A Doctor Thinks He Figured Out The Illness Hiding Behind Mona Lisa's Smile

Photo by Juan Di Nella

Did Mona Lisa have a secret? Many people over the centuries have interpreted her small, sly smile to indicate a sense of mischievous knowing. Others, however, think it was something a lot less glamorous: She was literally just feeling sick.

Now, a doctor may have just diagnosed the famous painted lady's mysterious illness.

In the portrait, Lisa Gherardini, the wife of a Florentine merchant named Francesco del Giocondo and likely the model for Leonardo da Vinci's acclaimed Mona Lisa painting, appears to have visible skin lesions and swelling on her hands. In the past, rheumatologists and endocrinologists have theorized that these dermatologic abnormalities were perhaps a sign of a lipid disorder and heart disease. They suggested high cholesterol levels passed down through her family and atherosclerosis (which refers to fatty buildup within the artery walls) may have led to Gherardini's death at age 63.

But Mandeep R. Mehra, M.D., the medical director of the Heart and Vascular Center at Brigham and Women's Hospital, has proposed a new theory: an underactive thyroid. In a letter published in the Mayo Clinic Proceedings journal, Dr. Mehra points out that those cholesterol and cardiovascular conditions likely would have killed Gherardini at a much earlier age, considering the fairly limited medical treatments that existed in 16th-century Italy, when she was alive. Furthermore, hypothyroidism can cause the hair to thin and the skin to become discolored—symptoms definitely visible in Mona Lisa.

Gherardini also appears to have a small bump at the neck, which Dr. Mehra claims could be evidence of a swollen thyroid gland. The Italian diet has historically lacked iodine, a deficiency that can lead to such swelling (called goiter), and many Italian Renaissance paintings and sculptures also feature people with the condition, as well. Historians have learned that Gherardini had given birth shortly before sitting for da Vinci, so it's possible she suffered from peripartum thyroiditis (the inflammation of the thyroid after pregnancy).

As for the enigmatic smile? Some have suggested the woman may have had Bell's palsy, which causes muscle weakness in the face. But hypothyroidism can also cause that type of muscle weakness, in addition to a generally "puffy face."

Regardless of her illness, of course, Lisa could clearly carry herself—there's a reason that portrait of hers has stuck around. Dr. Mehra suggests that her apparent illness might even contribute to her magnetic draw. As he put it, "In many ways, it is the allure of the imperfections of disease that give this masterpiece its mysterious reality and charm."

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