Anatomy of the Real
Thomas Eakins first began the scientific study of anatomy during the time of his joint enrollment in Jefferson Medical College and the Pennsylvania Academy of Fine Arts. Eakins' motivation was a desire to gain knowledge of the construction of human form in order to imitate that construction in his art. The focus of his studies of anatomy shifted from dissection to figure drawing from the nude model when he moved to Europe.
Late in 1875, when the announcement was made that Philadelphia would be the host of the Centennial Exhibition, the citizens of Philadelphia felt pressured to provide examples of America's equivalence to, or dominance over, Europe in a variety of fields. Eakins was one of the first artists to jump at the opportunity of providing artistic evidence of American excellence. For his exhibition painting, Eakins elected to return to Jefferson Medical College and paint the portrait of the famed surgeon Dr. Samuel D. Gross. The artist stated early on that this painting would be "very far better than anything I have ever done."
Originally titled The Portrait of Professor Gross, the painting is now known as The Gross Clinic. The painting endeavors to portray the reality of late nineteenth century surgery with its focal points being the bloody scalpel in the surgeon's hand and the bleeding incision on the thigh of the patient. The Portrait of Professor Gross brings the beholder into the amphitheater of the surgical classroom. In the 1870's the general public was often allowed to sit in on surgical lectures, but only those interested in anatomy or surgical issues chose to attend. Eakins' painting forced everyone interested in art who beheld the work to become an audience member, violating the sensibilities of many art patrons.
In The Portrait of Professor Gross Eakins gives significant attention to the details of the human forms and seems less invested with abstract space. The instrument tray in the foreground is blurry and the audience in the background blends with the darkness of the room, but the patient, surgeons, and anesthesiologist are intricately illustrated. Despite the general darkness of much of the room, it can actually be safely assumed that the surgery is occurring at mid-day. Surgeries in this period were typically lit only by skylights placed directly over the operating table. The rest of the amphitheater was always cloaked in darkness. Surgical lectures began at 11:00 everyday.
The painting depicts a team of five surgeons and one anesthesiologist removing a piece of dead bone from a man's leg. The patient lies on his right side with his knees drawn up, wearing only a pair of socks. One of the surgeons is almost entirely hidden behind the figure of Dr. Gross. Only his hand appears at Gross's left, holding a retractor. The patient's mother sits by the left edge of the painting, shielding her eyes from the gruesome sight. Gross, with a countenance of calm control, has paused during the surgery to lecture to the students and attendees.

To late twentieth century viewers, The Portrait of Professor Gross may seem to portray a very backward ideal of medicine. In fact, this was the perception even in the late 1880's after the adoption of aseptic procedures. To the jury of the Centennial Exhibition the painting was more modern than they could accept. Eakins divided the receptors of his art into those who were willing to allow for the bold artistic subject of surgery, and those who were not. The centennial jurists were among the latter group. When the painting was rejected for exhibition in the arts section, Dr. Gross intervened and sponsored the painting for the medical section. Eakins' introduction to controversy had begun, and would be followed in 1886 when he was forced to resign his teaching position at the Pennsylvania Academy of Fine Arts for allowing women students to practice form sketches using a nude male.

The rapid changes occurring in surgical practice are displayed in Eakins' 1889 painting The Agnew Clinic. Notice that the surgeons are dressed in the white, specifically medical clothing, whereas those of The Portrait of Professor Gross are wearing street clothes. The felt-lined instrument tray of the earlier painting has been replaced with the sterile covered case. Eakins was able, and indeed forced, to give greater detail to the audience members in the later painting because of the introduction of artificial lighting into the surgery.
Eakins' medical portraits complement the rowing pictures in addressing the definition of realism. Surgical studies were not a new subject of painting, but were also not common just prior to Eakins' era. The clinical paintings are similar to the rowing pictures in their portrayal of the middle class spectator event. Surgeons like Dr. Gross were celebrities of the gilded age as much as athletes were. Eakins' love for the human form drove him to go beyond the artistic study of the nude, and to actually peel back the skin on his subjects as he painted the open incisions of the surgical patient. Eakins felt that art should be driven, not by imitation of previous masters, but by intense observation of the chosen subject. Through anatomical study, Eakins gained an understanding of the "real" interior of his subject matter.