Intended for healthcare professionals

Feature Christmas 2012: Evolution of Practice

Gastroscopic painting

BMJ 2012; 345 doi: (Published 18 December 2012) Cite this as: BMJ 2012;345:e8323
  1. James Rose, consultant gastroenterologist, Ayr Hospital
  1. 113 Racecourse Road, Ayr KA7 2DQ, UK
  1. Correspondence to: J Rose jamesdrrose{at}

James Rose describes a time when science and art intersected with striking results

Early endoscopists realised the importance of recording their findings. Although small cameras had been used to take gastrophotographs in the mid-19th century, the slow film speed and low light intensity of the electric bulbs in gastroscopes made photography impractical.1 Coloured paintings were the only medium that could accurately represent what was seen. During the 30 years before photographic techniques improved, almost 600 coloured paintings were published. Little has been written of the artwork or the artists who enabled the internal world revealed to the gastroscopist to be appreciated by the wider medical community.

Association between painting and endoscopic photography

Endoscopy is an older technique than radiology, but radiology developed more quickly. For a long time the pictures produced by radiology seemed to make the hazardous and limited procedure of gastroscopy redundant. However, advances in endoscopy that allowed safer, clearer views of the stomach rendered photography more difficult. For a brief period painting flourished, only to be replaced by photography again.

An endoscopic photograph appeared in the BMJ as early as 1883,2 and Norbert Henning took gastrophotographs through the rigid endoscope and used them to illustrate his books on gastroscopy and gastritis in the 1930s.3 4 These photographs could be enlarged and coloured for greater effect. But the introduction of the semi-flexible gastroscope proved too much for the photography of the time, when film speeds reached a maximum of ASA 2. This speed compares with a standard fast film of ASA 400 before the advent of digital photography.

In 1937 Rudolf Schindler considered “gastrophotography to be obsolete.”5 Thus, the technical limitations of photography allowed painting to flourish until further technical advances improved the quality of photographs.6 The introduction of fibreoptics into endoscopy once more initially reduced the quality of …

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