A case of syphilis in Gustav Klimt’s Medicine? Iconodiagnosis and historical review

Abstract

At the beginning of the XX century, syphilis was a major cause of morbidity and mortality, earning the name "The Great Imitator" due to its complex manifestation. The causative agent of syphilis remained unknown until 1905, when Treponema pallidum was identified, followed shortly by the introduction of Salvarsan as the first effective treatment in 1910. The social stigma associated with syphilis compounded its public health challenge, especially in cities like Vienna, where urbanization, poverty, and prostitution fueled its spread. Paleopathological records indicate that congenital syphilis had been present in Vienna since the 18th century, emphasizing its historical persistence. The disease’s impact extended beyond health, permeating culture and art. Renowned painters, including Édouard Manet, Paul Gauguin, Vincent van Gogh, and Francisco Goya, are believed to have suffered from syphilis, while others, like Edvard Munch, drew inspiration from it in their work. Gustav Klimt, a pivotal figure of the Vienna Secession, created Medicine, a painting that reflects themes of life, death, and human vulnerability. Klimt’s depiction of human forms entwined in a cycle of life is characterized by the presence of death as a skeletal figure. Near death stands a woman with three pathognomonic signs of syphilis: saddle nose, Hutchinson's teeth and alopecia syphilitica. The two figures may symbolically represent the societal burden of syphilis. By capturing the fragility of human existence, Klimt’s work may suggest the pervasive influence of the syphilis epidemic on Vienna's cultural and artistic landscape. This interpretation situates Klimt within a broader narrative wherein syphilis shaped artistic expression in an era marked by both scientific discovery and public health challenges. The prevalence of syphilis in early XX-century Vienna may underscore the intersection of disease, art, and culture, making Klimt’s Medicine a testament to this complex scenario.