The Linacre Quarterly

Volume 38 | Number 4 Article 10

November 1971 Cosmas and Damian: Their edicM al Legends and Historical Legacy Ronald J. O'Reilly

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Recommended Citation O'Reilly, Ronald J. (1971) "Cosmas and Damian: Their eM dical Legends and Historical Legacy," The Linacre Quarterly: Vol. 38: No. 4, Article 10. Available at: http://epublications.marquette.edu/lnq/vol38/iss4/10 FIGURE 1

"Miracle of the Leg" (Uncertain artist. Has been attributed to School of Bellini. Ferrara and Mantegna) (Society of Antiguaries. London.)

Example of a portrayal stressing religious and lacking scientific orientatiol/. Cosmas and Damian Their Medical Legends and Historical Legacy

Ro nal d J. O'Re illy, M.D.

Medicine of the Middle Ages was cians have heard of them, few know often oriented far more to religion much about Cosmas and Damian . An that to sc ience. Medical kn owledge extensive search through the volumi­ was primitive . Great prayerful reliance nous accounts of medicine's history was placed on medical saints. Cosmas provides little concerning these early and Damian were the most popular of physicians. This paper explores the all medical saints during the Medieva l legends of these medical saints, reviews and Renaissance periods. their role as medicine's patrons, examines th eir medical portrayal in With the emergence of sc ientific art, and summari zes the role of medicine , Cosmas and Damian became Cosmas and Damian in our early obscure . Today , although many physi- medical history.

254 Linacre Quarterly The Legends of Cosmas and Damian Cosmas and Damian became known as legendary healers during the early The most popular version of the life Christian ce nturies. It was believed of Cosmas and Damian refers to them that the saints wou ld appear to as physician brothers who lived in sleeping patients and bring about Syria in the middle of the th ird miraculous cures. Table II recounts century. Some biographers refer to some of the medical fea ts attributed to them as twinsl , while elsewhere, they the brother physicians. are spoken of as brothers onlY2' They are said to have been martyred during the Christian persecution of the Medical Patronage Roman emperor Diocletian . During the Middle Ages the fame of There are many historica l conflicts Cosmas and Damian grew as patrons of regarding the lives of Cosmas and medicine. Many ea rl y medical facilities Damian. Even in the Christian tradi­ were dedicated to the twin patrons. tion, there are a number of widely They were depictcd on th e official sea l divergent accounts of th eir lives (Table of the Universities of Prague (1348), I). Furthermore. many historians Leipzig ( 1904), Ingolstadt ( 14 10) , doubt that Cosmas and Damian ever Wittenberg ( 1502), Oenipontana existed. Some hagiographers contend ( 1673)8. that they merely represent a Christian adaptation from Greek mythology of Cosma and Damian were prin- the twin heroes and healers Castor and cipally patrons of surgery during that Polluxs'6 . ph ase of medi ca l history when surgery

TABLEt Versions of the Life of Cosmas and Damian

Place Place Version Church Recognition Birth Practice Death Burial

Arabian Roman Catholic Arabia Aegea Martyrdom Cyrus Green Orthodox* (Emperor Diode t ian)

Roman Greek Orthodox Rome Rome Martyrdom Rome Russian Orthodox (Emperor Carinus)3

Provoked jealousy of their teacher of medicine and were stoned to death.4

Egyptian Greek Orthodox Egypt Egypt Natural Death Pheneman Russian Orthodox

*The Greek Church recognizes three pairs of brothers all named Cosmas and Damian.

Novcmhcr. 1971 255 9 was held in a very inferi or ro le . The scope and distribution. The physician French Confraternity of Cosmas and brothers were th e fr equent subj ec ts of Damian was an example of an ea rl y ar tists in Spai n, France, Holl and , Great surgica l associa ti on formed under their Britai n, and Ireland 12 . In Italy , patronage 1 0 . The College of Saint Cosmas and Damian we re patrons of Cosmas was an outgrowth of th e the powerful Medici fa mily of Fl or­ original Confraternit y. In 1723 , this ence. Through the Medici influence, a Coll ege became th e Academy of great man y Italia n Renaissance pain­ Surgery, th e forerunner of the prese nt ters (i.e. Angeli co, Pesellino, Titian) National Society. focused their attention on the lives and practices of Cosmas and Dami an. In England , the Barb er-Surgeo ns Guild was orga ni ze d in 1303 under the The brothers were almost always patronage of Cosmas and Dami an. This portrayed in a medical image either in orga ni zation remained corp orate un til reference to their habit, possessions, or 1745 . The Surgeo ns Company was ac ts. Of interest, Saint Luke (th e then form ed and was ultimately mod ern patron sain t of medicine) was re place d by the prese nt Royal Coll ege onl y ra rely artistica ll y por trayed as a of Surgeo ns 1 I . (Table III) physician 1 3 . Artists became historians wh en th ey record ed Cosmas and Iconography Damia n d ressed in th e physician habit of th e artists' own time and country. Artists of the ea rl y and middle Frequently, th ese sa ints are depicted ce nturies frequen tl y portrayed the attending a sick pa tie nt or performing saintly ph ysicians. The iconography of a surgica l procedure. Nea rl y always Cosmas and Damian is extensive in they are see n holding symbols of the

TABLE " Medical Legends of Cosmas and Damian

Condition "Therapy"

Cance r (leg) See text. Amputation and "Miracle of th e Leg" transplantation.

Anasarca Surgical drainage of the edema fluid. *

Breast Abscess Appeared in the dream of a physician telling him where to incise his p'atient's breast and wh at sa lve to apply. 7

Oral Abscess Laying on of the hands cau sing drainage and ultimate cure. 7

Hemorrhage Presc ription of a diet consisting of "cakes made with fl o ur."6

Breast Pain Prescription of an elixir of " Lese r mixed with pennyroyal."4

"Three Separate Tumors" " Prayer Alone.,,6

*This legend indica tes th e scientific naivety of the time.

256 Linacre Quarterl y TABLE III Medical Patronage of Cosmas and Damian

Patrons of Medical Groups: Physicians Wet Nurses Surgeons Hernia Healers Pharmacists* Bandagers Midwives

Patrons of Particular Disease States** The Plague (Along with SS Roch and Sebastian) Glandular Diseases Ulcers Childhood Convulsions Unhealthy Humors Actinomycosis of Horses

*In the United States, Saints Cosmas and Damian have been particularly known as patrons of pharmacy.

**Frequently a particular saint was invoked for a particular disease state. Co,mas and Damian were invoked fOl a wide variety of conditions.

TABLE IV Examples of Medical Symbols In TIle Iconography of Cosmas and Damian

Artistic Work Symbols of Medicine

Roger van der Weyden Urine Flask and Spatula "The Medici Madonna" (Painting)

Stain Glass Window Scalpel (one brother shown 16th Century incising the scalp) and Church of St. Jean des Murgers Urine Flask

Unknown Artist (15th Century) Mortar and pestle and Miniature from the Prologue Urine Flask to Chauliac Formulae

Tapestry (Erasmus Pharmacy at Urine Flask and Ointment Jar Warburg, Westphalia) and Spatula (many plants are pictured in the background of the tapestry. All the plants arc of pharmaceutical importance i.e. Digitalis purpurea, Hepatica triloba, etc.)

Lorenzo de Bicci (15th Century) Forceps and Small Medicine Retable Cathedral of Florence Boxes

Icon (Probably of Aramcnian Medicine Chests Origin) 1700 (From the van der Wieden Collection)

Miniature (II th Century) Medicine Box (Brothers shown Bibl. Vatican Manuscript receiving the box from the hand of God ex tending down th rough a cloud.)

November. 197 1 257 medica l profession. By studying th ese carrying pill boxes, surgical knives, sy mbols, we can discover mu ch about forceps, mortars and pestles, vases, pill th e in struments and meth ods of the roll ers, and spatul as. (Table IV) Medieval an d Renaissa nce physician. In this era , uroscopy was extremely Miracle of the Leg comm on and Cosmas an d Damian were often de picted intently exami n­ The "Miracle of the Leg" was the ing th e urin e fl ask. Ointment jars of mos t fre quently portrayed image of varying sizes and shapes frequ ently the surge on sain ts. According to this appear in th eir portraits. They are see n lege nd , Saints Cosmas and Damia n

TABL E V Analysis of Artistic Portrayals of the "Miracle o f the Leg"

Surgical and Surgical Surgical Artist Anatomic Detail Instrumentation Assistants

F ra Angeli co Poor. Mid thigh None. None. 1438 amputatio n.

Unknown (early Fair. A.K. amputa· None. Angels shown Three Angels. 16th Century) tion and trans­ with ointment cases (W u rttem bergisches plantation. One and spatulas. Land esmu seum, brother shown re­ Stuttgart) moving tourniquet at completion of operation

Pedro Berruguete Interesting. One brother shown Two feminine (15th Century) Transpl anted leg with a small knife obse rvers. Cova rru biu s. is lo nger th an the (resembling a (Burgos) con tralateral scalpel) in his normal leg. hand.

Unknown ( 16 th Poor. Pictu red as None. None. Large Ce ntury) a thigh trans­ num ber of visi tors (Oesterreichisc he plant (Black viewing the patient Galerie. Vienn a) thigh with a white Cosmas and Damian calf). Incision at no t shown in this mid-patellar level. work.

Fernando del Fair. A.K. None. One bro ther Rincon (circa Amputation. shown with an oint­ 15 00) ment dish and spatula. Other bro ther shown giving an ecclesi­ asti cal blessing.

Alonso De Sedano Fair. B.K. Amputa· None. One brother Three Angels. (Ci rca 1500) tation. However, giving blessing and only ca lf bone holding a medicine seen on cross box. Other brothe r section. is about to place the black extremity against the stump of the amputated upper calf.

258 Linacre Qua rterl y appeared to a white man in his sleep, amputated his cancerous leg, and transplanted the leg of a Negro who had just expired . I t is of interest to speculate on this legend in our time now that we have seen both cadaver transplantation and inter-racia l organ transplantation. A survey of a number of artistic portrayal of the "M iracle of the Leg" is given in Table V.

A portrayal of the "Miracle of the Leg" that appeared in a 15th century choir book is shown in Figure I. This work represents one of the most non-medical artistic portrayals. Note the poor anatomic detail (low thigh amputation and the crude instru­ mentation). TIle environment is more ecclesiastical than surgical. Asep tic technique is totally lacking, even to the point of the ridiculous, with the presence of a dog in the operating room area.

The painting by Ambrosius Francken (Figure 2) represents the other end of the spectrum. This work is unusual in terms of good anatomic and surgical detail. Even a tourn iquet is present above the amputation site. A large surgical knife is pictured in the foreground. Note that the patient's head is wrapped in a towel in a manner not dissimilar to tha t used in modern FIGURE 2 day operating room suites. The patient in Francken's work appears to display '"Miracle of tlt e Leg " (A mbrosius Fronckell) pain although in most portrayals, the (Kollinklijk MuseulIl. /111 twerp). Ullique patient is pictured asleep in accord­ portrayal in terms olaccurate anatomic and ance with the legend. The background surgical detail. of this painting is definitely medical with an obvious hospital motif. Even more unusual is the fact that the surgeons are pictured without halos, an extremely unique finding for religious art of that period.

November. 1971 259 Summary 10. Riesman, D., Th e Story of Medicine in the Middle Ages. Paul B. Hoeber Inc. New York. 1936 . Historically , the biography of 11. Young, S., The Annals of th e Barber­ Cosmas and Damian stands on a very Surgeons of London. Blades, East and insecure foundation. Yet for centuries, Blades. London. 1890. the medical sai nts were invoked in an 12. David-Danel, M., Iconographie des effort to ove rc ome illne ss . Saints Medecins Come et Damien. LiUe, Imp. Morel & Corduant, 11 , res des Bouchers. 195 8. The iconography of the brother 13. Ibid. sain ts developed during the Middle Ages and Renaissance periods provides insight into the medical history of these periods. Th rough the careful appraisal of their arti stic portrayals , we gain an unique appreciation of Cosma s and Dami an - their medical legends and historical legacy .

REFERENCES

I. Catholic Ency clopedia. Edited by C. G. Herbermann and others. Vol. 4. Robert Appleton Company. New York. 1908. 2. Walton, G., The Medical Saints Cosmas alld Damian. Proc. Charaka Club, 4:15-22. 1916. 3. Allbutt, T. , Greek Medicine in Rome. MacmiUian & Co. London. 19 2 1. 4. Baring, G., Th e Lives of the Saints. September. Vol. 10. John Grant. Edinburgh. 1914. 5. Harris, 1. , The Cult of the Heavenly Twins. Ca mbridge University Press. Dr. O'Reilly is chief of the Division 1906. of Special Procedures, Department of 6. Hamilton, M., Incubation or th e Cure Radiology, St. Mary's Long Beach of Disease in Pagan Temples and Hospital and an assistant clinical Christian Churches. Simpkin, Marshall , professor of radiology, UCLA School Mamilton, Kent & Co. London. 1906. of Medicine. 7. Acta Sanctorum. Spetembris. Tom. VII. Dr. 0 'R eilly, a winner of the John 8. Zimmerman, L. Cosmas and Damian, Fulton Medal, awarded annually for Patron Saints of Surgery. A mer. J. Surg., 33 : 160- 170. 1936. essays in the field of medical history, 9. Graham, H., Surgeons A ll. Ri ch and explores the legends of th ese medical Cowan. London. 1956. patrons and their portrayal in art.

260 Linacre Quarterly