Rx 14 / Lazarus
Westphalian master, Healing of Lazarus, 1400. Courtesy of Barnes Foundation.
He who conceals his disease cannot be healed.
- Ethiopian proverb
This small painting by a Westphalian master, made for private prayer, illustrates the canonized parable of Lazarus and Dives from the Gospel of Luke. The artist conflates multiple moments from the story in a single image. Dives was a rich man, Lazarus a beggar. After both men die, two devils drag the rich man into the flames of hell while the soul of Lazarus is carried by angels to the bosom of Abraham, to join in the celestial banquet. Surrounding Lazarus and Abraham are ghostly figures of music-making angels who perform the hymns of heaven. Here, Lazarus is both the pitiful beggar and the heavenly infant, embodying spiritual rebirth and purity. The pictorial space is visually divided by the recumbent Lazarus. The upper field is gilded in resplendent gold, a nod to Byzantine iconography. The landscape below has a characteristic tapestry-like quality, redolent of this highly prized fifteenth-century medium.
Theologists and philosophical treatises have ascribed various interpretations to the parable of “The Rich Man and Lazarus” and in particular, the physical ailment of Lazarus. Scholarship pre-dating the eleventh century diagnosed Lazarus with a myriad of conditions including paralysis, blindness, starvation, the plague, and most frequently, leprosy. Though weeping skin lesions in medieval artistic convention and vernacular literature do not necessarily connote leprosy, historical inertia beatified Lazarus as the patron saint of lepers. In fact, lazaretto, a fifteenth-century Venetian refuge for lepers, traces its name from lazzeri, or lepers. Further confounding the clinical diagnosis is the object clasped in Lazarus’s right hand, the leper wooden clapper, both a warning to passers-by to maintain distance and a symbol of marginalization.
Closer study of the Old Testament and classic medical texts reveals that Lazarus’s lesions are most likely generic sores, abrasions, and skin breakdown. Thus, the parable and painting were not intended to reference or stigmatizing any one disease. Rather, they serve as spiritual engagement and moralistic assurance of salvation for earthly suffering and eternal damnation for the merciless. Healing of Lazarus persists as compelling iconography that conveys both medieval socio-religious constructs of illness and the potential for artistic imagery to propagate a misrepresentation of disease over millennia.
reflections…
In the day of this painting, leprosy was perceived as a morally corrupt malady—a disease of the lecherous soul begetting physical deterioration. Unique in their ability to “spur salvation” as sufferers of preemptive purgatory, lepers were simultaneously regarded as social pariahs and liminal entities. The stigma of leprosy persists into the twenty-first century, as patients continue to suffer from the repercussions of social marginalization and discrimination according to one 2019 study in Scientific Reports. Recent research at Penn’s Center for Neuroaesthetics has similarly found that individuals with visible facial disfigurements are associated with negative attributes and generally stigmatized.
Initiatives such as the New Face of Leprosy Project are working to dismantle traditional, harmful constructs of leprosy. Through empowering stories and striking portraits of dynamic individuals living with and beyond leprosy, the project, led by Alexander Kumar, MD, reframes a millennia-old disease through a contemporary lens. Each profile is a testament to the significance of visibility; the initiative embodies the powerful intersection of art and activism and validates the diversity of lived experiences of those impacted.
What are other instances of impactful visual, verbal, and artistic works actively de-stigmatizing value-laden diseases, disfigurements, and disabilities? How can clinicians help to foster this supportive space for patients and work in alliance as advocates, as Dr. Kumar has done? How can we better understand the relational social context and culture-bound influences of stigmatized conditions, particularly as they pertain to international communities, immigrants, and refugees?
sources
“Abandoning the Stigma of Leprosy.” The Lancet, vol. 393, no. 10170, 2019, p. 378., doi:10.1016/s0140-6736(19)30164-3.
Bichell, Rae Ellen. “Iconic Plague Images Are Often Not What They Seem.” NPR, 18 Aug. 2017, www.npr.org/sections/goatsandsoda/2017/08/18/542435991/those-iconic-images-of-the-plague-thats-not-the-plague.
Green, Monica. “Lepers and Their Bells.” The New York Times, 22 Feb. 2013, www.nytimes.com/2013/02/23/opinion/lepers-and-their-bells.html.
Hartung, F., Jamrozik, A., Rosen, M.E. et al. Behavioural and Neural Responses to Facial Disfigurement. Sci Rep 9, 8021 (2019). https://doi.org/10.1038/s41598-019-44408-8.
Kopp, John. “How Do You View a Person with a Facial Deformity?” PhillyVoice, 27 June 2018, www.phillyvoice.com/penn-research-center-neuroaesthetics-facial-deformities/.
Kumar, Alexander, et al. “Picturing Health: a New Face for Leprosy.” The Lancet, vol. 393, no. 10172, 2019, pp. 629–638., doi:10.1016/s0140-6736(19)30158-8.
Porter, John D. H., and Anthony S. Kessel. “Needing to Know? Ethical Dilemmas In Leprosy Treatment and Control.” Leprosy Review, vol. 72, no. 3, 2001, 10.5935/0305-7518.20010030.
Science Museum Group. Copy of a 1600s wooden leper clapper, England. A635022Science Museum Group Collection Online. Accessed May 16, 2020. https://collection.sciencemuseumgroup.org.uk/objects/co147426/copy-of-a-1600s-wooden-leper-clapper-england-leper-clapper.
Strong, Justin David. "Lazarus and the Dogs: The Diagnosis and Treatment." New Testament Studies 64.2 (2018): 178-93.
Welch, Christina, and Rohan Brown. "From Villainous Letch and Sinful Outcast, to 'Especially Beloved of God': Complicating the Medieval Leper through Gender and Social Status." Historical Reflections/Réflexions Historiques, vol. 42, no. 1, 2016, p. 48+.
