This is the earliest surviving altar painting by Botticelli. Although it was sometimes called “The Altar of Koshertitak”, the exact purpose of the picture is unknown. The figure of the Madonna is larger than all the others, and together with two kneeling saints in red cloaks, Kozma and Damian, forms the triangle composing the basis of the composition.
Mary Magdalene stands on the left, holding a vessel for incense, while Catherine of Alexandria, who is on the right, rests on a wheel, seated with points, – the instrument of her martyrdom, accomplished after a refusal to change her faith and become the wife of Emperor Maxentius.
Kozma and Damian were the patron saints of the Medici, therefore their faces may have a portrait resemblance to the members of the family; But since these saints were also considered patrons of doctors, the picture, perhaps, had nothing to do with the Medici.