Standing on top of a pile of books on Thicknesse's desk is a grotesque, monkey-like figure brandishing a whip with both hands, whilst with his foot he breaks Death's spear.

This is a reference to a pet monkey which Thicknesse took with him on his travels in France, dressed as a postilion (a servant who rode of the outside of his master's carriage). He holds in his left hand a small phial labelled 'LAUDANUM', large doses of which were recommended by Thicknesse as a cure for gall-stones.