or   Lucy in the Sky with Diamonds

Mattias Grunewald’s Isenheim Altarpiece reflects a fascinating intersection of art, biology, and religion. The polyptych was commissioned for an Antonite monastery which attended to people with so-called “St. Anthony’s Fire,” a disease now known to be caused by ergot poisoning (ergotism), a widespread problem at that period of time. The images include horrific and wondrous images of Christ and St. Anthony to offer solace to afflicted hospital patients by suggesting that, like Christ and St. Anthony, suffering offered a means for them to embrace their religion.¹

The altarpiece is a polyptych with three views, 1) the closed position, 2) one set of wings open, and 3) the inner most wings open. In its first position, three panels are aligned horizontally and one panel, the predella, lies beneath them. In the center panel, the largest of the four, Christ hangs on the cross while the two Marys weep and St. John the Evangalist despair and John the Baptist points to Christ. The wings contain images of St. Anthony and St. Sebastian. In the predella, Christ lies lifeless off the cross about to be buried.

Grunewald’s Christ on the cross exudes pain and suffering through the posture of his broken body, his bleeding wounds, and his hands in the rigors of agony. Thorns pierce his head, chest, shoulders and hips, and blackened bruises tell of extended torture. His face, turned to one side, shows pain and exhaustion while dried bluish white lips speak of unquenched thirst. Grunewald’s choice of dark and muted colors for Christ and the background accentuates the overcast of death. When the middle panel is opened, the placement of the body on the cross off-center causes Christ’s right arm to detach from the rest of his body, mimicking the symptoms of ergotism. (See description below.)

In its second position, the highlights of Christ’s life are told in three panels: the annunciation on the far left, his birth on the middle panel, and on the far right, a colorful and uplifting Resurrection.¹ Unlike the closed position where the eye is focused on the middle panel, the one with Christ suffering on the cross, in this position, eyes are drawn to the far right panel of the Resurrection. No longer broken or suffering, Christ ascends from his coffin, knocking the Roman guards off their feet by his mere presence. Glowing with divine light and strength, Christ’s eyes lock with the viewer as if to say, ‘Yes, this came of my suffering. You, too, will find salvation on the other side of your pain.”

The third, inner position shows panels of St. Anthony as well as a shrine of Saints Anthony, Jerome, and Augustine, sculpted by another artist, Niclas Hagenauer. The predella changes to show additional sculpted busts of saints. Grunewald’s paintings of St. Anthony depict two scenes, one with St. Paul the Hermit and the other with demonic creatures. The vibrant colors used for the saints on the first view and used for Christ in the Resurrection scene are now used to portray the demons, including one who appears to be suffering himself from St. Anthony’s fire. His head is thrown back in agony. Black pustules cover his discolored and swollen abdomen. His extremities appear bloodless and dying. According to a letter of correspondence by Marcel-Frances Kahn in the medical journal Lancet (Lancet, Oct. 31, 1998) even St. Anthony shows signs of the disease through the ‘bluish atrophy’ of his fingers.

The legend of St. Anthony tells of how he spent decades undergoing torments by demons and the devil, but through piety and prayer he resisted breaking under pain or temptations. In the end, he emerged from his self-prescribed isolation to lead Christians in the ascetic way of life. In Grunewald’s painting, the demon’s torture causes St. Anthony to cry out, ‘Where were you good Jesus, where were you? Why were you not there to heal my wounds?’ According to Andree Hayum,

“… what is to be dreaded is not the manifest disfigurement symptomatic of the disease […], nor death itself, but the attendant possibility of loss of faith implied by the inscription on the cartello.”¹

The disease “St. Anthony’s Fire” was not an affliction by God or devil, but rather the outcome of unfortunate agricultural circumstances. The fungus Claviceps purpurea is a parasite of rye that produces dark ‘pegs’ between the grains which contain ergot. If the pegs are consumed along with the grain, it causes ergot poisoning. The fungus flourishes under unusually wet conditions, and because rye the food of poor people, peasants were more likely to be affected.

Coincidentally, monasteries tended to have higher quality food and other grains were less likely to be affected by the fungal contamination. When people suffering from ergotism flocked to Antonite hospitals their diet changed, removing the continuous ingestion of the poison, and for those who were not too far gone, this could lead to ‘miraculous’ recovery.² For the majority, though, St. Anthony’s Fire was a death sentence.

One of the active chemicals, ergometrine, causes blood vessels in the arms and legs to constrict so severely that blood flow ceases completely. As the person’s hands and feet die while still attached to the body, the patient suffers extreme burning sensations, as if being burned alive – hence the name St. Anthony’s Fire. The dead limbs become gangrenous and auto-amputate, that is, they fall off. Ergometrine affects other systems of the body, causing intestinal pain and muscle spasms severe enough to distort the body.³

Patients experienced the agony psychological pain also because along with the horrific physical symptoms, it also caused terrifying hallucinations. During Grunewald’s time, people referred to demons and the supernatural to explain this psychosis. We now know that ergometrine affects the mind as well as the body. Below is the chemical structure of ergometrine. Next to it is the structure of lysergic acid diethylamine, commonly known as the hallucinogen LSD. One does not need to be a chemistry expert to see how similar the two molecules are. The lines in purple show the structures they have in common. Lines in green show the slight differences between the two.4 When heated, ergot can change chemically into LSD, causing hallucinations when eaten. In fact, researchers first produced LSD when examining ergot for potential medically active compounds (Don’t try this at home!). With all the pain and bodily changes, it is no wonder that the people afflicted with ergotism tended to have ‘bad acid trips’. It is thought that ergot poisoning was responsible for the unusual behavior and subsequent persecutions of ‘witches’ at this same period of time in history.¹

Without the mass ergot poisonings of the times, there would have been no “St. Anthony’s Fire”. And without the religious figure of St. Anthony and the suffering of Christ on the cross, there would have been no way to relate the affliction of the people to the prevailing religion of the time. Just as the image of Christ’s Crucifixion permits “vast numbers of people to find community in pain and suffering”, 1 the Isenheim Altarpiece offers community and salvation (albeit not in this lifetime) to those afflicted with St. Anthony’s Fire.
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Footnotes
1. Smith, Jeffery Chipps. The Northern Renaissance. (New York, NY. Phaidon Press Inc. 2004.)
2. Smith, Jeffery Chipps. The Northern Renaissance. (New York, NY. Phaidon Press Inc. 2004.)
3. Hayum, Andree. “The Meaning and Function of the Isenheim Altarpiece: The Hospital Context Revisited.” The Art Bulletin 59 (1977): 507.
4. Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 110.
5. Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 110.
6. Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 113.
7. Alm, Torbjorn. “The Witch Trials of Finnmark, Northern Norway, during the 17th century: evidence for ergotism as a contributing factor.” Economic Botany 57 (2003): 403.
8. Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 113.
9. Some might say that ergometrine is not all bad (and no, I don’t mean hippies). Long before its mechanism was understood, it was used in medicine to induce labor. Unfortunately, because the dose could not be accurately controlled, it caused as many problems as it fixed, endangering both mother and child. However, in more modern times, doctors found ergometrine useful for decreasing the bleeding that accompanies childbirth after the infant has been delivered. By using it in a preventative manner before excessive bleeding became a problem, it lowered maternal deaths significantly.
Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 113.
10. Hayum, Andree. “The Meaning and Function of the Isenheim Altarpiece: The Hospital Context Revisited.” The Art Bulletin 59 (1977): 509.

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Bibliography
Alm, Torbjorn. “The Witch Trials of Finnmark, Northern Norway, during the 17th century: evidence for ergotism as a contributing factor.” Economic Botany 57 (2003): 403-416.
De Costa, Caroline. “St. Anthony’s fire and living ligatures: a short history of ergometrine” The Lancet 359 (2002): 1768-1770.
Hayum, Andree. “The Meaning and Function of the Isenheim Altarpiece: The Hospital Context Revisited.” The Art Bulletin 59 (1977): 501-517.
Smith, Jeffery Chipps. The Northern Renaissance. New York, NY. Phaidon Press Inc. 2004.
Van Dongen, Pieter W. J., and Akosua N.J.A de Groot. “History of ergot alkaloids from ergotism to ergometrine” European Journal of Obstetrics & Gynecology and Reproductive Biology 60 (1995): 109-116.