Hektoen International

A Journal of Medical Humanities

The plague of ergotism and the grace of God

Wilson Engel
Gilbert, Arizona, United States

Detail of a patient suffering from advanced ergotism in the Isenheim Altarpiece. Matthias Grünewald, Isenheim Altarpiece. Musée d’Unterlinden, France.

Perhaps the best known and least forgettable of all Renaissance art works depicting the graphic effects of disease is Matthias Grünewald’s Isenheim Altarpiece (1506–1515), now in the Musée d’Unterlinden, Colmar.1 On the closed center portion of the altarpiece, is Grünewald’s famous portrayal of the Crucifixion in which the intensely human Jesus is wracked as much by the ravages of the Flagellation as by pain of the Crucifixion.

The altarpiece was “commissioned for the Antoinite monastery at Isenheim and was intended to give support to patients in the monastic hospital.”2 According to Dr. Sally Hickson: “At the Isenheim hospital, the Antonine monks devoted themselves to the care of sick and dying peasants, many of them suffering from the effects of ergotism, a disease caused by consuming rye grain infected with fungus and popularly known as St. Anthony’s Fire.”1

The symptoms of ergotism consist of headaches, nausea, vomiting and diarrhea, paresthesias and itching, painful seizures and spasms, hallucinations, mania or psychosis. The gastrointestinal symptoms usually precede the central nervous system effects, and may be followed by extensive gangrene.3 “Dry gangrene is a result of vasoconstriction induced by the ergotamine-ergocristine alkaloids of the fungus. It affects the more poorly vascularized distal structures, such as the fingers and toes. Symptoms include desquamation or peeling, weak peripheral pulses, loss of peripheral sensation, edema and ultimately the death and loss of affected tissues.”3 The image shows a male patient figure with a clinical presentation consistent with advanced ergotism. In contrast to the images of disease and suffering, in the second position of the altarpiece is a panel revealing a glorious, roseate conflated image of the Resurrection, the Assumption, and Christ Triumphant. The message to the inmates of the hospital was clear: through devotion to Jesus Christ, the patients’ punishment and unrelenting suffering would be transformed after death into supreme glory.


  1. Hickson, Sally. “Grünewald’s Isenheim Altarpiece.” SmartHistory. Khan Academy. http://smarthistory.khanacademy.org/grenewalds-isenheim-altarpiece.html. [Archive available at: https://web.archive.org/web/20140203135857/http://smarthistory.khanacademy.org/grenewalds-isenheim-altarpiece.html].
  2. Pioch, Nicolas. “Grünewald, Matthias.” WebMuseum, Paris. July 27, 2002. http://www.ibiblio.org/wm/paint/auth/grunewald/.
  3. “Ergotism.” Wikipedia. http://en.wikipedia.org/wiki/Ergotism.

WILSON F. ENGEL, III, PhD, has published widely in the arts and humanities as well as medicine and the sciences. He was founder and editor in chief of Microbe Virus Vector Monitor, an international disease control newsletter that became a special classified disease control project of the US Navy. As an art historian, he discovered the Isenheim Altarpiece, which complemented his interests in infectious diseases and teleology. He is represented in The Directory of American Scholars and numerous Who’s Who publications.

Highlighted in Frontispiece Volume 7, Issue 4 – Fall 2015 and Volume 15, Issue 4 – Fall 2023 & Highlighted Vignette Volume 13, Issue 4 – Fall 2021

Fall 2015




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