Coloured vision? - The pharmacological
history of Van Gogh
30 Jun 90
APART from exciting the art world, the sale last month of a Van Gogh
painting for $82.5 million to Ryoei Saito of Japan made headline news
in the daily papers. But the painting itself is worthy of interest not
simply because of the money it can command. It also has considerable
medical interest.
The painting is a portrait of the man who was Van Gogh's doctor in his
last years, Dr Gachet of Auvers-sur-Oise. He is shown in melancholy
mood, head on hand, sitting at a table on which there are two books
and a flower in a vase. The books are Germinie Lacerteux (1865) and
Manette Salomon (1867), by the Goncourt brothers; the flower is a
purple foxglove.
Paul-Ferdinand Gachet was 62 at the time Van Gogh painted him. He
was himself a painter and etcher, signing his work 'P van Ryssel', and
he had many artist friends, including Renoir, Sisley, Pissarro, Monet,
Manet, whom he attended during his last illness, and Cezanne, with
whom he shared a studio and who painted Gachet's house at Auvers.
Gachet was regarded as an eccentric in Auvers, but Van Gogh, who
had been ill with recurrent bouts of a psychotic illness, sought his
company, attracted perhaps by the very melancholy which he was
later to depict in his portraits of the doctor. 'His experience as a
doctor,' he wrote to his brother Theo, 'must keep him balanced
enough to combat the nervous trouble from which he certainly seems
to me to be suffering as seriously as I'
Van Gogh's previous doctors had thought that he had epilepsy, but
Gachet suggested that he was suffering from the effects of too much
southern sun and of turpentine poisoning. Van Gogh probably found at
least the first of these diagnoses to his liking. When in Arles he had
written, 'Oh, the beautiful sun of midsummer! It beats upon my head,
and I do not doubt that it makes one a little queer.' However,
Gachet's diagnosis of turpentine toxicity was almost certainly off the
mark. In the amounts to which an artist would be likely to be exposed
it would cause giddiness, redness and burning of the face and throat,
itching and burning of the anus, and painful micturition and
defaecation, but only at much higher doses would it cause mental
effects or convulsions.
We do not know what, if anything, Gachet gave Van Gogh in the way
of treatment, but he did befriend him and regularly entertained him at
home. He later pronounced Van Gogh to have been cured. In return,
Van Gogh painted Gachet three times: once in May 1890, with a pipe
in his mouth, and twice in June 1890. It is one of the latter portraits
which recently came under the hammer; its twin is almost identical,
but in it Gachet holds the foxglove in his hand and the books are
missing.
Perhaps, as has been suggested, the books by the inseparable
Goncourt brothers in the first of these two paintings symbolised for
Van Gogh the relationship he wished he could have with his own
brother. Or perhaps, more prosaically, Van Gogh chose them because
they were yellow.
'How beautiful is yellow,' Van Gogh wrote, and his paintings suggest
that this passion began to manifest itself seriously in late 1888,
although by no means all of Van Gogh's paintings of this time show an
obsession with yellow. For example, the Yellow Cornfield of October
1889, despite its title, is dominated more by the greys and greens of
the sky and trees than by the yellow of the corn. However, many of
his paintings are strongly influenced by his use of yellow, including
Cafe at Night, Portrait of Armand Roulin, Yellow Chair with Pipe,
Wheatfield with Crows and, of course, the famous Sunflowers, of
which there are more than one. Van Gogh's house in Auvers was also
painted yellow.
Why Van Gogh felt the way he did about yellow is not clear. Perhaps
he derived his passion from a love of that same southern sun which
Gachet, and perhaps he himself, believed had caused his illness. 'What
I wanted to find out is the effect of a more intense blue in the sky,'
he wrote, and then, underlined, 'No blue without yellow.' Or perhaps,
as T. C. Lee has suggested, he derived it from using the purple
foxglove which he depicted in two of his portraits of Gachet.
The foxglove has been used for centuries as the source of a powerful
group of drugs known as digitalis, from the Latin name which
Leonhardt Fuchs gave to the plant in 1542. These compounds are also
known as cardiac glycosides, because they act on the heart and have
glucose-like molecules as a major part of their chemical structure.
Digitalis was first properly put on the medical map by the
Shropshire-born Birmingham physician William Withering, who in 1785
published a monograph in which he gave an account of 163 cases of
dropsies, accumulations of fluid in the body's tissues and cavities,
which he had treated with formulations of the leaves of the purple
foxglove.
But digitalis had been used for many other complaints for hundreds of
years before Withering wrote his monograph. It was particularly
popular for external application in the treatment of wounds, especially
those due to the King's Evil or scrofula, tuberculosis of the skin. It
is
for this reason that the group of plants to which the species of
foxgloves belong is called the Scrophulariaciae. Digitalis was also used
in the treatment of epilepsy, for which the herbalist John Parkinson, in
his Theatrum Botanicum of 1640 recommended 'two handfuls of the
herb taken with polypody (a type of fern)'.
In the 19th century, although Withering had clearly shown that it was
useful only in certain dropsies, digitalis was widely used for a range
of
maladies for which it is probably of no value whatsoever, including
mania, delirium tremens, migraine, and epilepsy. However, digitalis
does have effects on the brain. According to Withering's son, it was
also used by 'Women of the poorer class in Derbyshire, (who) drink
large draughts of Foxglove tea, as a cheap means of obtaining the
pleasures, or the forgetfulness, of intoxication.' In France, it was used
for treating sexual disorders, including nymphomania.
The effects of foxgloves on the brain would have been well known to
Van Gogh's doctors, including Gachet, and it is possible that one or
more of them may have treated Van Gogh with digitalis.
Now too much digitalis can cause visual disturbances, including
changes in colour vision. This was first described by Withering: 'The
Foxglove when given in very large and quickly-repeated doses,
occasions sickness, vomiting, purging, giddiness, confused vision,
objects appearing green or yellow . . .' Other abnormalities of colour
vision (brown, black, red, white and blue) may occur, and they may
be accompanied by haloes of light around objects. I have seen a
painting by a patient with digitalis intoxication showing a field with
regular blue splashes of colour superimposed. The 'confused vision' of
which Withering wrote may have been blurring of vision, blind spots in
the visual field, or photophobia (pain in eyes exposed to light).
Did Van Gogh take the foxglove? Is that why he became obsessed
with the colour yellow? Is that why he painted those startling
paintings of starry nights, with their whorls of colour? Certainly the
fact that he chose to portray Gachet with the foxglove suggests that
the doctor may have given it to him. But if intoxication with the
foxglove caused him to paint the way he did, his paintings and letters
suggest that his use of it would have had to have dated from before
the time of his meeting with Gachet, and there is no evidence
whatsoever of that.
An alternative suggestion, put forward by M. Albert-Puleo, is that Van
Gogh was suffering from absinthism. Absinthe, or wormwood, from
Artemisia absinthium, was a favourite drink in France in the 19th
century, and many poets, artists, and actors enjoyed it for its mildly
euphoriant, aphrodisiac, and hallucinogenic effects. Many paintings of
the time show absinthe drinkers with glazed looks in their eyes.
L'absinthe by Degas is a good example. Wormwood contains
substances called thujones, which can cause auditory and visual
hallucinations, paranoia, mania and convulsions. Van Gogh was known
to have drunk absinthe, sometimes in large quantities, and it is not
too far-fetched to believe that its pharmacological effects may have
caused his illness and influenced his painting style.
Wherein lay the source of Van Gogh's striking creations? The inner
workings of an unusual artistic mind? Certainly, but perhaps not only
that. Turpentine? Unlikely. Digitalis? I doubt it. Absinthe? Perhaps. We
shall probably never know whether any of these really influenced him,
but it is interesting to speculate nevertheless.
Jeff Aronson is a reader in clinical pharmacology at the Radcliffe
Infirmary, Oxford.
JEFF ARONSON
From New Scientist magazine, vol 126 issue 1723, 30/06/1990, page
© Copyright New Scientist, RBI Limited 2001