The horror, the horror! Damien Hirst has turned to realist painting. The press’s favorite art-world provocateur may still be best known for his shark suspended in formaldehyde – not to mention such time based installation works as a series of canvases in which butterflies, hatched for the purpose, were drowned in paint of saccharin hues, or glass and steel vitrines in which flies are lured towards rotting animal parts only to be fried by bug zappers. Now he has adopted the shockingly unshocking medium of photo-based painting to give further form to his ongoing obsession with modern medicine.

Gagosian has filled all six galleries of its Chelsea space with 31 canvases, some of mural proportion, depicting violent death, 21st-century style. The exhibition, which emotionally flushes hot and cold, has an epic scope, but it is hard to gauge whether the range of materials and experiences is cautionary or celebratory. In its baroque pretensions, the series seems to want to be called “The Apotheosis of Misery,” or “The Marriage of Hopeless Suffering and Healthcare Management.”

There are portentously moralizing, probably appropriated titles like “Addicted to Crack, Abandoned by Society,” and “Homo Florensiensis, A New and Diminutive Species of Human Being Has Been Discovered.” Images derive equally from the points where violence strike first and last – from a suicide bombing in Baghdad; a soccer hooligan’s battered face; a crack addict’s progressively ravaged features; a morgue; a hospital corridor at night; an autopsy, with neat slices of brain on a steel tray; a dissecting table at clean-up time. The show is poised between a science museum and a hospital soap opera.

For all that he might want to be the next Andy Warhol, glamorizing death, Mr. Hirst is on his way instead to being a latter-day Salvador Dali: He has found fame and fortune taking a chic art-world nihilism out to the masses but in the process has rendered himself artistically marginal.

Mr. Hirst clearly delights in playing to the press, in making work that in its instantly accessible language is broadly appealing (the revulsion neatly packaged). He tackles the universal, existential themes – life, decay, death – with shameless literalism. But the bigger his audience and subjects get to be, the more Mr. Hirst seems to will himself to the footnotes of art.

Take that shark, for instance, “The Physical Impossibility of Death in the Mind of Someone Living” (1991), to give it its proper name. It’s a dashing visual conceit, a canonical image that will linger even when the tiger shark in question disintegrates (which, by all reports, it is on its way toward doing). But art-world insiders instantly “get” the joke, the references that underlie its genesis: It’s Francis Bacon meets Jeff Koons, with the squirming painterly angst of the one and the super-cool packaging and objective absurdity of the other. The same is true for his sculptural installations of gruesome objects in neat vitrines.

A Hirst loyalist would say all art has origins in other art, but achieves broader human value according to its own strengths and aspirations: After all, how many impressionable teenagers who have marveled at Mr. Hirst’s vision know or care about such art-world references? But the turn to realism hardly makes Mr. Hirst an overnight Velazquez.

On the contrary, these paintings are so dreary and inconsequential, both in conception and execution, that it must be intentional: Ubiquity and banality are part of their meaning. Recalling the designer nihilism of his butterflies, you could say it’s business as usual: death by paint.

The best (formal) explanation for his turn to realist painting is that photography is too local and specific in its literal detail to achieve the interconnection and standardization he is after in this “frieze of death.” His academic paint handling, with its lack of differentiation, insists on a bland, seamless flow between various kinds of violence and disease, on the one hand, and the cold efficiency of surgery and fool’s paradise of chemical relief on the other.

The photographic source materials, appropriated rather than shot by the artist, would stand out as too specific to time and place; Mr. Hirst’s paint is a kind of visual anesthetic. While his painting is based in photography, however, it isn’t photorealist in the art-historical sense of being about discrepancies between the apparent world and photographic representation. That would be too subtle, too formal: Mr. Hirst is a literalist; he wants his images to go to the jugular.

Older Hirsts always did double duty, servicing existential themes and playing art-world jokes. As such, it is very tempting, despite a loss of this double-entendre, to interpret his move to pictorial realism as a continuation of such a joke.

Mr. Hirst’s career began as an almost self-conscious, caricatural realization of Michael Fried’s critique of conceptual and minimal art, which he dismissed for its “literalism” and “theatricality.” By turning to a perversely positivist photographic realism, it is as if the young Brit is stalking the famous American critic, who turned from championing the avant garde to studying historic realism, starting with Thomas Eakins.

Mr. Hirst has nothing of the classical poise of the Philadelphia painter, or the genuine scientific curiosity. Yet, his realism is very much like a tiresome, standard-issue provincial derivation of Eakins’s; if even the best of these paintings was a tenth of its size, it could be slipped into an alumni exhibition at the Pennsylvania Academy and pick up a third prize.

If you want to see Mr. Hirst’s careeer in terms of iconoclasm, you could say that by producing 31 dutiful, soporific canvases he has delivered a fatal overdose to painting more decisive than the assassination attempt of his pickled shark. But Mr. Hirst isn’t really an iconoclast. For all his razzmatazz and buffoonery, he is in deadly earnest about the power of images.

Better to note that in his extreme literalism, whether in paint or installation, and his simple, strident, almost sentimental morbidity, he is in fact an eminently Victorian painter. His secret is out (and his popularity explained): Mr. Hirst is a late Pre-Raphaelite.