Disease in the Middle Ages: A reflection on the relevance of Grünewald’s Isenheim Altarpiece in times of covid-19?

How did the Black Death impact Europe in the Middle Ages? How can paintings like Matthias Grünewald’s Isenheim Altarpiece provide solace to those afflicted?

The times are rather desperate. I bet most would agree. The streets are deserted. People are confined to their rooms, houses or apartments. The daily routine: A quick stroll to the supermarket, stock up on necessities and hurry back home. That’s just about it. Or, well, that’s just about it for the fortunate, for those who have not lost family members and friends to the current pandemic.

The disturbing stories that have emerged over the last year send chills down your spine. In Spain, the army stumbled across elderly patients abandoned in care homes. Forsaken, left to their own resort, they had to fend for themselves. In Italy’s Bergamo Province, a region particularly hard hit during the first wave of the Covid-19 pandemic, coffins were kept in tenebrous churches: neat rows of caskets anticipating cremation. Loved ones were not permitted to attend. Only the distraught village priest tended to the deceased. A swift prayer. A rushed blessing. No time. A new batch of coffins had arrived. Outside, expectant forklifts waited to hoist the coffins onto army trucks. Loaded, the burdened trucks set off. The bells tolled, telling tales of grief of sorrow. 

They died alone. Deprived of the intimacy of those last moments. No holding of hands. No last hugs. No, I love you dad. No, farewell mum. No whispered prayers. The Austrian poet Ernst Herbeck, who knew a thing or two about despair, wrote: “In der Zukunft liegt der Tod uns zu Füßen.” Death is indeed inevitable. It is something we – I speak of young folks now – tend to forget. Perhaps we should begin to listen to the strangely comforting words of the esteemed German philosopher Heidegger who understood that we can only live a genuine life in the anticipation of impending death. He was right. To acknowledge the approach of death is not to concede to trepidation. No. Quite the opposite, it is the zenith of fulfilled being.

The Middle Ages were beset by the rampant spread of disease. There was no cure at hand. No end in sight. It was a given. An everyday fact of life woven into the fabric of Medieval existence. But the accomplished German painter Matthias Grünewald (ca. 1480-1528) mounted a vivid response: the Isenheim Altarpiece. In this painting, as I understand it, he sought to address the matter and proffer advice to the afflicted. His work counsels acceptance: silent acquiescence in the face of an irreversible fate. This message, a lesson that may help us come to terms with the inevitable, is what I intend to explore in this essay.

Two years ago, it was the beginning of January, three friends and I decided to travel to Colmar to visit the Isenheim altarpiece. A pilgrimage of sorts, if you’d like. We followed humbly in the footsteps of the many that came before us. The very finest of early 20th-century German cultural elite appeared in Colmar to scrutinize Grünewald’s pièce de résistance. The poet Rainer Maria Rilke contemplated the panels of the Isenheim Altarpiece for an entire day. Stefan Zweig, spellbound, wrote: “Only here, confronted with this devastating reality are you wholly transfixed and understand that you have just seen one of the pictorial wonders of our earthly world.” The German composer Paul Hindemith, similarly enraptured, dedicated an opera to Grünewald: Mathis der Mahler. With this in mind, we stepped in the car. A long drive ahead of us, we were smart enough to leave around midnight. It was pouring rain. At dusk, we arrived in bleak, dripping wet Colmar. Bleary-eyed, still woozy from the long drive, the only thing to do was to wait over a cup of coffee for the doors of the Unterlinden museum to open.

The former chapel of the convent of the Dominican sisters of Unterlinden, now part of the Unterlinden museum, houses the altarpiece. The moment you cross the threshold, you realize that this is no ordinary crucifixion. It is unlike anything else. Aghast, you gaze. This Christ is agonizingly human: defeated, resigned, mangled. A crown of thorns presses firmly on his greasy hair. Blood, the color of carmine, drips from his wounds. Hands and feet nailed to the cross contort in pain. His skin sallow, tinged sickly yellow, is blotted, dotted with sores.

His near contemporaries Albrecht Dürer and Cranach the Elder or the Spanish painters Diego Velázquez and Francisco de Zurbarán, who picked up the baton roughly half a decade later, all beautified the crucified Christ. Spruced up, he appears blissful. Godlike. No longer a wonder of the earthly world. Grünewald’s crucifixion is different. His Christ suffers. His Christ shrieks with pain. The meaning of Grunewald’s painting is not subject to the story depicted. The onlooker need not know the gospel to get at its meaning. The painting speaks for itself. 

The Isenheim Altarpiece was commissioned by Guido Guersi, the preceptor of the Antonine monastery in the foothills of the Vosges near Colmar, and presumably completed by Matthias Grünewald between 1508 and 1516. The Antonines, a lay brotherhood founded in the 11th century and converted into a clerical order in 1247 after adopting the rule of St. Augustine, tended to the sick and the ill. Towards the end of the Middle Ages, their hospitals numbered in the hundreds.

The times were unimaginably harsh. In October, 1347, the plague reached the port city of Messina in Sicily aboard a handful of Genoese galleys. In the next four years, the bubonic plague ravaged Europe. A sheer twenty million unfortunates were to meet their end. It decimated the population. In the following centuries, the Black Death would repeatedly resurface. A century and a half later, yet another alarming disease, this time lurking on ships returning from their voyage west, hit the shores of Europe. On the 19th of February, 1495, Charles VIII, the youthful king of France, reached Naples. His foreign dalliance did not last long. To prevent being cornered in Naples by the army of the recently established Holy League, Charles VIII and his entourage of mercenaries retreated back to France. Syphilis, contracted by the king’s soldiers during their brief visit to Naples, made its harrowing appearance. It swept the continent, reaching Hungary and Russia within four years. Recurrent outbreaks of Ignis Sacer, better known as St. Anthony’s fire, similarly plagued medieval Europe. The people affected suffered from hallucinations and excruciatingly painful convulsions. Even worse, they were at risk of losing limbs that turned gangrenous, then shriveled and every so often detached. The mortality rate was high. In one instance, a tragicomic event of sorts, a woman turned up at the hospital holding her blackened leg aloft. It purportedly detached after she brushed against some shrubs on her ride to the hospital. A lugubrious sight it must have been. No doubt about it. The living was hard.

This is the backdrop of the Isenheim Altarpiece. I believe that many found solace in the heartrending pain on display in the monastery church. They, the ill and the maimed, could relate to it. Agony is essentially a solitary affair, but Grünewald’s ailing Christ must have made it just this bit more bearable. Sheltered in shared suffering, He gave them hope. 

Currently, the world struggles to overcome the covid-19 pandemic. We toil to save every life. No matter the cost. Life is sacred. We are loath to accept our passing. We refuse to resign to the fact that people depart. Grünewald, if I may be so bold, would have counselled caution: don’t forget! Disease, death and bereavement are part and parcel of our lives.

This painting, once forgotten, now salvaged from obscurity, is a disturbing reminder of a past that speaks to the present. Grünewald’s crucified Christ, watched over by St. Sebastian and St. Anthony, gave and still gives voice to a society in the clutches of a havoc-wreaking disease. As I stood before the altarpiece, I recalled John Berger’s essay on Matthias Grünewald. He wrote the following: “The longer I looked at the Colmar altarpiece, the more convinced I became that for Grünewald disease represented the actual state of man. Disease was not for him the prelude to death – as modern man tends to fear: it was the condition of life.” His painting transcends time: A testimony to the distant past, it is by the same token a testament to our immediate reality.

Eelco van Riel

Eelco is currently enrolled in a postgraduate program in Religion at King's College London. Eelco is interested in philosophy, theology and Islamic studies.