Trousseau's Syndrome in 19th Century Qing Dynasty Paintings of Breast Tumors: Early Insights into Cancer and Thrombosis Risk

“No. 35,181, March 25th, 1850. Steatomatous tumor, nineteen and a half inches in circumference. Li Shi, age 43, of the district of Pwanyu, had a steatomatous tumor, which 17 years since commenced just above the clavicle on the left side. When she presented herself at the Hospital, it had attained the abovementioned dimensions, and hung pendulous down into the axilla and over the breast, descending nearly to a level with the umbilicus. Its surface was traversed by large veins…” ([Fig. 1]); so wrote Dr. Peter Parker (1804–1888), a medical missionary and ordained Reverend, in the medical case notes of the 16th report of the Ophthalmic Hospital (present day Second Affiliated Hospital of Sun Yat-sen University, Guangzhou; Guangdong, China). Complementing the surgical description of the breast tumor was a vivid portrait of Madam Li, executed in an oil painting by Lam Qua (1801–1860), a western-trained Chinese painter. Although the primary purpose of the paintings was for visual testimony of Parker's missionary enterprise and medical skills, Lam Qua's rendition of images is a sobering portrayal of human suffering and the affliction of disease in 19th century Qing Dynasty, China.[1] The collaboration of Dr. Parker and Lam Qua reflected in the paintings of Parker's patients capture a pivotal period before the widespread use of photography for medical documentation.