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Quinten Metsijs
1465, Leuven – 1530, Antwerp, Belgium
Metsijs was born in Leuven and completed his apprenticeship under the influence of Bouts.
We do not know whether he also travelled to Italy to study art, as was customary at the time.
His work, however, whilst rooted in Flemish traditions, does show Italian influences, particularly from Leonardo da Vinci.
♦ Grotesque old woman ♦
The painting depicts an elderly woman holding a rosebud between her fingers.
She is wearing a dress with a low-cut neckline and an Italian-style headdress.
The realism of every detail and the caricature-like face are astonishing.
♦ Diagnosis
Main symptoms: ‘Facies leotina’ (lion-like face), broad, coarse nose, enlarged jaw.
Secondary symptoms: Female, elderly, well-dressed, hypertrophy and curvature of the right clavicle, skin tag.
Clinical diagnosis: Paget’s disease
♦ Definition: Paget’s disease
Paget’s disease is a localised bone disorder of unknown cause characterised by significantly increased bone formation and resorption.
♦ Discussion
This woman’s ugly face is painfully accurate, painted with precision and fluidity, complete with its deformities, abnormalities and distortions.
The nostrils, for example, are strange, wide open and excessively curved. The width of the cheeks is further emphasised by the ears, which protrude sharply from the head. The area beneath the nose bulges out. The broad, high cheeks and the large, coarse nose give the face an open, snorting appearance that is somewhat reminiscent of a wild animal – a lion, so to speak.
This characteristic facial appearance is referred to by clinicians as facies leotina or lion’s mouth.
The facial deformities in the woman in the painting can be explained by hypertrophy of the jawbones. These give the face a prominent upper lip and a nose and nostrils that are pushed upwards. It is also likely that the chin has grown to an abnormal size, as otherwise it would have receded as a result of the enlarged jawbones.
A skin tag on the right cheek is clearly visible. The right collarbone is curved and enlarged.
The hypertrophy of the upper and lower jawbones and the collarbone are characteristic of bone changes resulting from Paget’s disease.
♦ Portrait or caricature?
Although this artwork appears to refer clearly to an ancient disease, it is very difficult to interpret.It is all too easy to make a misdiagnosis, either by identifying a non-existent disease or by interpreting what at first glance appears to be a pathological condition, but is in fact nothing more than the expression of an artistic convention. (1);
When Alistair Smith commented on this painting, he stated ‘that it seems hardly possible that this painting could have been painted from life’. (2);
He claims that, at the time it was painted during Metsijs’s later years, there was a strong tendency towards caricature and satire, which was particularly prevalent in the visual arts in northern Europe. This genre was found primarily in woodcuts that commented on events of the time. It is therefore rather exceptional to find it in a painting, the formal status of which usually precluded such subjects.
The fact that the woman is holding a rosebud between her fingers – traditionally a symbol of tender youth or budding love – stands in stark contrast to her appearance.
Perhaps this suggests the possibility that the painter wished to depict an old, coquetish woman with the aim of entertaining his viewers or to convey a satire.
He may have been inspired to do so by the book In Praise of Folly by his friend Erasmus, in which he describes old women who ‘still flirt’, ‘are inseparable from mirrors’ and ‘do not hesitate for a moment to display their repulsive, withered breasts’.
This does not necessarily mean that the painter invented his model. He may well have used a real model. A ‘lion’s mouth’ (facies leontina) is such a grotesque deformity that the painter could not possibly have forgotten it once he had seen it.
It is possible that a drawing by Leonardo da Vinci was the direct source for this painting. (3);
The drawing, a replica of the one kept at Windsor Castle, was copied almost exactly by Metsijs. The painter merely added a few details, such as the lacework and the pattern of the headdress, the corset, the remarkable hands holding the rosebud, and the balustrade, which further emphasises the caricatured character of the elderly, self-indulgent woman.
What is important here is that Metsijs apparently had access to the drawings (or the replica) which he copied accurately.
This was not the first time Metsijs had borrowed from a drawing by Leonardo.
On at least two separate occasions, he copied heads from da Vinci’s renowned study of five grotesque heads, notably in his Martyrdom of John the Evangelist (1508–1511), a triptych (Royal Museum of Fine Arts, Antwerp), and in his painting Ill-Matched Lovers (Ill-matched Lovers) (National Gallery of Art, Washington).
The grotesque figures in Leonardo’s drawings resemble the eccentrics one sometimes sees on the fringes of society and are therefore most likely portraits from life. Various pathological symptoms can be seen in their faces.
The old woman (possibly Italian) who was drawn by Leonardo and copied in Metsijs’s painting may have suffered from Paget’s disease. He may have painted this grotesque old lady to mock the members of the Florentine merchant community in Antwerp, who were known for their usurious interest rates and their miserliness.
Owing to its grotesque and caricature-like nature, this image has continued to appear in engravings over the years, for example in this one by Wenzel Hollar (1607–1677) entitled The King and Queen of Tunis.
The jaw and facial bones are rarely affected by Paget’s disease, and when they are, it is usually at a young age (4);
Facial deformities, characterised by excessively bulging cheeks and a lion-like mouth, result from the jawbones protruding excessively. The enlargement of the jawbones and the hardening of the palate can cause problems with speaking, chewing or swallowing.
If the enlargement develops gradually, patients and their relatives are often unaware of the deformity that has developed.
Paget’s disease of the jaws is first noticed by the dentist, for example because extracting a tooth proves problematic or because dentures never seem to fit for more than a few months.
Source: Jan Dequeker – The artist and the doctor look at paintings
(1); Dequeker J., Paget's disease in a painting by Quinten Metsijs (Massys). Brit. Med. J. 1989; 299: 1579-81.
(2); Smith A., Early netherlands and German paintings. The national gallery schools of painting. London, Collins, 1985.
(3); Silver L., Power and Pelf: a new found old men by Massys. Simiolus 1977; 9: 63-92
(4); Hamdy R.C., Paget's disease of bone: assesment and management. Eastbourne, Armour Pharmaceutical, 1981