Friday, August 28, 2015


I presented this talk at a Harvard University  "Think Tank" on Health and Aging on April 13,2013. The two-day conference, held at the Charles Hotel in Cambridge, Massachusetts, brought together prominent scholars from the Harvard School of Public Health, as well as global experts in economics, health care policy and longevity, for a fascinating and thought-provoking colloquium on the demographics and consequences of aging in all societies.

It remains difficult for physicians to confront and accept end-of-life issues in their patients, because our professional education and ethos inform us to do all we can as doctors to fight disease and prolong life. Can we afford to continue to do so with no limits and constraints? Even if we could, should we? Those are the moral and existential questions which confront us today.

For ophthalmologists, it is extremely difficult to accept end-of-sight issues in our patients. 

Over the decades, our specialty has proudly trumpeted its splendid and  life-enhancing victories over various causes of visual loss: certainly against cataracts, where we can safely and permanently remove them, replace them with a plastic intraocular lens, and restore sight, and we have been performing that miracle for years. We have been less successful, however, in the management of glaucoma, macular degeneration and diabetic retinal disease, the other three leading causes of blindness, not only in developed societies, but increasingly in less developed ones as well, as the world's population is aging. These are diseases which we cannot yet cure, and over which we are only beginning to have some control. 

Based on cross-sectional studies, in the United States alone, almost three million people have advanced macular degeneration, my own mother being one of them, and over a million more have end-stage glaucoma or advanced diabetic retinal disease. There is a race, indeed a heated one, between research and development to bring new therapies to bear against these diseases, and the increase in their prevalence as we live longer lives.

The burden of those three diseases – glaucoma, macular degeneration and diabetic retinal disease - continues to loom over us, as they affect an elderly population which grows ever larger. The economic burden of these diseases thus continues to increase, as their progression causes more visual loss and medical visits, and more costly rehabilitation, low vision services and custodial care.  And what about the emotional burden? The emotional burden, for the patient and their family, is incalculable.

What is the price of vision, which is to say, what is the price of not going blind?

A 2012 global eye health survey performed in Spain, Russia, China and the US found that almost 70% of respondents in each of those countries would rather lose a limb, or ten years of life, than lose their sight.

Of course, eye specialists constantly preach preventative measures: annual eye exams for those over age 50, cessation of smoking, wearing UV-coated sunglasses when outside, weight loss, and eating a balanced diet, as the food journalist Michael Pollan reminds us, of real (that is, not processed) food, mostly plants, and not too much. To this I would also recommend the eating of cold water fish, in moderation, for their salutary omega-3 fatty acids, and to supplement with safe doses of Vitamins C and E, and the co-enzymes zinc, lutein and zeaxanthin. 

But we don’t always see the results of these strategies in clinical practice. At times, we face other more painful realities. 

So, how does an eye specialist deal with the patient and their family when that patient, who has end stage macular degeneration, glaucoma or diabetic eye disease, says to us, fearfully and plaintively, “Doctor, am I going to go blind?” ?

Our knee jerk reaction is, of course, that there must be something else to offer: to add another drop, to try one more injection, one more procedure, one more surgery. While we have been able to transplant corneas for over a century now, we cannot yet successfully transplant retinas or optic nerves, let alone whole eyes. So there are limits to our current technology, and when we do have to say to that patient, “I am sorry, there is nothing more to offer,” then what happens? Where does that conversation go? 

That patient is usually already infirm, perhaps with degenerative joint disease or rheumatoid arthritis, or suffering from the relentless consequences of bad choices over a lifetime, such as smoking and poor dietary habits, which have led to pulmonary disease and the metabolic syndrome of atherosclerotic cardiovascular disease, diabetes, and hypertension.

Yes, the patient is certainly alive, but what will the quality of that already difficult life become now, as they progressively lose vision? How will that patient now imagine their grandchildren, whose faces they have blissfully enjoyed seeing, often too infrequently? How will they drive their car, watch their favorite television shows, do their puzzles and sudokus, read their books and e-mails, or call their friends, all those comforting activities that stem the tide of the loneliness, and now the darkness too, that inexorably envelops them? For a few patients, as I have poignantly witnessed over the decades, end-of-sight becomes a life no longer worth living. One such narrative documents the arc and trajectory of one person's vision, and at once is a constant reminder to me of why I became  a physician and surgeon in the first place:

In 1995, I had the privilege of assuming the eye care of a prominent modern artist, a brilliant and inquisitive man, vibrant and trim and athletic even in his late 70s. His artistic style could be described as a wonderful amalgamation of the freedom  and gesture of the abstract expressionism of Pollack with the monumentality of the cubism of Cezanne and Picasso.

He had been diagnosed with cataracts, and was despondent because the cataracts had made it increasingly difficult for him to actualize his artistic vision and creations. I performed cataract surgery in both eyes, a few months apart,  and he and his art seemed to flourish afterward; indeed his palette regained the blues and purples and an overall vibrancy that the cataracts had stolen.  I remember giving a lecture on art and visual perception about a year after his cataract surgery, and he graciously came to that talk to explain to the audience the changes in his visual perception and his art before and after the eye surgery.

About five years later, for no explicable reason, he developed a condition called ischemic optic neuropathy (a "stroke" of the the optic nerves) in both eyes, a few months apart, with rapid and profound visual loss. The optic nerve is part of the central nervous system, an extension of the brain, and cannot regenerate if damaged. I sent him to the best neuro-ophthalmologists for subspecialty care.

A few months later, after extensive evaluations and treatments, he came back to me for follow-up, still with substantial loss of vision in both eyes. As I examined him, he leaned in and said to me, almost in a whisper, “Vincent, if I cannot paint, I cannot live.” About six months after that second eye had sustained profound visual loss from the stroke, he passed away. 

The memorial service was held in New York City, about a hundred miles from my office. As life would have it, I was scheduled for a busy  surgery session that day and I did not make it down for that very personal event.

About a month after the memorial, I received a note, which I still have on my desk. The note was from the artist’s spouse, herself a leading voice in American literature. lt read, “Dear Vincent,  He was so devoted to you. You were the architect of his eyes.” She told me that he had fallen, was hospitalized, and died of complications, yet I still wonder about the last days and thoughts of that wondrous mind and spirit.

No, ophthalmologists cannot accept end-of-sight.  Not easily at all. And that is how it must be, as it will continue to catalyze us to find cures for all causes of visual loss, and so that our patients, and at some point we are all patients, can enjoy all the beauty of this world while we are still here.

@ Vincent de Luise MD  A Musical Vision

Monday, July 6, 2015

Mozart in Retrospect

This essay was originally published as  "Perspectives on Mozart" in The Friends of Mozart Newsletter, Spring 2011. I have updated the research to include new findings and am republishing the essay here.

Wolfgang Mozart at age 26
by Joseph Lange (Mozart's brother-in-law)
(The  unfinished 1789 oil portrait,
 with the head cut and pasted here
from the orinal and completed1782 oil)

Who was Mozart?

Of course, we all know his music. The music ! That music, so refined and richly textured, melodic, timeless, ineffably beautiful and sublime.

But, who was Mozart? Who was the man behind those genius creations? So much has been written and said about Johannes Chrysostomus Wolfgangus Theophilus Mozart, much true and vetted, yet  more than a little hyped, hyperbolic and apocryphal. There are so many paradoxes with Mozart; for example, that posterity calls him  "Amadeus" when that wasn't even on his birth certificate and a name he never used in his lifetime.

There are many Mozarts. There is the 18th century Mozart, the undiscovered and neglected artistic genius.  There is also the re-imagined 19th century Mozart, a perfect porcelain musical god on a pedestal;  and now the truer and deconstructed 21st century Mozart, the first  "free-lance" musician, recognized as peerless and a foundational composer for so much that came after him. For many listeners, one or another of the above "historical" Mozart remains their truth, regardless of The truth.

Can we ever know Mozart only by his music, someone whose music seems at once so joyous, and yet is always tinged with sadness? Perhaps not. So, let us look at Mozart, the man, by revealing him through aspects of his physiognomy and personality, and by his legacy and "effect," gaining in the process  insight into this most wondrous of stars star in the musical firmament. 

The observations below are derived from the vetted written literature and scholarship. They paint a portrait of a man with all the imperfections and warts of humanity, who at the same time possessed a gift so rare  andso extraordinary, that its output, that music which we so adore, has been likened to the melodies and rhythms that underlie the universe itself.

W. Mozart
by Barbara Kraft
The posthumous portrait of 1819
Gesellschaft der Musikfreunde, Wien
What did Mozart Look Like?

More than any other composer, Mozart's image remains one of the least certain. An influential German biographer of the early 20th-century, Arthur Schurig, asserted that, "Mozart has been the subject of more portraits having no connection with his actual appearance than any other famous man; and there is no famous man of whom a more worshipful posterity has had a more incorrect physical picture than is generally the case with Mozart." Can any painter truly capture genius in a portrait? The answer is self-evident.

Given this perspective, descriptions by Mozart's contemporaries are the most illuminating. His sister Maria Anna (Nannerl) commented that "my brother was a rather pretty child," but after a bout of smallpox that both siblings sustained in 176l  (he, age 11; she, age l6),  his looks were permanently disfigured by scars. Nannerl went on to describe Mozart in her reminiscences in 1792, a year after his death, as being "small, thin, and pale in color and entirely lacking in any pretensions as to physiognomy and bodily appearance."

Mozart at age 14, with the Order of the Golden Spur
The 1777 copy of the lost 1770 original oil
(anonymous painter,
Accademia Filarmonica, Bologna)

Mozart is said to have suffered a temporary "blindness" as a result of the marked inflammation of his eyes (this could have been from a keratitis (a corneal inflammation) secondary to the Vaccinia virus of smallpox) and developed facial scars. Yet, in 1770, three years after that same smallpox epidemic,  the composer Johann Adolph Hasse wrote that "the boy Mozart is handsome, vivacious, graceful, and full of good manners." 

Michael Kelly, the tenor much beloved by Mozart himself, and the man who sang the roles of both Don Basilio and Don Curzio in the premiere of Le Nozze di Figaro (The Marriage of Figaro), famously reminisced about Mozart in 1826: "He was a remarkably small man, very thin and pale, with a profusion of fine hair, of which he was rather vain. He always received me with kindness and hospitality. He was fond of punch, of which I have seen him take copious draughts. He was kind-hearted and always ready to oblige; but so very particular that when he played, if the slightest noise were made, he left off."

Thomas Attwood, who was Mozart's composition student between 1785 and 1787, recalled his teacher being "of cheerful habit, though lacking a strong constitution." Attwood also remembered that  "in consequence of being so much over the table when composing, he (Mozart) was obliged to have an upright desk and stand when he wrote."
There is evidence that Mozart was small in stature; it has been calculated that he stood about 1.63 meters, or five feet, three inches in height. Mozart himself corroborated this when, as a 14 year-old in April 1770, he wrote to his sister from Rome about a visit to St. Peter's Basilica, stating that "I had the honor of kissing St. Peter's foot in the church, and having had the misfortune of being so small, I, that same old dunce Wolfgang Mozart, had to be lifted up." 

In 1777, at Mannheim, Mozart first met the Webers, the family of musicians who would figure greatly in his biography. Although he later married Constanze Weber, he fell initially in love with her elder sister, Aloysia, who spurned him. Many years later, Aloysia was asked why she rejected so famous a man as Mozart, to which she purportedly replied, "I did not know, you see... I only thought...well...he was such a little man."

Mozart himself may have put it best when he stated, "Mozart magnus, corpore parvus" ("Mozart the great, small in size.")

What Ailed Mozart? His Health and lllnesses

For someone possessed of such remarkable productivity, Mozart was often quite sick. To be sure, his ill health was in large part a consequence of his era,  to the endemic diseases and epidemics to which he was inevitably exposed as a result of extensive travels, particularly those undertaken in childhood and youth. For example, in the fall 1765, while on the grand tour that included the Hague, first Nannerl, then Mozart, contracted typhoid fever, and both children almost died.

There is a large body of  literature regarding Mozart's illnesses, much of it conjecture (as an autopsy was never performed). The following is a partial summary of what Mozart may have contracted during his life, as deduced by a careful reading of the primary medical literature (in German) of his physicians, and by the writings of friends and observers:  recurrent streptococcal infections, erythema nodosum (a nodular and painful skin disease related to a systemic inflammation),  typhus, variola (smallpox), quinsy (tonsillar abscess), recurrent bouts of acute rheumatic fever and  renal (kidney) disease.

Some of these illnesses may have led to  chronic endocarditis (heart disease) and chronic renal   disease, specifically a post-streptococcal glomerulonephritis, which in turn could have led to renal failure. Mozart may also have had antimony over-dosage (he  was self-medicating with this potential poison), a subdural or extradural hematoma (vide infra) and hypertension. There is also the possibility that he had acute trichinosis (Hirschmann Arch Int Med 161:1381-1389, 2001.  Indeed, Mozart wrote to Constanze in  October 1791 that had eaten some under-cooked pork cutlets).

Dr. Peter G. Davies, a gastroenterologist and Mozart and Beethoven biographer from Melbourne, has posited   that Mozart also suffered from the manic-depressive disorder cyclothymia (J. Roy. Soc. Med. 1991). The possibility of cyclothymia, quite common in many creative types, would explain some of Mozart's bursts of extraordinarily intense creativity, such as in the summer of 1788, when he wrote the last three symphonies, his greatest in the genre, works that were composed with no known commission, nor which Mozart ever heard performed except in his imagination. On the other hand, such an explanation must be weighed against several periods of sustained productivity; witness the years 1784 to 1786, when Mozart created an extraordinary number of masterworks in every musical genre.

A  distinction should be made between these chronic illnesses and Mozart's presumed medical conditions which were immediately proximate to and causative of his abrupt and early demise.  Dr. Davies has suggested that Mozart died of  the consequences of a cerebral hemorrhage resulting from hypertension secondary to an acute nephritis (kidney inflammation) from Henoch-Schönlein purpura, a rare disease which can result from streptococcal infection; Mozart was likely severely anemic and already in uremic coma; to compound matters, his physician,  Dr. Thomas Franz Closset (one of the best in Vienna), bloodlet him of almost a liter of blood, which only served to exacerbate the anemia and hastene his demise.)

Mozart's death certificate (as mentioned above,  there was no autopsy) stated “hitziges Frieselfieber” (“heated miliary fever”), a common clinical diagnosis of that era, but one which is far too non-specific a term on which to opine a diagnosis; it may relate to the inflammatory rash of rheumatic fever, which in turn may have been a result of Mozart's presumed repeated streptococcal ("strep") infectionsRichard Zegers M.D. (Ann Int. Med. 2009) reviewed the records of 5,011 Viennese adults who died in the two months before and after December 1791, and compared that data to comparable months in 1790 and 1792,  finding a much higher than normal rate of death from an epidemic of presumed streptococcal infection.    

In early 1791, Mozart fell , landing on his left temple, and as a result, may have sustained an extradural hematoma (a blood clot outside the brain membranes) that manifested itself in a fracture to his skull (M. Drake,  Neurol 43: 2400-2403, 1993).

The putative Mozart calvarium (a a skull missing its mandible)
in the Mozarteum, Salzburg

A skull in the possession of the Mozarteum in Salzburg, exhumed in 1801 by the successor of the grave digger who buried him on December 1791, and whose condition reflects such a trauma, may be that of Mozart, but forensic examinations in 2006 were inconclusive.
Haydn on Mozart, and the author Katherine Pilcher on them both

Franz Joseph Haydn recognized Mozart's genius during his lifetime and before most anyone else had realized this. Haydn said as much to Leopold Mozart at a February 12, 1785 string quartet party at which the last three of Mozart's six string quartets dedicate to Haydn were performed. Haydn said:  "I tell you before God, and as an honest man, that your son is the greatest composer known to me in person or by name.He has taste, but above all, he has the greatest knowledge of composition." 

After Mozart's death, Haydn wrote to his friend Michael Puchberg in 1792, that, " for some time I was quite beside myself over his death, and could not believe that Providence should so quickly have called away an irreplaceable man into the next world. Haydn went on to write that "posterity will not see another talent as his in a hundred years."

The author Karoline Pilcher was a contemporary of Mozart and Haydn, and knew both of them personally. In the 1820s, in her reminiscences, Pilcher writes this about them (trans lated here from the German):
"Mozart and Haydn, whom I knew well, were men who displayed in their personal intercourse no other outstanding mental ability and almost no sort of intellectual cultivation of a learned or higher education. Everyday character, flat humor and with the first (Mozart) a scantly sensible lifestyle, was all they publicly manifested, and yet, what depths, what worlds of fantasy, harmony, melody and feeling, lay concealed within these modest exteriors ! Through what inner revelation came to them this understanding, how they must have seized it, to bring forth such powerful effects, and express in tones, feelings, thoughts, passions, that every ear must feel with them, and be spoken to us as well as from greater depths."

The Mozart Effect

Almost as abundant as the research and speculation devoted to Mozart's health, illness, and death, is the literature on the physical, cognitive, and psychophysiological effect of Mozart's music on the listener. This discussion, originally grounded in rigorous scientific study, has formed the basis of later, pand opular claims revolving around the so-called Mozart "effect."

The French otolaryngologist Alfred Tomatis coined the term, the Mozart "effect"  in a 1991 book entitled, Pourqoui Mozart?   Tomatis developed the concept of auditory processing integration. While examining opera singers who were having trouble reaching and singing certain notes in tune, he discovered that those singers all had a coincident hearing defect in the same frequency as the vocal problem.

This relationship between audition (hearing) and phonation (voicing) had never been observed or reported previously. Tomatis posited that "the voice can only reproduce what the ear can hear." He subsequently focused his audiological research using Mozart's violin concertos, as well as Gregorian plainchant, at different hearing frequencies, to improve auditory processing, to "retrain the ear," if you will, of patients who had acquired sensori-neural hearing loss. Among those who gained improvement not only in their hearing as well as in their "voicing" by this technique were the actor Gerard Depardieu, the baritone Benjamin Luxon, and the popular singer Sting (Gordon Sumner).

In 1993, the researchers Frances Rauscher, Gordon Shaw and Katherine Ky ,working in the department of neurobiology at the University of California, Irvine, further investigated a “Mozart effect" in an experiment which was published in the October 14, 1993 issue of the scholarly scientific journal Nature , under the title: "Music and Spatial Task Performance." 

The Rauscher team found that a group of students who were "pre-treated" for ten minutes by listening to the first movement and part of the second movement of Mozart's two-piano sonata in D major, K. 448, performed better on a spatial-task reasoning Stanford-Binet test than when the same students were pre-treated with a "relaxation tape" or after thy had sat in silence for ten minutes prior to testing. (Stanford-Binet testing is a form of IQ test, which measures aspects of verbal and non-verbal reasoning. In the Rauscher study, the students were given a paper folding and cutting test: a piece of paper is folded several times and then cut. The students had to mentally "unfold" the paper and choose the correct shape from the numerous examples that they were given).

These results were temporary, lasting only through the time taken for the experiment, about fifteen minutes, and were specifically related to visual-spatial task reasoning, and not to other measures of intellect. More recent research has both confirmed and contradicted the results of the Rauscher  study, among them "Arousal, Mood, and the Mozart Effect," Psychological Science (2001; l2l3); "Re-examination of the Effect of Mozart's Music on Spatial Task Performance," Journal of Psychology (1997; 13l/4); "'Brain-Based"' Learning: More Fiction than Fact," American Educator (2006; fall issue); and "Prelude or Requiem for the Mozart Effect," Nature (1996).

The music educator and researcher Don Campbell was influenced by Tomatis' work and the results of the Rauscher study, and went on to write the best-selling 1997 book The Mozart Effect: Tapping the Power of Music to Heal the Body, Strengthen rhe Mind, and Unlock the Creative Spirit.

Campbell's claims went far beyond spatial intelligence improvement to include notions that Mozart's music improved mental health and cognitive ability.  Over the decades, the Mozart "effect" as put forth in Tomatis's original work, and subsequent misinterpretations of the Rauscher  study  have devolved into an assertion that early childhood exposure to classical music (specifically, Mozart's music) can ipso facto bestow a beneficial effect on mental development, leading to advantages and a range of lifetime achievement.

However, there a kernel of scientific fact in the studies. As an ophthalmologist with knowledge of the neuroanatomy of the sensory system, I agree with the findings that there is a feature of the music of Mozart (and several other composers, see below), which modifies or enhances brain function (J. Jenkins, Royal Society of Medicine, 2001).

Neurologists John Hughes and John Fino at the University of Illinois subjected to computer analysis fully 8l works by Mozart, 67 of Johann Christian Bach, 67 of J.S. Bach, and 150 works by 55 other composers. They found that the music of Mozart. as well as that of J.S. and J.C. Bach, but not the music of the other composers, contained a very high degree of long-term periodicity. They hypothesized that these specific harmonic patterns and chordal repetitions, found especially in the music of Mozart, J.S. and J.C. Bach (the latter was an influence on the young Mozart) have a function in brain coding: they act to align or "symmetrize" neurons in certain regions of the brain involved with auditory processing and memory (specifically the parieto-occipital cortex and right pre-frontal cortex) and which can lead to heightened mental capacity and function, even if only temporarily. There is neurophysiological evidence for a Mozart "effect" (as well as a "J.C. Bach effect" and a "J.S. Bach effect").

There are fundamental and physiological aspects that underlie the "Mozart effect" and to the music of Mozart in general - the pleasure, felicity, and depth of emotion of his music can provoke and stimulate a heightened intellectual, even spiritual awareness, and rapture.  Perhaps the timeless remark, ascribed to the Nobel-prize winning physicist Albert Einstein, himself a genius, resounds most compellingly to us today, that "Mozart's music is of such beauty and purity that one feels that he merely found it, that it has always existed as part of the inner beauty of the universe waiting to be revealed."
Vincent P de Luise, M.D.
Copyright @ 2011 -2015 


Saturday, May 16, 2015

The Third Cranach


 Lucas Cranach, the Elder, (1472 - 1553)
 in 1550, at age 78
(fig. 1)

Anyone who has taken a course in the history of western art, perhaps during high school, or in their collegiate or grad school years, has come across the name Lucas Cranach, one of the towering painters and printmakers of the German Renaissance. But, to which Cranach are you referring?
Those with good memories recall that there were actually two Lucas Cranachs: Lucas Cranach the Elder (1472 - 1553), and a son, Lucas Cranach the Younger ( 1515 - 1586, fig. 1).
The family name Cranach derives from the town of Kronach, in central Germany, near Nuremberg, whence the ancestors of Lucas Cranach the Elder hailed. Lucas Cranach the Elder  (Ger.: Lucas Cranach der Ältere) didn't have a last name. He was called  "Lucas, Maler der Kronach,"  i.e., "Lucas, the painter from Kronach."  
By 1504, Lucas Cranach the Elder  was working in Wittenberg,  250 km northeast of Kronach, for Duke Friedrich III, Elector of Saxony, who was also known as Frederick the Wise. Wittenberg was also the town where Martin Luther lived and preached. Luther and Cranach were friends and colleagues.

So, there were two Lucas Cranachs, an Elder and a Younger. Correct?
Well, no.
Lucas Cranach the Elder actually had two sons, the younger of whom was the aforementioned Lucas Cranach the Younger (that may sound like a tautology, but it is not), and there was another son, the elder son of Lucas Cranach the Elder. He was Hans Cranach (the baptismal certificate reads: Johann Lucas Cranach). Hans was born in Wittenberg in 1513 and became a master painter like his younger brother and father.

I first heard about Hans Cranach a few days ago, when I was visiting the splendid  galleries  within the newly Renzo Piano-reincarnated  Harvard Art Museums in Cambridge, Massachusetts. Among the treasures contained therein  is a noble portrait of Martin Luther by the School of Lucas Cranach the Elder (fig. 2).

(fig. 2) Martin Luther
Workshop of Lucas Cranach der Altere (Lucas Cranach the Eleder)

To the left of the Luther portrait is a most intriguing painting (fig.3). It certainly looks like a Cranach, but which one? The label for the painting states that it is a work by Lucas Cranach the Elder, and that it was painted c. 1535.
(fig. 3) Hercules and Omphale and her maids
Harvard Art Museum
? Lucas Cranach the Elder c. 1535
(on loan since 1983 by Carla Rolde)
The painting does not exist in any of the Harvard online catalogues, and that is because it is on loan,through the generosity of a Ms. Carla Rolde. (Interestingly, it has been on loan to Harvard since 1983).
(fig.4) Detail of the Harvard
Hercules and Omphale
? Lucas Cranach the Elder c. 1535
 (on loan since 1983 by Carla Rolde)
The painting  depicts  five figures: Hercules, Omphale, and her three maids, and Omphale's spinning wheel (is that Omphale or is one of her maids, holding her famous spinning wheel?). Each figure is rendered  with fine detailing of the face (fig.4), giving each  an individual personality, as was the custom in a type of 16th century northern European genre painting.
We observe a concerned Hercules looking worriedly at a strand of wool from the spindle. Hercules is surrounded by the four women, one of whom has hung a necklace around his neck and is adjusting a scarf on  him, another stares back at the viewer with a smirk as she pats Hercules' headdress (could this woman be Omphale, perhaps?),  another looks at the enslaved hero adoringly, and the fourth stares out into space.

Each of the  faces in the painting is individualized, some in the moment, others searching or deep in thought. To my eye, they are distinguishable from  faces painted by Lucas Cranach the Elder by a certain je ne sais quoi, call it a  youthful softness.  Is this truly a work by Lucas the Elder? Or could it be by his son Hans? Apparently, the attestations of authorship of a good number of paintings said to be by Lucas Cranach the Elder have now been thought to be by one or the other of his sons.

The label next to the Hercules and Omphale painting at the Harvard Art Museums is shown here:

The label tells us that the Hercules and Omphale painting belongs to a secular genre in German Renaissance art known as the Weibermacht, images illustrating the power of women. That makes this painting quite modern in its inherent meaning.

There is another version of Hercules and Omphale in the  Herzog-Anton-UlrichMuseum in Braunschweig, Germany, which resembles the Harvard painting somewhat, but with  differences in the heads of the figures and in the morphology of the wool on the spindle (fig. 5). Also, the woman on the far right is wearing an ornate hat with furry pompoms in the Braunschweig version, whereas she is "hatless' in the painting at Harvard.
(fig.5) Hercules and Omphale
Lucas Cranach der Altere (1537)
Herzog-Anton-Ulrich Museum
Yet another version of the Hercules and Omphale story is  in the Thyssen Bornemisza Museum in Madrid.  This painting (fig. 6), however,  is signed by Hans Cranach and also contains his insignia. The Madrid painting is similar to the one in the Harvard Art Museum,  but only depicts two maids attending Hercules. Here  a certain serenity permeates the women's faces and Hercules himself looks almost sedated.
(Fig. 6) Hercules, Omphale and her Maids
signed by Hans Cranach (1537)
Thyssen Bornemisza Museum, Madrid
The story of Hercules and Omphale is not discoverable from original Greek sources. One must seek it out in that magnum opus of the Roman poet Ovid (Publius Ovidius Naso, 43 BCE - 18 CE), his Metamorphoses.

To atone for his accidental murder of Iphitus, Hercules (Herakles) was remanded by the Delphic Oracle to be a slave of the Lydian princess Omphale for three years.   (Omphale (Attic:   Ὀμφάλη) was a daughter of King Dardanus of Lydia, an ancient kingdom in Anatolia, in what is now western Turkey).

During the period of Hercules'
 incarceration, Omphale and her maids had their way with him, among other things dressing him in women's clothes, and forcing him to do their labors, as  per the lovely story in the Metamorphoses.

Both the Harvard version and the version in the Thyssen Bornemisza Museum have this Latin inscription at the top:

Herculeis manibus dant Lydae, pensa puella imperium dominae fert deus ille suae, sic capit ingentis animos damnosa voluptas fortiaque enervat pectora mollis amor."
"The Lydian girls gave the daily task (of spinning wool) to the hands of Hercules, that god who bears the authority of his mistress; thus her (Omphale's) damaging pleasure  takes possession of his great spirit, and her soft love weakens his power and courage."  
(my translation from the Latin).

Not much is known about Hans Cranach’s  brief life. Like his brother, Lucas Cranach the Younger, Hans began painting as a young boy in the Wittenberg workshop of their father. Hans Cranach’s work, the little that is extant,  is barely distinguishable from that of his father's, except, in my view, for that youthful softness.

We possess only a few tantalizing tidbits  from Hans Cranach's life:
1) He received a payment for a bill for a painting by his father at the Michaelis Market in 1534.
2) He is mentioned in a bill for a work done at Torgau Castle in 1536.
3) The art historian Christian Schuchardt, who first discovered  Hans Cranach's  existence, credits him with an altarpiece at Weimar, signed with the monogram "H.C." and dated, 1537.
4) There  exists a sketchbook, dated 1537, which Hans Cranach used while in Italy. Later that year, in Bologna, he died of unknown causes.
Martin Luther mentions Hans Cranach’s death in his Colloquia Mensalia ("Table Talk"), and Johann Stigel, a contemporary poet, celebrates him as a painter and draftsman (Maler und Zeichner). Stigel, in his euology, In immaturus obitum Johannis Lucas F. (filius) Cranachii, ("The premature death  of Johann Lucas, son of Cranach)," recognizes Hans Cranach as a “"talented and fertile" painter, who must have had a significant role within the Cranach workshop."

Only two extant paintings, both at the Thyssen Bornemisza Museum in Madrid, contain both Hans Cranach's   signature and his insignia, a winged serpent between the initials "H" and "C." One painting is of a bearded man, from 1534  (fig. 7), and the other is the previously discussed painting of Hercules and Omphale of 1537.

(Fig. 7) Portrait of a bearded man
Hans Cranach (1534)
Thyssen Bornemisza Museum, Madrid
 In 1900, the art historian Eduard Flechsig attributed a number of works from the Cranach workshop to Hans Cranach. However, he later revoked these attributions. There are paintings in Oslo, Paris, San Francisco and Linkoping that have been attributed to Hans Cranach, but none of these has been fully attested.
There are a  number of Hercules and Omphale paintings in Cranach's oeuvre: twenty-six are catalogued in the Corpus Cranach  
The version loaned to Harvard by Rolde since 1983 may have been purchased at auction at Sotheby's on 27 March 1963 (fig.8).

(fig. 8) Hercules and Omphale
(photo from Sotheby's sale 27 March 1963)
There are yet other versions. For example, the painting below, at the Fondation Bemberg in Toulose,  Hercules and Omphale, is said to be by Lucas the Elder (fig.9).
Evidently, the story of Hercules and Omphale was an archetype for the Cranachs. They all got in the act of painting it. Here, presumably in father Lucas' hand, all is joyous (and that delightful hat makes its appearance again on the  woman on the far right):

(fig 6) Hercules and Omphale
Lucas Cranach the Elder ? 1537
 The insignia of the Cranach workshop changed in 1537, perhaps in association with the death of Hans Cranach (fig. 7). The previously erect wings of the snake (see below) became stretched and horizontal. This may have been a decision made by the father's now closest collaborator, Hans’ younger brother, Lucas Cranach the Younger.

(Fig. 7) Insignia of Cranach family

Sic transit Gloria mundi.

Vincent P. de Luise MD @ 2015.

Saturday, May 9, 2015

The Tree That Makes Music

There is a tree that grows in Africa, which goes by the nickname "The Tree that Makes Music."
The world's finest clarinets and oboes are made from this east African hardwood. It is sometimes referred to as Grenadilla wood. In Swahili, the tree is called 'Mpingo.  The Portguese know it as pau preta. Its Linnaean taxonomic name is Dahlbergia melanoxylon
It is an angiosperm in the family Fabacaeae, and it is endangered. The only remaining viable stock is in northern Mozambique, Tanzania, and southern Kenya.
The 'Mpingo has been called the "Tree of Music"  because, for two centuries, oboes, clarinets, highland bagipes and their chanters, Northumbrian bagpipes and their chanters, wood piccolos, some transverse flutes (Blockflote), and the black keys on the finest pianos, have been crafted from this amazing, hardy, incredible dense, and now sadly depleted woody perennial.
(East African blackwood is no longer called "ebony". That term is reserved for a timberwood of the genus Diospyros; these have more of a matted appearance and are more brittle).
The genus Dalbergia  yields other valuable and "musical" timbers such as Brazilian rosewood  (Dalbergia nigra) and cobolo (Dalbergia retusa). I have several clarinet barrels  (the cylinder between mouthpiece and upper joint) of different lengths made of 'Mpingo, one made of rosewood and one made of cocobolo.

A beautiful clarinet barrel made by Chadash.
Notice the lathe above.

Each of these barrels has its own subtle and distinct timbre and resonance, based on the inherent acoustic characteristics of the specific wood.

"The Tree That Makes Music"
Dalbergia melanoxylon
East African Blackwood
The cortex (the heartwood) of the 'Mpingo is the hardest known material in the plant world, behaving more like stone or metal. It is this feature that makes the wood  ideal for crafting fine woodwinds as it can tolerate multiple lathe shaving and drill holes without cracking.
Until recently.
As you might imagine, like any commodity in  great demand with limited supply,  'Mpingos are being overharvested, felled before maturity, and smuggled. Poachers clear cut these magnificent trees and brush fires in Kenya, Tanzania and Mozambique are destroying them; the fires weaken the cortices of those trees which manage to survive.
This sad fact was brought home to me shortly after I bought my A clarinet and my Bb clarinet, at the House of Woodwinds in Berkeley, California during my internship at UCSF, in 1978.
In the early 1980s I  read a news article about clarinet and oboe  craftsman in those venerable old line manufacturing facilities - Selmer and Buffet Crampon in Paris-  and similar workshops  in Vienna and Germany, noticing that the timber was cracking under the lathes during polishing and drilling. The cracking was analyzed and  was determined to be secondary to the fires in east Africa affecting the usually extremely hard, dense and strong Dalbergia melanoxylon.
The Buffet Crampon Company in Paris  developed their Greenline series, in which scraps of cracked and broken Dalbergia melanoxylon, instead of being discraded, are crushed and mixed with resin, making a material that can be crafted into perfectly serviceable clarinets, though not quite the same as natural 'Mpingo.

Today, conservation efforts such as Clarinets for Conservation, The 'Mpingo Conservation and Development Initiative (MCDI), and the African Blackwood Conservation Project, are raising awareness in the region, planting new Dalbergia melanoxylon saplings, all the while teaching music to children.
These projects are helping to bring forth new and wondrous "Trees of Music" so that the next generation (maybe we have to wait for the generation after that, as the trees take almost 70 years to mature), and future generations will be able to play their clarinets, oboes and bagpipe chanters on wood from the 'Mpingo.
There is a wonderful movie, entitled    "'Mpingo:  The Tree That makes Music," which came out in 2001.

Here below is the world's greatest clarinetist, the remarkable phenom that is Martin Fröst,  playing Mozart's indelible concerto for basset clarinet and orchestra in A major KV 622 (a basset clarinet is a clarinet with four extra semitones at its bottom-you can see and hear it).
Fröst, himself  a god of Music, is playing a Buffet Crampon basset clarinet pitched in A, made out of, what else, the 'Mpingo, wood from the  "Tree of Music".
And isn't it perfectly appropriate that the  adagio movement of the ineffable Mozart basset clarinet concerto was made famous in the movie, Out of Africa (of course ! ).