As Medgadget reports, "Several years ago, psychiatrist Andrew Levitas and geneticist Cheryl Reid made an interesting discovery:
[They] identified a 16th-century Flemish Nativity painting in which one angelic figure appears distinctly different from other individuals in the painting with an appearance of Down syndrome. . . . This may be one of the earliest European representations of Down syndrome.
The British Medical Journal elaborates:
The 1515 Flemish painting, by an unknown artist, . . . shows an angel (next to Mary) and possibly one other figure, the shepherd in the centre of the background with the syndrome.
"If our diagnosis is correct, this implies that Down's syndrome is not a modern disease," say [Levitas and Reid] (American Journal of Medical Genetics 2003;116:399-405).
The diagnosis of Down's syndrome in the angel was based on a number of features: a flattened mid-face, epicanthal folds, upslanted palpebral fissures, a small and upturned tip of the nose, and downward curving of the corners of the mouth. The hands, crossed over the breast, have short fingers, especially on the left.