A Stone Never Cut for: A New Interpretation of <b><i>The Cure of Folly</i></b> by Jheronimus Bosch

Abstract

From the late 15th century onwards, cutting for stones in patients' heads to cure mental illness was depicted in European art. The earliest and most famous painting of this kind is The Cure of Folly, painted by Jheronimus Bosch around the turn of the 15th to the 16th century. In general, these depictions are thought to relate to surgical as well as mental health practices of that time. However, it can be questioned whether barber surgeons or quacks cut for stones in patients' heads, and if they did not, what the meaning of Bosch's and other artists' paintings might be. Paintings from the 15th to 17th centuries and historical sources from the history of medicine as well as art history served as a basis for this contribution. The combination of sources from the histories of urology and psychiatry opens a new perspective on depictions of cranial lithotomy. Taking this into account, it does not seem likely that surgeons or quacks cut for cranial stones in early modern Europe. Few therapy options existed to effectively treat mental problems, and, hence, most interpretations of Bosch's picture point to the gullibility of patients as its central theme. At the same time, the depictions of cranial lithotomy may illustrate the limits of the medical profession and an abstract hope for successful psychosurgery analogous to the surgical removal of stones from the urinary tract.

Cutting the Stone: Health Defined in the Era of Value-based Care

“…The text on the painting reads "Master, cut the stone out, my name is Lubbert Das." In those days, cutting a stone from someone’s head (or, like a magician, pretend to cut a stone from someone’s head) was considered to be a cure for stupidity and madness [1]. The alternative title of this painting is "The cure of folly".…”

The Surgeon, or The Extraction of the Stone of Madness, by Jan Sanders van Hemessen (c 1500–1566)

“…A new interpretation of the allegory argues that the extraction of the cranial stone is analogous to that of urinary calculi, a dangerous and morbid surgery contemporaneously performed to treat severe cases of nephrolithiasis. 8 As such, the idea of a cranial lithotomy symbolizes the limits of the medical profession at the time, as well as the abstract hope for neurosurgery to treat psychiatric disease in the future. 8 The popularity of 20th-century lobotomies demonstrates the powerful persistence of this hope.…”

“…8 As such, the idea of a cranial lithotomy symbolizes the limits of the medical profession at the time, as well as the abstract hope for neurosurgery to treat psychiatric disease in the future. 8 The popularity of 20th-century lobotomies demonstrates the powerful persistence of this hope. Hemessen's allegory, however, teaches us to proceed with prudence, caution, and humility, lest "the doctor appear more insane than the patient he is attempting to cure, and his false knowledge does nothing more than reveal the worst excesses of a madness immediately apparent to all but himself."…”