Abstracts

Rationale: The biblical view that epileptic seizures were manifestations of demonic possession was prevalent during the Middle Age and continue past the Baroque period. Within this religious framework, epilepsy was occasionally the subject of the arts, often making reference to Christ's miracle of the epileptic child (Mark 9:14-29). Methods: The clinical and historical angles of Francisco Goya's "St. Francis Borgia at the Deathbed of an Impenitent" are examined in detail. Results: Painted in 1788 by Goya, "St. Francis Borgia at the Deathbed of an Impenitent" was commissioned by the Duke of Osuna for the Saint's Chapel at the Cathedral of Valencia, Spain. The painting presents a stunning mystical drama. The Saint, holding a bleeding crucifix in 1 hand and raising the other hand in a gesture of consternation, stares towards the impenitent, in the presence of a cluster of 4 laughable demonic creatures. The dying man's torment, underscored by the heaving chest, sunken eyes, gasping mouth, rigid body, and the disheveled bed sheets, is highly suggestive of an epileptic generalized seizure at its initial tonic phase, seconds before the impenitent's death. Goya based the scene on an account of the Saint's life, c. 1557, given at the canonization depositions and later included in a published biography of St. Francis. Seizures at end-of-life are a well known occurrence, although persons with epilepsy have a greater risk of death due to an underlying common cause than from the seizure itself. Biographical accounts of the impenitent's criminal background raise possibilities such as head trauma and alcoholism as explanations for the seizure. Conclusions: The painting could be interpreted as abetting the demonic superstitions attributed to epilepsy during Goya's time—eg, seizure as demonic punishment for a life of crime. However, Goya's comical depiction of the bedside demons keeps with his introverted and humanistic/biting satire on social attitudes of the time and transforms these symbols of darkness into those of folly and ignorance. Support: Acorda Therapeutics, Inc.