Just a week after finding out that Paget’s disease might be linked to distemper virus, I was surprised to see the disease mentioned in a story in the Guardian newspaper, in connection with a pianting I know well from visits to the National Gallery. The painting entitled ‘A Grotesque Old Woman’, is one of the most popular in the National Gallery, London, is commonly known as the ‘Ugly Duchess’. It was painted by the Flemish artist Quinten Massys, in 1513. The painting inspired illustrations for the Duchess (who owned the Cheshire cat) in Lewis Carroll’s Alice’s Adventures in Wonderland by Sir John Tenniel.

According to the Guardian story, the painting was studied by Michael Baum, Emeritus professor of Surgery at University College, and his student Christopher Cook who concluded that the subject was suffering from a rare form of Paget’s disease. Paget’s disease, osteitis deformans, is named after Sir James Paget, the British surgeon who first described it in the late 19th century The disease usually affects the lower body such as the pelvis and femur, and when it does affect the skull it is normally just the cranium so the woman was suffering from a particularly rare form. The condition most likely happened later in life so, according to Baum, she may even have been a beauty before the condition set in. Aside from the effect on her looks, she may have suffered no more than headaches and a damaged pituitary gland. Nothing else is known about the woman who was so meticulously portrayed, who she was, or why she was the subject of the painting. Baum speculates that she was a rich, powerful person who paid the artist handsomely to paint the picture.

The other interesting thing to emerge from research into the painting is that the theory that the painting was made from drawings by Leonardo Da Vinci is probably not true, and that it is more likely that Leonardo or his followers copied the Massys painting.

I am sure that we will never be know how she came to have Paget’s disease, or if there was any connection with distemper or dogs, but it is a thought, and one to ponder on the next visit to the National Gallery.

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