Theartofsurgery

Danielle Dray on a project that aims to set the records straight on the valuable role of modern medical illustration

The ‘Rehoming Schetky’ project aims to catalogue, digitise and rehome our historic art collections. As such, we have had a fantastic opportunity to get to grips with an area of our collections that can sometimes be overlooked.

Medical illustrations are a valuable tool in teaching and demonstrating pathologies and techniques that surgeons may have few opportunities to observe. Detailed depictions of disease, injuries and operations became an important area of medical teaching that developed in both style and function.

Throughout history many outstanding surgeons were also talented artists. Charles Bell, Joseph Lister and John Alexander Schetky all illustrated interesting and rare cases they came across during their practice. These illustrations all relied on traditional artistic techniques and styles. However, in the early 20thcentury new styles and techniques were developed that changed the face of medical illustration.

Max Brödel (1870–1941) was a German immigrant living and working in the US. He arrived in Baltimore in 1894 to accept a post at Johns Hopkins Hospital illustrating pioneering abdominal surgeries undertaken by Dr Howard Kelly. However, he had not originally trained to draw operations and organs, and felt unable to capture the complex textures of living tissue with traditional techniques. He therefore developed a new technique using Ross board and carbon dust.

The technique involved outlining an image on tracing paper and using this to leave an imprint on a heavy board covered with either chalk or china clay. Carbon dust would then be slowly layered onto the outline to give a sense of depth. Precise details were etched in afterwards.

In 1910 Brödel became Associate Professor of the Department of Art as Applied to Medicine and established the world’s first medical illustration programme. In his 30 years of teaching Brödel taught his methods to over 200. Audrey Arnott (1901–1974) is recognised as the only British student he taught. She returned to the UK and shared what she had learned with three professional associates, Dorothy Davison (1889–1984), Margaret McLarty (1908–1996) and Clifford Shepley (1908–1980).

The group were concerned with the standards of UK medical illustrators. Both world wars had highlighted the need for skilled artists who could accurately convey the disease or injury shown. For example, AK Maxwell (1884–1975) was highly regarded for capturing, in a more aesthetic style, the injuries from First World War trench warfare. Shepley, who valued realism, said he had “never much cared” for Maxwell’s work.

Davison proposed the formation of a professional association to ensure a high standard of work and provide accreditation. The Medical Artists Association of Great Britain was established in 1949 and with it the recognition of medical illustration as a professional practice.

Professional medical art thereafter tended to follow a more standardised form; clear, straightforward illustrations that demonstrated the technique or disease being shown. Shepley, Davison and Arnott continued to favour the Ross board method, and the technique became something of a 'gold standard' in British medical illustration. However, across the Atlantic, medical art was again moving in a different direction. American Frank Netter (1906–1991), who trained in both art and medicine, worked with pharmaceutical companies to produce illustrations advertising their products. Netter’s bold, eye-catching style was markedly different from Brödel’s. Throughout the 1940s wartime propaganda posters successfully utilised a similar style. The broad influence of Netter’s work led to a more visually appealing style of medical illustration.

The fact that relatively few early medical illustrations survive today is a testament to how undervalued they have been. Some were unfortunate losses: a huge portion of Maxwell’s work was lost when the Royal College of Surgeons of England was bombed during the Second World War. Others were discarded and even within our own collection it is not uncommon to find notes on the reverse of drawings that read “keep until cast is found”.

We have in our care several hundred illustrations from the early 19th to the late 20th century. Our project has provided an insight into a field that bridges the gap between art and science, and elicited an opportunity to bring these fantastic artworks back into the limelight.