Introduction

Out of doom and misery, the most beautiful song may rise1

Few people know that Pierre-Auguste Renoir, who lived from 1841 to 1919, suffered from severe rheumatoid arthritis for the last 25 years of his life. At the 13th European congress of rheumatology in Amsterdam in 1995 Mr Paul Renoir, the artist's 70 year old grandson, revealed several previously unpublished aspects of his grandfather's disease.

Disease and evolution

There is little doubt that Renoir suffered from rheumatoid arthritis, but there is still some discussion about the precise year the arthritis started.2 It must have been around 1892, when Renoir was about 50 and in the prime of life. He was married to Aline Charigot, and two of his three sons had already been born. He was recognised as an established painter, having had exhibitions not only in Paris and other places in France but also in Brussels, London, Boston, and New York.

He was active and hardworking, painting and making study tours to Algiers, Italy, Germany, and Spain. His friends included the painters Manet, Sisley, and Cézanne and the writers Zola and de Montpassant.

Although no medical records remain, it is possible, thanks to photographs, his personal letters, and biographical notes by people who knew him well to get a reasonable idea about the course of his disease. The arthritis started around the age of 50, took on an aggressive form from 1903 onwards, when he was about 60, and made him quite handicapped from the age of 70 for the last seven years of his life.

In a photograph of 1896, when he was 55, the swelling of the metacarpophalangeal joints can be clearly seen (fig 1). Five years later, in 1901, when he was 60, he could still use his hands fully as witnessed in the way he holds …