COVER ART Domenico Ghirlandaio An Old Man and His Grandson (ca 1480-1490)

HE IDENTITIES of the 2 figures in this paint- ing the existence of entire extended families. Married ing by Domenico Ghirlandaio are un- women were under pressure to repopulate the family and known, but the picture conveys such a community by being almost continuously pregnant, ex- close relationship between them that it has posing themselves repeatedly to the pain and serious risks long been assumed that they are grandfa- of childbirth. Mortality rates among infants and chil- therT and grandson. Ghirlandaio was among the busiest dren were very high; historians estimate that about half and best-known painters in in the late 15th cen- of all children died before they were ten years old. Un- tury— trained in his workshop—and this der these harsh conditions, families were especially pleased work was almost certainly commissioned by a wealthy to have a healthy boy who could continue the family name Florentine family of that era. and help sustain the family economically on reaching Art of the time was moving beyond strictly religious adulthood and for whom no dowry would be needed. But subject matter. This painting can be considered an early a healthy girl could also help with domestic chores and psychological portrait, with a bit of landscape included in raised the prospect of creating advantageous new links the window at the upper right. Its main theme seems to between families through marriage. be bonding across the generations. Ghirlandaio pro- So, what about the grandfather’s nose? Evidently, vides visual clues suggesting a comfortable intimacy he had a rhinophyma, a cosmetically disfiguring but oth- between the older man and the boy: their chests touch, erwise benign condition thought to be the end stage of the man’s embracing left arm is reciprocated by the rosacea, a common facial dermatosis. Although the man’s boy’s left hand resting on his chest, and the man’s kindly head may be tilted at a relatively flattering angle, his de- downward gaze is returned by the boy’s attentive look formed proboscis is still right in the center of the pic- up at him. ture. It is thus a stark example of the shift during the Re- In his book on the family (Della Famiglia), Renais- naissance away from the idealized, generic human faces sance author Leon Battista Alberti wrote “...everyone typical of earlier religious art toward the more natural- says that small children are the comfort and delight of istic, distinctive faces of real individuals—warts and all. their fathers and of the old people of the family.”1 Broader social factors also contributed to the high value placed Thomas Koepsell, MD, MPH on children. In contrast to the grace and sophistication Seattle, Wash of , medicine and public health of the time were primitive. Periodic epidemics of plague decimated 1. Alberti LB. The Family in Renaissance Florence. Watkins RN, trans-ed. Co- cities, wiping out much of the work force and threaten- lumbia: University of South Carolina Press; 1969:50.

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