Francisco José de Goya y lucientes and dermatology: A reluctant and unfortunate association

SETTING THE SCENE

To the uninitiated, Francisco José de Goya y Lucientes is just a Spanish artist. But to the medical fraternity, he is a lot more nuanced. Goya was born on March 30^th, 1746, in the village of Fuendetodos (Spain). He lived a long life of 82 years as a celebrated artist, outliving most of his family, friends, and confidants. He lived his life through the long Spanish Inquisition and served three Spanish kings, even though the French occupation of Spain.

He was made the First Royal court painter at the age of 43 in 1789. His most subversive satirical work was in his 50s, called Los Caprichos (1796–1799). This was followed by “Disasters of war/Los Desastres de la Guerra” (around 1810–1820) in his 60s, which highlighted the cruelties of war through French occupation led by Napoleon Bonaparte, where Goya continued to serve as a royal painter. However, he is most known for his most provocative, unseen, unnamed artwork in the walls of his farmhouse, posthumously named “Black paintings/Pinturas negras” (1819–1823) for its dark, demonic, and gory tones, which he painted in his 70s; a stark difference from his usual art.

What has always been a point of discussion regarding Goya is the transition in his artwork. Long adored by royalty and public alike, the creation of “Black paintings” was never intended to be seen by anyone, as they were painted in isolation and over the walls of his farmhouse. Many attribute his overall work to two main time frames: Art before his illness and after his illness. Three important illnesses are known to have plagued him throughout his lifetime; the highlight being the 1792 illness that left him deaf (at 46 years of age). It is this illness that has not only led to various speculations by the medical fraternity but is also suspected to affect his art greatly. Although he discovered his love for art at a very young age, it was displayed through various techniques and media throughout his life. The range of Goya’s art has made him the first of the great Masters and reportedly inspired Manet and Picasso. Although employed by the royal court, his artwork always caused a stir in the more conventional and conservative eyes of the monarchy. Since he was the court artist throughout the French occupation, Goya’s loyalty was subsequently questioned when Spain was back in power. He was exiled and subsequently moved to Bordeaux in France. The last years of his life were marred by illness, and he passed away on April 16^th, 1828.^[1-3]

DIFFERENTIALS OF GOYA’S ILLNESS

Various people in the medical fraternity have hypothesized regarding Goya’s illness and resultant deafness. He is not the only artist to have been deaf, but it is the cause of said deafness that seems to have divided doctors in various specialties, including dermatologists. Justification through epidemiological data, family history of possible illness, clinical complaints, deduction of his artwork, or correspondence during that time has been provided in retrospect to possibly explain the diagnosis.

The most prevalent theory is that Goya was affected by syphilis. This was deduced through symptoms Goya had as perceived by his correspondence during that time, hearsay regarding Goya’s private life and/or partners, and a long history of pregnancy losses endured by Goya’s wife.

Other differential diagnoses provided are: Lead poisoning owing to his profession, Vogt-Koyanagi-Harada syndrome, mercurial poisoning, quinine poisoning, severe depression, early schizophrenia, Susac’s syndrome, Cogan’s disease and vasculitis, progressive arteriosclerosis, typhoid fever, yellow fever-like illness, deafness as a result of measles, Meniere’s syndrome, among others.

We will not attempt to try and solve this mystery as there is just not enough conclusive evidence to pinpoint one definitive diagnosis, and although various arguments are made to strengthen their diagnosis, syphilis continues to be in the forefront due to the various demographic, epidemiological, and obstetric data available.^[4-8]

GOYA AND MEDICINE

Although physicians have long made Goya’s diagnosis a guessing game; its Goya’s portrayal of physicians that has triumphed in this duet of Goya versus doctors.

Goya and doctors

References: 1799: “Of what ill will he die?/De que mal morira?” Signifies an ignorant and inept donkey–physician caring for a patient on their deathbed [Figure 1]; 1820: “Self-portrait with Dr. Arrieta/Autorretrato con el doctor Arrieta’ Self-portrait was gifted to his physician, Dr. Arrieta as thanks for compassionate nursing Goya back to health during his 1819 illness [Figure 2]; a stark contrast to Goya’s portrayal of physicians in the previous painting.^[9-11]

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Figure 1: Francisco de Goya y Lucientes, Plate 40 from “Los Caprichos”: Of what ill will he die?/De que mal morira?, 1799, Etching (burnished aquatint), 21.3 × 14.8 cm in plate. Minneapolis Institute of Art (MIA). Credit Line: Gift of M. Knoedler and Co., 1918. Object Number: 18.64 (40). Photo: MIA. Reproduced by permission of MIA. https://www.metmuseum.org/art/collection/search/378024.

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Figure 2: Francisco de Goya, Self-Portrait with Dr. Arrieta, 1820, Oil on canvas, 114.62 × 76.52 cm. Minneapolis Institute of Art (MIA). Donor credit: The Ethel Morrison Van Derlip Fund. Accession Number: 52.14. Photo: MIA. Reproduced by permission of MIA. https://new.artsmia.org/programs/teachers-andstudents/teaching-the-arts/artwork-in-focus/goyas-self-portrait-with-dr-arrieta.

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GOYA AND DERMATOLOGY

In addition to the prominent association of Goya and syphilis, as previously stated, there have been depictions of dermatological disorders in Goya’s art, specifically disorders of hair.

• References: 1791–1792: “La Boda/The Wedding” shows a child at the corner with hair loss; contemplated to be tinea capitis or alopecia areata. Back then, many physicians believed that fungi caused alopecia areata, so either of the diagnoses is possible [Figure 3].

• References: 1791–1792: “Boys climbing the Tree” representing the crouching child with possibly favus showing scutula if the brushstrokes are taken into account [Figure 4].

Phocomelia (a rare congenital anomaly of absent proximal extremities) was brought to prominence due to the thalidomide tragedy (1950s and 1960s), but the causes of most cases of phocomelia are still to be determined. There has been evidence of phocomelia being mentioned long before thalidomide was identified as one of the causes, dating as far back as 2500 years ago on a clay tablet inscription in the Assyrian–Babylonian literature.

• References: “L’Enfant difforme/The Deformed Child” shows the handling of a nude infant with a possible congenital abnormality slated to be phocomelia [Figure 5].^[20-26]

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Figure 3: Francisco de Goya, La Boda/The Wedding, 1791–1792, Oil in canvas, 269 × 396 cm in canvas. ©Photographic Archive Museo Nacional del Prado. Inventory number: P000799. Reproduced by permission of Museo Nacional del Prado. https://www.museodelprado.es/en/the-collection/art-work/the-wedding/6340b840-5e11-49cd-9151-0c1fdd240389?searchMeta=la%20boda.

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Figure 4: Francisco de Goya, Boys Climbing a Tree, 1791–1792, Oil in canvas, 141 × 111 cm in canvas. ©Photographic Archive Museo Nacional del Prado. Inventory number: P000803. Reproduced by permission of Museo Nacional del Prado. https://www.museodelprado.es/en/the-collection/art-work/boys-climbing-a-tree/ff09a7a9-33d3-4efa-881c-6206689472e8?searchMeta=boys%20climbing%20a%20tree.

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Figure 5: L’Enfant difforme/The Deformed Child by Francisco de Goya. System identifier 84-001033. Inventory number: RF6911-recto. Catalog number: Inv. Ecole espagnole 196. Permalink: https://collections.louvre.fr/ark:/53355/cl020022104. Reproduced with the permission of the ©Louvre Museum, Paris as per guidelines put forth https://collections.louvre.fr/en/page/cgu#ART6_EN (Accessed May 12, 2025).

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CONCLUSION: GOYA THE ARTIST

Although consensus may not be reached regarding his illness, it is after this very illness that led to his most compelling art. Deduction of his art as a reflection of his psyche/loneliness resulting from deafness would be reductive. The possibility of syphilis will forever be etched into the discussion regarding his illness, but he would not be the only artist affected by it. Vincent van Gogh, a patron at local brothels, was known to be affected with gonorrhea and syphilis before his death at the age of 37 years. Édouard Manet is another artist known to be affected by syphilis in his 51 years of life. Although both these artists were born after Goya’s death, Goya had a longer lifespan than both of them.

Although these later paintings are said to be a reflection of his psyche, we would digress from this ideology; probably inspired by Goya comparing us physicians to donkeys (Might not the pupil know more?/Si Sabrá mas el discipulo? [Figure 6]). With Goya’s knack for satire, we can assume it to signify that bad teachers make bad students, perpetuating the cycle of ignorance. Hence, we will not maintain the longstanding theory that Goya was riddled by syphilis or by a haunting psychiatric disorder that went on to affect his art and his life. We believe that this man had lived a long life filled with grief, illness, loss, and war horrors. Maybe living beyond his loved ones or the average life expectancy, and through the political unrest, finally led him to express exactly what he wanted to about brutality in humanity. Moreover, he could only do it in the medium he knew how; his art.

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Figure 6: Francisco de Goya, Plate 37 from “Los Caprichos”: Might not the pupil know more?/Si Sabrá mas el discipulo?, 1799, Etching (burnished aquatint), 21.3 × 14.8 cm in plate. Minneapolis Institute of Art (MIA). Credit Line: Gift of M. Knoedler and Co., 1918. Object Number: 18.64 (40). Photo: MIA. Reproduced by permission of MIA. https://www.metmuseum.org/art/collection/search/378026.

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