The knee gives it away. It is enlarged, deformed and covered in
hard lumps. The Renaissance genius who painted the ceiling of the
Sistine Chapel almost certainly had gout.
In a piece of forensic medical detective work an American doctor
has diagnosed Michelangelo's condition from a fresco by Raphael
that adorns the Pope's library, the Stanza della Signatura, in the
Vatican.
Dr. Carlos Hugo Espinel, a specialist in blood-pressure
disorders at Georgetown University, Washington, also suggests in an
article in The Lancet that Michelangelo's obsession with his work
and neglect of his diet may have caused the problem. Espinel cites
Vasari, the writer and painter, who observed that the master would
go for days on bread and wine.
Wine, notes Espinel, was processed in lead containers, and
Michelangelo may also have been exposed to lead-based paints.
Plumbism, or lead poisoning, could explain the gout. The key to the
diagnosis is the central figure in Raphael's School of Athens.
The fresco portrays luminaries of pre-Renaissance thought,
including Plato holding his Timaeus, Aristotle with his Ethics and
Diogenes reclining on the steps. One man, in the center foreground,
remains unidentified. Espinel believes it is Michelangelo.
There are several clues. The figure is not included in cartoons
Raphael drew in preparation for the fresco, suggesting he was a
late addition. He is in contemporary clothes, a simple purple
cassock and boots, while the rest are in classical robes.
Of the Sistine Chapel's 300-plus figures, that of Jeremiah, one
of Michelangelo's alleged self-portraits, has a hint of boots.
Vasari described him wearing ``buskins of dogskin.'' The man is of
the right age and size and, although his head is turned, his nose
appears to be twisted, in keeping with Vasari's description that it
was ``somewhat flattened, broken in his youth by Torregiano's
fist.''
But why was Michelangelo included? Espinel suggests that Raphael
may have had an early glimpse of the Sistine chapel when
Michelangelo allowed the first viewing on 14 August 1511.
One glance would have persuaded him that Michelangelo belonged
with the greatest geniuses who had lived.
``Scanning the divine images above, realizing that now he would
have to change and the world would have to change, Raphael may have
decided to add a portrait of Michelangelo. The style of this
portrait, the figure's space, mass and perspective are ... more
akin to the images in the Sistine chapel.'' The seated figure has
his right knee framed and highlighted by his own shadow, with his
boots rolled down.
Espinel writes: ``It is not a hot knee: its skin, pale and
tense, show no sign of inflammation, nor is there ulceration. But
underneath the skin there are lumps, knobs of a light yellow that
appear dense and hard.'' In his writings Michelangelo described
episodes of bladder and kidney problems that persisted throughout
his life.
In one poem he laments ``I'ho `imparato conoce l'orina'' [I have
learnt to know the urine] and later he recorded in a letter how he
had passed ``gravel'' and fragments of a kidney stone.
Putting this together with his knobbly knee, Espinel says there
is only one possible diagnosis. Although written descriptions of
the condition are common throughout history, illustrations are
rare. Michelangelo's knee, as portrayed by Raphael, can take its
place in medical textbooks, suggests Espinel, as an early pictorial
description of gout.
