The real da Vinci code: the cause of death of the Mona Lisa
In 1503, Leonardo started the painting of Madonna Lisa Maria de Gherardini (born in Florence in 1479 and died at the age of 37.) He worked on the painting for 4 years. The Mona Lisa has been acclaimed as “the best known, the most visited, the most written about, the most sung about, the most parodied work of art in the world.”
With only a history of premature death as a clue, let’s move on to the clinical examination of the beautiful and ever-smiling Mona Lisa. Two important findings are present:
Firstly, a careful inspection of the famous painting reveals a yellow irregular leather-like spot at the inner end of the left upper eyelid. This is currently known as a Xanthelasma, which is a yellowish deposit of cholesterol underneath the skin.
Secondly, there is a soft bumpy well-defined swelling of the dorsum of the right hand beneath the index finger about 3 cm long, which raises the possibility of a subcutaneous lipoma.
An infrared detailed photograph published in 1974 reveals that the yellow skin alteration was an integral part of the painting at the time of its initiation, and not a subsequent addition.
These findings in a 25-30 year old woman, who died at the age of 37, may be indicative of essential hyperlipidemia, a strong risk factor for ischemic heart disease in middle age. A stronger evidence for this would be the observation of a corneal Arcus, but that is not the case with the Mona Lisa.
In short, the Mona Lisa probably died of a heart attack.
Although Hyperlipidemia is often primary and familial, it could also occur secondary to other disorders including Hypothyroidism (could explain the absence of eyebrows, although that could have been the result of epilation, a common practice at the time), Diabetes Mellitus and Nephrotic Syndrome.
As far as is known, this portrait of Mona Lisa painted in 1506 is the first evidence that xanthelasma and lipoma were prevalent in the sixteenth century, long before the first description by Addison and Gall in 1851.
