Medical Illustration and the Ethics of Representation

84A little over a week ago I attended an conference on the ‘Promises of Monsters’, which explored various manifestations of monsters and the monstrous in contemporary culture. One of the plenary papers, delivered by Professor Margrit Shildrick, raised several key questions about the ethics of representing the monstrous visually. What, she asked, is at stake when we visualise something – or someone – in an academic discourse? Do we have the right to comment on ‘monstrous’ bodies by virtue of our scientific approach, or does this actually render our relationship to the monstrous even more problematic?

These questions reminded me of a 2014 Slate article by Rebecca Onion called ‘History, or Just Horror?’ Reviewing the Wellcome Library’s book The Sick Rose: Disease and the Art of Medical Illustration, Onion weighs the ethics of displaying vintage medical images of ‘monstrous’ bodies (none of which I’ve reproduced here) in the digital age:

As historical medical images go digital, scholars and archivists are being forced to weigh the benefits of disseminating the undoubtedly important and interesting record of the evolution of medical practice with concerns that the images will be misused and misunderstood. Making the images available will almost certainly lead to some tone-deaf uses, lacking empathy and regard at best – exploiting the shock value of a disfigured face or body at worst. On the other hand, digitization of the kinds of images that were once available only to researchers with the means to travel to archives can do a lot of good. Such visibility can raise awareness about past wrongs, facilitate connections between historians and the families of former patients, even provide us with a new way to think about our own mortality.

What is our responsibility to the people in these images? Onion discusses a particular case in which these archived photographs found another, less historically-minded function:

Some photographs from the Project Façade archive ended up used in the design of the genetic mutants (‘splicers’) that players of the videogame BioShock must battle. One of the patients in the photographs, Henry Lumley, a pilot trainee, was injured on the day of his graduation from flying school and lived with his injury for a year before being admitted to Gillies’ care. Lumley died of postoperative complications, at age 26. (Here’s his page on the Project Façade website. And here’s an image of the BioShock character in question.) Lumley and his fellow patients are now forced to wander about in virtual space, made into monsters for the entertainment of gamers.

14f36705d99c356a607fb3a89176e222Is this morally objectionable? Should we only use such images for educational purposes? In the rest of the article, Onion demonstrates how the situation is more complicated than that. In the end, she concludes that what we really need to cultivate in response to these images is reflection – something for which there is increasingly little time in our internet culture:

[A] vanitas requires space for contemplation – a space the Web seems ill prepared to offer. Susan Sontag’s final book, Regarding the Pain of Others (2003), was written as the Web was in the process of scattering photographs to the four winds. Sontag wrote that photographs of suffering could be a ‘memento mori’ and serve as a still point around which to contemplate mortality. But she wondered how this might work – or fail to work – in ‘a modern society,’ where ‘space reserved for being serious is hard to come by.’ If she thought that about art galleries, books, and television, one wonders what she might have made of Pinterest.

These types of responses are comparable to those Shildrick suggests we must cultivate as researchers of the monstrous. To come to terms with the monster, ethically speaking, we must continually question our own parameters of identity. Otherwise we risk mistakenly identifying ourselves in these figures, overwriting their identity in the process. Or worse – identifying them as alien, absolutely different, and impossible to live alongside. We shouldn’t turn away from images of the monstrous, but we must also be wary of becoming desensitised to these images, or sentimentalising them.


Onion’s final thoughts on the matter are similar. In the last paragraph of her article, she writes:

Perhaps the answer might be image or video files that contain within them a trigger that activates a program blocking the rest of the Web. Just for a minute, or two, you’d be forced to look, see, and feel, without distraction. Like a visitor sitting at a patient’s bedside, you’d bide a while with a fellow human, a witness to our collective frailty.

Well and Unwell: The Body in the Nineteenth Century (possibly NSFW)

George Goodwin Kilburne junior (1863-1938), A Game of Tennis (1882).
George Goodwin Kilburne junior (1863-1938), A Game of Tennis (1882).

Last week Thursday I flew from Cardiff back to the Netherlands, where I’ll be whiling away the holidays with my partner. It’s not all oliebollen and ice skating, though. I am determined that there will be at least some thesis work conducted during this break.

‘Her Majesty’s Corset’ from the H. O’Neill & Co. 1897-8 Fall & Winter Fashion Catalogue

On Friday (the day after I arrived) I made a trip into Amsterdam for my very first Dutch-language conference – Well and Unwell: The Body in the Nineteenth Century.This was the most recent in an annual series of conferences, hosted by the Werkgroup De Negentiende Eeuw, which also publishes a journal. Because I figure some of you might be interested in the proceedings (but unable to speak Dutch), I thought I would translate some of the highlights for you and post them here.I was especially interested to experience how the nineteenth century is studied outside of the Anglophone world. Most of the day’s lectures focused on Dutch, German, French, or Belgian sources, which offer a very different perspective on ‘Victorian’ culture than British or American ones. Though all of the papers were excellent, the notes I took were naturally biased by my own research interests. Hopefully you’ll have a decent overview of the seven papers we heard, including the names of the presenters in case you’re interested in learning more.

From the very beginning of the day it was clear that the group of academics gathered for this conference was extremely diverse (skin colour being the only visible exception) and interdisciplinary. We had people working in history, literature, archeology, visual arts, and sports studies, focused on multiple time periods. There were seasoned scholars and MA students, old and young, from all over the country – and from the neighbouring Belgium.

After the requisite cup of coffee (who says you can’t have a coffee break before the conference starts?) we launched into the day’s lectures with a short introduction by Professor Wessel Krul, the president of the workgroup. He emphasised the link between the body and culture, and revisited the nineteenth-century prevalence of the idea that one’s physical, external body reflected one’s internal, spiritual, or mental state.

In her paper ‘Representations of Homosexuality in the East around 1900’, Professor Mary Kemperink from the University of Groningen used travel journals and literature to examine the development of ideas about homosexuality during that period. Specifically, she cited Charley van Heezen’s 1918 novel Anders (‘Different’), in which two men from different cultural and ethnic backgrounds are united in their sexual orientation, and are also described by others as having a strangely similar appearance due to their shared ‘femininity’ and ‘sensuality’. For a good period at the turn of the century homosexuality was apparently conflated with the Orient, or the ‘inverse’ side of the globe. Here Kemperink also cited British Orientalist and explorer Sir Richard Francis Burton (1821-1890), who suggested a relationship between pederasty and the area around the equator (which he called the Sotadic Zone). Towards the end of the 19th century homosexuality moved from being recognised a tourist attraction for Europeans in the Orient (and here the French author Gustave Flaubert was cited as an example) to a state of being that was not only unique to the East, but united people in all parts of the globe.

A Victorian woman, drawn by Luke Fildes and published in 1880
A Victorian woman, drawn by Luke Fildes and published in 1880.

Following this came Utrecht University‘s Dr Willemijn Ruberg, who spoke about ‘Menstruation in Court: The Female Body and Forensic Medicine in the Nineteenth Century’. At the beginning of the nineteenth century (before 1860), menstruation was part of the humours school of medicine, in which the bodies four fluids (or humours: ) had to be in balance in order for a person to be healthy. Problems with menstruation were theorised to cause blockages in the head or genitals, causing temporary madness (called ‘monomania‘). This kind of temporary madness was a common defense in nineteenth-century courts, especially for young girls. By way of example, Ruberg shared some Dutch arson cases (including that of Marretje Moonen in 1840) where problems with menstration were linked to pyromania, and sometimes resulted in the girls being absolved of direct responsibility for their actions. After 1850 people began to criticise the idea of pyromania as temporary madness, and menstruation came to be seen as a sickness, less directly linked to the psyche.

 A 'Venus' medical mannequin from the 'Anatomie des Vanités' exhibit at the Erasmus House in Brussels, Belgium
A ‘Venus’ medical mannequin from the ‘Anatomie des Vanités’ exhibit at the Erasmus House in Brussels, Belgium

The last paper before lunch was by Tinne Claes and Veronique Deblon, PhD researchers at KU Leuven. Their paper (‘Bodily Confrontations in Popular Anatomical Musea: 1850-1870’) dealt with Dutch and Belgian anatomical exhibits, and the changing ways these marketed themselves over the decades. In addition to shifting focus from religion (the human body as the pinnacle of God’s creation) to discipline (the abnormal human body as a warning against deviant behaviour), the audience for anatomical exhibits broadened in the 1860s to include women and the lower classes. Claes and Deblon pointed out an interesting contrast here with anatomical exhibits in the UK, where publicists had long used the fact that their visitors included women to emphasise the wholesomeness of their displays. There was also (to my uncontainable glee) a section of the talk dedicated to freak shows and the ‘abnormal’ body, which usually took up a separate section in these exhibits and would require that you pay an additional fee.

Portrait of a man with tribal scarification, Bahia, Brazil, 1860 © Schomburg Center for Research in Black Culture
Portrait of a man with tribal scarification, Bahia, Brazil, 1860
© Schomburg Center for Research in Black Culture

After the lunch break (sandwiches and milk all around), we carried on with the last four papers. The first was Erasmus University Rotterdam‘s Professor Alex van Stipriaan on ‘The Enslaved Body’. Van Stipriaan prefers the term slaafgemaakt (enslaved) to slaaf (slave) when speaking about a person or people, as it places the emphasis on the state a person is placed in (he was enslaved), rather than associating that state directly with the person (he is a slave). He dealt with an extremely broad range of topics – and actually went quite a bit over time – but gave a good overview of the ways the enslaved body (in this case the black body) was portrayed and perceived in nineteenth-century Holland and its colonies. Some points that particularly stood out were the comparison between the brand as a symbol of slavery and scarification as a symbol of resistance, the mass ‘lightening’ of the coloured population in Suriname as a form of upward mobility, and the fact that unlike enslaved men, who were often described purely in bodily terms, as machines or animals, enslaved women were typically written about or envisioned in terms of their characters or actions, humanising them in a small sense.

In a completely different tone, Jelle Zondag from the Radbound University in Nijmegen presented on the writings of C.M.J Muller Massis (1870-1900), who published extensively on sports in the context of national health and nationalism. The material he presented is difficult to translate into an English context (though Muller Massis apparently cited sports teams at English boarding schools as the reason for their success as an empire), but it involved an interesting discussion of the concept of a ‘natural’ and ‘national’ body, and the emergence of the bicycle as a Dutch national icon.

"Dear diary, today I was indisposed..."
“Dear diary, today I was indisposed…”

Dr Leonieke Vermeer, also from Groningen, is working on a long-term project examining nineteenth-century diaries to learn more about the way sickness and health care was experienced by the patients, which represents a gap in the current, professionally dominated discourse. She has already discovered some interesting uses of terms and remedies, including the fact that most diary keepers describe illness (from mild to serious) using the word ongesteld (literally ‘indisposed’, but used today only to describe menstruation). Although she only had time to mention it briefly, one aspect of Vermeer’s research that I found very interesting was the use of ‘silence’ or empty space in diaries, particularly following traumatic events or entries. One woman left an entire blank page after an entry on the death of her mother. Using examples of the ways diary writers record illness to help them deal with emotion, for reflection, or simply to make themselves feel better, she explained how a ‘bottom up’ approach to studying illness in the nineteenth century has a lot to offer us. Among other things, it shows us how the medical discoveries of the nineteenth century were actually being implemented, and the kinds of things patients would have expected (and accepted) from medical professionals.

Finally, we had a lecture by Dr Marjan Sterckx from the University of Ghent on female artists from Belgium, France, and the Netherlands who created nude sculptures. Nude sculpture was still quite scandalous in the nineteenth century, though less so in France, and female sculptors of nudes generally either sculpted children or used classical tropes, both of which were less controversial. You can actually read an article by Sterckx in English on what seems to be a very similar topic at this link. Specifically, Sterckx looked at the work of French/Belgian sculptor Marie-Louise Lefevre-Deumiers (1812-1877), in particular her 1861 La Nymphe Glycera and her 1865 Diana, which was also exhibited in the Hague. Sadly no photographs of Diana exist (that we know of.

This is actually a nineteenth-century drawing

We closed the session with a general 45-minute panel discussion on the body in the nineteenth century, which mainly consisted of several rounds of questions. All in all it was a productive day, and I can’t imagine where else I could have heard papers on such vastly different topics in so short a span of time. Also, where else but the Netherlands do you get books like Seks!… in de negentiende eeuw (‘Sex!… in the nineteenth century’) with awesome covers like the one pictured here. The conference book stand was full of interesting titles, though I didn’t take any home this time around.

And naturally, we wrapped up the day with a good borrel, where we could mingle with each other and with the speakers over a glass of something tasty. I managed to get in a couple of questions that I would never have been brave enough to ask the speakers in the public, post-lecture rounds, and I got some great blog suggestions (Quigley’s Cabinet and Morbid Anatomy anyone?) from Tinne Claes and Veronique Deblon, who also blog themselves (in Dutch).