Abstract
Dr Hijmans and Dr Dequeker (November 2004 JRSM1) have presented five 15th century paintings by Dirk Bouts (1410–1475) and his son, Albrecht. Each of these portrays a woman with a distinct deformity of one or both fifth fingers. They have proposed that a single sitter for all of these portraits had camptodactyly, a congenital, often hereditary, fixed flexion of the proximal interphalangeal (PIP) joint of the fifth finger but without flexion of the distal interphalangeal (DIP) joint. This is accompanied by compensatory hyperextension of the metacarpophalangeal joint.2 This conformation of the fifth finger is not physiological. That is, most people cannot flex the PIP joint of the fifth finger without also flexing the DIP joint. It is reasonable, then, to suggest a pathological basis for the fingers in the portraits. Hijmans and Dequeker dismiss ‘mannerism’ as an explanation, having found no such anomalies in works by other artists of the time. However, I have come across several camptodactyly-like hands in The Metropolitan Museum of Art. Some examples are shown in Figure 1. The artists are, reading left to right from top to bottom, Gerard David (1455–1523), Fillipo Lipi (1406–1469), Hans Memling ((1430–1494), Pietro Perugino (1448–1523), Cosimo Roselli (1439–1507), and Luca Signorelli (1445–1523). It seems that both northern and southern European artists from roughly 1420 to 1520 used this unphysiological affectation, perhaps to imbue the hand with a certain delicacy and grace. Figure 1 Renaissance hands from the Metropolitan Museum of Art I suggest that Dirk Bouts and his son were not using a sitter with a pathological deformity, but were simply following the fashion of the time.
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