History of Medicine

REMBRANDT’S ANATOMY LESSON OF DR. TULP

     Rembrandt Harmenszoon van Rijn was still a young up-and-coming artist in 1632 when he received a commission from the Amsterdam Surgeon’s Guild to paint the Anatomy Lesson of Dr. Tulp. The painting is original in many ways and made his career.

Rembrandt Self Portrait one year before moving to
Amsterdam (NationalMuseum, Stockholm, Wikipedia)

     Rembrandt, at the time recognized but not famous, had moved to Amsterdam from Leiden only a year before the commission. Dr. Nicolaes Tulp, as Praelector of the Surgeons' Guild, was responsible for public dissection. Tulp was born in 1593 into a prosperous Amsterdam family as Claes Pieterszn. He studied medicine at Leiden University, finishing the three-year course at age 21. He practiced medicine and surgery in Amsterdam for the next 40 years and was by all accounts a hard-working, diligent physician with a large practice. He was community oriented, serving as a city councilor, burgomaster, and other offices during his life (while still in practice). His career coincided with Holland’s tulip mania and because he had placed a plaque painted with a tulip outside his

Page from Observationes Medicae showing ileo-
cecal valve (Hathi Trust)

office he was referred to as Dr. Tulp. He wrote a highly regarded book on medicine, Observationes Medicae that went through many editions. In it he gave a detailed description of the ileocecal valve, the most complete thus far published. He also described accurately beri beri, kidney stones, and angina, and gives many case histories – some studied at autopsy, anticipating Morgagni by many years. Tulp and others collaborated on the first Amsterdam pharmacopeia, helping to control indiscriminate use of medications. He lived to age 80.

     A public anatomy dissection had been performed annually in Amsterdam by the Praelector of the Surgical Guild since the latter half of the fifteenth century, using executed criminals. The event was held in January (to minimize decomposition of the body) in the Surgeons' Guild quarters in the weighing house (Waaghaus) of St.

St. Anthony's Gate, part of old city wall, where the Surgeons'
Guild was located (Wikipedia)

Anthony’s Gate. The building had originally been part of the old city wall. Guild members were required to attend and persons of note were invited. Talking and laughing were prohibited.

     Paintings of anatomy lessons were not new either. The Anatomy Lesson of Dr. Willem van der Meer and The Anatomy Lesson of Dr. Sebastion Egbertsz are two prior examples. In both, however, the static atmosphere predominates as the surgeons "look at the camera". The subjects generally posed

The Anatomy Lesson of Dr. Willem van der Meer, by Michiel and Pieter van
Mierevelt, for Surgeons' Guild in Delft, 1617. (Wikimedia Commons)

separately in the artist’s studio before the final version. Rembrandt, on the other hand, though he also used studio portraits, conceived a painting with action and narrative.

     The pale cadaver forms an emphatic diagonal. A dissection of  

The Anatomy Lesson of Dr. Tulp, by Rembrandt (Wikimedia Commons)

the forearm and hand, styled after a woodblock print in Vesalius’ atlas, is the center of attention. With his left hand in flexed position Tulp

From Vesalius' De Humani Corporis  Fabrica,
probably a source for arm dissection by Tulp
(Hathi Trust)

demonstrates the function of the flexor tendons that he holds in his right hand. The hand held a special place in anatomy circles, and Vesalius had described it as “the physician’s chief instrument”. It was common, too, at the onset of “anatomy lessons” to mention a dissection as showing the wonder of God’s creation, lending it a metaphysical bent.

     The viewers, all surgeons, are focused intently on the corpse’s hand, Tulp’s hand, or an anatomy book at the corpse’s feet, evoking a drama and intensity not seen in other works of the genre. Much ink has been spilt over the accuracy of the anatomic details of the depicted flexor tendons and muscles, but Rembrandt’s version is at least nearly correct. The dissection is out of order, however. Generally the abdomen was opened first, since in the days before preservatives that area decayed easily.

     Do we know who the cadaver was? Yes. His name was Adriaen Adriaensz, alias Aris Kint. He had been punished multiple times for theft, including floggings and possibly branding. The painting shows no sign of this, however, and neck marks from the hanging are not visible. Most intriguing is that X-ray studies have shown that the right arm was painted originally without a hand, the hand being added later(see Middelkoop et al). Amputating the hand of a thief before hanging was not unheard of at the time and may have been inflicted on Kint. A translation of the court record suggests that it was (Siegal). It is believed, however, that Rembrandt was not present at the actual dissection, so what he knew about the cadaver remains conjecture.

     X-ray studies have shown other items that were painted over. The head at the far left was a later addition, possibly by another artist. The added head destroys the original composition of the subjects set within two overlapping triangles. Other alterations show that the surgeon at the top originally wore a hat, and the paper with the list of names (at Tulp's right) originally showed an anatomic figure. A reconstructed version before alterations can be seen at the Schupbach reference, plate #1.

     A later painting by Rembrandt, The Anatomy Lesson of Dr. Jan Deijman (1656), shows the brain being uncovered following

Anatomy Lesson of Dr. Jan Deijman (1656) (Wikipedia)

dissection of the abdomen, as was the custom. The upper portion of the painting was damaged and is not shown. The position of the cadaver and its foreshortening are almost certainly derived from a painting by Mantegna (see illustration), a painter that Rembrandt admired, though he probably saw only a copy.

Lamentation over the Dead Christ by Andrea Mantegna (Wikimedia Commons)

     The Anatomy Lesson of Dr. Tulp not only established Rembrandt as a major painter, it has also kept historians of medicine and art busy for generations.

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SOURCES

       Middelkoop, N. et al. Rembrandt Under the Scalpel. 1998; Mauritshuis, The Hague.

       Siegal, N. The Anatomy Lesson. 2014; Doubleday.

       Simpson, D. “Nicolaes Tulp and the Golden Age of the Dutch Republic”. ANZ J Surg. 2007, 77: 1095-1101.

       Mellick, S. “Dr Nicolaes Tulp of Amsterdam, 1593-1674: Anatomist and Doctor of Medicine”. ANZ J Surg. 2007; 77: 1102-1109.

        Schupbach, W. “The Paradox of Rembrandt’s Anatomy of Dr. Tulp”. Medical History, Suppl 2, 1982.

       Goldwyn, R M. “Nicolaes Tulp (1593-1674)”. Medical History 1961; 5: 270-76.

       Cook, H. Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age. 2007; Yale U Press.

       Wallace, R. The World of Rembrandt: 1606-1669. 1968; Time-Life Books.

       Ormiston, R. Rembrandt: His Life and Work in 500 Images. 2012; Lorenz Books, London.

      Clark, K. Rembrandt and the Italian Renaissance. 1966; Norton Library.