—  SYMPOSIUM #23  —

Paleopathology
Moderators: Dr. Marvin Allison and Dr. Enrique Gerszten

Section 2 - Results of the First Explorations of the Medicean Tombs in Michelangelo's Church of San Lorenzo ( Florence, 16th-18th Centuries)

Gino Fornaciari
Division of Paleopathology, Department of Oncology
Transplants and Advanced Technologies in Medicine
University of Pisa, Italy


Starting from the 14th century the Medici, one of the most powerful and influential families of the Renaissance, achieved their fortune through banking and commerce. They gained prominent position in the political life of the city of Florence, which became the cultural centre of Europe. Lovers of the arts, the Medici were patrons of Michelangelo, Leonardo, Botticelli, Galileo and Benvenuto Cellini. Almost all the most prominent members of the Medici were buried under the vaults of the Basilica of San Lorenzo in Florence (Sommi Picenardi 1888).

In 2002, the Superintendent of Florence Antonio Paolucci authorized examination of 49 of the Medici corpses buried in the church. This was a unique opportunity to study the health conditions, lifestyles and causes of death of some of the most important members of this family.

There are two main branches in the genealogical tree of the Medici family, which ruled Florence and Tuscany in the golden years of Renaissance: that of Lorenzo the Magnificent (1446-1492), and that of the Grand Dukes of Tuscany, from John of the Black Bands (1498-1526) to the last Grand Duke Gian Gastone (1671-1737). The "Medici Project" intends to study the latter, which is the less investigated series. Aim of the "Medici Project", coordinated by the University of Pisa, the University of Florence and the Superintendence of the Florentine Museums, is to perform an archaeological and paleopathological research on 49 of the funerary depositions in the Chapels. The research will include funerary archaeology, anthropology, paleonutrition, parasitology, pathology, histology, histochemistry, immunohistochemistry, electron microscopy, molecular biology and identification of ancient pathogens. The most recent biomedical techniques will be used to obtain as much information as possible about these important figures (Fornaciari et al. 2005, 2006).

In order to study the bodies, we set up a temporary laboratory in the "Lorena Chapel", the funerary crypt of the Grand Dukes of the Lorena Dynasty, which ruled over Florence and Tuscany after the Medici, until 1859.

Following the exploration of some burials during the second World War, we first decided to examine the tomb of Gian Gastone, the last Grand Duke of the Medici (1671-1737). A dark marble disk with no epigraph, considered a simple floor decoration was removed, displaying a secret opening, with a small stone stair leading to a totally unknown hidden crypt. The small funerary crypt revealed a sort of raised floor level surrounding a room which hosted a large sarcophagus, and many small wooden coffins, completely collapsed on the floor, and covered by a layer of dry mould, as a result of the 1966 flooding. Dampness (90%) and temperature (30 °C) were so high that specific equipment was necessary to control climatization at the entrance of the crypt. This climatization eliminated the danger of damage to the coffins and bodies, by the introduction of external air during the works of archaeologists.

A number of funerary depositions were unexpectedly well preserved as for example the burial of a 5-year-old child with dress, shoes and silver crown. The dress was formed by a red silk jacket with thin collar and buttons, in a flowery pattern with silver gallons, and large plus-fours of the same tissue.

The external wooden sarcophagus of the Grand Duke Gian Gastone with a badly damaged lid collapsed in its interior contained another sarcophagus in lead, with a large Christian cross and six iron handles on the lid. The funerary deposition of the Grand Duke was intact: he was still wearing his funerary crown in gold-covered copper and was covered by the silk Great Cape (Cappa Magna) of Grand Master of Knights of the Order of St Stephen. Two large golden medallions, about 110 grams each, appeared at the sides of the Grand Duke's head as well as a silver crucifix on the chest and a large lead tube, probably containing a parchment with some writings celebrating the Grand Duke.

The study of the skeleton of Cosimo I (1519-1574), 1st Grand Duke of Tuscany, revealed that he was a vigorous man, with anthropological age of 50-60 years, 1.78 m tall, medium-sized skull and a narrow nose (Krogman and Isçan 1986). The muscular insertions were those of a very strong man (Robb 1994). The horseman markers were all present, showing the ergonomic pattern of a perfect knight (Belcastro et al. 2001). During adolescence, reveals that, during adolescence, Cosimo must have carried very heavy loads on his thorax, probably the armours of that period, as attested by the presence of some Schmorl vertebral hernias (Weiss 2005).

The clinical history of Cosimo I is evidenced by the very rich archive data, including the reports of the ambassadors and court physicians. Apart from some well recovered diseases, such as smallpox, malarial fevers, gravel and bronchitis, we have a picture of severe early arteriosclerosis, with paralysis of the left arm, right hemi paresis, dyslalia, psychical instability, urinary incontinence, aphasia and agraphia. There is an acute articular disease, a sort of arthritis, named "gout" of the right knee, or generic "gout". Finally, death was caused by catarrhal fever, probably bronchopneumonia, at the age of 55 (Pieraccini 1986).

The paleopathological study of the skeleton reveals that Cosimo I suffered from diffused vertebral and extra-vertebral arthritis, probably caused by his intense physical activity. Ossification and fusion of the anterior vertebral ligament and extensive ossification of the articular ligaments demonstrate that he was not affected by gout, as referred by the court physicians, but by DISH (Diffuse Idiopathic Skeletal Hyperostosis), an articular disease linked with diabetes and obesity. Ossification and fusion of the anterior right vertebral ligament, at the level of the 6th, 7th an 8th thoracic vertebral bodies, is typical of DISH (Ortner 2003).

At autopsy and embalming of the body (Fornaciari and Marinozzi 2005), the court surgeon tried to cut the skull at the level of the right parietal bone; only at the third attempt was he able to obtain a coarse horizontal cut. Finally, the skull was levered with a large chisel, which damaged the skullcap in three points.

The study of the skeleton of Eleonora di Toledo (1522-1562), wife of Cosimo I, reveals that she was a woman with an anthropological age of 36-46 years, 1.58 m tall, with medium low skull, high orbits and narrow face and nose (Krogman and Isçan 1986). The muscular insertions show a fairly good muscular activity (Robb 1994). The clinical history of Eleonora is characterized by many deliveries: she gave birth to 11 babies between the age of 18 and 32. Probably for this reason, from the age of 29, she developed pulmonary tuberculosis which, together with an outbreak of pernicious malaria, killed her at the age of 40 (Pieraccini 1986). A famous portrait by Bronzino shows a very thin and ailing Eleonora, affected by phthisis.

The paleopathological study of the skeleton reveals that Eleonora suffered from a light form of rickets during childhood, as appears from the curvature of her tibiae (Ortner 2003). She presents pelvic skeletal markers of her numerous deliveries (Krogman and Isçan 1986). She also presented slight vertebral and extra-vertebral arthritis. Finally, Eleonora suffered from severe dental disease, with destroying caries, probably due to loss of calcium caused by her frequent pregnancies.

The study of the skeleton of Francesco I (1541-1587), 2nd Grand Duke of Tuscany, reveals that Francesco I was a vigorous man, with an anthropological age of 40-50 years, a stature of 1.74 m, a medium-sized skull and a narrow nose (Krogman and Isçan 1986). The muscular insertions are those of a very strong man and the typical horsemen markers are almost all present (Belcastro et al. 2001). This new data contrasts with the traditional knowledge of an intellectual, sedentary prince, all dedicated to his alchemic studies (Berti 2002). He was affected by acute bronchitis and bronchopneumonia at the ages of 20 and 38 respectively and after 35 years of age he grew rather fat, suffered from gravel with colics (at 44-45 years) and died of pernicious malaria at the age of 46 (Pieraccini 1986). His great interest towards alchemy led him to fuse rock crystal, producing the so-called "Medicean porcelain" (Liverani 1936), a sort of luxury pottery very similar to china in his laboratory of Pitti palace. Therefore, he was certainly exposed to chronic poisonings and the toxicological study of his bone tissue will be of great interest to establish the exact grade of exposure to the different substances. The rumors according to which he with his second wife the Grand Duchess Bianca Capello were poisoned together, by his brother Ferdinando - who succeeded him on the throne – with an arsenical compound, are certainly false (Pieraccini 1986). Owing to the frequent use that contemporary surgeons made of arsenical mixtures in embalming and visceral processing (Fornaciari and Marinozzi 2005), toxicology is unlikely to be able to verify this legend. The paleopathological study of the skeleton demonstrates that Francesco I suffered from moderate vertebral and extra-vertebral arthritis (Ortner 2003) and reveals a well recovered fracture of the coccyx, probably the result of a fall. Finally, the section of the body of the sternum, clearly made to perform autopsy and embalming, is worth mentioning (Fornaciari and Marinozzi 2005).

The Archduchess Joan of Austria, wife of Francesco I, was a very religious woman, as confirmed by the finding of her well preserved rosary, made in simple wood. Joan was an unattractive woman, as appears from numerous portraits and some contemporary reports even describe her as "humpbacked". She had six very difficult deliveries and died during childbirth, following uterus rupture, at 30 years of age. Study of the skeleton reveals that Joan was a woman with anthropological age around 30 years, a height of 1.57 m, medium-low skull and orbits and narrow face and nose (Krogman and Isçan 1986). Her weak muscular insertions witness scarce physical activity. There is section of the body of the sternum, clearly made to perform autopsy and embalming of the copse are confirmed by a section on the sternum of the body. The paleopathological study of the skeleton witnesses a large number of diseases, including: Prognathism, with a marked anterior projection of the mandible, resulting in the famous Hapsburg jaw; marked hyperostosis: ca 1 cm congenital thickening of the cranial vault (Ortener 2003); amelogenesis imperfecta: congenital malformation of the dental crowns (Aufderheide and Rodríguez-Martin 1998); severe scoliosis of the lumbar column with impressive deformity of the pelvis, responsible for her difficult deliveries and death by uterus rupture; incomplete congenital hip dislocation (Ortner 2003); clear signs of her numerous deliveries, such as enormous retro-pubic foveae, deep pre-auricular sulci (Krogman and Isçan 1986).

A preliminary study of the skeletal remains of 9 immature individuals aged between 0 and 5 years allowed us to diagnose 6 cases of rickets, 5 cases of porothic hyperostosis and one case of hydrocephaly (Ortner 2003). It is very likely that rickets was caused by the scarce exposure to light of the children in the environment of the Renaissance and Modern age courts, while porothic hyperostosis was probably determined by prolonged nursing of the babies.

These are the results of the explorations of the the first 15 out of 49 tombs, and include those of 9 children. The laboratory studies are still in progress.

Another 39 burials, the majority of which are intact, will be explored in the next two years. The study of the Medicean funerary depositions and bodies will certainly expand our knowledge of the diseases, style of life, and tastes of the members of that dynasty, so important for the Italian Renaissance.

References:
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  2. Belcastro MG, Facchini F, Neri R, Mariotti V. 2001. Skeletal markers of activity in the early Middle Ages necropolis of Vicenne-Campochiaro ( Molise , Italy) . Journal of Paleopathology 13: 9-20.

  3. Berti L. 2002. Il Principe dello Studiolo. Francesco I dei Medici e la fine del Rinascimento fiorentino. Pistoia: Maschietto Editore.

  4. Fornaciari G, Brier B, Fornaciari A. 2005. Secrets of the Medici. Archaeology 58/4: 36-41.

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