Seishu Hanaoka (1760-1835), published his illustrated Surgical Casebook probably in 1825 (Fig. 1) [1]. Seishu and his wife are portrayed in a famous Japanese book and movie titled, „The Doctor’s Wife”. Seishu’s operation on his wife was a 19th c. attempt to perform a complex surgical procedure under general anesthesia using Tsusen san, an herbal mixture of mandragora and aconite roots.
Fig. 1. Seishu Hanaoka (1760-1835), illustrated Surgical Casebook
Surgical and pathological aspects of breast cancer are depicted in a 16th century manuscript by GM Faenisch (Fig. 2).
Fig. 2. Illustration from a 16th century manuscript by GM Faenisch
A drawing from 17th century describe a mastectomy (Fig. 3): the operator excises the breast with the „tenaculum helvetianum”. His assistant has a case of lancets attached to his belt. A set of cautery irons is smouldering on a stand on the left. The patient is seated, held by two men: she appears to be fainting. On the right, a man in a tall hat points towards her: he is possibly meant to be a physician.
Fig. 3. Mastectomy, drawing attributed to a Dutch artist, 17th century
An illustration for the use of a House of the Franciscan Order, probably in Austria or South Germany (Fig. 4), of a woman having a breast operation (ca.1675), is accompanied by a close up of the surgical instruments used [3].
Fig. 4. Arzneibuch. Compendium of popular medicine and surgery, receipts, etc., in German
A case from 1689 in an engraving by M. Burghers: Elizabeth Hopkins of Oxford, showing a breast with cancer which was removed by Sir William Read (Fig. 5).
Fig. 5. Engraving by M. Burghers: Elizabeth Hopkins of Oxford
Rubens was one of main baroque painters who practices realism, which means that he painted whatever his eyes capture. That fact has helped us with the visual aspect and the circumstances where such paintings were painted. This has allowed us to discover alterations in the breast of the models he painted, which suggest breast cancer. In ‘The three Graces’ (Fig. 6) we can see that the model on the right has an open ulcer with reddening of the skin, nipple retraction, reduction of breast volume as well as axilar lymph nodes. This is a visual aspect of a locally advanced breast cancer [2].
Fig. 6. ‘The three Graces’, by Rubens
A surgical operation to remove a malignant tumour from a man’s left breast and armpit in a Dublin drawing room, 1817 is depicted in a watercolour from 1817, by Robert F Power (Fig 7) [3].
Fig. 7. Watercolour by Robert F Power: a surgical operation to remove a malignant tumour from a man’s left breast and armpit
One of six watercolor portraits in a group of works depicting people of Leeds, England with serious illnesses entitled „Gentlefolk of Leeds Afflicted with Disease” describes the breast cancer [2,4]. Mrs. Prince of Coborough Street is depicted in 1841 as a woman of about 40 years of age wearing a lace cap, a yellow shawl and a purple dress. Her dress opens below the bosoms revealing the wound where her right breast was surgically removed (Fig. 8) [3].
Fig. 8. Gentlefolk of Leeds Afflicted with Disease
In this picture (Fig. 9) the people are wearing early 17th-century costume but the patient is lying down, as in surgery of the anaesthetic era (post-1846), showing that this is a late 19th-century idea of what a surgical operation might have been like in the early 17th century [6].
Fig. 9 Surgeons performing an operation on a woman’s breast in the seventeenth century
Fig. 10. Cancer Tumor , Jacob Nicolas Henri, 1860s
References
- http://archive.nlm.nih.gov/proj/ttp/flash/hanaoka/hanaoka.html
- Grau JJ, Estapé J, Diaz-Padrón M. Breast cancer in Rubens paintings, Breast Cancer Res Treat. 2001 Jul;68(1):89-93
- http://www.cerebral-coffins.com/spk/medical-illustrations.html
- http://metalonmetalblog.blogspot.com/2010/02/medicine-in-art.html
- http://www.randomhistory.com/1-50/029cancer.html
6.http://books.google.fr/books?id=xSnlnqHEcYAC&printsec=frontcover&hl=ro#v=onepage&q&f=false