The “Lost Caravaggio”: a probable case of goiter in seventeenth-century Italy

Excerpt

The canvas, named “Judith Beheading Holofernes,” was discovered in a sealed-off part of the attic space of a house near Toulouse (France), which had to be accessed to repair a water leak in 2014. The painting represents the biblical figure Judith decapitating Holofernes according to the apocryphal Book of Judith (Fig. 1). Preliminary investigation attributed the painting, probably painted in Rome (or Naples) in 1604–1605, to Caravaggio (1571–1610) [1], although the attribution is still far from certain. However, it most certainly shows a case of goiter in the neck of the old maid. This evidence of probable multinodular goiter (MNG) [2] may be the result of any chronic low-grade, intermittent stimulus to thyroid hyperplasia; the size represented in the canvas attributes this case of MNG to the second stage of the WHO classification. Among accepted risk factors, old age and female sex clearly characterize the maid. If one accepts the stance that the canvas was painted in Rome or Naples, also suspect a third risk factor, iodine deficiency can be hypothesized since Latium and Campania were well-known iodine-deficient areas. The focus on goiter probably underlines the poor status of this servant, and its recognition allows medicine to better understand the historical presentation and evolution of endocrinological diseases throughout history.

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