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Leonardo
Goya's Illness: A Case of Lead Encephalopathy?
Author(s): William G. Niederland
Source: Leonardo, Vol. 6, No. 2 (Spring, 1973), pp. 157-161
Published by: The MIT Press
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Leonardo,Vol. 6, pp. 157-161. PergamonPress 1973. Printedin Great Britain
GOYA'S
OF
LEAD
CASE
ENCEPHALOP
ILLNESS:
A
WilliamG.Niederland**
fulminating impact and lasting consequences. From
contemporarydocuments (letters, preservedrecords,
and so on) we know a good deal about the symptoms
of the disease that lasted for many months: paralysis
of the right side; vertigo; impairment of balance,
hearing, and speech; partial blindness; tremors;
convulsive manifestations; resounding noises in the
head; mental confusion, probably accompanied by
hallucinatory experiences; and comatose or semicomatose states. A man of remarkably robust
constitution and vigor, Goya was able even in his
late seventies to travel across the Pyrenees repeatedly
on his way to France as a political exile from Spain
and recovered after a year or so of convalescence.
But the disease produced two lasting changes: He
remained totally deaf until the end of his life and he
emerged from the ordeal a different person or,
I. INTRODUCTION
The medical history of Goya's personality and
illness (or illnesses) has long been the subject of
investigation by art historians, biographers, clinicians and scholars interested in the relationship
between disease and creativity. The medical
problems pertaining to Goya's life and artistic
career are of considerable interest, not only because
of his exceptional achievement as an artist-he was
a master portraitist-but also because during his
long life he suffered protracted periods of physical
and/or psychiatric disabilities. The exact nature of
these conditions has never been identified.
The firstbiographic notes we have about Francisco
Jose de Goya y Lucientes (1746-1828) go back to
1828, the year of his death. In one of the earliest
catalogues of the Madrid museum, now called
el Prado, originally known as the Galeria del Museo
del Rey, we find the following terse entry:
'Francisco Goya. Born at Fuendetodos, Arag6n,
in 1746. Nominated Painter to the King in 1786
and later made Senior Court Painter; now on a
pension for old age. . . He had no other master
than his own observation of famous paintings
and painters in Rome and Spain, from which he
drew greatest profit.'
This brief entry ends on an equally succinct note:
'Article communicated by himself.' It contains no
reference whatever to the serious, at times lifethreatening, disease or diseases or the permanent
deafness from which Goya suffered from at least
his middle forties until his death at the age of eightytwo. We know also of an earlier disability between
1778 to 1781, described as a state of depression or
melancholia, which kept him partially away from
his work during this period.
II. EFFECT OF ILLNESS ON HIS
PAINTINGS
Late in 1792 or early 1793 Goya was stricken with
an incapacitatingdisease of apparentlysudden onset,
* Abridged version of article that appeared in the New
York State Journalof Medicine, 72, 413 (1972). Reprinted
with permissionfrom the Medical Society of the State of
New York.
** Clinical professor of psychiatry, 1143 Fifth Avenue,
New York, N.Y., U.S.A. (Received25 April 1972.)
Fig. 1. 'Infante Don Manuel Osorio de Zuniga', oil,
1788. (Collectionof the MetropolitanMuseumof Art,
New York.)
157
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158
WilliamG. Niederland
^gB_
y
. :' .
....
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Fig. 2.
'La Nevada', oil, 1786. (Collection of El Prado,
Madrid.)
perhaps more precisely, a different arttist. Once a
painter of gentle genre pictures, colorfiul scenes of
picnics and games, elegant tapestry and cartoons in
rococo style, he now became a man ^vho took a
harsh, often merciless, and vengeful Nview of the
world without and within. As the art critic, Canaday
[1], has put it: 'Goya's life was split in two near
its midpoint by an illness that nearly kill(ed him... a
new Goya emerged, Goya the humane and bitter
social observer, the scourging and despairing
delineator of vice and cruelty ... whos e picture of
nightmares explored the most desperalte realities.'
Although this is essentially correct, it is noteworthy
that some of Goya's earlierpaintings, naimely, those
before 1792 and 1793, also show at times a sinister
note, for example, the ominous-looking gray cats
in the beautiful child portrait of the Infante (Fig. 1),
or the melancholy, almost leaden quzality of the
'La Nevada' winter scene (Fig. 2).
III. NATURE OF GOYA'S ILLNESS
What was the nature of Goya's illniess ? Most
biographers of the nineteenth and earlly twentieth
centuries thought it was syphilis. In sup)port of this
thesis, they adduced the allegedly 20 pre:gnanciesor
stillbirths of his wife Josefa. Only one clhild, his son
Javier, survived. However, biographers today are
no longer sure about the number of Joisefa's pregnancies. Some believe that in thirty-nine years of
marriageshe bore four or five children of whom only
Javier grew to manhood. Those who sltill consider
syphilis as the most likely cause of Goya.'s recurrent
disabilities also point to some obscure passages in
contemporary writings, for instance, a phrase in a
letter by Martin Zapater, Goya's schoc>1mate and
lifelong friend, which reads: '. . . Goya was led to
this [the disease] by his own lack of refllection . . .'
In the present author's opinion, neither the number
?of the wife's pregnancies nor Zapater's critical
statement can be viewed as sufficient evidence of a
syphilitic condition. In fact, there appear to be
other explanations available for the wife's (controversial) stillbirths or unsuccessful pregnancies and
Zapater, who remained a modest civil servant in
Zaragoza while his friend was to become Primer
Pintor de Camara (first painter) at the royal court,
may have, understandably, harbored unresolved
feelings of rivalry and jealousy toward the latter.
Also, the French author Chabrun [2] points to the
fact that Goya did not die 'until 35 years later'
[after the almost fatal sickness of 1792 to 1793] and
states that 'a diagnosis of general paralysis or even
cerebral syphilis cannot be upheld'.
Psychiatrists, such as Reitmann and Soler, have
suggested that Goya may have suffered from a
'schizophrenicpsychosis' or 'paranoid schizophrenia
associated with deafness', respectively. From a
differential diagnostic viewpoint, Reitmann [3]
also considers involutional melancholia and manicdepressive psychosis as clinical possibilities but
ultimately arrives at the diagnosis of schizophrenia
as the most likely cause of Goya's mental disabilities.
Wolfenstein [4] in her recent analytic study has
summed up the present status of our lack of knowledge concerning Goya's sickness in these words:
'Doctors are still trying to identify this illness, but
its nature remains obscure.'
IV. POSSIBLE LEAD ENCEPHALOPATHY
In an attempt to advance our medical knowledge,
at least with regard to some of these obscurities, I
have approached the problem via a different route
of investigation, based partly on clinical observations with victims of lead encephalopathy and partly
on studies of Goya's particulartechnics and manner
of work as a painter [5]. As to the latter, it is known
that Goya was a highly prolific and versatile artist.
He never ceased to experiment in new media and
innovatory processes of the graphic arts, and, at the
end of his long career as a portraitist, draughtsman,
cartoonist, engraver of aquatints and etchings, he
even mastered the novel technic of lithography.
This versatility alone speaks, in my opinion, against
the assumption of a schizophrenic process.
In Goya's time artists had to do their own grinding
of pigments and colors. Paints are complex mixtures
of solids, solvents and various other substances. In
a study on Goya's technic, Schmid [6] has reproduced a picture of Goya's palette which shows
the color flake white as the number one pigment
used by the painter. Generally speaking, 'it is
known', Schmid writes, 'that Goya painted very
quickly . . . and used three tints, a light flesh tint
composed of 4/5 terre verte, 1/5 light red plus 1/3 of
flake white'. The latter is lead white. This was one
of the most important and most frequently used
pigments in Goya's art work, as can be seen from
his paintings in white, gray or mother-of-pearl
(Figs. 3 to 6). Although not all paintings by Goya
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Goya's Illness
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159
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such as zinc white, lithopone or titanium white,
"were
introduced only during the second half of the
-~
nineteenth century or early in our century. Moreiwi':
over, in examining the brilliance and luminosity of
Goya's pictures, one finds that frequently the paint
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is brushed in with bold, liquid strokes, a procedure
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that may have entailed much splatteringand spilling.
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To save time, he also painted wet paint on wet. It is
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well
to rememberthat the art of painting, especially
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.
in those days, involved the creative artist personally
in all the operations and stages of the technical
process, with special emphasis on the grinding of
_colors.
Facilities for washing and other cleansing
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procedures were notoriously poor in Madrid,
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during the long and dry summer
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seasons. Thus, it can be assumed that Goya,
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precisely because of his capacity for painting with
tremendous speed, may have been much more
intensely and massively exposed, via inhalation
and/or ingestion, to the noxious effects of the materials then, in use. Again, I call attention to the
large canvas named 'La Nevada' with its 'leaden'
sky, landscape and figures (Fig. 2). Many of Goya's
canvasses have an irridescent, sparkling quality,
_, :'~ '~.:.::'~,"'with
almost infinite gradations of white, whitish
gray and twilight gray.
If we now examine the well-documented symptomatology of Goya's illness, we find several phenomena which, in conjunction with his known use of
leaded substances, suggest the probability that a
severe form of lead encephalopathy may have
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Fig. 3. 'MarquesadePontejos',oil, 1786. (Collectionof
National Galleryof Art, Washington,D.C.).
can be dated accurately, most art historians agree .::
that both the portrait of the Marquesa de Pontejos
and the famous 'Burial of the Sardine' were done
:
prior to the outbreak of his devastating illness in
1792 to 1793, the latter painting perhaps during or
......
immediately before its onset. Also Doerner [7],
who has dealt with the materials Goya used in his
paintings, has stated that 'most of his pictures [had]
grounds laid over pure white primings ... on these
he worked freely with white, achieving a peculiar
charm of mother-of-pearl tones'.
;i"
None among these non-medical authors appears
to have suspected that according to their own
descriptions Goya must have been in frequent and
direct contact with the toxic lead compound which
i
is essentially basic carbonate of lead, namely,
2PbCO3.Pb(OH)2. Grinding this poisonous compound into paint is particularly hazardous, since it
facilitates inhalation or ingestion by manual
handling. Here, again, Goya's technic deserves ' :
careful consideration. The characteristicluminosity
of many of his paintings was presumably attained
with the aid of certain preparations which, among
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white in equal parts. Innocuous white pigments,
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.
Fig. 4. 'MarquesadePontejos'(detail).
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.
160
WilliamG. Niederland
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Fig. 5. 'The Burial of the Sardine', oil, 1792/93(?).
(Collection of Academy San Fernando, Madrid.)
developed. The fulminating onset of the illness,
with its cerebralinvolvement and the manifestations
of paralytic, convulsive and mental disorder, would
point to such a diagnosis.
In the case of Goya, encephalopathy due to
plumbism, if plumbism it was, may have played a
role on at least three occasions: between 1778 to
1781, when depressive symptoms prevailed; in 1792
to 1793, when a fully developed form of encephalopathia saturninawith acute brain damage may have
struck him; and, again in his last years, sometime
between 1820 and 1825, when he once more became
ill. A careful study of his artistic work indicates
that each episode was preceded by the type of
intense occupational activity, frequent exposure to
lead white and similar toxic materials mentioned
previously. One might object that white lead was
the most important pigment in the history of Western '
painting, hardly a major, pre-nineteenth-century
European painting exists without it, and that,
therefore, other artists should likewise have developed similar symptoms. Here again, Goya's impetuous personality and specific modus operandiwhen
painting his large canvases should be recalled. He
worked at such a frenetic pace that he was able to
complete several large canvases in the same time
it would take other artists to finish only one. He,
therefore, must have inhaled twice or three times
the amount of lead white as did other painters
during a comparable period of time. Furthermore,
90 to 100per cent of all intoxications went undetected X
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There are other admittedly more subtle indications that make the diagnosis of encephalopathy
likely in Goya's case. Art critics have referred to
'Goya's dislike of painting hands' [8]. In one of
his portraits, the hand of the subject is thrust into
his waistcoat 'in a Napoleonic gesture', as Trapier
puts it, 'while the other ... is of strange proportions
and kept out of sight in the shadows'. Similar
configurations regarding the hands occur in other
paintings. Could this mode of painting the subject's
hands have reflected Goya's difficulties (tremor,
muscle weakness) with his own hands? Although
we have no evidence of a permanent damage to the
nervusradialis, familiar in many cases of plumbism,
we know that Goya was unable to paint during the
episodes of illness and, for some time thereafter,
that his right arm was paralyzed during the 1792 to
1793 disease and that at least one of his self portraits
shows, in addition to markedly distorted hands, the
typical pallor that we find in patients sufferingfrom
lead colic. The very intensity of the symptoms,
may have saved his life. They forced him
give up painting almost entirely for comparatively
periods of time, that is to say, to reduce or
'
...long
eliminate the exposure to lead. He thus was able
to regain his physical health after each episode.
That his robust constitution also played a part in
the recovery can be taken for granted.
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6.
'e
Brial
of
the
Sardin'
Fig. 6. 'TheBurialof the Sardine'(detail).
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161
Goya's Illness
Earlier, I mentioned his wife's unsuccessful
pregnancies. Some of the children were born alive
but appear to have died in early infancy. Several
authors have adduced this repetitive event as
evidence of paternal syphilis. Without discounting
the fact that such early infant death does occur in
congenital lues, it may be permissible to refer not
only to the general infant mortality rates in those
days but also to the increased incidence in cases of
parental lead intoxication. In other words, the
very argument so often adduced in support of the
assumption of syphilis may be well used to corroborate the thesis of lead poisoning pfesented here.
Today we are well aware of the sperma-damaging
effects of even small amounts of lead circulating in
the blood stream.
There are risks inherent in all pathographic
writings, particularly in a posthumous attempt,
such as this one, to arrive at a clinical diagnosis
ex post facto. Like previous efforts along such
lines, the present study does not offer conclusive
evidence; it limits itself essentially to diagnostically
pertinent data. But since these data, perhaps for
the first time in a study of Goya's medical history,
also include documented material on the occupational hazards to which Goya undoubtedly was
exposed, it is hoped that this research may serve to
stimulate further work with a view to resolving the
mystery of Goya's recurrentillnesses.
V. COMMENT
The relationship that appears to link creativity
and psychiatric illness has received much attention
in the literature. Physical and/or psychic suffering,
it is stated, stimulates artistic creation. In Goya's
case, this often discussed tie between psychiatric
illness and great art, although the nature and sources
of the creative process itself are still obscure,
manifests itself with particularpoignancy. The 1792
to 1793 illness profoundly affected not only his
personal life but also his artistic style and achievement.
publication [9] in which the nature of Goya's illness
is diagnosed as having been 'probably acute
labyrinthitis'. Like previous speculative attempts
along these lines (syphilis, schizophrenia etc.) such
a diagnosis appears unfounded. It does not take
into account the profound and permanentalterations
caused by the 1792/93 illness in Goya's life and
professional achievements; nor does it consider his
known use of lead pigments in his work. Goya's
exposure to lead was not limited to white lead alone,
though this was the most toxic compound and his
pigment numberone. He also used lead chromates
(green, yellow, orange pigments) that, while less
toxic than lead white, probably contributed to the
total exposure to damaging materials. If the recently
published monumental work on Goya by Gassier
and Wilson [10] suggests that 'it therefore seems
wise not to attempt a "modern"diagnosis of Goya's
illness. . . ', such an inattention as also suggested
by others [11] does little justice to Goya's genius,
tribulations and achievements.
REFERENCES
1. J. Canaday, Goya and Horror, Horizon 10, 90
(1968).
2. J. F. Chaburn,Goya-His Life and Work(New
York: Tudor,1965).
3. F. Reitmann,Goya-A MedicalStudy,in Character
andPersonality(Durham,N.C.: Duke University
Press)Vol. 8, p. 1.
4. M. Wilfenstein,Goya'sDiningRoom, Psychoanal.
Q. 35, 47 (1966).
5. W. G. Niederland, EncephalopathiaSaturnina
(Bonn,Germany: W. Hueber, 1931); quoted in
Health(Geneva:Huebner,
of Workers'
Encyclopedia
Internat.LaborOffice,1934-1935).
6. F. Schmid,The Techniqueof Goya, in TheArt of
Goya,D. C. Rich, ed. (Chicago:The Art Institute
of Chicago,1941).
7. M. Doerner,TheMaterialsof the ArtistandTheir
Use in Painting (New York: Harcourt, Brace,
1934).
8. E. du Gue Trapier,Goya-A Studyof His Portraits
(New York: The HispanicSociety of New York,
1955).
VI. POSTSCRIPT
After the completion of the manuscript of the
above article my attention was called to a recent
9. J. Am. Med. Assn.219, 136 (1972).
10. P. Gassierand J. Wilson, TheLife and Complete
Workof FranciscoGoya(New York: Renal, 1971).
11. J. Am. Med. Assn.220, 648 (1972).
11
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