Visible signs of illness from the 14th to the 20th century: systematic review of portraits

C Als; Y Stüssi; U Boschung; U Tröhler; J H Wäber

doi:10.1136/bmj.325.7378.1499

Through The Artist's Eye

Visible signs of illness from the 14th to the 20th century: systematic review of portraits

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7378.1499 (Published 21 December 2002) Cite this as: BMJ 2002;325:1499

Data supplement

Figure A: Overweight Bernese man (corpulent body, swollen face, fat neck, periorbital swelling) with a goitre (probably WHO grade II). Portrait of v.M.J. (1752-1809), a historian, by an unknown painter. Photo: G Howald, Kirchlindach, Switzerland

Figure B: Small (diffuse?) goitre, probably WHO grade II) in a 5 year old Bernese girl. Oval portrait of: v.R.(M.S.)C. (1855-1929), painted in 1860 by Friedrich Dietler (1804-74). Photo: G Howald, Kirchlindach, Switzerland

Figure C: Goitre (probably WHO grade II) in a young man from Berne. Portrait of v.S.V.R. (1786-1813), an officer in imperial French service, painted by an unknown artist. Photo: G Howald, Kirchlindach, Switzerland

Figure D: Overweight Bernese woman with small goitre (probably WHO grade II), partly hidden by a ribbon for reasons of idealisation. Portrait of ? v.S.—E.B.S. (1724-1828) by an unknown painter. Photo: G Howald, Kirchlindach, Switzerland

Figure E: Goitre (probably WHO grade II) in a 45 year old Bernese woman. Portrait of ? v.G.—T.J.(D.) (1675-1730, painted in 1720 by an unknown artist. Photo: G Howald, Kirchlindach, Switzerland

Figure F: Overweight Bernese woman (corpulent body, fat neck) with a goitre (probably WHO grade II). Portrait of v.H.—v.M.H.P. (1809-1880) by ? David Sulzer (1784-1864). Photo: G Howald, Kirchlindach, Switzerland

Table 1 [posted as supplied by author] Frequency of all signs of disease that could be evaluated in people having heir portrait painted in Canton Berne, 14th to 20th century. Known and unknown refers to sitters’ identities

			14 century			15 century			16. century			17.century			18.century			19. century			20. century			Total			Total
			n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%		n	tot	%
Known	Men	<40years	2	2	100.0%	2	5	40.0%	15	17	88.2%	179	224	79.9%	401	548	73.2%	203	467	43.5%	1	8	12.5%	803	1271	63.2%	Men	1220	1844	66.2%
		>40 years	0	1	0.0%	0	0	-	13	27	48.1%	87	120	72.5%	186	209	89.0%	117	187	62.6%	14	29	48.3%	417	573	72.8%

	Women	<40years	0	0	-	0	0	-	4	4	100.0%	102	118	86.4%	314	424	74.1%	244	424	57.5%	1	6	16.7%	665	976	68.1%	Women	792	1145	69.2%
		>40 years	0	0	-	0	0	-	0	0	-	18	25	72.0%	50	59	84.7%	57	79	72.2%	2	6	33.3%	127	169	75.1%

Unknown	Men	<40years	0	0	-	0	0	-	0	0	-	28	28	100.0%	85	108	78.7%	50	81	61.7%	0	0	-	163	217	75.1%	Men	250	316	79.1%
		>40 years	0	0	-	0	0	-	1	1	100.0%	15	15	100.0%	50	54	92.6%	21	29	72.4%	0	0	-	87	99	87.9%

	Women	<40years	0	0	-	0	0	-	1	1	100.0%	17	18	94.4%	92	104	88.5%	87	127	68.5%	0	1	0.0%	197	251	78.5%	Women	251	310	81.0%
		>40 years	0	0	-	0	0	-	0	0	-	5	5	100.0%	18	19	94.7%	31	35	88.6%	0	0	-	54	59	91.5%

Known	Men+Women	<40years	2	2	100.0%	2	5	40.0%	19	21	90.5%	281	342	82.2%	715	972	73.6%	447	891	50.2%	2	14	14.3%	1468	2247	65.3%	Known men+women	2012	2989	67.3%
	Men+Women	>40 years	0	1	0.0%	0	0	-	13	27	48.1%	105	145	72.4%	236	268	88.1%	174	266	65.4%	16	35	45.7%	544	742	73.3%
Unknown	Men+Women	<40years	0	0	-	0	0	-	1	1	100.0%	45	46	97.8%	177	212	83.5%	137	208	65.9%	0	1	0.0%	360	468	76.9%	Unknown men + women	501	626	80.0%
	Men+Women	>40 years	0	0	-	0	0	-	1	1	100.0%	20	20	100.0%	68	73	93.2%	52	64	81.3%	0	0	-	141	158	89.2%


Know+Unknown	Men	<40years	2	2	100.0%	2	5	40.0%	15	17	88.2%	207	252	82.1%	486	656	74.1%	253	548	46.2%	1	8	12.5%	966	1488	64.9%	Known + Unknown all Men	1470	2160	68.1%
Know+Unknown	Men	>40 years	0	1	0.0%	0	0	-	14	28	50.0%	102	135	75.6%	236	263	89.7%	138	216	63.9%	14	29	48.3%	504	672	75.0%
Know+Unknown	Women	<40years	0	0	-	0	0	-	5	5	100.0%	119	136	87.5%	406	528	76.9%	331	551	60.1%	1	7	14.3%	862	1227	70.3%	Known + Unknown all Women	1043	1455	71.7%
Know+Unknown	Women	>40 years	0	0	-	0	0	-	0	0	-	23	30	76.7%	68	78	87.2%	88	114	77.2%	2	6	33.3%	181	228	79.4%

Known + Unknown	all men	all ages	2	3	66.7%	2	5	40.0%	29	45	64.4%	309	387	79.8%	722	919	78.6%	391	764	51.2%	15	37	40.5%	1470	2160	68.1%		1470	2160	68.1%

	all women	all ages	0	0	-	0	0	-	5	5	100.0%	142	166	85.5%	474	606	78.2%	419	665	63.0%	3	13	23.1%	1043	1455	71.7%		1043	1455	71.7%

Total	men+women	all ages	2	3	66.7%	2	5	40.0%	34	50	68.0%	451	553	81.6%	1196	1525	78.4%	810	1429	56.7%	18	50	36.0%	2513	3615	69.5%		2513	3615	69.5%

		14 century			15 century			16. century			17.century			18.century			19. century			20. century			Total
		n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%
Known	Men	2	3	66.7%	2	5	40.0%	28	44	63.6%	266	344	77.3%	587	757	77.5%	320	654	48.9%	15	37	40.5%	1220	1844	66.2%

	Women	0	0	-	0	0	-	4	4	100.0%	120	143	83.9%	364	483	75.4%	301	503	59.8%	3	12	25.0%	792	1145	69.2%

Unknown	Men	0	0	-	0	0	-	1	1	100.0%	43	43	100.0%	135	162	83.3%	71	110	64.5%	0	0	-	250	316	79.1%

	Women	0	0	-	0	0	-	1	1	100.0%	22	23	95.7%	110	123	89.4%	118	162	72.8%	0	1	0.0%	251	310	81.0%

Known + Unknown	all men	2	3	66.7%	2	5	40.0%	29	45	64.4%	309	387	79.8%	722	919	78.6%	391	764	51.2%	15	37	40.5%	1470	2160	68.1%

	all women	0	0	-	0	0	-	5	5	100.0%	142	166	85.5%	474	606	78.2%	419	665	63.0%	3	13	23.1%	1043	1455	71.7%

Total	men+women	2	3	66.7%	2	5	40.0%	34	50	68.0%	451	553	81.6%	1196	1525	78.4%	810	1429	56.7%	18	50	36.0%	2513	3615	69.5%

Table 2 [posted as supplied by author] Goiter frequency in case of evaluable neck in portraitized individuals over the centuries. Known and unknown refers to sitters’ identities

			14 century			15 century			16. century			17.century			18.century			19. century			20. century			Total			Total
			n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%		n	tot	%
Known	Men	<40years	0	0	-	1	1	100.0%	1	3	33.3%	1	3	33.3%	5	15	33.3%	11	50	22.0%	0	1	0.0%	19	73	26.0%	Men	21	86	24.4%
		>40 years	0	0	-	0	0	-	0	0	-	0	1	0.0%	2	6	33.3%	0	5	0.0%	0	1	0.0%	2	13	15.4%

	Women	<40years	0	0	-	0	0	-	0	0	-	15	28	53.6%	66	141	46.8%	40	141	28.4%	0	5	0.0%	121	315	38.4%	Women	139	343	40.5%
		>40 years	0	0	-	0	0	-	0	0	-	2	2	100.0%	14	20	70.0%	2	5	40.0%	0	1	0.0%	18	28	64.3%

Unknown	Men	<40years	0	0	-	0	0	-	0	0	-	0	0	-	1	2	50.0%	4	6	66.7%	0	0	-	5	8	62.5%	Men	5	8	62.5%
		>40 years	0	0	-	0	0	-	0	0	-	0	0	-	0	0	-	0	0	-	0	0	-	0	0	-

	Women	<40years	0	0	-	0	0	-	0	0	-	7	7	100.0%	35	48	72.9%	28	50	56.0%	0	1	0.0%	70	106	66.0%	Women	82	121	67.8%
		>40 years	0	0	-	0	0	-	0	0	-	0	0	-	9	11	81.8%	3	4	75.0%	0	0	-	12	15	80.0%

Known	Men+Women	<40years	0	0	-	1	1	100.0%	1	3	33.3%	16	31	51.6%	71	156	45.5%	51	191	26.7%	0	6	0.0%	140	388	36.1%	Known men+women	160	429	37.3%
	Men+Women	>40 years	0	0	-	0	0	-	0	0	-	2	3	66.7%	16	26	61.5%	2	10	20.0%	0	2	0.0%	20	41	48.8%
Unknown	Men+Women	<40years	0	0	-	0	0	-	0	0	-	7	7	100.0%	36	50	72.0%	32	56	57.1%	0	1	0.0%	75	114	65.8%	Unknown men + women	87	129	67.4%
	Men+Women	>40 years	0	0	-	0	0	-	0	0	-	0	0	-	9	11	81.8%	3	4	75.0%	0	0	-	12	15	80.0%


Know+Unknown	Men	<40years	0	0	-	1	1	100.0%	1	3	33.3%	1	3	33.3%	6	17	35.3%	15	56	26.8%	0	1	0.0%	24	81	29.6%	Known + Unknown all Men	26	94	27.7%
Know+Unknown	Men	>40 years	0	0	-	0	0	-	0	0	-	0	1	0.0%	2	6	33.3%	0	5	0.0%	0	1	0.0%	2	13	15.4%
Know+Unknown	Women	<40years	0	0	-	0	0	-	0	0	-	22	35	62.9%	101	189	53.4%	68	191	35.6%	0	6	0.0%	191	421	45.4%	Known + Unknown all Women	221	464	47.6%
Know+Unknown	Women	>40 years	0	0	-	0	0	-	0	0	-	2	2	100.0%	23	31	74.2%	5	9	55.6%	0	1	0.0%	30	43	69.8%

Known + Unknown	all men	all ages	0	0	-	1	1	100.0%	1	3	33.3%	1	4	25.0%	8	23	34.8%	15	61	24.6%	0	2	0.0%	26	94	27.7%		26	94	27.7%

	all women	all ages	0	0	-	0	0	-	0	0	-	24	37	64.9%	124	220	56.4%	73	200	36.5%	0	7	0.0%	221	464	47.6%		221	464	47.6%

Total	men+women	all ages	0	0	-	1	1	100.0%	1	3	33.3%	25	41	61.0%	132	243	54.3%	88	261	33.7%	0	9	0.0%	247	558	44.3%		247	558	44.3%

				14 century			15 century			16. century			17.century			18.century			19. century			20. century			Total
		BU	Sex	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%
Known	Men	1	1	0	0	-	1	1	100.0%	1	3	33.3%	1	4	25.0%	7	21	33.3%	11	55	20.0%	0	2	0.0%	21	86	24.4%

	Women	1	0	0	0	-	0	0	-	0	0	-	17	30	56.7%	80	161	49.7%	42	146	28.8%	0	6	0.0%	139	343	40.5%

Unknown	Men	2	1	0	0	-	0	0	-	0	0	-	0	0	-	1	2	50.0%	4	6	66.7%	0	0	-	5	8	62.5%

	Women	2	0	0	0	-	0	0	-	0	0	-	7	7	100.0%	44	59	74.6%	31	54	57.4%	0	1	0.0%	82	121	67.8%

Known + Unknown	all men			0	0	-	1	1	100.0%	1	3	33.3%	1	4	25.0%	8	23	34.8%	15	61	24.6%	0	2	0.0%	26	94	27.7%
						-			-			-			-			-			-			-			-
	all women			0	0	-	0	0	-	0	0	-	24	37	64.9%	124	220	56.4%	73	200	36.5%	0	7	0.0%	221	464	47.6%
						-			-			-			-			-			-			-			-
Total	men+women			0	0	-	1	1	100.0%	1	3	33.3%	25	41	61.0%	132	243	54.3%	88	261	33.7%	0	9	0.0%	247	558	44.3%

Table C [posted as supplied by the authors] Overweight in people from Canton Berne, 14th-20th century. . Known and unknown refers to sitters’ identities

			14 century			15 century			16. century			17.century			18.century			19. century			20. century			Total			Total
			n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%	n	tot	%		n	tot	%
Known	Men	40years	1	2	50.0%	1	5	20.0%	8	17	47.1%	110	224	49.1%	258	548	47.1%	104	467	22.3%	0	8	0.0%	482	1271	37.9%	Men	811	1844	44.0%
		>40 years	0	1	0.0%	0	0	-	8	27	29.6%	67	120	55.8%	166	209	79.4%	80	187	42.8%	8	29	27.6%	329	573	57.4%

	Women	40years	0	0	-	0	0	-	2	4	50.0%	49	118	41.5%	130	424	30.7%	99	424	23.3%	1	6	16.7%	281	976	28.8%	Women	346	1145	30.2%
		>40 years	0	0	-	0	0	-	0	0	-	9	25	36.0%	30	59	50.8%	24	79	30.4%	2	6	33.3%	65	169	38.5%

Unknown	Men	40years	0	0	-	0	0	-	0	0	-	9	28	32.1%	43	108	39.8%	20	81	24.7%	0	0	-	72	217	33.2%	Men	136	316	43.0%
		>40 years	0	0	-	0	0	-	1	1	100.0%	12	15	80.0%	40	54	74.1%	11	29	37.9%	0	0	-	64	99	64.6%

	Women	40years	0	0	-	0	0	-	1	1	100.0%	10	18	55.6%	35	104	33.7%	27	127	21.3%	0	1	0.0%	73	251	29.1%	Women	106	310	34.2%
		>40 years	0	0	-	0	0	-	0	0	-	3	5	60.0%	11	19	57.9%	19	35	54.3%	0	0	-	33	59	55.9%

Known	Men+Women	40years	1	2	50.0%	1	5	20.0%	10	21	47.6%	159	342	46.5%	388	972	39.9%	203	891	22.8%	1	14	7.1%	763	2247	34.0%	Known men+women	1157	2989	38.7%
	Men+Women	>40 years	0	1	0.0%	0	0	-	8	27	29.6%	76	145	52.4%	196	268	73.1%	104	266	39.1%	10	35	28.6%	394	742	53.1%
Unknown	Men+Women	40years	0	0	-	0	0	-	1	1	100.0%	19	46	41.3%	78	212	36.8%	47	208	22.6%	0	1	0.0%	145	468	31.0%	Unknown men + women	242	626	38.7%
	Men+Women	>40 years	0	0	-	0	0	-	1	1	100.0%	15	20	75.0%	51	73	69.9%	30	64	46.9%	0	0	-	97	158	61.4%


Know+Unknown	Men	40years	1	2	50.0%	1	5	20.0%	8	17	47.1%	119	252	47.2%	301	656	45.9%	124	548	22.6%	0	8	0.0%	554	1488	37.2%	Known + Unknown all Men	947	2160	43.8%
Know+Unknown	Men	>40 years	0	1	0.0%	0	0	-	9	28	32.1%	79	135	58.5%	206	263	78.3%	91	216	42.1%	8	29	27.6%	393	672	58.5%
Know+Unknown	Women	40years	0	0	-	0	0	-	3	5	60.0%	59	136	43.4%	165	528	31.3%	126	551	22.9%	1	7	14.3%	354	1227	28.9%	Known + Unknown all Women	452	1455	31.1%
Know+Unknown	Women	>40 years	0	0	-	0	0	-	0	0	-	12	30	40.0%	41	78	52.6%	43	114	37.7%	2	6	33.3%	98	228	43.0%

Known + Unknown	all men	all ages	1	3	33.3%	1	5	20.0%	17	45	37.8%	198	387	51.2%	507	919	55.2%	215	764	28.1%	8	37	21.6%	947	2160	43.8%		947	2160	43.8%

	all women	all ages	0	0	-	0	0	-	3	5	60.0%	71	166	42.8%	206	606	34.0%	169	665	25.4%	3	13	23.1%	452	1455	31.1%		452	1455	31.1%

Total	men+women	all ages	1	3	33.3%	1	5	20.0%	20	50	40.0%	269	553	48.6%	713	1525	46.8%	384	1429	26.9%	11	50	22.0%	1399	3615	38.7%		1399	3615	38.7%

Visible signs of illness from the 14th to the 20th century: systematic review of portraits

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Visible signs of illness from the 14th to the 20th century: systematic review of portraits

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