Anatomy Unzipped: John of Arderne’s Sweden Scroll (ca. 1425–35)

The English physician John of Arderne (1307–ca. 1380) is remembered as one of the founding figures of modern surgery. He was one of the earliest scholarly “master surgeons”, who differentiated themselves — through rigorous training and by thoroughly documenting their techniques — from the barber-surgeon generalists that were still blood-letting and pulling teeth across Europe. Arderne authored De Arte Phisicali et de Cirurgia (On the Art of Medicine and Surgery), a treatise full of actionable instructions for a wide range of maladies. Pharmacological recipes appeared for kidney stones, sciatica, poisoning (by toad bite and scorpion sting), cataracts, and “frenzy”. Ingredients ranged from the culinary (egg white, rye bread) to the unsavory (earthworms, “the urine of a virgin”). Most famously, Arderne’s Fistula in Ano includes detailed descriptions for the surgical treatment of anal fistulas (apparently, a more common issue in horseback riding’s heyday). Dozens of manuscripts transcribing Arderne’s work survive today: testament to how useful his guide was to the working surgeon. So useful was Fistula in Ano, finds historian Peter Murray Jones, that the text remained a well-trafficked reference work until the late 1600s.

Pictured here is a highly unusual manuscript of Arderne’s work: rather than the more-often-preserved crude, convenient copies made for the surgeon’s reference, the Sweden scroll is lavishly illustrated vellum, measuring 542 cm (17 feet 9 inches) long and 36 cm (1 foot 2 inches) across. The only known Arderne manuscript in a scroll format, and the most richly illuminated, it was too unwieldy to have been used in the operating theater. Based on its extravagance (polychrome painting across six calfskin sheets) and the inclusion of an obstetrical treatise, scholars surmise that it was likely commissioned by a wealthy female Londoner sometime between 1430 and 1450. How, then, did the manuscript find its way to the National Library of Sweden? The document has been linked to the Swedish queen Philippa, born an English princess in 1394.

Alongside an abridged version of De Arte, Fistula in Ano, and a text on childbirth attributed to the author Muscio, we find more than 120 painted figures, mostly in the margins: noblemen and noblewomen — identifiable from their fashionable pointed poulaine shoes, many of them obligingly opening their robes to show their representative diseases. The oft-copied surgical diagrams from Arderne’s Fistula appear, along with a series of infants spinning in balloon-like wombs. By far the most remarkable images, however, are the four full-size figures descending down the scroll’s central column.

One nude stands, arms open, with a bright red circulatory system traced over his skin; below, a skeleton, a red halo throwing the grayscale bones into high relief. Then another nude, tongue lolling, and white pigment etching out the paths of the nervous system. Finally, another standing figure, split from the top of the head to the abdomen. Blood drips like the fringe of a carpet around his open torso, pried apart to reveal a confectionary jumble of stylized internal organs. The figure helpfully holds his own chest cavity open, his bent elbows displacing waves of text on each side.

On the reverse side of the scroll, in the very same position (semi-traced from the show-through), each of the four figures has his double: the same view, but from the backside. Unlike the other illustrations in the Sweden scroll, most of which are tied to the text in some way, these anatomies are free-floating, without comment. The organs and bones, nerves and veins are unlabeled. Together, they are among the most remarkable anatomical illustrations of the era.

The final figure, with his vivid jumble of viscera, is particularly haunting. It is difficult to identify art-historical points of comparison for this cheerful, eviscerated figure. Though his pose — standing, with “unzipped” abdomen — echoes the earlier anatomical drawings of the French surgeon Henri de Mondeville (ca. 1260–1320), the degree of detail in the Sweden scroll is far greater. The image anticipates the illustrations of Jacopo Berengario da Carpi (ca. 1460–1530), a pioneering Renaissance anatomist who posed his flayed figures in sturdy, lifelike stances: in some cases, holding the sheets of their skin away from their bodies like curtains. Vesalius, building on da Carpi, would infuse lifelike artistry into human anatomy in his 1543 De Humani Corporis Fabrica. However, écorché (the French term for a “skinned” anatomical representation) generally penetrates no deeper than muscle and tendon. The Sweden scroll is just one idiosyncratic moment in the tides of human dissection and anatomical illustration bridging the Middle Ages and the Renaissance.

Across the scroll, marginal figures reveal their swollen arms, their pocked faces, their bloodied extremities (even their kidney stones). “The displaying of the sick parts of the body is the most explicit visual device”, writes art historian Eva Lindqist Sandgren. This visual device is mirrored by a literary one: Arderne often includes personal anecdotes of his successful healings, even naming his noble patients. Yet he is not the only figure that speaks. The halved man on the scroll offers his own kind of late medieval testimonial: affirming not just the moment of healing, but scientific knowledge of the body itself. Perhaps that’s why we can read just a hint of pride into his doubled face, as he pries himself open for our pleasure.