During the American Civil War, two key instruction books were used by both the Union and Confederate forces. Colonel William Hardee’s 1855 treatise Rifle and Light Infantry Tactics was used to teach unpracticed young men how to kill each other. As the first shots were being fired according to Hardee’s lesson plan, Dr. Samuel D. Gross, Professor of Surgery at the Jefferson Medical College in Philadelphia, rushed a book into print to treat the survivors: A Manual of Military Surgery; or, Hints on the Emergencies of Field, Camp and Hospital Practice.
Dr. Gross distilled decades of skill and practice into his 1861 book, issued in a pirated edition the following year by the Confederate forces. Despite the grim reputation today of “Civil War Surgery,” Gross achieved extraordinary results with his manual. Too old to take the field himself, Gross’ wartime efforts capped a lifetime of achievement in the medical profession. By the time the United States celebrated its first century of nationhood in 1876, Gross was lionized as “the emperor of American surgery.”
In 1875, as preparations began for the Centennial International Exhibition in Philadelphia, a young artist, Thomas Eakins, fixed upon Dr. Gross as the ideal subject for a painting to display at America’s first world’s fair. The Philadelphia-born Eakins aimed high with his work of art. He would immortalize Dr. Gross, while, in the same instant, depicting the heroic past of American civilization and its boundless, promising future.
Today, Eakins’ The Gross Clinic is the centerpiece of a small, though spectacular, exhibit at the Philadelphia Museum of Art. The exhibit presents the fascinating story of how Eakins came to paint Dr. Gross lecturing to his students with blood-stained hands and the gaze of an Old Testament prophet.
But the story of The Gross Clinic only starts with the 1876 Centennial. In recent years, this iconic painting has earned front-page headlines with a dramatic 2007 fund-raising effort to keep it in Philadelphia. Now, a joint conservation effort by the staffs of the Philadelphia Museum of Art and the Pennsylvania Academy of the Fine Arts has restored The Gross Clinic to its original condition.
Eakins’ The Gross Clinic is a staggering work of art, both in size and emotional impact. Portrait of Dr. Samuel D. Gross, as it is formally titled, measures 8 feet (240 cm) by 6.5 feet (200 cm). Dr. Gross is presented in the act of lecturing to students seated in a surgical amphitheater while he operates on a young patient suffering from an infected thigh bone. Included in the painting is a barely recognizable self-portrait of Eakins, located near the right edge of the work, and an unforgettable depiction of a cringing woman. She is commonly thought to be the patient’s mother.
The medical procedures featured in The Gross Clinic met with all of the accepted standards of the mid-19th century. In April 1875, at the exact time that Eakins was beginning work on The Gross Clinic, a medical convention hosted by the Pathological Society of London debated the germ theory. Many of the attending doctors endorsed conventional views that discounted the role of bacteria-spread infections. The fact that Dr. Gross is operating while clad in his street clothes is thus far less significant than the professional way that his associate, Dr. Daniel Appel, uses his retractor to keep open the incision made by Gross’ scalpel. Equally noteworthy is the napkin soaked with chloroform being held over the patient’s face by the anesthetist, Dr. W. Joseph Hearn.
The Gross Clinic presents a laudatory image of a dedicated man of science. It is a counterpart of Dr. Gross’s frequent lectures to his students at Jefferson Medical College on the theme of “Then and Now.” Gross, who was born in 1805, had witnessed and had made many significant contributions to the rise of medical science. In his “Then and Now” lectures, Gross reassured his students that the medical profession was making rapid strides from the days when he had attended the school in the 1820’s.
Look at The Gross Clinic, however, and your eyes are immediately drawn to the bloody fingers of Dr. Gross and the surgical knife he wields. The exhibit reinforces the image by showing an ivory-handled lithotomy knife owned by Dr. Gross. A mere decade separates this stunning oil painting from the battlefield surgeries where Dr. Gross’ Manual of Military Surgery was put into practice. Eakins’ picture struck a nerve far deeper than merely offending Victorian sensibilities. The image of Dr. Gross evoked memories of scenes of carnage which Americans, north and south, were trying to forget.
Many were not happy to be reminded. In a controversy lasting over the next few years, newspapers and art journals weighed in, with a growing body of negative judgments deflating Eakins’ hopes of a major triumph. The Art Interchange editorialized that “although vigorously treated…” The Gross Clinic “ought never to have left the dissecting room.” “Power it has,” the New York Times proclaimed, “but very little art.”
A far more devastating verdict was delivered by the Centennial’s art jury committee. They rejected The Gross Clinic from being exhibited in the specially built gallery known as Memorial Hall, later to become the first home of the Philadelphia Museum of Art. Eakins had five other works approved for display, but they were all far below the epic stature of The Gross Clinic. Perhaps because of Dr. Gross’ international renown, his portrait made it into the Centennial, albeit in a less than advantageous setting. The Gross Clinic was hung on the back wall of the U.S. Army’s exhibit of a model post hospital. There, amid beds festooned with mosquito netting, stood Dr. Gross, a singular figure even when rejected by an art committee.
After the Centennial ended, Eakins sold The Gross Clinic for $200 to the alumni of Jefferson Medical College, who gave it to the school in 1878. It was hung in a special gallery, constructed more like a side chapel in a Gothic Revival church than a proper museum space. There the great work lingered on in a strange after-life, a source of pride to Jefferson alumni, especially after the revered Dr. Gross died in 1884. Five years later, it was paid a belated tribute when Eakins received a commission to paint a similar work showing Dr. D. Hayes Agnew of the University of Pennsylvania lecturing to his students while performing a mastectomy. Gone are the street clothes, hysterical relatives and any signs of blood. Dr. Agnew holds forth, attired in white, sanitized surgical garb, with a practicing nurse in attendance.
Eakins’ The Agnew Clinic is shown together with The Gross Clinic in the Philadelphia Museum of Art exhibit just as it was displayed in 1893 in Chicago’s World’s Columbian Exhibition. Eakins received a medal in Chicago in recognition of his work but it was not until 1917, predictably a year after his death, that the art world began to realize the extent of his achievement. Shown at a memorial exhibition at New York’s Metropolitan Museum of Art, The Gross Clinic started to ascend to its present position as one of the greatest works of American art.
As its reputation rose, the physical condition of The Gross Clinic began to suffer. The second part of the Philadelphia Museum of Art’s exhibition details the ravages and the restoration efforts that brought Eakin’s painting back from the brink of disaster.
Several key works in the exhibit chart the course of the restoration of The Gross Clinic. These reveal the brilliance of the detective work and the amazing skill that went into the process.
In order to make his case to the art world, Eakins made a superb drawing of The Gross Clinic which he then had reproduced in Europe as a collotype art print. In 1917, a black and white photo was taken of The Gross Clinic which shows little change in comparison with the collotype. A few years later, a color photo of the painting was taken that was then used as the frontispiece of the 1925 Jefferson Medical College Yearbook. This time there was a change and a very disturbing one.
The alteration centered on the passageway leading to the surgical amphitheater. When Gross performed the operation depicted by Eakins, the lighting came from an overhead skylight. Eakins brilliantly articulated the subtle tones of natural lighting at all points on the picture plane. Since there was no source of artificial light, such as flickering jets of gaslight, the passageway was painted in a muted amber tone. As a result, the two figures standing there are illumined by the skylight, as is Dr. Gross.
The 1925 photo shows a major transformation. The passageway is now a garish red-orange, reducing the two figures to darkened specters. The glaring effect of the color change also makes the amphitheater appear to be lit by an artificial light source. Gone, or greatly diminished, is the interplay of natural light in Eakins’ 19th century setting.
What had occurred to produce this alarming transformation? At some point after the 1917 Metropolitan Museum exhibition, an art conservator changed the color tones of The Gross Clinic passageway. Damage, however, was not limited to the front of the canvas. Twice, in 1915 and in 1940, the painting was attached to plywood. By the late 1950’s, a seam in the canvas began to develop, caused by warping of the plywood. A major 1961 restoration effort by a Philadelphia Museum of Art team carefully removed the plywood, layer by layer, and the seam was mended.
The Philadelphia Museum of Art team led by Theodor Siegl finished their rescue mission by covering the painting with a coat of varnish. This effort was very much in keeping with Dr. Gross’ “Then and Now” theme. Siegl’s team deliberately used a removable type of varnish that would not permanently affect the composition of the painting. Gone were the bad old days of damaging an art work in order to save it.
As study of The Gross Clinic progressed over the years, art historians realized the extent of the earlier conservators’ changes in the original painting. In 2008, with Eakins’ great work now jointly owned by the Philadelphia Museum of Art and the Pennsylvania Academy of the Fine Arts, a team of staff members from both institutions was assembled to evaluate it. Led by Mark Tucker, the senior conservator of paintings at the Philadelphia Museum of Art, the team then commenced the daunting process of turning the clock back to 1875.
They did so by using 21st century technology and exacting standards of modern scholarship. The Gross Clinic was analyzed in 2009 by taking 42 full-size X-radiograph pictures of the painting. The exhibit presents a half-size X-ray compiled digitally from the full-size films. The effect of peering below the surface of the finished version of the painting is little short of astonishing.
“The radiographs show a spirit and energy that people don’t usually associate with Eakins,” art historian Kathleen Foster said in a recent interview. “The X-rays show Eakins painting like Manet, using broad, vigorous strokes to block out the underlying form of The Gross Clinic.
“The X-rays also show the development of Eakins’ decision making, as he moved the placement of figures and objects on the canvas to heighten their effect. This is especially noteworthy in the case of the recording clerk. The X-rays show that initially he was placed on a level with Dr. Gross, but then moved to a position slightly higher. This adjustment insured that the central focus would remain on Dr. Gross, while giving a diagonal sweep to the picture, reaching from the recording clerk to Dr. Gross and then to the operating table.”
The X-rays also revealed a major alteration at the bottom of the canvas. A sweeping band of color had been placed there, evidently with the use of a palette knife. This represented the railing of the amphitheater. But Eakins changed his mind and Foster thinks it was a brilliant decision.
“By removing the railing,” Foster said, “Eakins broke down the barrier between the viewer and the operation. As a result, you enter into the drama and become, in effect, the other doctor.”
That of course, is exactly what Eakins wanted the viewers of The Gross Clinic to be. This astonishing painting is ultimately a work of inclusion, drawing all who behold it into this gripping life-or death incident and into the greater drama of the American story, “then and now.”
An Eakins Masterpiece Restored: Seeing The Gross Clinic Anew
Philadelphia Museum of Art, Perelman Building
July 24, 2010 – January 9, 2011