James L. Franklin
|A Bar at the Folies-Bergère. Édouard Manet. 1881-1882. The Courtauld Institute of Art. Accessed via Wikimedia.|
Édouard Manet (1832–1883) was one of the most famous modernist painters of nineteenth-century France. He painted life as creatively and elegantly as he lived in it, translating onto canvas the fashionable salons, racetracks, and picnics of the Parisians. With one foot artistically in the past and another in the future, he fully embraced neither realism nor impressionism, but created his own visual vocabulary of the people and scenes he painted.
He had been in good health for most of his life. In 1870 he served in the Franco-Prussian war, and was in the artillery during the siege of Paris. In the fall of 1879, while leaving his studio, he was struck by sudden pain in the back, his legs became weak, and he fell on the pavement. For the next three years he lived in constant pain, his walking painful and difficult, his life largely restricted to sitting in a chair. But clear in his mind, he was able to work until his last day. At first he was too proud to admit he had a handicap, and when once offered a chair to sit down he refused it, saying he was not incapacitated. In 1879 he saw a physician who recommended a thermal cure of therapeutic showers and massages. These proved unhelpful and felt to him like torture. In 1888 he saw the famous Professor Piere Potain, who to his great relief told him that his ataxia (incoordination) was not due to syphilis and prescribed ergot derivatives.
Manet’s style had to change because of his physical handicap, but he continued to produce excellent paintings in oil and watercolor. One of his last works was the famous A Bar at the Folies-Bergère, exhibited in the Salon of Paris in 1882.
Towards the end of 1881 his life was brightened when a new government came into power and he was awarded the Legion d’ Honneur. He was as pleased as a child, and despite his incapacity went to visit those who had voted in his favor. Constantly troubled by pain, he sometimes became brusque with even his best friends, who however stood by him during this difficult time; and he liked to talk and reminisce about his favorite subjects: the sea, the Netherlands, Italy, and Spain. Bitter about the doctors who had been unable to cure him, he said they looked like undertakers and their presence always made him think of death.
During his illness Manet was seen by several physicians or consultants. One of them suggested he should go easy on drugs. Yet another physician, who claimed he could cure diseases of the nervous system, also prescribed an ergot derivative that he began to take in increasingly large doses.
In April 1883 gangrene set in. A black spot appeared on his left foot, then spread. An operation was carried out in his house, and he died several days later. The story has it that in his last days he had developed phantom pains and shouted loudly when the visiting Claude Monet sat on the place where his leg had been.
It is likely but by no means certain that Manet had tabes dorsalis (locomotor ataxia), the kind of neurosyphilis that affects the spinal cord but not the brain. Characterized by lightning pains and ataxia (incoordination), tabes had been noted as early as 1840 by Moritz Romberg and later more completely by Duchenne de Boulogne. By 1872 Charcot had published eight articles on it, but the disease became better known after its more definitive and extensive description in a famous book in 1882. Only after 1905 was the microorganism causing syphilis described, then cultivated, and finally found in patients suffering from neurosyphilis. No alternative diagnosis has ever been suggested for Manet’s affliction; tabes dorsalis remains the most likely candidate, most likely worsened by the excessive ingestion of ergotamine precipitating lower extremity gangrene.
- Julien Bogousslavsky and Laurent Tatu. Édouard Manet’s Tabes Dorsalis: From Painful Ataxia to Phantom Limb. Eur Neurol 2016;76:75–84.
- Antonin Proust. Édouard Manet. Paris, Librairie Renouard 1913.
- Theodore Duret. History of Édouard Manet and his work. Paris, H. Fleury editor, 1902.
GEORGE DUNEA, MD, Editor-in-Chief
JAMES L. FRANKLIN is a gastroenterologist and associate professor emeritus at Rush University Medical Center. He also serves on the editorial board of Hektoen International and as the president of Hektoen’s Society of Medical History & Humanities.