If you listen to NPR, you may have heard yesterday’s story on “Why Certain Poor Shepherds In Nativity Scenes Have Huge, Misshapen Throats.” According to retired surgeon Renzo Dionigi of the University of Insubria in Varese, Italy (NPR), goiters have been a sign of poverty and geographic location. The purpose of including goiters in paintings may have been to elicit an emotion such as pity or revulsion, or to indicate where someone was from, as some areas did not supply people with the vital nutrients. Or, as Mary Ann Liebert, Department of Medicine University College in Cork Ireland, wrote in The Many Reasons Why Goiter is Seen in Old Paintings, a goiter may have also been used as an erotic device. (What?!?) Monna Vanna 1866 Dante Gabriel Rossetti 1828-1882 Goiterville doesn’t have a view of the sea At least 41% of women and 24% of men had goiters in portraits from the Renaissance to the 20th Century, in Berne Switzerland. Goiters are also seen in Renaissance and Baroque paintings in Florence. They were rarely seen in Venice, near the sea, where there is iodine. Goiters were so geographically based that sometimes goiters were used to indicate the hometown of the figure depicted. Rogier van der Weyden – Deposition (detail) 1435 Lovely lady lumps Before the 1900’s, goiters were so common they were seen as normal. When an artist’s model had a goiter, this was included in the artwork. Goiters were most common in young women. Perhaps this is why small goiters were not only seen as normal, but were considered a flattering attribute. A small goiter on an attractive woman was considered an adornment. Pre Raphaelites Not so bad, really I had a goiter for a few years. I had graves disease, a genetic hyperthyroid condition. The goiter wasn’t painful, it was just a swollen part on my throat, and the swelling went away after I had the thyroid cooked by radiation. I’m all the way better now. I didn’t feel it was a particularly attractive feature to carry, but it didn’t seem so bad either. I could see how it could easily be normalized, and how a few lovely ladies with swollen necks could potentially turn this modern view of malformation into something more acceptable. (a) Judith with the head of Holofernes (c. 1575), by Jan Massys (b) Judith with the head of Holofernes (c. 1550-75), by Vincent Sellaer (c) Judith and Holofernes (1540), by Jan Sanders van Hemessen (d) Judith with the head of Holofernes (c. 1540-50), by Girolamo da Carpi (Girolamo Sellari), (e) Judith (c. 1548-51), by Lambert Sustris (f) Judith with the head of Holofernes (c. 1562), by Lorenzo Sabatini – Image collection from The Indian Journal of Endocrinology and Metabolism (a) Judith and her maidservant with the head of Holofernes (c. 1520-30), by Guido Reni (b) Judith and Holofernes (a copy from original of Guido Reni) (1625), by Carlo Maratta (c) Judith and Holofernes (c. 1610-40), by Sigismondo Coccapani (d) Judith with the head of Holofernes (c. 1605-10), by Giuseppe Cesari aka Cavalier d’Arpino (e) Judith and Holofernes (c. 1600-20), by Antiveduto Grammatica (f) Judith with the head of Holofernes (c. 1610-15), by Carlo Saraceni – – Image collection from The Indian Journal of Endocrinology and Metabolism (a) Judith and her maidservant (1608-9), by Orazio Gentileschi (b) Judith and her maidservant (1610-12), by Orazio Gentileschi (c) Judith and her maidservant (1613-4), by Artemisia Gentileschi (d) Judith and her Maidservant with the Head of Holofernes (c. 1623-5), by Artemisia Gentileschi (e) Judith slaying Holofernes (c. 1614-20), by Artemisia Gentileschi (f) Judith (1678), by Eglon van der Neer – Image collection from The Indian Journal of Endocrinology and Metabolism (a) Judith and her maidservant with the Head of Holofernes (c. 1710), by Giovanni Antonio Pellegrini (b) Judith with the head of Holofernes (c. 1730), by Giuseppe Marchesi (c) Judith and Holofernes (c. 1730), by Giulia Lama (d) Judith and her Maidservant with the Head of Holofernes (unknown), by Venetian school (e) Judith with the Head of Holofernes (1695), by Giovanni Gioseffo dal Sole (f) Judith (c. 1840), by August Riedel – Image collection from The Indian Journal of Endocrinology and Metabolism Doctors are so unobservant “Even if the function and the role of the thyroid were discovered only after thyroidectomy was started to be performed at the beginning of the 19th century, artists of the Italian Renaissance had the intuition that thyroid swellings were related to specific psychological and humoral conditions.•(…) Artistic intuition and sensibility often precede scientific demonstrations, and it should be a guide for science development.” – Antonio V.SterpettiM.D., F.A.C.S., F.R.C.S.GiorgioDe TomaM.D.AlessandroDe CesareM.D. Portrait of a Young Woman with Loose Hair by Albrecht Dürer Diagnose this portrait! Peter Paul Rubens painted the same lady twice, the portraits separated by three years. According to medical students Leah Zhao and Tetyana Maniuk, the paintings show that lady was suffering from a thyroid condition. Can you spot it? Peter Paul Rubens, portrait of Susanna Lunden Peter Paul Rubens, portrait of Susanna Lunden (3 years later) The Holy Virgin’s Holy Goiter Mary Ann Liebert also wrote that the thyroid gland increases in size with pregnancy, and may not fully regress after delivery. So it’s likely that an artist’s model would arrive for a sitting with a goiter that was increased by a current or previous pregnancy. This could explain why there are many representations of pregnant women, even the Virgin Mary, with goiters. Madonna of the carnation Leonardo da Vinci 1452-1519 Virgin and Child 1505 Cima da Conegliano Durán Madonna (c. 1435–1438) by Rogier van der Weyden Portrait of Charles Baudelaire (1821-67) – Emile Deroy So leave a little love for the lovely lady lumps. They’re really not so bad.