The woman in the painting is playing an ornate zither.
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culture
The poem opens 锦瑟无端五十弦，一弦一柱思华年, 'the ornate zither, for no reason, has fifty strings; each string, each bridge recalls the years of youth', and closes 此情可待成追忆，只是当时已惘然. Readers have argued for a thousand years over whether it mourns a wife, a lover or the poet's own lost youth.
usage
李商隐 often named a poem after its first words, a way of leaving it untitled, and this is one of them. A 瑟 is an ancient zither, usually said to have twenty-five strings, which is why fifty is strange.
