This essay is reprinted with permission fromThe Conversation, an online publication dedicated to the latest research.
Simonetta Vespucci is considered one of the most frequently depicted women of the Italian Renaissance. Many believe Sandro Botticelli used her as the model for Venus, portraying her in an idealized form across several of his renowned artworks.
Vespucci passed away in 1476 at the young age of 23. For many years, historians attributed her death to tuberculosis, a common and often deadly disease at the time, which seemed to fit the narrative of a young woman rapidly declining in health.
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In 2019, my colleagues and I suggested an alternative theory. We analyzed Botticelli’s portraits and period descriptions to see if her facial features changed in ways indicative of an underlying health issue.
We noticed a gradual alteration in her facial features across multiple paintings—subtle changes in the jaw, brow, and soft facial tissue. Such changes are commonly seen in patients with a pituitary adenoma, a tumor located at the base of the brain that regulates hormones.
We specifically suspected a tumor that secreted both growth hormone and prolactin. These hormones can alter facial features over time and sometimes cause unexpected lactation—one allegorical figure in Botticelli’s work seems to depict this symptom.
Our 2019 paper was cautious. We did not claim proof; rather, we offered a plausible medical interpretation of the visual evidence, merging art history with clinical endocrinology.
In a new paper published in Endocrinology, Diabetes and Metabolism, we have expanded on this theory. We propose that Simonetta’s sudden, rapid, and dramatic death aligns with a specific medical emergency: pituitary tumor apoplexy.
Apoplexy occurs when a pituitary tumor bleeds or swells rapidly, typically leading to a sudden and severe headache, vision loss, confusion, and a rapid decline as hormonal regulation fails.
We argue that apoplexy explains the swift decline from apparent health to death, which tuberculosis alone does not account for, as it typically causes a slower, more visible deterioration.
Our hypothesis is based on three main pieces of evidence. First, the physical changes in Botticelli’s portraits from the 1470s to the posthumous Birth of Venus (1482–1485) suggest a tumor growing over months or years.
Second, the symptoms described in documents from her final illness—including letters between Piero Vespucci and Lorenzo de’ Medici noting her collapse at a ball, and subsequent headaches, hallucinations, vomiting, and fever—closely match the clinical presentation of apoplexy.
Third, two events before her death—her collapse during vigorous dancing at a ball and an alleged violent encounter with Alfonso II of Aragon, Duke of Calabria—could have triggered a bleed or sudden tumor growth.
While this is not definitive proof—since there are no tissue samples from 1476, no scans, and no direct examination of Simonetta—we rely on paintings, letters, and clinical reasoning centuries later.
A tumor capable of gradually altering a person’s appearance is also capable of causing sudden death if it ruptures. When combined, the portraits and historical records provide a fuller narrative than either source alone.
We hope this prompts both historians and medical professionals to reassess cases like Simonetta’s. Sometimes, medical insights can resolve questions that historical records cannot, and historical puzzles can encourage medicine to rethink how diseases progress over time.
This article was originally published on The Conversation. Read the original article.
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