Thomas Jefferson University

The Gross Clinic

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The Gross Clinic was sold to the Philadelphia Museum of Art and Pennsylvania Academy of Fine Arts in January 2007. A replica now hangs in the Eakins Gallery.

Thomas Eakins took a second course of anatomy at Jefferson Medical College in 1874, when he attended surgical lectures and clinics presided over by Professor Samuel D. Gross. who was one of America's most distinguished and influential surgeons, physicians, anatomists, authors, and teachers.

As chair of surgery from 1856 to 1882, Dr. Gross inspired thousands of Jefferson medical students and assistants with his articulate lectures, calm judgment, mechanical dexterity, and contributions to surgical technique. Gross was author or editor of hundreds of articles and many books. His two-volume System of Surgery of 1859, perhaps his best known work, appeared in six editions and in several foreign languages. Gross was deeply involved in local, national, and international medical societies and was a founder and office holder of many. His numerous institutional honors and awards reflect his acclaim as the "Nestor of American Surgery" (a wise leader and patriarch named after the legendary Greek hero).

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Thomas Eakins was aged thirty-one and had never before attempted such an ambitious composition when he requested Dr. Gross, then seventy years old and at the pinnacle of his profession in 1875, to approve his conception for a portrait of the physician in his surgical clinic. The young artist's confidence must have stemmed from his knowledge of anatomy and his prior experiences in the medical environment. He hoped to establish his professional reputation by displaying this heroic work in the art gallery of the upcoming Philadelphia Centennial Exposition, which aimed to celebrate American progress and excellence. Gross exemplified these patriotic ideals.

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The graphic scene of clinical instruction takes place in a surgical amphitheater, the upper lecture room of Jefferson's Medical Hall. The commanding figure of Samuel D. Gross stands at the apex of a group consisting of his surgical assistants, the patient, and the patient's mother. Seated to the left and behind Dr. Gross is a clinic clerk who records operative notes. In the background are tiers of students observing the proceedings. A table with bandages and a box of surgical instruments is in the foreground. The two figures standing in the tunnel are an orderly, on the left, and Dr. Gross's son, the surgeon Samuel W. Gross, on the right. The first figure seated to the right of the tunnel is a self-portrait of Thomas Eakins sketching or writing.

Professor Gross has turned away from the operative site to explain the procedure for removing a segment of diseased bone from the left thigh of the patient who suffers from osteomyelitis. The adolescent male patient lies on his right side on bright white sheets. His hips and knees are bent so that his body is greatly foreshortened. His buttocks and left thigh are the only exposed areas of his body. His feet are clad in thick gray socks. His head is concealed under the chloroform-soaked towel held by the anesthetist at the head of the operating table. Four other assistants (one is partially obscured behind Gross) hold a retractor or tenaculum to expose or probe the wound.

All figures but one are intensely engaged in participating in or observing the operation. The veiled woman, traditionally identified as the patient's mother, is so distraught that she shrinks away in horror, covering her eyes with tensely clenched, clawlike hands. Her fright is palpable although ironic, because her son's life was not in danger and the humane procedure would save his leg from amputation.

Like the other participants Dr. Gross is garbed in black business clothes, as was customary then. The forehead of his magnificently delineated head is bathed in light pouring down from the skylight above, his wiry hair creating a silver aura around his face. His angular features are sculpturally defined by the dramatic contrasts of bright light and deep shade. The painting's single bright color is the emphatic red of fresh blood oozing from the patient's wound and staining the surgeons' hands and linens. The blood is especially lustrous on Dr. Gross's right hand which holds a scalpel.

In Eakins's time most critics found the mother's gesture overly melodramatic. With few exceptions the critics and public complained that such an operation was an inappropriate subject for a painting, and the bloody scene too realistic to be accepted for display by polite Victorian society. The New York Tribune reporter said, "It is a picture that even strong men find it difficult to look at long, if they can look at it at all; and as for people with nerves and stomachs, the scene is so real that they might as well go to a dissecting room and have done with it."

The bold and innovative painting was rejected by the committee of selection for the Centennial's art exhibition, although five other Eakins works were accepted. Instead it was eventually shown at the U.S. Army Post Hospital, a model hospital that was an annex to the U.S. Government's display at the fair. This alternative site was probably found through the influence of Dr. Gross. He must have realized that The Gross Clinic's multiple portraits of Jefferson faculty members operating in the surgical amphitheater could further enhance the reputation of Jefferson Medical College in the history of American surgery. The painting was purchased by the college for two hundred dollars in 1878.

Ironically anticipating The Gross Clinic's popular success, Eakins copyrighted the work in 1876 and arranged for an unknown quantity of high-quality, photomechanical reproductions of it. He exhibited the reproduction a few times and gave several to friends. A recently discovered collotype in the Jefferson collection is signed by the artist and inscribed to Dr. Edward A. Spitzka, the professor of general anatomy from 1905 to 1914.

The Gross Clinic depicts a heroic physician calmly performing the multiple tasks of instructing students, training assistants, and operating on a patient. Today the once maligned picture is celebrated as a great nineteenth-century medical history painting, featuring one of the most superb portraits in American art. The monumental composition still has the power to shock viewers with the artist's bravura paint style and the bold matter-of-factness and immediacy of the action.