The Isenheim Altarpiece (c. 1512-1516)

To understand the Isenheim Altarpiece, one must first forget the museum and picture a hospital ward of the early sixteenth century. It is there, and not in a gallery, that the work takes on its full meaning: it was conceived for the sick, by monks whose very vocation was to care for them.

The Order of the Antonites

The Canons Regular of Saint Anthony, or Antonites, were a hospitaller order founded at the end of the eleventh century (c. 1095) in the Dauphiné, around the relics of Saint Anthony the Great, the father of the monks of Egypt.^[7][8] Their charism was precise: to welcome and treat the victims of a terrifying scourge that ravaged medieval Europe, the burning sickness. Placed under the protection of the great ascetic of the desert, they had made him their patron and intercessor.

Called to Alsace by the Habsburgs, the Antonites settled at Issenheim in 1298 and developed there one of the most important preceptories of northern Europe. Its peak came at the end of the fifteenth and the beginning of the sixteenth century, under two builder-preceptors: Jean d'Orlier and Guy Guers (Guido Guersi).^[9] It was the latter who, c. 1512, commissioned from Grünewald the painted panels meant to cover and transform the carved shrine already in place.^[10]

"Saint Anthony's fire": ergotism

The Saint Anthony's fire — other names: burning sickness, ignis sacer ("holy fire") — is what modern medicine calls ergotism.^[11] Its cause, long mysterious, was elucidated much later: rye, the cereal of the poor, could be colonised by a parasitic fungus, rye ergot (Claviceps purpurea). Ground with the grain and eaten in bread, ergot released alkaloids (including ergotamine) which caused violent vasoconstriction of the blood vessels.^[12][13]

The effects were appalling. Limbs, deprived of blood, burned with unbearable pain, blackened, then became gangrenous until they detached from the body; ulcerated pustules covered the skin; and the poisoning was often accompanied by hallucinations and convulsions. Hence the name of the burning sickness: the sick had the feeling of being devoured by an inward fire.^[14] Not knowing the cause, the sick were sometimes taken to other places — where, no longer eating the contaminated bread, some recovered: according to a common hypothesis among historians of medicine, this change of bread could favour such recoveries, which were attributed to the intercession of Saint Anthony.^[15]

An image to heal and console

The Antonites possessed a genuine hospitaller knowledge. A balm made of lard steeped with medicinal plants was applied to the wounds, and the sick were given to drink the holy vinage — or Saint Anthony's wine —, a wine in which relics and herbs had macerated.^[16] But the care of the body never went without the care of the soul.

As soon as they arrived, the sick were led before the altarpiece. It was hoped that Saint Anthony would intercede to obtain a miracle; and, failing that, that the sick person would find in the contemplation of the painted scenes a comfort and a consolation.^[17] This is the key to the whole work: the Isenheim Altarpiece is not a chapel decoration, it is a spiritual therapeutic instrument, conceived for men and women who watched their own flesh rot. Grünewald painted for them.

The altarpiece is the combined work of two masters and two arts: sculpture first, painting afterwards. The core of the ensemble — the central shrine with its gilded figures — was carved c. 1490 by a Strasbourg sculptor; the painted wings that envelop and transform it were added some twenty years later by a painter of genius long left in the shadows.

Mathis Gothart Nithart, known as Grünewald

The painter we call Grünewald never named himself so. His real name is Mathis Gothart Nithart, born probably c. 1475-1480 in Würzburg and died in 1528 at Halle.^[18] The name "Grünewald" was attributed to him by mistake in the seventeenth century by the historian and painter Joachim von Sandrart (1675), and usage has kept it.^[19] From 1511 onwards, he was court painter to the archbishop-elector of Mainz.

His work, almost entirely religious, deliberately ignores the classical elegance of the Italian Renaissance to prolong, bringing it to its height, the Gothic expressiveness of central Europe. He is a painter of drama, of supernatural light and of suffering flesh. Very little of his work has survived: barely ten paintings and some thirty drawings.^[20] Forgotten for centuries — to the point that his panels were for a time attributed to Dürer —, he was truly rediscovered only at the end of the nineteenth century, when his emotional intensity overwhelmed moderns and romantics. The Isenheim Altarpiece is, by far, his masterpiece.

Niclaus of Haguenau, the sculptor

The sculpted heart of the ensemble — Saint Anthony enthroned between Saint Augustine and Saint Jerome, and the predella of Christ surrounded by the twelve Apostles — is the work of Niclaus of Haguenau (Nicolas of Haguenau), one of the great wood sculptors of Strasbourg, active at the end of the fifteenth century.^[21][22] These figures of polychrome and gilded limewood, executed c. 1490, already formed on their own an altarpiece worthy of a great sanctuary. Grünewald did not have to replace them: he enveloped them, giving them as a setting painted wings which, when closed, hid the gold of the sculpture behind the night of the Cross.

Two generations, one theology

The twenty-year gap between the sculpture and the painting is no accident: it reveals how a great altarpiece was built in stages, as means and successive preceptors allowed. Jean d'Orlier had had the shrine raised; Guy Guers had it completed and magnified by painting.^[23] The result is of perfect spiritual unity: the two artists, a generation apart, serve the same faith and the same sick person — the one who, from the depths of his pain, raises his eyes to the image.

The singularity of the Isenheim Altarpiece lies in its mechanism. It is not a fixed image, but a transforming polyptych: a set of hinged panels that were opened and closed according to the liturgical season. Like a book one unfolds, the work offered three successive faces, from the darkest to the most glorious.^[24][25]

The simplest image is that of a cupboard with several superimposed doors. At rest — this is the first view —, the altarpiece is closed: one sees only the Crucifixion and the saints flanking it. Opening the first wings reveals the second view, luminous, dedicated to the joyful and glorious mysteries. Opening further reaches the third view, where the gilded sculptures of Saint Anthony and the panels of his life appear.

This progression was not decorative: it followed the calendar of the Church. The altarpiece remained closed on the Crucifixion on ordinary days and in penitential seasons; it opened onto glory on the great feasts of Christ and the Virgin; and it disclosed its sculpted heart on the feast of Saint Anthony.^[26] The sick person thus saw the image change through the year — pass from shared suffering to the hope of healing and glory. The very form of the altarpiece preached.

Closed, the altarpiece presented to view the most famous scene of all German painting: Grünewald's Crucifixion. Against a night background, in a desolate landscape, rises an oversized cross on which hangs a titanic and tortured Christ. Nothing in the history of art has shown the Passion with such crudeness nor such compassion.^[27][28]

A Christ covered with wounds

The body of the Crucified is of unbearable realism. The skin, greenish and livid, is studded with wounds, splinters and pustules; the fingers clench and twist in a last spasm; the head sinks, crowned with thorns; the weight of the body bends the crossbeam of the cross. This Christ does not look like a serene hero: he looks like a sick man, like one plague-stricken, like a man eaten away by the burning sickness.^[29][30]

The choice is theological, not morbid. By showing a Christ with wounds like their own, Grünewald told the sick of the hospital one precise thing: the Son of God has known your sickness. He is not a distant God, untouched by pain, but the one who "has borne our griefs" (Isaiah 53:4). Before this image, the sick person could recognise himself in Christ, and recognise Christ in himself.^[31][32]

"He had no beauty or majesty to attract our gaze… Despised and rejected by men, a man of sorrows and acquainted with grief… Surely he has borne our griefs and carried our sorrows." — Isaiah 53:2-4, the song of the Suffering Servant^[33]

John the Baptist and the Lamb: "He must increase"

To the right of the cross, in an impossible posture — for he had died before the Passion —, stands Saint John the Baptist. Grünewald places him there outside time, as a theological witness. With his excessively long finger, he points to the Crucified; at his feet stands the Lamb bearing the cross, whose blood flows into a chalice; and above his hand runs a Latin inscription in red letters:^[34]

"Illum oportet crescere, me autem minui." "He must increase, but I must decrease." — John the Baptist, according to the Gospel of Saint John 3:30^[35]

This pointing finger is the key to the whole work. The Forerunner does not draw attention to himself: he turns the gaze away from self to carry it to Christ. To the sick person tempted to shut himself up in his own suffering, the image teaches the same movement: look towards Him. The lamb with the chalice recalls that this death is a sacrifice — that of the Agnus Dei "who takes away the sin of the world" (Jn 1:29) — and that the blood shed is the very blood received in the Eucharist celebrated on this altar.^[36]

The Virgin, Magdalene and John

To the left of the cross, the group of sorrow. The Virgin Mary, clothed in white, faints with grief, supported by Saint John the Evangelist, to whom Jesus had just entrusted her (Jn 19:26-27). At their feet, Mary Magdalene, kneeling, joins her hands in a gesture of desperate supplication, her jar of perfume set beside her.^[37][38] These figures give the beholder models of attitude: faith that falters but does not let go, love that supplicates. The sick person is not alone before the Cross: he enters it with Mary, John and Magdalene.

The wings: Saint Sebastian and Saint Anthony

On either side of the Crucifixion, two fixed wings present the two healing saints par excellence. On the left, Saint Sebastian, pierced with arrows — long invoked against the plague. On the right, Saint Anthony the Great, the patron of the Antonites, standing, serene, attacked by a small glassy demon that does not reach him.^[39][40] The two intercessors thus frame the Crucified: between the saints who protect from the scourge and the Christ who bears it, the sick person knows himself surrounded.

The predella: the Lamentation

Beneath the great scene, the movable predella depicts the Lamentation over the body of Christ taken down from the cross, watched over by the Virgin, John and Magdalene, before the entombment.^[41] A detail moving for the place: this predella could slide, so that the dead body of Christ seemed, by a play of panels, to be itself amputated — a discreet echo of the limbs the sick were losing. Down to its mechanism, the altarpiece wedded the condition of those who looked at it.

On great feasts, the wings of the Crucifixion were drawn aside. The night then opened onto a display of dazzling colours: three great panels celebrating the Incarnation and the paschal victory. The sick person who had meditated on shared suffering suddenly discovered the promise to which it leads.

The Annunciation

On the left, the Annunciation: the archangel Gabriel bursts into a Gothic chapel towards the Virgin kneeling at her book, while the dove of the Spirit hovers. This is the beginning of all: the Word becomes flesh in order to come and share — even to the cross — the condition of men. The presence of a prophet (Isaiah) in the vault recalls that this moment fulfils the Scriptures.^[42]

The Concert of Angels and the Nativity

At the centre, the most mysterious panel: the Concert of Angels and the Nativity, joined and as if separated by a curtain. On the left, beneath a flamboyant shrine, a cloud of angels as musicians — including a strange feathered figure — plays the viol to celebrate the birth of the Saviour. On the right, bathed in golden light, the Virgin holds the Child in her arms with infinite tenderness, amid a landscape where the sky opens onto the glory of God.^[43][44]

The contrast with the Crucifixion is deliberate: to the undone flesh of Good Friday answers the new flesh of the Child; to the black of the night of Golgotha, the gold and light of Bethlehem. The same body that suffers on the cross is here welcomed, cradled, loved. The image says that suffering is not the last word.

The Resurrection: the transfigured Christ

At the right, finally, the summit of the work: the Resurrection. In an explosion of light, Christ rises above the tomb, wrapped in a shroud passing from red to white then to gold, his face radiant like a sun. The guards, struck down, are thrown to the ground.^[45][46] It is one of the most extraordinary images of the Resurrection ever painted.

The decisive detail lies elsewhere: on the hands and feet of the Risen One, the wounds remain — but they are no longer bleeding injuries. They have become points of light, stars radiating glory. Grünewald painted, literally, the transfiguration of suffering: what was wound has become a source of light.^[47][48] To the sick person of Isenheim, the image said the unimaginable: your wounds too, one day, will be glorified; your mortal body will be "sown perishable, raised imperishable" (1 Cor 15:42-43).

"What is sown is perishable, what is raised is imperishable; what is sown in dishonour, what is raised in glory; what is sown in weakness, what is raised in power." — Saint Paul, First Letter to the Corinthians 15:42-43^[49]

The last opening, reserved for the feast of Saint Anthony (17 January), disclosed the sculpted heart of the altarpiece and two painted panels devoted to the life of the great hermit. It was the view most directly linked to the healing vocation of the place.

The sculptures of Niclaus of Haguenau

At the centre sits enthroned Saint Anthony the Great (c. 251-356), father of monasticism, in majesty, framed by Saint Augustine and Saint Jerome, two Fathers of the Church; at his feet, small donors and animals. Beneath the shrine, the carved predella shows Christ surrounded by the twelve Apostles.^[50][51] These gilded limewood figures, of great nobility, recalled that the healing asked of Saint Anthony is rooted in the communion of the Church and in Christ himself, source of all salvation.

The Visit of Saint Anthony to Saint Paul the Hermit

The left wing recounts an episode drawn from the tradition of the Desert Fathers: the meeting of Saint Anthony and Saint Paul the Hermit, in a rocky landscape of strange poetry, where a raven brings bread to the two old men.^[52] The scene celebrates the eremitical life — the very life the Antonites claimed as their own — and the Providence that feeds its servants in the desert.

The Temptation of Saint Anthony: "Where were you, good Jesus?"

The right wing is one of the most famous: the Temptation of Saint Anthony. The saint is thrown to the ground, pulled by the hair, assailed by a cloud of monsters straight from nightmare — figures of dread that seem to come out of the very visions of the ergotism sufferers.^[53][54] In the foreground, on the left, lies a creature with distended belly, limbs covered with ulcers and wounds: a striking depiction of a body eaten away by Saint Anthony's fire, painted from life.^[55][56]

Near this figure, an inscription bears the cry of the sick person — and of every suffering man:

"Where were you, good Jesus, where were you? Why did you not come to heal my wounds?" — Inscription of the Temptation of Saint Anthony (Ubi eras Iesu bone, ubi eras? Quare non affuisti ut sanares vulnera mea?)^[57]

This cry is overwhelming because it is allowed. The altarpiece does not censor the revolt of the sick person: it gives him words for it, those of lament to God — like the Psalms. But this lament, the work places within a whole: to the question "where were you?", the Crucifixion answers I was on the cross, covered with the same wounds, and the Resurrection, I shall be the light of your wounds. The Temptation is not the end of the road: it is the trial through which faith passes.

The Isenheim Altarpiece is not a mere masterpiece to admire: it is a painted sermon, a theology offered to the eyes of those who could not read. Its power comes from answering the hardest of questions — why do I suffer — not by reasoning, but by an image.

The God who shares suffering

At the heart of the work, an intuition profoundly Catholic: the Christian God is not an impassive spectator of human pain. By becoming incarnate, the Word took a true flesh, capable of suffering; and by dying on the cross, he wedded the suffering of men to its depths.^[58] The plague-wounded Christ of Grünewald is no concession to a taste for blood: it is the affirmation that "by his wounds we are healed" (Is 53:5).

This conviction is nothing abstractly consoling. To the sick person wondering whether God had abandoned him, the image showed a God who had crossed the same night. Suffering, without ceasing to be an evil, became a place of encounter: the sick person no longer suffered alone, but "with Christ", completing "in his flesh what is lacking in Christ's afflictions" (Col 1:24).^[59]

From wound to glory: the pedagogy of the altarpiece

The brilliant pedagogy of the altarpiece lies in its movement. It does not stop at the wound: it leads from wound to glory. The three openings compose a true spiritual journey:

• the Crucifixion: Christ shares your suffering;
• the Incarnation and the Resurrection: this suffering is not the last word, flesh is made for glory;
• Saint Anthony: intercessors and the whole Church pray with you.

And the transfiguration of the wounds of the Risen One — become light — is the ultimate answer: what you bear in your flesh is not lost, it will be glorified. The altarpiece does not deny evil; it inscribes it within the hope of the resurrection of the body.

A sacred image, not a mere painting

One must finally recall what this work was: not an art object, but a sacred image, set upon an altar, before which the Eucharist was celebrated and prayers said. Like the Eastern icon, it was a window through which gaze and heart passed to the mysteries depicted, without stopping at wood and colour. The honour given to the image "passes to the prototype": it was not the painting that was venerated, but Christ, the Virgin and the saints it makes present.^[60] On the dogmatic foundation of this veneration — the Incarnation, the distinction between veneration and adoration —, see the theology of the icon and Byzantine icons.

A word, finally, on Grünewald himself. He has been credited with sympathies for the nascent Reformation, and he left the service of Mainz in the troubled years of the Peasants' War.^[61] But his masterpiece remains a work fully Catholic in function and theology: an altarpiece, peopled with interceding saints, the Virgin and the Eucharistic Lamb, conceived for the prayer of monks and the comfort of the sick. Art here outran and outgrew the quarrels of its time.

The altarpiece remained nearly three centuries in the Antonite chapel of Isenheim. But the order itself was declining: the canons of Saint Anthony were suppressed and united to the Order of Malta in the 1770s, and the community of Isenheim dispersed.^[62] The French Revolution sealed the fate of the work.

From the Revolution to the Unterlinden Museum

In 1793-1794, in the revolutionary turmoil, the altarpiece was dismantled and its panels sheltered at Colmar to preserve them from destruction and pillage.^[63][64] Regarded as a national treasure, they were first kept in the library, then installed in 1852-1853 in the former Dominican convent of Unterlinden, become a museum — where the work has been since.^[65] It is there, in the nave of the former convent chapel, that the polyptych is presented today, its various wings taken apart so that the three views can be seen simultaneously.

Wars and restoration

The work went through the two world wars not without perils. Transferred to Munich from 1917 to 1919, it returned to Colmar. During the Second World War, it was sheltered far from the front, notably at the castle of Haut-Kœnigsbourg and at Hautefort, before its return to the museum in 1945.^[66][67] Finally, from 2018 to 2022, a complete restoration, carried out in the museum itself before the eyes of the public, gave back to it the radiance of colours long darkened by old varnishes.^[68] The Isenheim Altarpiece remains, by far, the treasure of the Unterlinden Museum and one of the most visited works of Western art.

Five centuries after Grünewald, in a world that hides sickness, pushes back death and flees suffering, the Isenheim Altarpiece keeps a burning relevance. It first recalls that Christian art was never afraid of suffering flesh: not from complacency, but because it is precisely there, in the wound, that Christ willed to meet man.

It then bears witness to a Christian way of accompanying the sick. The Antonites did not separate care of the body and care of the soul: alongside balm and wine, they offered an image that gave meaning to pain and opened a hope. The altarpiece is, in this sense, one of the oldest monuments of what would today be a pastoral care of the sick — a care that never abandons man to his mere biology.

It finally states the essential of faith: that suffering does not have the last word. From the plague-wounded Christ to the Risen One whose wounds have become light, the altarpiece traces the whole path of Christian hope. To the one who cries "where were you, good Jesus?", it answers with an image five centuries have not exhausted: I was on the cross, in your place; I shall be your light, in your very flesh. That is why the Isenheim Altarpiece is not only a summit of art: it remains, for whoever truly looks at it, an image that heals.

Related Ignispedia articles

• The theology of the icon — the doctrine of the sacred image, its foundation in the Incarnation and the veneration / adoration distinction, of which the altarpiece is a moving Western application.
• Byzantine icons — the great tradition of the sacred image, Eastern counterpoint to the art of Grünewald.
• Christ Pantocrator — the other great way of depicting Christ: glorious majesty, to compare with the Christ of pain of Isenheim.
• Our Lady of Vladimir — the Marian icon of tenderness, echoing the Virgin holding the Child of the Concert of Angels.
• Duccio's Maestà — another great sacred altar image, Marian and glorious, to compare in its liturgical function.

Principal sources

• Isenheim Altarpiece, notices of the Unterlinden Museum of Colmar and of the collections database — dating, structure, 2018-2022 restoration.
• Retable d'Issenheim and Isenheim Altarpiece, Wikipedia (FR / EN) — sourced syntheses on the artists, the configurations and the iconography.
• Britannica, Isenheim Altarpiece — general presentation and inscription of John the Baptist.
• Smarthistory, Matthias Grünewald, Isenheim Altarpiece — iconographic and theological analysis.
• The Isenheim altarpiece: religion, art and medicine (PubMed) — medical context of ergotism and hospital function.
• Scripture: Gospel according to Saint John (1:29; 3:30; 19:26-27); Isaiah 53; 1 Corinthians 15; Colossians 1:24.