Abstract and Introduction
Michelangelo, the great Renaissance artist, is often included on lists of celebrated gout patients. His letters describe a single acute attack of foot pain at the age of 80, but a case for early onset has been presented, based on a fresco by a contemporary artist, Raphael. A figure resembling Michelangelo at the age of 36 appears to have nodules resembling tophi over his knees.
In this report, we review Michelangelo's medical history, discuss the proposal that he had tophaceous gout, and address the significance of "knobby" knees in his works and those of other artists.
Michelangelo Buonarroti (1475–1564), one of the greatest artists of the Italian Renaissance, had a long and highly productive life as a sculptor, painter, architect, and, to a lesser degree, a poet.[1–6] His talent was recognized early on, and at the age of 15, he was taken into the Medici household by Lorenzo the Magnificent, ruler of Florence and famous patron of the arts. After 4 years there, he moved to Rome and eventually created works for 7 popes at various times during his long life.
One of his first commissions was for a sculpture, the Pieta, showing Christ, just removed from the cross, draped over the lap of his grieving mother. Michelangelo placed his signature on the Pieta but never did so on his later works. Returning to Florence in 1501, he started work on a giant sculpture, which was later placed on the square in front of the Palazzo Vecchio (City Hall). Michelangelo was only 26, several years older than his Old Testament subject David, recreated in marble. The Florentines saw their city as a brave and resourceful young David overcoming the sinister Goliaths in Italy and beyond. This was the first large statue of a nude since Roman times and was influenced by classic ancient work, which had been collected at the Vatican and by the Medicis. There is no evidence that a live model was used. Michelangelo's familiarity with human anatomy had been acquired by dissecting cadavers. The sculpture was recognized as a masterpiece and remains today the most popular of Michelangelo's Florentine works.
Recently, one of us (N.S.) visited the Academy of Design, where David now stands; as a "goutologist", NS noticed nodularity over the right patella, which she suspected to be a tophus. This observation motivated us to learn more about Michelangelo's history. Many artists have included personal markers or their own image in their works, and Michelangelo did so in several paintings and sculptures.
Michelangelo may have had gout, but his general appearance differed greatly from that of David. He was older, thinner, and had a broken nose. However, in his poetry, he identified himself with David.[6,8] In one of the earliest surviving fragments of his poetry, dating from the time of David's creation, he wrote: "…David with his sling and I with my bow." "Bow" refers to an instrument used to drill holes in stone. In this report, we explore Michelangelo's medical history, including the evidence for gout and associated illnesses, and review the impact of his illness on his artistic productivity.
J Clin Rheumatol. 2015;21(7):364-367. © 2015 Lippincott Williams & Wilkins