Vereniging Oud Medische Stafleden CWZ

Abstract St Anthony’s Fire in the Middle Ages
Pieter WJ van Dongen

Epidemics of ergotism occurred frequently in the Middle Ages. They were caused by eating bread contaminated by a fungus, resulting in spontaneous gangrenous amputations, hallucinations,  convulsions, agonizing  burning sensations in limbs hence called St Anthony’s  Fire or Holy Fire and frequently death.
The religious order of St Anthony was founded with the explicit purpose of nursing  and treating Holy Fire victims.  People flocked during epidemics to churches and hospitals of the Anthonines. Treatment of Holy Fire being a hot disease, consisted of cold medications such as Mandragora, the Mandrake plant with bark of humanlike roots and juice of a red berry. However, it contains belladonna alkaloids, also leading to hallucinations. Ergot victims  (ergotants) were therefore twice afflicted by hallucinations: first by ergometrine and then by alkaloids.
These symptoms and their treatment were a rich source of inspiration in frescoes, woodcuts and paintings. The  “Temptation of St Anthony” is a frequent theme, such as in Grünewald’s (1480 – 1530) altarpiece with a typical ergotant while a devil tortures St Anthony.  One of Pieter Brueghel’s  (1530 – 1560) paintings shows cripples and beggars with amputated feet, suggesting ergotism. The garden belongs to an Anthonine hospital.
The most spectacular example has been  painted by Jheronimus Bosch (1452 -1516) in his famous Temptation of St Anthony tryptich.   He painted all three interior panels with outrageously strange and diabolical scenes as if seen by a hallucinating  mind. The colourful scenes are populated with grotesque aspects of devils and angels, strange flying  “aircrafts”,  fire in a St Antony cloister, sufferers with contractures and  the Mandrake’s  “devil’s apple” and root.   Other cold treatments are seen such as thistle, fishes and water. The man in a red cloak begs for money, showing an amputated foot on a towel. The mandrake’s  roots contain human figures. Mandrake was considered to be an aphrodisiac, as is mentioned  in the Bible and in sung in madrigals.
The central panel of Bosch’s tryptich The Last Judgment shows a typical ergotant with bluish feet and hands, and a swollen belly. He turns a human body on a spit , perhaps as an allegory of  hellish pain suffered by ergotants. The outside view depicts St Bavo of Gent giving alms. The ergotant with both an exhibited amputated foot and a severe contracture asks for attention.
Did Jheronimus Bosch himself suffer from hallucinations due to ergotism? He certainly knew all aspects of ergotism and was able to depict both details of the human body with its aberrant forms and flamboyant hallucinations.