Our new mini-series looks at potential medical issues in famous works of art. Dr Keith Hopcroft looks at a portrait of a woman by a 17th-Century Dutch painter
This is Portrait of a Woman by Frans Hals (1635), who is rather better known for his Laughing Cavalier, painted 11 years earlier. Very little is known about the identity of the sitter in this picture, so the possible pathology here is pure speculation on my part.
Hint Could there be a connection between the ruddy complexion and the fact that she seems to be clutching her heart?
Answer The facial appearance has been speculated upon, and has included suggestions such as rosacea, SLE or simply too much rouge. But then there’s also the odd posture of her hand: Hals painted numerous portraits of ladies but this is the only one where the sitter appears to be clutching her chest. So could this be mitral facies resulting from mitral stenosis? Which, of course, can cause atrial fibrillation, leading to palpitations or breathlessness – both plausible explanations for that posture. After all, rheumatic heart disease was much more common in those days – 25% of patients with it developed mitral stenosis, and two thirds of those were women.
Dr Keith Hopcroft is Pulse’s medical adviser and a GP in Basildon, Essex
No, the lady clearly cannot see below her ruff. She suddenly had a nasty thought that she might have forgotten to put on her bodice this morning, and cannot look to see if she is naked, so she clutched her hand to her front in a panic to check she was decent. The caused her ruff to move, and the artist had to ask her to hold her apparel in this awkward fashion to make it sty put while he finished the sketch.
The ruddy cheeks are from Fifth disease. The ruff is to stop her being able to poke her nose in where not wanted, because she would get it stuck in the hole and be spotted.
However, it is curious that the right cheek, there does appear to be bleeding runnnig down her engle of the jaw and chin, so she may also be hidin a significant injury…
Malar flush = Mitral Stenosis.
It is not blood “running down the engle of the jaw “… ’tis a pearl drop dangling from the head-cap, and the pearl can also be seen on the right hand side.
I’m going to join in——–has anyone noticed the lack outer eyebrows possibly signifying an under active thyroid?—–but then of course the Elizabethans used to pluck their eyebrows anyway. This occurred in ‘myxoedema madness’—–but she looks otherwise normal to me.
If the photo of our Keith were to be analysed in a few hundred years time, the question will be——”why is he wearing a stethoscope around his neck in the surgery”——it was becoming dated even in2023