1737–1830), based on Savile's death mask, is currently on display at Tate Britain as part of the 'Return of the Gods: Neoclassical Sculpture in Britain' exhibition, with its permanent home being the Victoria and Albert Museum. It reveals Sir George exactly as he was, a thoughtful, but finally defeated man, in his blemished glory. Notably, on Sir George's left ear, there is a crease visible running diagonally across the earlobe, most likely to be Frank sign. Frank first described a link between this dermatological sign and coronaryartery disease in 1973.1 There is also known to be a significant association with carotid intima-media thickness and with cerebrovascular disease.2

Sir George Savile was a remarkable 18th century political figure who eschewed the laid-back life of huntin', shootin' and fishin' (sic) commonly pursued by his fellow acolytes. Instead, he engaged himself in public life, taking many unpopular positions and steered by his own opinions arrived at by ‘integrity and disinterestedness’.3 Like his famous grandfather the Marquis of Halifax, he had a major impact on the political saliences of his day – American republicanism, Catholic emancipation and electoral reform. His portrait hung in Benjamin Franklin's house a decade before the American Revolution.4 A man interested in evidence and rationality, he was Member of Parliament for Yorkshire from 1759 to 1783, a fellow of the Royal Society and a patron of the Westminster Infirmary.


Savile died in the arms of his friend David Hartley in January 1784 eight months after he collapsed while speaking in Parliament. ‘He was proceeding to speak in favour of the motion when finding himself too weak to speak with that animation that he wished to express, he sat down, to the great mortification of the House, who were distressed



Figure 1

Joseph Nollekens. Portrait Bust of Sir George Savile, 1784. Victoria and Albert Museum, London, UK







Figure 2

Closer view of left ear of bust



to see so good a man in so infirm a state of health.’5 This sudden weakness and his subsequent demise over a short period offer us but the slightest clue to the condition or disease process that killed him. However, taken together with his Frank sign, the differential diagnoses include uncontrolled angina and ischaemic stroke. An angina attack brought on by the stress of public speaking is certainly a possibility. An adrenaline-associated increase in heart rate and heightened vasoconstriction could well have prompted an acute attack in Sir George who was 57 years old at that time, but against this is the fact that he was as a well-practised orator. The weakness described in the Parliamentary record is associated with an inability to speak, which may have been dysphasia. His steady slide to death in less than a year is consistent with a neurological diagnosis. Of course, both cardiac and neurological events may have occurred in combination with an underlying atherosclerotic aetiology. Perhaps it was the bed rest that finally brought about his end. His immobility will have further added to his risk factors for cardiovascular disease and thromboembolic events.


In conclusion, Sir George Savile, a man who bore the aural stigmata of cardiac/cerebrovascular disease, collapsed under stress and died shortly after at the age of 57 years. As to the precipitant being angina or stroke, we can only speculate. Atherosclerosis, towards which his Frank's sign may point, is a stage upon which either or both could have played a part.