Hans Holbein produced his Dance of Death in Basle in 1526, mainly because he needed the money. Pictures of the dance of death were fashionable, featuring on the walls of cemeteries, and people wanted their own pictures. The pictures have been reproduced many times in many forms since then, and the latest version is a book by Penguin published this month. It makes a perfect Christmas present.

People in medieval Europe were intimate with death but wanted anyway to be reminded often of death and the brevity of earthly life. Everybody believed in God and the afterlife and knew that earthly life was a fleeting trial before the eternity of an afterlife. That afterlife might be spent in either heaven or hell, and being frequently reminded of death helped people concentrate on living a good life and so qualifying for heaven. Everybody—no matter whether king or peasant, physician or patient—danced with death throughout their lives, as we do now. Pictures of the dance of death emphasised the equality of all before death.

Holbein learnt his trade as an artist from his father in Augsburg, an important city in the Holy Roman Empire. But once trained he left Augsburg for Basle, where he painted religious pictures and portraits and decorated buildings. Once of his most famous paintings, in Basle Cathedral, shows the decaying body of Christ. In those days artists were lowly artisans and needed commissions and patrons. Holbein was probably commissioned by the master woodcutter Hans Lützelburger to produce a series of pictures for a dance of death.

Gutenberg had printed his first Bible only 70 years earlier in 1450s, and Holbein’s pictures were printed from woodcuts. Holbein drew his pictures on the wood blocks, and Lützelburger then cut them into the wood. The pictures in the Penguin book are reproduced on a page each and are easy to see, but the actual pictures were 65mm by 48mm, about the size of four stamps. That Holbein could draw such detailed, freewheeling, and inventive pictures at such a size is impressive, but in some ways it’s just as impressive that Lützelburger could cut them into wood. The pictures were initially sold singly, and it was 12 years before they first appeared as a book.

There are 41 pictures plus 26 alphabet blocks that show all the letters and stories of death around them. The first three pictures show God creating man, drawing Eve from Adam’s rib; Eve being tempted by the snake, which has a human head, in Paradise; and then Adam and Eve being expelled from Paradise. Death, always shown as a skeleton, appears beside them for the first time as they flee from Paradise.

The next picture shows Adam working in the fields with death helping him and Eve in the background suckling Cain, the first murderer. (This picture fascinates me because of the idea that humans moving from the free if short life of hunter-gatherers to the near slavery of an agricultural life was the origin of the myth of the expulsion from the Garden of Eden.) The final picture before the main series shows hundreds of skeletons blowing trumpets, bearing drums, and enjoying the most tremendous party—the triumph of death?

Most of the pictures show death visiting individuals ranging from the highest to the lowest. Many of the pictures deal with religious orders, starting with the Pope and working down to monks and nuns. They are shown accepting bribes, selling indulgences, and ignoring the poor. Holbein was drawing these pictures in the early years of the Reformation. Secular and aristocratic powers from the Emperor to the Lady are similarly mocked, with death appearing in a wide variety of guises. The pictures are ironically full of action and life, and many are funny.

The professions are represented by the physician and the astrologer. The physician wearing a big hat and costly robes is seated at a table with a large book in front of him. Death leads in by the hand an elderly patient and hands the physician a bang of money, presumably payment for the death of the patient. Many physicians these days, particularly oncologists, are paid handsomely for shepherding their patients to death. The astrologer has equally grand clothes and looks up at an astrolabe without noticing death handing him a skull.

Holbein was more sympathetic to the poor. In the picture of the ploughman death is driving the horses pulling the plough, hastening the ploughman through his arduous life. On the hill is a church with the sun coming up behind the hill, a symbol of the heaven that awaits the hard working ploughman. The next picture shows death taking away a child from a hovel in which his distraught mother is cooking over an open fire. (I think of huts in Africa where mothers still cook inside and children frequently die before the age of five.)

The penultimate picture shows the Last Judgement, and the book is intended to prepare its readers for that day. Finally, Holbein draws an extraordinary Escutcheon of Death.

Your spouse or children may be shocked if you give them Holbein’s marvellous Dance of Death for Christmas, but perhaps they need the book and its message even more than the readers of the Middle Ages familiar with death.

You can see all the pictures here.

Richard Smith was the editor of The BMJ until 2004.