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In 1516, Giulio di Medici, then bishop of Narbonne in southern France at the cathedral of St. Lazarus and
future Pope Clement VII, commissioned for his church The Transfiguration (Fig. 8) from painter Raphael de
Sanzio, a native of Urbino, Italy. At that time, the beginning of the Renaissance, there was considerable
upheaval, both from within and from outside, in the Christian world. The Catholic Church was at that time
threatened by the progression
of the Ottoman Empire. The ordering of a painting of the transfiguration had a sense of glorification in this
setting as the celebration of the transfiguration had been scheduled on the Christian calendar on August 6,
anniversary of the victory against the Turks at Belgrade
in 1456.

Giulio de Medici commissioned this painting for St. Lazarus Church in Narbonne. The saint of this church,
Lazarus of Bethania, had been resuscitated by Jesus (John XI.1–43), and it is interesting to learn that Giulio de
Medici ordered, at the same time and for the same church, The Raising of Lazarus from Sebastiano del
Piombo [14,15]. (Sebastiano was supported by Raphael’s admired rival Michelangelo, so Giulio de Medici might
well have created some competition.) The symbolic meaning of the name of the powerful Medici family (medici
is the plural of medicus, which is Latin for ‘‘physician”) adds a connotation of healing to this painting.

In the same year Giulio de Medici ordered The Transfiguration, the Lateran Council ended and Luther’s theses
were proclaimed in Wittenberg. Meanwhile, in Rome, two spiritual movements opposed each other: on the one
hand, the Neo-Platonic humanistic concept of Christian spirituality, in which man seeks mystic unity with God
by his own means, and on the other hand, the movement of Divine Love, in which mystic unity is not a result of
personal struggle, but a gift from God to man. The way to receive this gift is total devotion void of intellect
and abandon of oneself. Giulio de Medici’s predecessors on the papal throne, Giulio II and Leo X,favored the
Neo-Platonic vision, whereas Clement VII was close
to the Divine Love movement.

Raphael’s personal position on this question evolved with time [16]: initially close to Neo-Platonic ideas, he
ultimately adopted and expressed in later paintings the Divine Love concept of spirituality. In March 1514, in
his hometown of Urbino, he joined the company of Corpus Domini and shared friendship as well as
spiritual exchange with Sadolet and Giberti, two influential members of the Oratoria Amor Divinus.

On Holy Friday in 1520, on his 37th birthday, Raphael died. The painting was then almost but not completely
[17,18] finished. It is now exhibited in the Vatican Museum. Raphael was a much appreciated painter during his
lifetime and he had a workshop with students who finished certain commissions according to his
plans. However, the detailed study of the painting technique [17–19] in The Transfiguration supports the idea
that the painting was almost completely painted by his own hand, thus highlighting the importance he himself
granted to that work.

True, the transfiguration and the healing of the boy with epilepsy have both been subjects of various medieval
paintings serving primarily as a visual document. Raphael’s The Transfiguration exemplifies the evolution of
this
type
of
scholastic
painting
with
mnemonic
function [20] to Renaissance painting with a mainly rhetoric function. Giulio de Medici had commissioned The
Transfiguration, but Raphael’s genius went further by bringing together in one single painting two verses from
the Bible that the three evangelists relate in exactly the same order. For an artist to go beyond a precise
commission by the Medici in such a way he needed to have a lot of nerve, a strong conviction, a vision. One of
the reasons for the revolutionary idea might be that the healing of the boy with epilepsy exemplifies the vision
of healing through pure faith in God and his might. The healing relieves the human being in his most miserable
state, possessed and ‘‘as dead.” Not one of the apostles sees the transfigured; only the possessed boy with one
eye and two ‘‘minor,” humble and devoted spectators on the upper left, who might be St. Felix and St. Agapit
[21: quoted by 16, Ref. 62] kneeling in an attitude of simple devotion, see the transfigured.

The mutual interdependence of the two parts of this painting has been recognized, for example, by writers
(Goethe) [22], philosophers (Nietzsche) [23], and epileptologists (Janz) [24]. We can be sure that this
innovation, this contraction of two verses in one painting, is not innocent but corresponds to a specific concept
that we are now going to study, and in doing so we will pay particular attention to the transfigured son and the
seized son. Jesus takes Peter, James, and John with him up to the mountain where he is transfigured, while a

voice comes from the heavens: ‘‘This is my beloved son who has my blessing, listen to him.” Jesus announces
his passion and the three Apostles hear with great surprise and disbelief of their Master’s future crucifixion.
While descending from the mountain Jesus meets a crowd that has awaited him. A man comes up to him and
cries (St. Luke):

"Master, I beg you to look at my son, for he is my only child. And behold, a spirit seizes him, and he suddenly
cries out. It convulses him so that he foams at the mouth, and shatters him, and will hardly leave him. And I
begged your disciples to cast it out, but they could not."

In the upper part of the painting, which is both bright and serene, we can see Jesus transfigured, and the
Apostles seem to be carried by a divine breath. The bottom half of the painting, more somber and turbulent, is
separated by a diagonal that opposes the group of Apostles on the left to the one on the right in which we can
recognize the epileptic child and his family.
As for the two main characters, Janz [24] has described the subtle links between the young man and Jesus:
‘‘They are the only two characters among the 26 represented in whom we see the two eyes. Christ’s look is
lost in the beyond while the eyes of the young boy are bulging, the right eye directed towards Jesus and the
left one towards his father.”

Behind Christ, the light of the cloud reminds one of the divine voice that asserted he was the beloved son,
while the son’s mouth lets out that epileptic scream from which, as Dostojevski said, ‘‘suddenly all human
element disappears” [25]. So, the vision is doubled by two vocal manifestations, a divine and an evil one.

Jesus has just had a sublimation, in absolute contrast with the child who is possessed by an evil spirit who
‘‘throws him on the floor; he foams at the mouth, grinds his teeth and becomes stiff” (St. Mark); thus, ‘‘he
falls into the fire and often into the water” (St. Matthew).

Lastly, Jesus and the child are the only figures whose bodies form a cross.

There is a painter who clearly grasped this unity between the transfigured and the defaced. That painter is
Pieter Paul Rubens. In 1600, at the age of 23, he went to Italy for the first time, and Vincent Gonzagua in
Mantua became his patron. He sent him to Rome to carry out copies of major works, to perfect himself in
Italian art. In this context Rubens painted toward 1604 a baroque interpretation of the The
Transfiguration (Fig. 9), which added dynamics and a horizontal composition to the originally vertically
oriented Renaissance work.
As in Raphael’s work, Christ is dressed in white. In the Bible, the three evangelists insist on the white. St. Mark
was the most explicit: ‘‘his clothing became radiant, of such a tone of white that no fuller on earth could
whiten it to this point.” This dazzling white, enhanced by the Divine light, offers to our eyes not only Jesus but
the twisted body of the boy with epilepsy as well, as he in turn looks toward Christ. Rubens says with color
what Raphael expressed in structure—that there is a link between Christ and the boy with epilepsy. But what is
the nature of this link?

One of the characteristics of the shape of the boy is the contrapposto pose, a pose used in Renaissance painting
to represent the rhetorical figure of antithesis [14,26]. If the boy is the antithesis down on the dark and
tormented
earth,
clearly,
Jesus
represents
the divine thesis up in the bright and serene heaven.

The position of Jesus’ arms and left foot (Fig. 11) reproduces the shape of the letter s (tau), the last letter in
the Hebrew alphabet, which was associated in Christian symbolism to the saving cross. It would symbolize
death conquered by sacrifice [27].

The boy is represented in a posture that can be encountered in a frontal lobe seizure [28,29]. This is
fascinating to epileptologists, but I am not aware of any source suggesting that Raphael personally observed

someone
with
frontal
lobe
seizures,
and
admittedly,
the chances are few. It might be more significant to argue that both the boy and Jesus are figured at the
climax of their respective fate (transfiguration, seizure).

The boy’s arms are in the shape of a cross, and if we take into account the position of the left leg (Fig. 11), we
find the shape of the Greek letter v, which resembles the letter X of our alphabet. The v corresponds to the
first
letter
of
the
name
of
Christ.
Used
alone,
but especially superimposed over the second letter in Christos, the Greek q (rho), the v forms a Christogram,
the Chrismon (Fig. 10).

The v evokes Christ, thus replacing his image. For example St. Paul recommended beginning any action with a
prayer or an invocation of the Lord, and this was established very early in Christian tradition. In written form,
this invocation of the Lord could be expressed by a phrase or by a Chrismon, the qv in most cases. This
monogram became widely used after the victory of Constantine over Maxentius in 312 AD, when he had a cross
painted on soldiers’ shields after he was told to do so in a dream (hoc signo vinces) [30,31].

Nevertheless, Raphael did not paint the Chrismon as such; dramatizing his painting he staged the boy himself in
the shape of a v cross and Jesus in the shape of a s cross (Fig. 11) symbolizing their partial identity.

The hypothesis emerges that the son with epilepsy, who implores with his look the Son of God, symbolizes
through
his
posture,
which
combines
the
posture
of
a
motor
seizure
and
a
v
cross, the latter’s future Passion. This pathic identity has yet another dimension, because, as the Bible tells us,
the boy will arise after his seizure, as will Christ in the dynamics of his resurrection.

Aside from the medical (epileptic seizure as a transient form of death) and religious (v cross as a
representation of Christ) arguments, data from art history support this interpretation of the boy with epilepsy
prefiguring the Passion of Christ: there is what is painted by default, like a sort of negative of a painting. The
fact, not to mention the evidence, is a known artistic technique. In The Transfiguration Raphael, for example,
does not represent God himself, but only suggests his presence through the cloud out of which we imagine the
Lord’s voice. Our next example is less obvious, but presumably seen and recognized by well-instructed
Renaissance noblemen and cardinals attending the Vatican court, where discussing and interpreting paintings
constituted a much appreciated activity. We have already mentioned the lower diagonal, a strange vacuum in
which there exist nevertheless, directions, structured by arm movements and positioning. Among these, one
structure becomes apparent if we refer to an early ca. 1503 painting of Raphael, The Crowning of Mary (Fig.
12). The main composition of this painting already announces that of ‘‘The Transfiguration.” The sarcophagus
around which the Apostles are grouped has to be kept in mind when looking again at The Transfiguration (Fig.
13) [32] in which we find it, this time as a negative with Jesus above it, in the air, that is, resurrected.

4. Conclusion

This article started with the self-description of a seizure of a young patient who first underwent his seizures as
a self-experience of death. The disruption of the continuity of life is the hallmark of the epileptic seizure, as
the crucifixion is the hallmark of the life of Christ. With time and experience, our patient wonders if the
epileptic seizure is rather an experience of birth. The idea of death as the nadir of a movement leading to
rebirth is a concept expressed by various writers and philosophers and put into poetic form by Goethe in his
last major collection of poetry, the West-östlicher Diwan, or West-Eastern Divan [33]:

"Und
so
Dieses:
Bist
du
Auf
(And
so
long
this,
You
will
on this dark earth)

lang
Stirb

du
nur

ein

der
as
‘‘Die
only

das
und

you
be

dunklen
have
and
a

nicht

hast,
werde!
trüber
Gast
Erde."
not
attained
it,
become!”
gloomy
guest

In Raphael’s vision (Fig. 8), the young boy with epilepsy represents in his oscillatory relationship with Jesus a
metaphor of the Passion, of the end and also of the resurrection of Christ. United in their opposed and yet
similar fates, the Son of God is tinted with human experience and the boy with a Divine experience.
The Transfiguration is the culmination of a long-standing iconographic tradition which was masterly surpassed
by Raphael. There is no known later equivalent to this subject. One of the reasons might be the fact that
medical reasoning, however imperfect, by and by supplanted spiritual interpretation. The first book of modern
times on cerebral diseases (De Cerebi Morbis, Pratensis) was published in 1549. It mentions convulsions and
describes epilepsy as attached to ‘‘both the sense and the feelings of the head and also of the mind” [2].

Acknowledgments
Particular thanks go to Colum P. Hourihane from the Princeton Index of Christian Art for iconographic
assistance and to Ph. Auliac, Hospital St. Anne, Paris, for technical assistance digitalizing the iconographic
material.

Appendix
A.
Supplementary
data
Supplementary data associated with this article can be found, in the online version, at
doi:10.1016/j.yebeh.2009.10.006. Colour reproductions of this article are found on the website of Epilepsy and
Behaviour.

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