A Down Syndrome Angel.

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.

I agree with the BMJ but the figure is surely not an angel. The people paying for the painting usually had them painted on it, so IMO the *angel* is just family.
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What Chris??!! An actual angel didn't grace this earthly plane and sit for a group portrait?? No way!!

Fascinating stuff otherwise. Helped kick-start the brain this morning.
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Actually I think what Chris means is that the figure wasn't intended to represent an angel, but rather a random kid from the family that commissioned the painting. I wouldn't want to make a judgment on that without seeing the painting in color and at a better resolution. I'm assuming that the people who studied the painting had a better perspective than we do with the small B&W reproduction.
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Whoah. I'm totally fascinated. Regardless of whom the Down Syndrome figure actually represents, its amazing to see someone with this syndrome truthfully and positively represented in such a portrait of that era. I mean, when ya think about it, the 16th century must of been a harsh time for anybody with such a disability. Not understanding such an affliction, perhaps, the family would be distressed so see an infant displaying those characteristics upon birth. One could imagine that these infants were turned away by families, or even worse being the subject of infanticide, if not loved and cared for. Some cultures might of even viewed such syndromes as the work of evil or the devil. Anyway, back on the subject of paintings and portraits; Perhaps when families commissioned portraits they would instruct the artist to portray the disabled individual as "normal", thus the absence of such works of art as we see here (By the way I am not inferring that the painting above represents a family).
Anyway, yeah, nice picture.
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Uh, I think the experts are jumping the gun. I think most of the people in the painting (but not all), have similar facial features... I'd guess that was just the artist's style for drawing women or softer features - and certian people done in his style end up looking like Down's Syndrome people. I could be wrong, but if so, most of the other people in the painting seem to have odd faces to me.
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" '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)."

Well no duh! Who thought this was a modern disease? That makes no sense. I always assumed that it was just a human genetic condition that always existed.
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Citizen Politician, this quote from the article explains the reason behind the "modern disease" comment:
Given the distinctive phenotype and prevalence of Down syndrome in the modern era, a number of authors have sought historical evidence of individuals who lived before its initial recognition, particularly in Renaissance and earlier art. Interchanges among various authors were published in the Lancet in 1968. Mirkinson [[1968]] hypothesized that Down syndrome was a modern disease, given its apparent rarity in art, and challenged others to find historical depictions of the disorder as evidence against.
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The depiction of divine beings with Down Syndrome features isn't new. There are several examples in Gothic and Renaissance art of "typical angellic features" which have an uncanny resemblance to Down Syndrome features.
Reims cathedral has a statue that stands out in my mind.
There is also one at the met from France that seems to resemble the Reims example.
There are also the giant Olmec heads...
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I like what swallowtail said and agree it must have been hard. And I'm not an expert, but if this were the case that people with down syndrome were thought to be a work of evil or devil children, why would one be in a nativity painting, or that one would pose and sit still for a painting. And why would an artist choose to include an angel with down syndrome in the painting? I took a closer look and the person does in fact have wings and appears to have down syndrome.

Just curious.
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Different communities interpreted their behavior and appearance in different ways. One town might decide that a "different" child was demonically possessed, where another just down the road would decide that such a child was saintly or angelic. Most ordinary people rarely traveled more than a couple of miles outside their own towns, and most of them didn't read or have access to information sources which could explain these things to them, so when an anomaly appeared they ended up interpreting it in a good way or a bad way depending on the makeup of the community, etc.
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It would be cool if it was a family member with Down Syndrome included in the painting. My guess is it's just a poorly-drawn "ordinary" child, probably a family member, since that's what artists did.

The whole "modern disease" business is BS. Do they really need to disprove someone's silly comment from 1968? At that time, we were still coming out of our own dark ages in our attitude towards Down Syndrome, freeing people from being strapped to beds in mental institutions.

Loved the first few comments, by the way. But, how do you know that people with Down Syndrome aren't angels?
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I think the response to the 1968 comment was a side issue. They were mainly interested in showing that the distinct constellation of physical features was recognized at the time.
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I find it amusing that the term for the medical condition changes every 25 years or so to avoid offending somebody. In the US, it is now "Down Syndrome" whereas we formerly called it "Down's Syndrome", which most of the rest of the English-speaking world still uses. As a kid growing up, it was the same genetic condition (not a disease... I'm surprised the American Journal of Medical Genetics considers it a disease!), but those with it were respectfully called "Mongoloid" even by their loved ones -- the term was not in the perjorative. Before that, medical books in the early 20th century used "Mongolian Idiot", something that would make our politically correct modern selves cringe, but was perfectly accepted and not considered offensive.

I'm not taking sides on what the term should be, but ANY classification of people in what is perceived to be suboptimal or least-favored conditions (economic status, minority ethnicity, race, mental intelligence, whatever) soon gets morphed into some new term that lasts for a couple decades until people decide that the new name doesn't truly cure anything or even alleviate any suffering, so they try yet another NEWER name. And so it goes... You can bet "Down Syndrome" will be replaced by something else in 20 years...

As another note, many folks justify the switch from Down's --> Down, because Down himself didn't actually have the syndrome, and merely described it in a scientific manner. Well, that applies to Alzheimer's Disease, Parkinson's Disease, Crohn's Disease, Asperger's Syndrome, Kleinfelter's Syndrome &c. Are we going to rename all these as well? The number of medical conditions named for those who first studied them is endless! What foolish semantics -- an utter waste of effort on meaningless feelgoodedness.
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The World Health Organization passed a ruling that disorders, such as Alzheimer Disease, Down syndrome, etc, should have the possesive removed from them. The disorders do not belong to those people. That was at least how it was explained to me. So it doesn't just count for Down syndrome.

Also, a lot of people don't want to call it Down syndrome because Dr. Down was a horrible person. Only English speaking countries still call it Down syndrome. Most of the rest of the world calls it Trisomy 21. (As Down syndrome is the result of a third 21st chromosome.)
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There was a tradition of naming diseases and other medical conditions after the person who first described them in the medical literature. At present, we still say
Alzheimer's Disease, Parkinson's Disease, Crohn's Disease, Asperger's Syndrome, etc., as Sid points out, although Down's has gone out of favor. I don't think anyone ever thought the diseases "belonged" to the person who they were named after. That's a linguistic argument that makes no sense to me so I see it as Sid does, changing fads and fashions. Something that sounds fine in one era sounds horrible to another.
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World Health Organization = United Nations = loss of sovereignty.
Count me out.

As for Down himself being a "horrible person", that is the first time I've heard that. Curious, I looked him up on Wikipedia. It makes no such claims and in fact says:
1. He quite liberally supported the higher education of women.
2. Was concerned that all children with any mental incapacity were regarded as beyond help.
3. During the American Civil War, he refuted apologists for Negro slavery and supported the concept of unity of mankind.

Yes, he used terms like "idiot" and "Mongolian Defective", but these were legitimate medical terms of the day, not perjoratives!

Perhaps he did have some feelings of racial difference which would be today be considered bigoted, but nearly EVERYONE felt this way in that day, including the most progressive supporters of reform. It's really quite unfair to judge people on the standards of our era, over 100 years later. If we do, we should likewise impugn Washington, Lincoln, Gahndi, Churchill, and other great men of history. People must be judged in the context of their own time.

If you have some specifics on his "horribleness", you ought to back it up. As near as I can tell, he worked to help "idiots" at a time when everyone thought him daft for doing so. What horrible things did he do?

As for "Trisomy 21", I didn't know the term! Thanks for educating me on that, but it simultaneously confirms my hypothesis about the unending name-changing. Now parents can tell friends that their kid has "trisomy 21". It sounds better because not many people are familiar with it yet. In 20 years we'll call it something different (again). If liberals can't cure a disease/syndrome (or end crime & poverty), they rename it and feel better about themselves for making the original problem go away. Better to spend the effort helping the people with it live normal, rewarding, productive lives than doing linguistic semantics.
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If you read the paper (Am J Med Genetics, 2003, (116(4)),399-405) you will find that:
1. This is a picture of an individual with Down Syndrome, depicted as an angel (not an angel with Down Syndrome).
2. It is not only the facial features that identify the syndrome, it is also the small hands (another characteristic of the syndrome), markedly different from all the other hands in the picture.
3. The reason it was important to question whetheror not Down Syndrome was a "modern disease" in 1968 was this: It was long known that babies with Down Syndrome were more commonly born to mothers 40 or older. The discovery of the Trisomy 21 was only a few years old, and not universally accepted, in part because it did not explain the association with advanced maternal age. If it could be shown that Down Syndrome existed before many children were born to mothers over 30, it would add to the weight of evidence for the trisomy as the cause.
4. The medical science of the 16th century and earlier did not associate dysmorphic features with intellectual disability. We cannot know how the other people in this picture (a patron's family? the artist's family? we do not know) regarded this child. Favorably enough to have included him or her in the picture, is all we can know.
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Very interesting point about the time line. The fingers and various other features are also mentioned in the BMJ article above. And I'm sure, as I pointed out above, that no one thinks the painter had a REAL ANGEL sit for him.
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Just a thought to add to the mix. It is possible that the child/angel in the picture represents a child that passed away before the painting was completed or even comissioned. As a mother of a daughter with Downs (a.k.a. T21) I can see the features clearly in the painting, although I wish I could see a bigger version. Since the painting was completed in 1515, obviously we can only guess, but regardless of the meaning or specifics, it is intriguing and frankly endeering to see him/her portrayed.
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The model was a child with Down Syndrome, clearly. The inclusion of such children shouldn't be a surprise. Such people would not have been as out of place in that society, since I would imagine most people back then could only just read and write and do basic mathematics at what we might consider an elementary level, unless they were scholars or merchants. So someone who was a bit "slow" would only be slightly below the average curve. People with Downs can be just as social and funny and creative as "normal" folks. Someone with unusual features might have gotten a few second glances, but I imagine for the most part, they were just considered a little "slow" or "awkward" but still could be a productive part of that society.
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EVERY ONE SHOULD READ THE BOOK WRITTEN IN THE 1950'S BY DALE EVANS ROGERS ENTITLED, "ANGEL UNAWARE". This is a message we should all receive. People with Down Syndrome are ANGELS on EARTH with their love of simple things, CHRISTIAN LOVE FOR ALL and it is so obvious to me since my daughter has Down Syndrome and she is nothing but an ANGEL! Rebecca Mann
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I am also a mother of one of these 'earthly Angels'and do not understand why so many of you are at odds with the idea that these children could be represented in art. My daughter reminds me everyday of what is truly important in life. Angels are interpreted as beings of pure love. How do we know that the rest of us are SHORT by one chromosome????
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