Lanfranco’s Dropsical Child: The First Depiction of Congenital Heart Disease?

Abstract

* Abbreviation: VSD — : ventricular septal defect Hanging in an unassuming side gallery in Rome’s Palazzo Barberini is an unusual painting, arguably both an artistic masterpiece and a landmark in medical history (Fig 1). Acquired from a private collection by the Italian State in 2011, the painting was completed shortly after 1620 by Giovanni Lanfranco, one of the masters of the Italian Baroque.1 This brief article describes the painting and explores its importance for the history of pediatrics. FIGURE 1 St Luke Healing the Dropsical Child , Giovanni Lanfranco, c.1620. Lanfranco’s oil painting shows an elderly man holding the wrist of a small child, with a young woman (presumably, the child’s mother) standing behind both of them. Standard religious iconography (eg, the ox) identifies the haloed man as St Luke, known as “the beloved physician” in the New Testament (Colossians 4:14), and attributed as the author of the third Gospel. As a beautiful reminder of the close relationship between art and medicine, St Luke is depicted both as a painter (he was traditionally accredited with painting the first portrait of the Virgin Mary) and as a physician (here, he has a book entitled Hippocrates near his lap). This depiction of Luke acting simultaneously as both physician and artist seems unprecedented in previous Italian art.2 But what is even more extraordinary, particularly from the viewpoint of medical history, is the portrayal of the child himself. The child is perhaps 2 or 3 years old, based on his height compared with the woman. He appears weak: his left arm is limp in the hand of St Luke, and his back is lightly supported by the woman (Fig 2). What is most noticeable is the child’s swollen belly. Indeed, the painting’s title St. Luke Healing the Dropsical Child ( S. Luca guarisce il bambino idropico ) points to the child’s dropsy (from … Address correspondence to Thomas F. Heyne, MD, Harvard Internal Medicine and Pediatrics Residency, 175 Cambridge St, 5th Fl, Boston, MA 02114. E-mail: theyne{at}partners.org