['The man with the withered hand': iconography of the saturnine palsy?]

INTRODUCTION: The synoptic gospels tell about a man who cannot extend his hand, that appeared dried. The description is consistent with radial palsy. Christian artists depicted this gospel story producing a rich material, unexplored from the medical point of view.

AIM: To analyze the mentioned iconography verifying the depicted lesions and their possible causes.

DEVELOPMENT: Six representations of the evangelical text pertaining to the period comprehended between 10th and 17th centuries were selected. Four belong to illuminated gospels, one is a mosaic and the other one is a fresco. In three of them the figure with the palsy hand appeared holding the affected member with the opposite hand; another one has a foot drop. The description of postures that are characteristic of extensor palsies points out that these artists must have known real patients. Saturnism, frequent in Europe during the period in which these works were created, was probably the cause of the paralysis in these cases. Another hypothesis was that the artists could have suffered themselves saturnism, caused by manipulating paints with high lead content; this could not be confirmed.

CONCLUSIONS: The iconographies of 'the man with the withered hand' are realistic representations of motor paralysis consistent with saturnine neuropathy. These works preceded for a long time the best medical descriptions of such condition.