The Garden of Earthly Delights
Left panel

The left panel (sometimes known as the Joining of Adam and Eve) depicts a scene from the paradise of the Garden of Eden commonly interpreted as the moment when God presents Eve to Adam. The painting shows Adam waking from a deep sleep to find God holding Eve by her wrist and giving the sign of his blessing to their union. God is younger-looking than on the outer panels, blue-eyed and with golden curls. His youthful appearance may be a device by the artist to illustrate the concept of Christ as the incarnation of the Word of God. God's right hand is raised in blessing while he holds Eve's wrist with his left. According to the work's most controversial interpreter, the 20th-century folklorist and art historian Wilhelm Fraenger:

As though enjoying the pulsation of the living blood and as though too he were setting a seal on the eternal and immutable communion between this human blood and his own. This physical contact between the Creator and Eve is repeated even more noticeably in the way Adam's toes touch the Lord's foot. Here is the stressing of a rapport: Adam seems indeed to be stretching to his full length to make contact with the Creator. And the billowing out of the cloak around the Creator's heart, from where the garment falls in marked folds and contours to Adam's feet, also seems to indicate that here a current of divine power flows down, so that this group of three actually forms a closed circuit, a complex of magical energy...

Eve avoids Adam's gaze, although, according to Walter S. Gibson, she is shown "seductively presenting her body to Adam". Adam's expression is one of amazement, and Fraenger has identified three elements to his seeming astonishment. Firstly, there is surprise at the presence of the God. Secondly, he is reacting to an awareness that Eve is of the same nature as himself, and has been created from his own body. Finally, from the intensity of Adam's gaze, it can be concluded that he is experiencing sexual arousal for the first time.

The surrounding landscape is populated by hut-shaped forms, some of which are made from stone, while others are at least partially organic. Behind Eve rabbits, symbolising fecundity, play in the grass, and a dragon tree opposite is thought to represent eternal life. The background reveals several animals that would have been exotic to contemporaneous Europeans, including a giraffe, a monkey riding an elephant, and a lion that has killed and is about to devour his prey. In the foreground, from a large hole in the ground, emerge birds and winged animals, some of which are realistic, some fantastic. Behind a fish, a person clothed in a short-sleeved hooded jacket and with a duck's beak holds an open book as if reading.

To the left of the area, a cat holds a small lizard-like creature in its jaws. Belting observes that, although the creatures in the foreground are fantastical imaginings, many of the animals in the mid and background are drawn from contemporary travel literature, and here Bosch is appealing to "the knowledge of a humanistic and aristocratic readership". Erhard Reuwich 's pictures for Bernhard von Breydenbach's 1486 Pilgrimages to the Holy Land were long thought to be the source for both the elephant and the giraffe, though more recent research indicates the mid-15th-century humanist scholar Cyriac of Ancona 's travelogues served as Bosch's exposure to these exotic animals.

According to art historian Virginia Tuttle, the scene is "highly unconventional cannot be identified as any of the events from the Book of Genesis traditionally depicted in Western art." Some of the images contradict the innocence expected in the Garden of Eden. Tuttle and other critics have interpreted the gaze of Adam upon his wife as lustful and indicative of the Christian belief that humanity was doomed from the beginning. Gibson believes that Adam's facial expression betrays not just surprise but also expectation. According to a belief common in the Middle Ages, before the Fall, Adam and Eve would have copulated without lust solely to reproduce. Many believed that the first sin committed after Eve tasted the forbidden fruit was carnal lust. On a tree to the right, a snake curls around a tree trunk, while to its right, a mouse creeps; according to Fraenger, both animals are universal phallic symbols.
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