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Art and Images in Psychiatry
August 2005

The Hangover (Gueule de Bois)

Author Affiliations
 

JAMES C.HARRISMD

Arch Gen Psychiatry. 2005;62(8):824. doi:10.1001/archpsyc.62.8.824

His pitiless observation captures the beauty of life, and the philosophy of vice which he sometimes flaunts with a provocative ostentation nevertheless takes on, because of the forcefulness of his drawing and the seriousness of his analysis, the instructional value of a lesson in practical morality.—Gustave Geffroy on Toulouse-Lautrec, La Justice, February 15, 18931(p165)2(p2)

Henri de Toulouse-Lautrec (1864-1901) was born in Albi, France, the son and heir of Comte Alphonse-Charles de Toulouse-Lautrec (1838-1912). He was the last in the line of a family dynasty of noblemen who had ruled much of Rouergue, Provence, and the Languedoc, France, for more than a thousand years. His ancestor, Raymond IV (c 1038-1105), count of Toulouse, organized the expedition that was primarily responsible for the capture of Jerusalem in 1096 in the First Crusade.3

Many French nobles chose to keep the wealth that remained in their families by using intermarriage to maintain purity of the bloodline. Henri’s grandmothers were sisters and his parents were first cousins, as were his aunt and uncle. Among them all, they produced 16 children, of whom 4, including Henri, were short-statured. He was the product of a full-term pregnancy but failed to thrive, weighing 10 pounds at 6 months of age. He walked at age 17 months and, when he began to speak, spoke with a lisp. Henri was sickly and short-statured, and when he was 7 years old, his mother took him to Lourdes to pray for a cure. His bone structure was so fragile that he suffered 2 femoral fractures, at ages 12 and 14 years, after minor falls. His height as an adult was 150 cm (4 ft, 11 in). He used a cane nearly all his adult life; friends reported that he walked any distance only with reluctance and difficulty.

The death of his brother, Richard, in infancy heightened his mother’s concern about him, and she was constantly vigilant. They slept in the same bed until he was 8 or 9 years old, and even when Henri became an adult, his mother spent much of the year close by his studio, dining with him regularly and living in housing near Montmartre. His father was subject to unpredictable mood swings and lived in quasi-isolation from the family. A superb athlete, he was deeply involved in all forms of hunting; he was reputed to be an incorrigible womanizer.3

Although handsome as an infant and young boy, Toulouse-Lautrec’s facial appearance changed as he grew older. He developed a pendulous lower lip and a tendency to drool, and he had a speech impediment with poor dentition. He was self-conscious about his appearance, wore a beard all his adult life, rarely smiled for a camera, and wore a hat indoors and outside. The isolation he had experienced because of his disability may have enhanced the accuracy of his observations of others.

Unsuited for the country life of riding and hunting, Toulouse-Lautrec showed an early gift for drawing. He went to Paris with his mother, where he studied with Bonnat and Cormon and set up his own studio when he was 21 years of age. Original in his draftsmanship, he mastered graphic art and introduced technical innovations in color lithography and painting. He illustrated the music halls, circuses, brothels, and cabaret life of Paris with a considerable objectivity. His posters captured the atmosphere of life in Montmartre. His first and most famous poster, Moulin Rouge–La Goulue(Figure), depicts Louise Weber, known as La Goulue (the glutton) because of her habit of outdrinking anyone at the bar, doing the can-can. Weber’s partner, Jacques Renaudin, is shown in the foreground in the poster. The shadow figures, spectators in the background, suggest links to Japanese art and the artist’s interest in the shadow play.

Moulin Rouge–La Goulue, 1891. Color lithograph, 191 × 117 cm (sheet). Art Institute of Chicago, Mr and Mrs Carter H. Harrison Collection. Courtesy of the Bridgeman Art Library.

Moulin Rouge–La Goulue, 1891. Color lithograph, 191 × 117 cm (sheet). Art Institute of Chicago, Mr and Mrs Carter H. Harrison Collection. Courtesy of the Bridgeman Art Library.

Marie-Clémentine Valadon, known as Suzanne, a name proposed by Toulouse-Lautrec, was his model and mistress. Her first contact with art came through modeling. Although she had no formal art training, she began to draw. Impressed with her work, Toulouse-Lautrec showed her drawings to Degas, who arranged a professional exhibition of them. She sought to marry Toulouse-Lautrec and threatened suicide if he refused. He and a friend followed her to her apartment and overheard her confessing her scheme to her mother. Feeling manipulated and betrayed by her behavior, Toulouse-Lautrec ended the relationship. Afterward, he painted her as a drunk. The Hangover(cover) reveals her as a formidable personality, tight lipped with an absent gaze, somber yet with an air of virility.4 Her emotional desolation contrasts with the revelry shown in the poster, revealing 2 aspects of life in Montmartre.

Henri de Toulouse-Lautrec (1864-1901), French. Cover: The Hangover (Gueule de Bois), prob 1888. Oil on canvas, 45.1 × 53.3 cm. Fogg Art Museum, Harvard University, Harvard University Art Museums, Bequest of the Collection of Maurice Wertheim, Class of 1906. Courtesy of the Bridgeman Art Library, New York, NY.

Henri de Toulouse-Lautrec (1864-1901), French. Cover: The Hangover (Gueule de Bois), prob 1888. Oil on canvas, 45.1 × 53.3 cm. Fogg Art Museum, Harvard University, Harvard University Art Museums, Bequest of the Collection of Maurice Wertheim, Class of 1906. Courtesy of the Bridgeman Art Library, New York, NY.

Ultimately, it was Toulouse-Lautrec’s own alcohol abuse, and probably his syphilis too, that destroyed his creativity. His mother placed him in an asylum in 1899 for alcohol rehabilitation. To prove his sanity, he painted a series of circus pictures and was discharged. After the discharge he was under constant surveillance, but he began to drink again, and his health continued to decline. After a life of enormous productivity (more than 1000 paintings, 5000 drawings, and 350 prints and posters), debauchery, and alcoholism, Toulouse-Lautrec died at the age of 36 years. In the last year of his life, his health continued to deteriorate, he had 2 strokes, and he returned home to his mother, dying in her arms.1(p126)

Maroteaux and Lamy,5 who initially described pycnodysostosis [OMIM #265800], proposed it as his diagnosis, identifying it as the malady of Toulouse-Lautrec. Pycnodysostosis is a congenital disease of bone evident from infancy and characterized by short-limbed dwarfism, a large skull with persistent fontanel, a receding chin, dental anomalies, frontal and occipital bossing, a small face, hypoplasia of the angle of the mandible, a parrotlike nose, and mild exophthalmos. There is osteopetrosis with increased bone fragility, increasing the risk for fractures, especially of the lower extremities, as was the case with Toulouse-Lautrec. It is an autosomal recessive osteosclerosing skeletal disorder caused by mutations in the CTSK gene, located at 1q21, which codes for cathepsin K—a lysosomal cysteine protease.6 Mutations in this gene affect the metabolism of the skeletal system, resulting in a disorder of bone resorption and remodeling and craniofacial abnormalities. Confirmation of Toulouse-Lautrec’s diagnosis awaits DNA analysis; however, pycnodysostosis remains a likely diagnosis.7

Toulouse-Lautrec’s life raises questions about the meaning of disability and its treatment. If treatment were available, how might it have affected Toulouse-Lautrec’s art? Would he have lived a privileged country lifestyle like his father’s and never have become an artist? His disorder affected his relationships with his family and others and shaped his personality. This may have resulted in the objectivity that allowed him to chronicle life in Montmartre, and its excesses, during the Belle Epoch.

References
1.
Fréches  CFréches  J Toulouse-Lautrec: Scenes of the Night.  New York, NY Harry N. Abrams1994;
2.
Thompson  RCate  PDChapin  MW Toulouse-Lautrec and Montmartre.  Princeton, NJ National Gallery of Art in association with Princeton University Press2005;[Exhibit, July 16 to October 10, 2005, Art Institute of Chicago, Chicago, Ill]
3.
Frey  JB Toulouse-Lautrec: A Life.  New York, NY Viking, Penguin Books1994;
4.
Rose  J Mistress of Montmartre: A Life of Suzanne Valadon.  London, United Kingdom Richard Cohen Books1998;
5.
Maroteaux  PLamy  M The malady of Toulouse-Lautrec.  JAMA 1965;191715- 717PubMedGoogle ScholarCrossref
6.
Ho  NPunturieri  AWilkin  DSzabo  JJohnson  MWhaley  JDavis  JClark  AWeiss  SFrancomano  C Mutations of CTSK result in pycnodysostosis via a reduction in cathepsin K protein.  J Bone Miner Res 1999;141649- 1653PubMedGoogle ScholarCrossref
7.
Maroteaux  P Toulouse-Lautrec’s diagnosis [reply, Frey JB].  Nat Genet 1995;11362- 363PubMedGoogle ScholarCrossref
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