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The itinerant charlatans known as “scalpellini” flourished in the Netherlands and Belgium in the 15th and 16th centuries.
Based on an ancient medieval superstition—that madness and stupidity were caused by a small stone lodged in the head—these charlatans would make small incisions on their patients’ skulls to extract the supposed offending pebble.



In Madness and Civilization, a book whose Italian edition features on the cover Peter Bruegel the Elder’s The Extraction of the Stone of Madness (1557), Michel Foucault writes:
"Let us not forget Bosch’s famous doctor, even crazier than the one he seeks to cure: for all his false science has done little more than cover him with the worst rags of a madness that everyone can see except himself."
“Bosch’s famous doctor” has his head covered with a funnel, traditionally used in iconography to symbolize a pair of opposites: intelligence and stupidity. In its original position, with the spout pointing downward, the funnel represents intelligence, because it is the place into which everything converges, encompassing all. In Bosch’s painting, however, the inverted funnel indicates the folly of false science.
From the hapless patient’s head, it is not a stone, but the bloom of a tulip.