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The Philadelphia Museum of Art is a world-renowned public museum that contains a rich variety of artworks from different time periods and regions. One of the famous paintings that was loaned from the University of Pennsylvania by the museum is The Agnew Clinic, an oil painting by the American painter, Thomas Eakins. As of today, the painting is located in the John Morgan Building at the University of Pennsylvania. The Agnew Clinic measures 84 ⅜ inches by 118 ⅛ inches and is Eakins largest work. In 1889, medical students commissioned Eakins to paint a portrait of Dr. David Hayes Agnew, who was retiring from the University of Pennsylvania that year. Students wanted to commemorate Dr. Agnew’s contributions to the educational institution and the medical field. Dr. Agnew was well-respected and beloved anatomist, physician, and educator. However, what was supposed to be a portrait later evolved into an extensive masterpiece that captured a much more interactive scene set in a medical operating theater with Dr. Agnew assuming his position as both a surgeon and educator. At the time, Thomas Eakins’ great ambitions, dedication, and deep respect for the field of science and medicine is reflected in this painting. The subject matter of The Agnew Clinic is unique and bridges the art and science world; it illustrates the study of medicine through art. While remaining faithful to his scientific and medical observations, Eakins presents the scene of the painting through an artistic lens. The Agnew Clinic depicts Dr. Agnew performing a partial mastectomy, a type of surgery on the breast, in a medical amphitheater. This painting repeats the subject of Eakins’ earlier work, The Gross Clinic. When comparing the two works of Eakins, one can notice the medical advances and the evolution of surgical techniques during the19th century. Thomas Eakins’ The Agnew Clinic demonstrates scientific realism and remains one of the most important pieces of art relating to medicine.
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When considering The Agnew Clinic from an artistic point of view, Eakins’ manipulation of light dominates the painting. The Agnew Clinic demonstrates the dramatic effects of lighting through chiaroscuroas well as tenebrism. The painting is predominantly warm-toned and in the shadows, which cover over ⅔ of the canvas. The only lighted section is the area in which Dr. Agnew stands and the operation table. The white clothes of the doctors, the sheet covering the patient as well as her pale skin sharply contrasts the dark tones in which the students are painted. The heads of the spectators are turned toward the operation and contribute to Dr. Agnew, the focal point of the painting. While Dr. Agnew is not located at the center of the composition, his isolation from the crowd attracts attention. There is also a lack of certain Renaissance compositional elements, such as the square, rectangle, circle, and pyramidal structure. Instead, Eakins adopts an “oval foreground and trapezoidal background” (Frumovitz). The Agnew Clinic also exemplifies Eakins’ scientific realism. Eakins’ rendering of people is so photographically precise that all individuals, with the exception of the patient, can be identified in the semi-dark room:
Nurse Clymer looks on as Dr. William White applies the final dressing to the wound. Dr. Joseph Leidy holds the patient’s legs, wiping away excess blood. Dr. Ellwood Kirby administers the anesthesia, keeping the patient in her ether-induced sleep. Having agreed to pose for Eakins while he painted, each student, dressed in his dark suit, is identifiable. For example, William Furness, III, slouches in the back row, asleep, probably to the chagrin of his well-known socialite parents. On the far right, Dr. Fred Milliken whispers to an onlooker, Eakins himself (Frumovitz).
Thomas Eakins had demonstrated his deeply-rooted desire to accurately capture human figures early in his career as a growing artist. Eakins was obsessed not only with scientific study of human anatomy but also light, mathematics, and perspective.
Thomas Eakins has a history of being a controversial individual in the art field. His headstrong, radical, and nonconformist character often invited troubles to himself. He was greatly determined to accurately capture anatomical details and the human figure. He frequently studied from “men rowing on the Schuylkill River, renowned surgeons performing operations, trained vocalists singing arias” (Forgione). Though he greatly contributed to the Pennsylvania Academy of Fine Arts and transformed the school into a leading and prestigious art institute since the beginning in 1876, he was later forced to resign because of his method of teaching and subject matters, which were especially focused on nudity. While Eakins was openly comfortable with studying the nude and believed that it was an essential element of academic study, it did not sit well with Victorian Philadelphia. During one of his lectures about the pelvis, he removed the loincloth of the male model so that he was able “to trace the course of a muscle” (Wienberg). His lectures, which included female students, shocked and repulsed people. He was confronted with angry protests from parents and students and consequently stepped down from his position in 1886 (Wienberg). He and his students were also in possession of a vast amount of nude photos, some of which were racy (Forgione). Though evident that most of these photos “record the human body in motion and clearly served as anatomical studies for paintings,” the sheer number of pictures caused people to question Eakins’ intentions and character (Forgione). In addition to his sexual “scandals,” Eakins was accused by his brother-in-law for raping his younger sister, Margaret, after her death. After some years, Eakins’ niece, who was known to be mentally unstable, committed suicide. Having resided with Eakins and taken art lessons from him, many people believed that her death was a result of Eakins’ disturbing mind (Forgione).
When considering the conservative mindset of this time and Eakins’ history, it is no surprise that The Agnew Clinic received backlash when it was revealed. Eakin’s work was criticized for his depictions of the female body and the subject matter. Though the painting takes place in a strict medical setting, the depiction of the partially nude female patient and a room full of male spectators become a controversial topic due to its disturbing “eroticism” and “gore.” Expectantly, the aforementioned art school where Eakins taught, Pennsylvania Academy of Fine Arts, rejected The Agnew Clinic for exhibition in 1891. The oil painting was also regrettably rejected at the New York’s Society for American Artists in 1892. The Agnew Clinic was first exhibited in Chicago’s 1893 World’s Columbian Exhibition, where it was heavily criticized. From a Victorian perspective, many critics believed that Eakins was subjugating femininity and emphasizing male dominance (in the world of science and medicine). However, during this period of time, there was a lack of women in the medical field. Nurse Clymer is the lone female professional, aside the patient, in the scene of The Agnew Clinic. In fact, Dr. Agnew himself, had refused to teach at the Women’s Medical College because he did not feel that it was appropriate to expose young women to “unpleasant sights and facts” of venereal diseases (Frumovitz). In addition to Eakins’ supposedly sexual depiction, his decision to paint an ongoing surgical operation was considered to be wildly frightening and grotesque. Familiar with Eakins’ past work, The Gross Clinic, Dr. Agnew was very wary of Eakins’ depiction of him. Dr. Agnew was adamant that there be no blood in the painting since many people of that time associated surgeons with butchers. However, today, many art historians and scholars consider Eakins to be a hero in modern surgery.
Thomas Eakins’ earlier work, The Gross Clinic, which was produced in 1875, shares many similarities as well as differences with The Agnew Clinic. Both works were of the same subject matter and depicted a surgical operation performed by a living physician. They were controversial and not warmly received by the public. A critic even stated that The Gross Clinic should have never left the dissecting room (Portrait of Dr. Samuel D. Gross). It was rejected from the Centennial Art Exhibition in Philadelphia in 1876 for being “unsightly” (Alverez). Like Dr. Agnew, Dr. Gross assumes his position as both an educator and surgeon within the scene. However, The Gross Clinic is more dark and “gruesome” in nature. It is cooler in tone, less saturated in color, and subdued. The sense of tension is evoked, and there is a significant theatrical element to the scene. Differences in composition between the two works of Eakins are evident as well. While Dr. Agnew is off-center and alone, Dr. Gross is in the classical pyramidal structure and more intertwined with the surgical operation. The Gross Clinic is vertically focused whereas The Agnew Clinic is horizontally focused. The difference in width also produces a feeling of constriction which contributes to the sense of tension previously mentioned. The mother of the patient, who is seated on the left, is shown in distress, and the body of the patient is contorted. Additionally, more blood is displayed in The Gross Clinic than The Agnew Clinic; there is an ample amount of blood streaming from the incision on the patient, and blood sticks onto the hands of Dr. Gross and his scalpel. On the other hand, when Dr. Agnew noticed that Eakins had painted a few drops of blood on hand, he felt offended and was very adamant about the removal of them. During this Victorian time period, people often associated surgery with amputations and perceived surgeons as butchers. Perhaps due to the backlash of The Gross Clinic, The Agnew Clinic was less tense and dramatic. The Agnew Clinic was also a commissioned artwork while The Gross Clinic was not.
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Aside from artistic differences, historical changes in medical procedures between Eakins’ The Gross Clinic and The Agnew Clinic are shown as well. In The Gross Clinic, Dr. Gross and the attendees are wearing “business” suits instead of the “white coats” found in The Agnew Clinic. This attire was worn since bloodstains would not appear, and physicians would not have to change (Frumovitz). Upon closer historical analysis, by Agnew’s era, “sterile techniques had been embraced.” Physicians routinely “washed their hands for operating, patients were prepped aseptically, instruments and towels were sterilized, and gowns to be worn only in the operating room were provided to surgeons” (Frumovitz). However, the practice of wearing gloves has not been adopted yet. The use of artificial lighting was introduced during the era of The Agnew Clinic as well. Earlier, surgeons would work under natural light, and the area in which they worked were not as bright, as exhibited by The Gross Clinic. When viewing and comparing both of Eakins’ work, scholars today can appreciate Eakins’ overwhelming desire to precisely record and document anatomical details and medical practices of the 19th century.
Another artwork that should be acknowledged is The Anatomy Lesson of Dr. Nicolaes Tulp, which was painted by Rembrandt van Rijn in 1632. Thomas Eakins referenced this painting along with other baroque artworks and studied their use of chiaroscuro and the relationship between light and dark. The Anatomy Lesson of Dr. Nicolaes exhibited a high degree of naturalism and drama. The painting conveys depth and dimension through the contrast of the dark background and light foreground. Though the cadaver being studied is the brightest section of the composition, the faces of each fellow physician are illuminated and carefully rendered and distinguished. Their craning necks and watchfulness draw the attention of viewers to the lecture as well, similarly to how the turned heads of the spectators in The Agnew Clinic direct the viewer’s gaze to Dr. Agnew. The crowding of the physicians around Dr. Nicolaes Tulp and their interactive relationship establish a more intimate and serene setting than The Agnew Clinic. However, the asymmetry of the composition in The Anatomy Lesson of Dr. Nicolaes can be seen in the foreground of the The Agnew Clinic. Both Dr. Nicolaes and Dr. Agnew are slightly isolated from the crowd, though Dr. Agnew more so than Dr. Nicolaes. Dr. Nicolaes is not the center at the composition. Rather, he is placed slightly to the right with his body exposed the most out of all the physicians. Like Eakins, Rembrandt’s commissioned artwork captured his desire to reflect his study of science and nature.
As elaborated before, The Agnew Clinic received much criticism from the public because of its subject matter and depictions. Many people were suspicious and questioned Eakins’ intentions. Dr. Agnew was known for “his expertise in the treatment of gunshot wounds and wrote extensively on the surgery of kidney and abdomen” (Frumovitz). Yet, Eakins chose to depict a mastectomy. This surgery was considered to be of low difficulty and one of the simpler procedures of this time. Instead of painting Dr. Agnew performing a more complicated or “signature” procedure, Eakins was speculated to depict a mastectomy in order to shock the audience and evoke strong emotions. After receiving harsh criticism from his first medical painting, The Gross Clinic, Eakins was already aware that he would face the same response for The Agnew Clinic because of the subject. While he did make adjustments in his presentation in order to respect the wishes of the medical students of the University of Pennsylvania and Dr. Agnew, he firmly chose to paint the same subject matter because of his personal beliefs. He actually deeply admired Dr. Agnew and held him in high regard. Eakins wanted to portray Dr. Agnew as an accomplished professional and to highlight his strength of character and heroism. Unfortunately, Eakins intentions were misinterpreted and his approach disagreed upon.
Regrettably, Eakins grew discouraged by the continuous criticisms that were hurled at him, and The Agnew Clinic became his last work relating to medical procedures. Today, scholars and critics appreciate his works. Some even consider him a hero in modern surgery. Eakins was able to accurately capture and document medical practices of the 19th century. The Agnew Clinic remains one of the most important pieces of art relating to medicine and bridges these two worlds.
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