EVA LUAC IO N DEL CREC IM IENTO :

am coining, another steppeth down before me ..."

The word 'Bethesda' has been interpreted as meaning 'Place of the Alkaline S a l t 1 and the stirring of the water may have been due to the intermittent bubbling of a natural spring.14- Hogarth, probably under the guidance of his friend Bishop Hoadly, whose preaching on the topics of compassion and caring were in line with Hogarth's own views, developed the theme in a way that is relevant to its contemporary context. His Biblical story is set as if Dn a stage. The scenario broadly accords with the Biblical text,but the individual characters are ones that could have been seen in the eighteenth century hospital environment, and each provides his or her own story in true Hogarthian fashion in which detailed observation enriches convention.

Centre stage is a rather bland Jesus, looking serene, calm and tranquil in LeBrunian (and Raphaelesque) style, directing his

*•!> *

compassionate gaze and outstretched hand to the 'impotent' man at his feet (Plates 25 & 27). The latter gazes back at Jesus with an expression of esteem and veneration (Plate 27). His well-developed muscles belie his apparent paralysis and support the twentieth century diagnosis of Myotonia Congenita. This condition is manifested by difficulty in initiating the action of walking, which may become normal after a few steps. Muscles are well developed or unusually large, resulting in an athletic build. Symptoms become worse during emotional upset or exposure to cold. This man, in his answer to Jesus, implied that it took him a long time to get down to the pool "while I am coming, another steppeth down before me...". His conception

seems to be of three-fold origin in this painting. He may owe his we 11-developed frame to a model from the life-class school at the St. Martin's Lane Academy, his expression to LeBrun and his pose and situation to Raphael's 'Healing of the Lame Man in the Temple' (Plate 28). In Hogarth's painting the expression of veneration of the lame man is exceeded only by that of the angel hovering overhead who is to 'trouble the waters'. His features approach those regarded as ecstatic (Plate 27).

The small group in the background towards the right-hand side of the painting, consisting of woman and child with a man deterring her from entering the water before his mistress does, may also have come from Raphael's 'Healing of the Lame Man*. The mistress for whom he

IS

seeks preference is 'beauty unadorned' in Venetian fashion and^sald to be in the shape of Hell Robinson, a celebrated courtesan known to Hogarth and living in the Chiswick area where Hogarth had his country residence.1® This academic study of the,, nude, Ideally portraying moral and physical perfection, is marred by her stiffly held, swollen and inflamed knee, which would be recognised by many as being the result of her prom'isco-s^s life style and its retribution in the form of gonococchal or syphilitic arthritis. Her naked presence at the Pool in this pose seems to advertise her way of life. Articular complications of early syphilis most commonly involve the ankles, foot joints, elbows and shoulders, but may affect hands, wrists, knees and ankles, causing acute inflammation (periostitis) with pain, swelling, tenderness and limitation of movement. Arthritis following an infection with gonorrhoea two to three weeks previously usually affects many joints at once and is accompanied by fever. Only one

knee appears to be affected here. The lady's expression is one of sadness "arising from the uneasiness the Soul feels at some evil or defect, which the impressions on the Brain represent to her " - according to LeBrun's interpretation (Plate 27)ie. A similar sadness pervades the pale features of the young girl behind Jesus. She modestly veils her head, but her breast is partially exposed with a red area of inflammation clearly visible.

The mother on the right-hand side with her baby looks pleadingly towards her assailant. Her sick baby may be suffering from either rickets or congenital syphilis. The two presented some similar features. Dr. Francis Gllsson (1599-1677) had described the signs of rickets in the seventeenth century,17, and John Freke wrote about it in an essay in 1748. 113 Both referred to the flexibility of the joints which were unable to sustain the body, and tQ weakness. Gllsson said that if children were affected

"within the first year of their age or thereabouts, they lose the use of their feet later by reason of that weakness."

Later they

"totally lose the use of their feet; yea, they can scarce sit with an erected posture, and the weak and feeble neck doth scarcely, or not at all, sustain the burden of the head." He cites

"unusual Bigness of the Head" and says that

"certain swellings and knotty excrescences are observed about some of the joynts. These are chiefly conspicuous in the wrists, and somewhat less in the ankles . . . some bones wax crooked."

Freke follows his description of Rickets with one of a Scrophulous Disease of the Bones which did not affect infants "till

they are completely formed." This caused swellings of bones and led to bony destruction. Venereal Disease led to similar destruction of the bones according to Freke who wrote:

"many are liable to reckon them one species, from the Effects they produce, but an account of the Numbers of Children who are descended from worthy Parents, being greatly affected with Scrophulous Complaints, I shall suspend my sentiments upon

it."

Hogarth's infant's pallor, large unsupported head, swollen wrist and flaccid body seem to present a picture of Rickets, which was prevalent at the time. The child in the foreground who apparently requires a crutch to enable him to walk and whose spine is curved and arm bandaged may represent Freke's Scrophulous condition.

Sadness and Dejection are evident in the features of the old man on the right of the painting. He looks ashen-coloured and ill. He is leaning on a crutch and resting his hand upon his swollen ascitic (fluid - filled abdomen). Freke wrote 'Of Tumours proceeding from Melancholy':13

"... the Blood at certain Seasons is liable to become void of all Floridness, appearing almost as black as Ink, which the Antients have termed the 'atra Bills' or Melancholy of the Blood. When it is in this State, carcinomatous and cancerous Diseases are said to be occasioned from thence."

LeBrun described the features with

"the Nostrils drawing downwards, the Mouth somewhat open and the corners down; the head seems negligently hanging upon one Shoulder, the whole Face of a wan lead colour, and the Lips entirely pale." (Plate 27)

The advanced state of malignant disease of this man would have been recognised by many eighteenth century observers in the context of the Hospital.

The blind man on the left hand side of the painting would also have been recognised by his pose and long stick. His presence was dictated by the Biblical text, but was also a reference to one of the charitable functions-of the Hospital. Freke had been appointed as the first Eye Surgeon there in 1727 "Through a tender regard for the deplorable state of blind people ...".20 His appointment was to

"couch and take care of the diseases of the eyes of such poor persons as shall be thought fit for the operation and for no other reward than the six shillings and eightpence for each person so couched as is paid on other operations. ":E1

•Couching' was an operative treatment which had been performed on the eye, especially for cataracts, since ancient times. The opaque lens was manipulated by a sharply hooked needle and broken up to displace the pieces below the level of the pupil. The opacity was thought to be 'inspissated humour' between the lens and the iris and not opacity of the lens itself. It was not until the late eighteenth century that the true nature of the cataract was recognised, and the couching operation continued throughout the century.'22

Interest in the philosophical problems of blindness surfaced in the eighteenth century with questions concerning the perceptions of the blind and their ability to see normally if their vision was restored. Were perceptual abilities innate or acquired? The surgeon Cheselden reported the result of a cataract operation in the 'Philosophical Transactions' of 1728, on a boy who had been born blind

or had become blind at an early age so that he had no recollection of sight. Cheselden couched him at the age of 13-14 years, following which he could distinguish shapes, but not name them. Estimation of distance and understanding pictures he found difficult after the operation on the first eye. After operation on the second eye, things seemed larger. He Imagined that what he saw touched his eyes in the same way that what he felt involved touching his skin. He asked which sense deceived him, seeing or feeling?23

The rather angry-looking woman on the blind man's left views the latter with sidelong glance. Jaundice, such as she displays, was supposed to indicate a choleric disposition (choler = bile) in line with the humoral theory of medicine, and Hogarth provided the apt physiognomy indicating an irascible temperament.

The pallid cachectic woman on his right, looking frail, emaciated and fearful illustrates both the 'passions' of 'Hope' and the possible effects of a scrophulous tubercular condi + 'tcra (Plate 27). The colour of her face with its greenish tinge provided the contemporary label of the 'Green Sickness' - a generic term for all anaemias, and termed 'Chlorosis' by Jean Varandal in 1615. In 1731, Friedrich Hoffman recognised an iron deficiency anaemia often associated with a 'Virginal pallor' for which the physician, Sydenham (1624-89) had advocated the use of iron. Sydenham suggested that "the Sick must drink some mineral waters, impregnated with the Iron Mine such as Tunbridge Waters.nsA This might explain the presence of this

'patient' at the 'Po dI'.

Pain is expressed in the features of the man with the bandaged arm as he tries to protect it from the pressing crowd. 'Gout' as

is suggested for this sufferer was a common complaint in the eighteenth

century. It is an affliction which does not usually appear before the age of 40 years and is usually confined to males. Dr. Thomas Sydenham was an Important physician in the seventeenth century and had built up a practice in London which was famous throughout Europe, His main interest was in the natural history of disease, and his approach along these lines is evident in his description of gout, from which he himself suffered for thirty years:

"The Gout most commonly seizes such Old men, as have liv’d the best part of their Lives tenderly and delicately, allowing themselves freely Banquets, Wine, and other Spirituous Liquors, and at length by reason of the Sloth that always attends Old-Age, have quite omitted such Exercises as young Men are wont to use. Moreover they who are Subject to this Disease have large Skulls, and most commonly are of gross Habit of Body, moist and lax, and of a Strong and lusty Constitution, the best and richest Foundation for Life."®3 Hogarth must have been familiar with the spectacle of gout sufferers experiencing the excruciating p?Mn which is a feature of this condition, and LeBrun described the method to be used for the expression of bodily pain (Plate 27). Although in the early stages the first joint of the big toe is the usual site of affliction, repeated attacks result in ^involvement of other joints, one of which is the wrist. Mineral water therapy had been advocated by the Greeks, and throughout the Middle Ages certain Holy Wells were famous for their healing powers for certain diseases. Such a fashion was becoming established again in the early eighteenth century as, for example, at Epsom where Mrs. Mapp the bone-setter had found employment, and the presence of this man with gout at the ’Pool* was appropriate for this condition.

The mentally handicapped girl displaying features now recognised as being due to thyroid deficiency (cretinism), such as stunted growth, obesity, coarse features, thick lips and 'dull' expression in keeping with her mental faculties, would not have had her condition understood. The presence of such a person was not uncommon in European paintings and Hogarth's character is not a stranger to such surroundings.

The landscapes surrounding the 'Pool' and 'The Good Samaritan' were painted by John Lambert, and the ornamental surrounds, in late Baroque style, by artist R i c h a r d s . I n the latter painting, the Good Samaritan represents the caring attitude associated with the hospital which is equated with the Inn where the traveller will stay until he is well. Convention and LeBrunian physiognomies again dictate the style and demeanor of the participants, pain being clearly demonstrated upon the face of the injured man. The Biblical text for this is St. Luke ch. 10 v. 30-.2,3

Although Hogarth made other forays into the realms of 'Great Historical Painting', he reverted to his more popular style in the form of 'Modern Moral Histories', but the 'Pool of Beihesda' and 'The Good Samaritan' give an indication of how Hogarth seemed to be involved with real-life contemporary events even in his "great stile of history painting", which necessarily made direct reference to academic conventions. His remarkably accurate observations of people and medical circumstances gave a sense of immediacy to pictures which otherwise could have become merely minor examples within the long- established tradition of Biblical history painting.

Thomas Bar dwell and his JJIflgaEihfail!. Allegory of Joshua Ward

Clinical appearances associated with disease are evident in an eighteenth century oil painting by T h o m s Bardwell which is displayed in the Royal College of Surgeons (Plate 29) It was engraved by Baron and published in 1749. This painting is an allegorical one in which a moral regarding an individual is conveyed through symbolic language - a practice normally reserved for Royalty or higher nobility. The individual so described is Joshua Ward (of 'Drop' and ’Pill' fame), who appeared in Hogarth's 'The Arms of the Company of Undertakers*. However, his portrayal in this painting offers a different concept of his activities and of how they were perceived by those who had cause to be grateful for his Charity. A verse underneath the engraving of the painting reads:

"'Tis thou, 0 Gen'rous Ward, thrice bless'd we see Crouded with those that seek thy Charity.

The Poor distress'd, the sick, the lame, ye blind, Here seek relief from thee relief they find.

If volumes have been wrote on Faith,..and Hope, Sure Charity deserves a greater scope.

0, happy Ward! thy charity’s so great.

It wants not words to make it more compleate The multitudes that daily croud thy door Loudly proclaim thee

Father of the Poor."

In the painting, 'Britannia' is shown leading a crowd of poor and sick people and is offering Ward a purse as a reward for his services to them, He is pointing tD the figure of 'Charity' - represented as a woman suckling her baby and with two naked infants by her side - indicating that the money should go to her. Behind him 'Time' is holding back a curtain so that he m y see what is preventing the sick and poor from entering his domain where one mother and her

baby are already In tbe shadow of 'Death'. Vard appears as a successful and benevolent practitioner, well but soberly dressed, exuding confidence and solicitude and standing between the poor and

'Death'. The portrit emphasises his charitable role in society.

The engraving and the accompanying verse are in line with the testimonial and advertisement regarding Ward's activities which appeared in the Gentleman's Magazine in December 1734, referring to the 'Thousand people' weekly whom Ward restored to health (quoted on p. 85>.a»

Perhaps in an effort to curtail the influx of these people an advertisement from the 'Daily Advertiser' reads;-

"... Mr. Ward intimates that he ...will not for the future give his Medicines gratis to any Person, except such as send or come in an Afternoon, with a Certificate sign'd by the Minister and Church Wardens, or Overseers of their Parish, setting forth their Circumstances and Distempers; and that those who are Deaf, Blind or have Disorders in the Head, must come on Mondays and Thursdays in the Morning fasting."30

It is not known who commissioned this painting or the engraving, and Vard himself may have done so. Bar dwell has been described as a well-known copyist,31 and examination of the painting or print shows that some of his crowd of poor and sick people are similar to some of Hogarth's characters. Individuals with similar gestures and physiognomy are evident, and the use of contemporary scenes of personal tragedy within a classical or allegorical theme are Hogarthian. The man on the left with his stick, holding his ascitic abdomen, the woman behind him with her sick baby, the woman with hand to her brow and the blind man with his stick seem to have come from

•The Pool of Bethesda', and 'Charity' might be seen breast-feeding her baby in Hogarth's painting 'The March to Finchley' (Plate 19).