Issue 20: Lam Qua
An extraordinary series of medical portraits
It’s been said that the painter Lam Qua, who lived and worked in 19th century Canton (now Guangzhou), was a student of the English artist George Chinnery, who taught him to paint in the Western style. Chinnery had deserted a marriage in Ireland, then fled debtors in India, before ending up as a portrait and landscape artist in Macau. The pair knew each other, and Lam Qua expressed admiration for the Englishman, although as Lam Qua’s star rose, the compliment wasn’t returned. What Chinnery could have taught him is unclear. Lam Qua came from a family of artists adept at painting in both Chinese and Western idioms, which were big export business in the first half of the 19th century. Lam Qua was a sophisticated artist with a successful commercial career. He was acclaimed in Canton for his Western-style portraits, he produced likenesses for important Western and Chinese dignitaries, and exhibited internationally, including at the Boston Athenaeum and the Pennsylvania Academy of Arts in the USA, and at the Royal Academy in London.
He also produced an extraordinary series of paintings that, even by today’s standards, are disturbing and moving to look at.
In 1834, an American medical missionary, Peter Parker, travelled to Canton with a plan to set up an Opthalmic hospital. Parker was an expert in treating cataracts and other eye diseases, and he wanted to use his work as a way to convert the Chinese to Protestantism—to show them the light of God by repairing their eyesight. But his hospital was inundated with patients—thousands of them, from every sector of Canton society—requiring treatment for debilitating tumours and severe skin conditions, and surgery soon became the mainstay of Parker’s work at the hospital.
Soon after arriving in Canton, Parker was introduced to Lam Qua. He commissioned the artist to make a series of paintings of his patients, for display in the hospital waiting area. Lam Qua produced over a hundred portraits, depicting people afflicted with the most terrible deformities. Patients young and old, men and women, from across the class spectrum: the son of a tea merchant, a gardener, a shoemaker, a civil servant, a stone cutter. People suffering from gangrenous skin peeling from their legs, from enormous tumours and pendulous goiters growing from their heads, arms, genitals, breasts. Tumours so big as to almost be second torsos. Growths like enormous bags of rocks, veined and angry with red and suppurating black colour, the skin stretched pale and glistening across pustular eruptions that seem ready to burst out of the patient’s body.
The paintings are skillfully made. They’re as eerily beautiful as they are hideous. These are portraits of both people and pathologies, and Lam Qua depicts the patient’s deformities with care and detail. (They are accurate to the extent that, even today, student dermatology specialists at Yale New Haven Hospital are given diagnostic training exercises using Yale University’s collection of Lam Qua paintings.) Most of his subjects are presented against plain ochre backgrounds suffused with a dark and atmospheric light. Some are shown in simple interiors, while others are placed in the foreground of natural landscapes. The worst cases must have presented logistical challenges to both artist and sitter: the weight of the tumours, or their position on the body, would have made posing in one position for any length of time uncomfortable.
Oddly, only one example of a post-operative patient exists. In Portrait No. 31, a young man named Po Ashing sits on a wooden chair in gloomy light, naked from the waist up, staring directly at the viewer. His upper left arm is consumed with a fiery-looking tumour, which developed after the patient had twice broken his humerus, and it failed to heal properly. Parker decided to amputate the arm at the shoulder. Portrait No. 32 shows the youth stood on the shore of a lake or sea, blue-grey mountains in the distance, the slightest hint of pink dawn light emerging above the horizon. He gazes off to the left of the composition and he wears a hat and coat, open at the side to show his amputation scar. The serene landscape seems to suggest that Po has become a part of the world again, no longer isolated by his medical condition; the loss of a limb, ironically, making him whole again.
Lam Qua’s subjects appear disconcertingly calm. He never displays expressions of pain or discomfort. It’s a strange disconnect between persona and body that makes them appear almost like Surrealist paintings from a century later. Ari Larissa Heinrich, who has studied Lam Qua’s work extensively, suggests a few reasons why the sitters might have been presented this way. “One possible explanation,” writes Heinrich in the essay ‘Handmaids to the Gospel: Lam Qua’s Medical Portraiture,’ “is simply that in the English grand style or contemporary styles of portraiture, it was not customary to portray a subject’s emotional state.” Feeling was expressed through clothing, props, and setting. Another theory is that medical portraiture in the West at this time was developing an approach that “portrayed individual patients who bore their stigmata with curious detachment.” Disassociation suggesting a kind of extreme Stoicism, a kind of visual dispassion which in the 20th century became conflated with objectivity in both art and medical photography.
Heinrich also offers a third reading: that Lam Qua “strove to portray the vision of the Chinese patient that Parker wished to communicate to his Western audience, the vision that Parker himself had of what it meant to be Chinese and to suffer from what seemed like horribly inconceivable pathologies.” Parker used Lam Qua’s paintings on return trips to the USA and to Europe to help fund-raise for his missionary work and for the hospital. The paintings helped reinforce North American and European ideas about the Chinese, and notions Parker felt might further his own cause: whatever his medical or theological misconceptions were, for instance, about Chinese tolerance for pain, or that their resistance to Western surgery was analogous to their refusal to accept Christianity. Clearly, Lam Qua was in a complex position. He was creating medical portraits, which have a different purpose to conventional portraiture, yet he imbues each of his images with subtle emotional qualities. (These days, medical portraiture might be used as part of a patient’s therapy.) Furthermore he was making work for a client, and had to square the brief Parker gave him with his own sense of identity and position as a portraitist, a genre which is all about the relationship between artist and sitter. There is evidence that Parker paid Lam Qua for his work, but it’s thought that the artist largely provided his services pro bono, because he appreciated the fact that the doctor did not charge people for the surgical procedures, and because his nephew was studying under Parker at the hospital.
The largest collection of Lam Qua’s medical paintings is now at Yale. A number are also at the Peabody Essex Museum in Salem, Massachusetts, Cornell University, Ithaca, at Guy’s Hospital and the Wellcome Collection in London. These are difficult paintings to look at. Difficult because of the history, yes. Difficult, more importantly, because they’re images of suffering. And difficult because this sort of imagery is so rarely seen in art, or in everyday life outside the medical profession. While there has been a wave of writing over the past decade or so about illness, images of pathology are not so common. Essay books theorizing the sick body are seldom, if ever, illustrated. Those kinds of images are rendered invisible for practical reasons (not all disease is visible to the eye), for reasons of ethics—where are they being seen? Who is being looked at and who is doing the looking?—or because more conceptual forms of art tend to occlude them, address them only obliquely. (The AIDS crisis of the 1980s was possibly the last major period in which images of illness were produced. But I’m also always struck, for instance, by the way British artist Jo Spence’s photographs of herself, following a diagnosis of breast cancer in the 1980s, remain not just unflinching but relatively rare.) The kinds of tumours that Parker’s patients suffered in the 1830s are now uncommon—they’d be treated before they ever reached the state seen in Lam Qua’s paintings—but they remain powerful reminders of what the body is capable of doing to itself. Repeated viewing makes it less difficult to look at these pictures. The spectacle of the disease starts to retreat and, importantly, the person comes to the fore.
—“What brings you here, from England?” “‘Cos I heard New York’s where the money’s at.” “Haha, that’s what you think.” Keith, Kat & Blondie, Gotta Get Some Money, from 1988 on Nu Groove Records. Superb old school house track about New York, subway trains, fake English accents and the eternal question of how to get some cash.
—Jennifer Higgie, art critic, editor, novelist, screenwriter—and my long-time colleague at frieze—has a brand new book coming out on 2nd February. The Other Side is about women artists and spiritualism—from Hildegard of Bingen to Georgiana Houghton, Agnes Pelton and, of course, Hilma af Klint—and it’s a follow-up, in a sideways kind of way, to her study of women’s self-portraiture, The Mirror and the Palette. Pre-order it from the beyond here.
—Launched in the USA a year ago, these McNally Editions—reissues of lost gems, brought to you by the McNally Jackson bookstore people—are pretty great. (Has the bug for obscure reissues which has gripped the music world now been caught by publishing?) One of the first out of the gate when the series launched last year was They, Kay Dick’s long-lost sci-fi novel about artistic censorship, which you must read. Gavin Lambert’s The Goodbye People, about Los Angeles in the 1960s, is the next on my list, and yours too if you like Eve Babitz I’d imagine.
—This is beautiful. Peter Pears, accompanied on the piano by his partner Benjamin Britten, sings ‘O Waly, Waly,’ an adaptation of the folk song, ‘The Water is Wide’. Filmed for the BBC in, I think, 1964.