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This article describes what we believe to be the key to interpreting the concept represented by Michelangelo's painting the Creation of Adam. This fresco, one of his most famous masterpieces, is situated in the heart of the Sistine Chapel and is viewed by millions of people every year. A man of many talents, Michelangelo's proficiency in anatomical dissection is reflected in his artwork. As such, analyses of hidden meanings in this fresco have been ascribed, including the concept of the "Brain-God." However, we see a postpartum uterus and adjacent anatomy, justifying our interpretation that Michelangelo was depicting something far more fundamental: the birth of mankind. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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The Deliveryof Adam: A Medical
Interpretation of Michelangelo
Stefano Di Bella, MD; Fabrizio Taglietti, MD; Andrea Iacobuzio, DVM;
Emma Johnson, MBBS; Andrea Baiocchini, MD; and Nicola Petrosillo, MD
This article describes what we believe to be the key to interpreting the concept represented by Michel-
angelos painting the Creation of Adam. This fresco, one of his most famous masterpieces, is situated in the
heart of the Sistine Chapel and is viewed by millions of people every year. A man of many talents,
Michelangelos prociency in anatomical dissection is reected in his artwork. As such, analyses of hidden
meanings in this fresco have been ascribed, including the concept of the Brain-God.However, we see a
postpartum uterus and adjacent anatomy, justifying our interpretation that Michelangelo was depicting
something far more fundamental: the birth of mankind.
ª2015 Mayo Foundation for Medical Education and Research nMayo Clin Proc. 2015;90(4):505-508
Michelangelo di Lodovico Buonarroti
Simoni, commonly known as Michel-
angelo, was an Italian sculptor, painter,
architect, poet, and engineer of the High Renais-
sance. He was born on March 6, 1475. He died
in 1564 at the age of 88 years.
Michelangelo is widely considered an inimi-
table genius of the 16th century, and his world-
renowned masterpiece painted onto the ceiling
of the Sistine Chapel attracts millions of visitors
a year to the Vatican. This extraordinary creation
was commissioned by Pope Julius II and took
Michelangelo 4 years to complete (1508-1512).
However, despite being one of his most famous
pieces, Michelangelo initially refused to accept
this invitation because he considered himself
an inadequate painter for such a vast and com-
plex work: Michelangelo., believing the vault-
ing of that chapel to be a great and difcult
labour, and considering his own want of practice
in colours, sought by every means to shake such
a burden from his shoulders, and proposed Raf-
faello for the work. But the more he refused, the
greater grew the desire of the Pope, who was
headstrong in his undertakings.
1, p28
Interpretation of a historical work is chal-
lenging because contemporary context is dif-
cult to reproduce, and we believe that this
fresco is no exception. The heartof the
Sistine Chapel reveals the Creation of Adam,
one of the best-known and most reproduced
works in the history of art. The depiction of
the Hand of God giving life to Adam is thought
to be purposefully central, representing the pri-
mum movens: the creation of the human being.
Initially commissioned to depict the Apostles,
Michelangelo negotiated more freedom and
went on to illustrate a plethora of biblical scenes.
How far he extended such freedom is fervently
debated, and armed with the knowledge of
Michelangelos enduring interest in anatomy
and the human body, many medically orientated,
adjunctive interpretations of these scenes exist.
partum uterus while Adam lies on a womans
torso. For years, varying medical interpretations
of the imagery depicting the Creation of Adam
have been proposed. For example, nephrologists
can detail the sections that resemble kidneys, and
historical evidence of Michelangelosstruggle
with renal stones only adds to this curiosity and
The most common interpretation, however,
is the concept of the Brain-God,which is
based on the similarity of the shape painted
behind the gure of God with that of a human
However, in our opinion, this inter-
pretation does not marry with the painting
title, and the proposed signicance remains
to be fully explicated.
Other suggestions have been made, and in
1955, Adrian Stokes, a prolic art historian,
wrote: .on the Sistine ceiling the anomaly
of the issue of Eve from Adams side, beckoned
forth by the Almighty midwife, dissolves; and
we realize with awe that the keen, the sublime,
From the 2nd Infectious
Diseases Division,
National Institute for
Infectious Diseases,
Lazzaro Spallanzani,
Rome, Italy (S.D.B., F.T.,
A.B., N.P.); freelance
anatomical painter, Mug-
giò, Italy (A.I.); and
Department of Molecular
Biology and Biotech-
nology, University of
Shefeld, Shefeld, United
Kingdom (E.J.).
Mayo Clin Proc. nApril 2015;90(4):505-508 n nª2015 Mayo Foundation for Medical Education and Research 505
God the Father of the Creation of Adam con-
trols about him an uterine mantle lled with
attendants who clamber close, souls yet to be
born, attributes as yet of his own essence.
7, p89
This obstetric-themed context was unique,
but more recently, a group of Italian scientists
proposed a congruous obstetrical interpreta-
tion of the painting.
We support their conjec-
ture about the true signicance of the painting
but seek to further the theory by offering addi-
tional pieces to such a captivating puzzle.
We believe that in such a great artistspaint-
ing, nothing is casual: everything has its specic
place and explanation. From this premise and
with the help of anatomical drawings, we expose,
step by step, what we believe is the real interpre-
tation of this inspired centerpiece (Figure 1).
1. The rst clue to understanding the central sec-
tion of the fresco is the small oval shape in the
right upper part of the painting (burgundy ar-
row). In fact, it appears to be like the stalk of
an apple (the apple would be the large dark
red oval [brown arrow]). Looking with an
anatomists eye, one can recognize the small
oval as a section or cut of a hollow pipe (eg,
a large artery). However, we see this hollow
organ as the fallopian tube.
2. The color and shape of the large oval
(brown arrow) could resemble that of a
heart chamber or a cloak. However, look-
ing at it carefully, one can perceive that
even this is a hollow organ. The large
oval is the uterus, but not one under
normal physiologic conditions; rather, it
is a postpartum uterus.
3. The folds of the large oval (yellow arrows),
resembling those of a cloak, are the folds of
the mucosa of the uterus in the postpartum
period. The mucosa of the uterus in normal
physiologic conditions has no folds. These
folds are apparent only after delivery due to
the subsequent retraction of the uterine mus-
cle. Furthermore, the dark red color of the in-
ner aspect of the large oval is typical of the
endometrium after birth.
4. In the lower part of the large oval there is a
ruche (blue arrow), resembling the fold of a
fabric. This fold appears to bend toward the
inner part of the large oval. This is the uter-
ine cervix.
5. Under the small oval there is an unrecogniz-
able stain (purple arrow). This red spot ap-
pears like a sh out of water,perhaps
looking like a doodle or an attempt to retouch
something that was not understood during
the several restorations of the Sistine Chapel.
FIGURE 1. The Creation of Adam (Sistine Chapel).
FIGURE 2. Drawings: female body and uterus.
506 Mayo Clin Proc. nApril 2015;90(4):505-508 n
It took time and thought for us to understand
what this spot represents. Its position under
the tube and its shape make it clear that it is
the ovary. It is likely that the original painting
had more shades in the image but that these
were lost with the restoration because the re-
storers were not aware of what that stain
6. Adam seems to be resting on what looks like a
rock. In ancient times, the rock also had the
meaning of a generating mother (eg, many di-
vinities, such as Mithra, are born from a rock).
However, behind the rock there is a back-
ground of different color (blue) that does
not seem connected to the rock. Looking care-
fully one can see a female body outline, with
thenipplejustaboveAdams head (orange
7. With reference to the female form, the po-
sition of the uterus lies directly above what
would be the lower abdomen of the female,
as if projecting the uterus to its correct
anatomical place.
To emphasize our imagery, we present single
andoverlaiddrawingsinFigures 2,3,and4,
courtesy of the anatomical painter Andrea Iaco-
buzio. It is, of course, no secret that our minds
are powerful and may naturally associate even
unrelated images, yet the incredible similarities
between the painting and the anatomical details
are striking.
Michelangelo, and, indeed, his talented
contemporary Leonardo da Vinci, had early ex-
periences in anatomical dissection. Dissection
was previously forbidden by the Church, but in
the late 15th century, Pope Sixtus IV granted
permission for educational purposes. While Leo-
nardo da Vinci studied corpses at the Hospital of
Santa Maria Nuova, Michelangelo, who was 23
years younger, practiced anatomy on the corpses
in Santo Spirito, thanks to a friendship with the
church prior.
In the pre-antibiotic era, peripar-
tum or postpartum sepsis leading to death was
common. Although accurate records of mortality
secondary to childbirth are not available before
the 19th century, 5 to 6 maternal deaths per
1000 births is no doubt a conservative estimate.
Compared with the medical students of
today, therefore, Michelangelo had plentiful
opportunity to examine such pathology. Gior-
gio Vasari, a historian of that time, writes about
Michelangelos experiences:
Moreover, in order to be entirely perfect,
innumerable times he made anatomical studies,
dissecting mens bodies in order to see the prin-
ciples of their construction and the concatena-
tion of the bones, muscles, veins, and nerves,
the various movements and all the postures of
the human body; and not of men only, but
also of animals, and particularly of horses,
which last he much delighted to keep. Of all
these he desired to learn the principles and
laws in so far as touched his art, and this knowl-
edge he so demonstrated in the works that fell
to him to handle, that those who attend to no
other study than this do not know more.
1, p104
The Sistine Chapel is arguably the most visited
room in the world. With mass global tourism
growing every year, some 5 million people, and
up to 20,000 per day in summer, enter the
Chapel and crane their necks upward. So one
may wonder: Why, despite millions of people
having looked at the painting, has this imagery
not been seenbefore? The inspirational artists
of the Renaissance embraced a 360culture, yet
art academics and historians have little medical
or anatomical knowledge and perhaps may inter-
pret the paintings according to their own view-
points. Indeed, even an expert pathologist
might not immediately identify the uterus owing
to its unusual quasi-sagittal section and the
FIGURE 3. Overlapping images: female body.
FIGURE 4. Overlapping images: uterus.
Mayo Clin Proc. nApril 2015;90(4):505-508 n 507
particular paraphysiologic situation, that is, the
postpartum condition. Usually, anatomists and
medics alike study only the normal or the patho-
logic uterus in standard sections. Crucially, how-
ever, irrespective of the origin of the various
interpretations, it is paramount that we purpose-
fully adopt the attitude of the Renaissance period,
a time when those most interested in human
anatomy were, of course, the artists.
We believe that our interpretation con-
siders clues that have been overlooked in other
studies. Scrutinizing this important piece from
an alternative perspective, pursuing the mind-
set of man living through the Renaissance,
allows us to present this view. The rebirth
of our contemplations permits a logical and
plausible explanation for this remarkable pièce
de résistance.
In memory of Prof Andrea Tranquilli. We also
thank Prof Monica Emanuelli for her kind help
in reviewing the manuscript.
Correspondence: Address to Stefano Di Bella, MD, 2nd
Infectious Diseases Division, National Institute for Infectious
Diseases, Lazzaro Spallanzani,Via Portuense 292, 00149,
Rome, Italy (
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... His deep knowledge in human anatomy turned into marvelous masterpieces, including sculptures, paintings and drawings [6,7]. Apart from this well-known Michelangelo's expertise in anatomical studies, in some works different anatomical structures have been curiously envisaged in the ceiling of the Sistine Chapel, as encoded hidden messages [8][9][10][11][12][13][14]. This pareidolia has been partly criticized just in terms of visual illusions [15][16][17][18]. ...
... Accordingly, the specialist literature describes the renowned Renaissance artist Michelangelo Buonarroti (1475-1564) as one of the greatest anatomist-artists of his time (1). Therefore, over the years, as well as historians, many doctors and anatomists have attempted to better understand the inspirations, and even the possible diseases that affected this genius of human anatomy (1)(2)(3)(4)(5)(6)(7). Thus, the specialist literature (1,(8)(9)(10)(11)(12) has pointed out that Michelangelo's various self-portraits and self-caricatures contained in various of his works produced at different stages of his life may offer some insight into Michelangelo's physi-cal form and, consequently, provide evidence of his health at different stages of his life. ...
Full-text available
The scientific literature has shown that the renowned Italian Renaissance artist and genius of human anatomy Michelangelo Buonarroti (1475-1564) included his self-portrait into some of his most famous works. It has been suggested that the various self-portraits and self-caricatures the artist used in his works over the years may offer some insight into Michelangelo's physical form and, consequently, provide evidence of his health at different stages of his life. Accordingly, this manuscript presents new evidence [based on facial features described by Daniele of Volterra (1509-1566) and Giorgio Vasari (1511-1574)] that Michelangelo may have inserted his self-portrait into one of the figures that make up the Epifania cartoon, made by the artist in 1553, which is currently in the collection of the British Museum in London, England. Thus, the information contained in this manuscript is not only useful for future analyses of Michelangelo's health [based on facial features] when he was approximately 78 years old, but also how the artist, who was known for being very introspective, saw himself physically in his old age.
... 5,10 Within this historical context, it is highly likely that Michelangelo knew of these authors and their publications about sign language, and also about the importance of the ancient Italian manual alphabet for the deaf community, for like many Renaissance artists, Michelangelo was a versatile artist with extensive knowledge in many areas, including those related to the organization and functioning of the human body. 9,[15][16][17][18] This is completely in keeping with what Leon Batista Alberti (1404-1472), a prime example of Renaissance man, wrote. According to Alberti, the artist in his social context cannot be a mere artisan, but an intellectual well versed in all disciplines and fields. ...
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Since antiquity, specialists have worked to facilitate the communication of hearing impaired individuals, which according to the current literature, is among the disabilities that have the greatest impact on the quality of life. The system by which deaf people communicate is based essentially on sign language and the manual alphabet, employing gestures, and facial and body expressions. Although there is no exact data on how many people communicated through sign language in ancient times, studies show manual alphabets were used by deaf people in Europe in the early 15th century. Perhaps this was a reflection of a significant number of deaf people living throughout Europe at that time and who needed sign language to communicate. In this context, this manuscript, for the first time, demonstrates the renowned Italian Renaissance artist and genius of human anatomy Michelangelo Buonarroti (1475-1564) may have used deaf sign language in the fresco The Crucifixion of Saint Peter [Cappella Paolina, Vatican City, Italy]. This would demonstrate the engagement of one of the greatest Renaissance artists, with a clinical condition that has been studied by numerous health specialists since ancient times.
... B. die Fresken in der Sixtinischen Kapelle in Rom) sind weltweit bekannt. Michelangelos Werke zeichnen sich durch ein hervorragendes Wissen der menschlichen Anatomie aus, das durch das in der Renaissance eingeführte Studium von Ärzten und Künstlern in Sektionen erworben wurde und im Werk der Sixtinischen Kapelle an vielen Stellen zum Ausdruck kommt [1,2]. Michelangelo widmete sich vollständig seiner Kunst und zog sich aus sozialen Interaktionen zurück. ...
... In addition, the anatomical positions themselves and the configurations of both Adam researchers. Interestingly, some of these interpretations have suggested that the figures of Adam and God are designed in the form of a placenta, or even a postpartum uterus and adjacent structures ( Tranquilli et al., 2007;Di Bella et al., 2015). ...
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Michelangelo’s unparalleled frescoes in the Sistine Chapel have been traditionally construed to represent the traditional, Roman Catholic interpretation of the Seven Days of Creation in the Book of Genesis and the Last Judgement. Indeed, in September 2018, Pope Francis I offered a benediction for the Vatican’s art treasures and for “those who contributed to the Church’s history through art.” A number of studies have suggested that Michelangelo concealed anatomic information about the human brain in his renderings of God and biblical prophets and saints. Was the anatomic content of these images purposeful or coincidental? Was the anatomy intentionally concealed? Is there a common pattern with symbolic connotations in the anatomic representations? Was Michelangelo sending an encoded message? In this study, we analyze the imagery in the Sistine frescoes in light of the literature surrounding Michelangelo’s artistry with a particular interest in the relationship between the certain purported anatomic depictions and details demonstrable using scientific and anatomic techniques available during the High Renaissance.
The study of human anatomy, besides being fundamental to the practice of medicine, has traditionally always been present in the daily life of many Renaissance artists. In this context, the specialized literature has described the famous Renaissance artist Michelangelo Buonarroti (1475-1564) as being among the greatest artist-anatomists of his time. Thus, many researchers have tried to better understand the inspirations of this famous artist, and even the possible diseases that affected this genius of human anatomy. Therefore, for the first time, this manuscript provides evidence that Michelangelo Buonarroti may have concealed letters, numbers, and faces in the anatomy of the Vatican's Pietà [Virgin Mary/Jesus Christ] in 1498-9. The revelation of these findings, besides testifying to the artist's considerable skill in representing the corporeal forms in his sculptures, will also be provide useful insights into the iconographic understanding of a work of art that is undoubtedly one of the most important of the Renaissance. Moreover, the present study shall be important for professionals in the medico-artistic field and those who keep some interest in the history of human anatomy, which is undoubtedly a fundamental discipline for the practice of medicine.
This chapter proposes that among the wealth of Shakespearean plays that the science-fiction Western series Westworld evokes, it is The Tempest which offers a particularly productive comparative reading, as both the series and the tragicomedy are centrally concerned with the question of how we need to reconceptualise the human. Focusing on returns from the dead, the chapter explores paternal parthenogenesis, melancholic reanimations, the maze as dramaturgical principle, and the feminist, postcolonial revision of The Tempest in Westworld. The rebuilding of the dead in a meta-adaptational manner comments on the series’ strategy of engaging with the cultural memory of Shakespeare, which, once activated, cannot be contained in a few quotations, but shapes the action on a fundamental level.
Aim: To confirm that the sixteenth century surgeon-anatomist, Jacopo Berengario da Carpi, used a woman who died of a ruptured uterus as a model for a woodcut of female genital anatomy, and that the presentation was based on the cloak in Michelangelo’s Creation of Adam after visiting the Sistine Chapel in the Vatican whilst he was in Rome. Method: Analysis of the woodcut for evidence of a uterus at term, and comparison with the shape of the cloak in the Creation of Adam, coupled with Berengario’s own description. Results: The size of the uterus is that in the 38th to 40th week of pregnancy, further supported by striations of the endometrial surface, rather than the smooth surface of the non-gravid. By rotating the woman’s image 90° counterclockwise, the outline of the woman’s cloak becomes almost perfectly superimposed over God’s cloak. Conclusion: In the woodcut, the open belly of the model shows typical features of the full-term uterus. The use of God’s cloak softens the features. At the same time, it exemplifies the creative power of God and describes the birth of humanity in both theological and physiological ways. Intertwining art, religion and anatomy, Michelangelo and Berengario allow scholars to appreciate the concepts of divinity and humanity at multiple levels.
According to Giorgio Vasari (1511‐1574), the great genius of anatomy, Michelangelo Buonarroti (1475‐1564), in painting the frescoes on the ceiling of the Sistine Chapel (1508‐1512), demonstrated to the world a new dimension/perspective of painting, especially in the sublime manner with which the artist represented the anatomical details of the characters that made up his frescoes. Since then, the Sistine Chapel has received millions of tourists annually, who marvel at the anatomical beauty of the characters depicted on its ceiling. It has also received many scholars of art and even anatomists, who have often tried to infer theses and explanations regarding Michelangelo’s real intentions in elaborating this great work. However, even after five centuries, the Vatican's own official explanations of the true intentions of the artist remain quite uncertain. In an attempt to elucidate Michelangelo’s possible intentions in the design of this memorable work, this article presents unpublished evidence that all the frescoes on the ceiling of the Sistine Chapel were organized by the artist according to a code based on the number of characters in each fresco, the gematria of the Hebrew/Greek alphabet, and the Golden Ratio. This decoding process could reveal a key factor influencing the artist’s intentions in ordering the elements in this work. This article is protected by copyright. All rights reserved.
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Michelangelo (1475-1564) had a life-long interest in anatomy that began with his participation in public dissections in his early teens, when he joined the court of Lorenzo de' Medici and was exposed to its physician-philosopher members. By the age of 18, he began to perform his own dissections. His early anatomic interests were revived later in life when he aspired to publish a book on anatomy for artists and to collaborate in the illustration of a medical anatomy text that was being prepared by the Paduan anatomist Realdo Colombo (1516-1559). His relationship with Colombo likely began when Colombo diagnosed and treated him for nephrolithiasis in 1549. He seems to have developed gouty arthritis in 1555, making the possibility of uric acid stones a distinct probability. Recurrent urinary stones until the end of his life are well documented in his correspondence, and available documents imply that he may have suffered from nephrolithiasis earlier in life. His terminal illness with symptoms of fluid overload suggests that he may have sustained obstructive nephropathy. That this may account for his interest in kidney function is evident in his poetry and drawings. Most impressive in this regard is the mantle of the Creator in his painting of the Separation of Land and Water in the Sistine Ceiling, which is in the shape of a bisected right kidney. His use of the renal outline in a scene representing the separation of solids (Land) from liquid (Water) suggests that Michelangelo was likely familiar with the anatomy and function of the kidney as it was understood at the time.
THE BRILLIANT Italian Renaissance artist Michelangelo Buonarroti painted magnificent frescoes on the ceiling of the Vatican's Sistine Chapel, laboring from 1508 to 1512. Commissioned by Pope Julius II, Michelangelo performed this work himself without assistance. Scholars debate whether he had any guidance from the Church in the selection of the scenes, and what meaning the scenes were to convey. In the fresco traditionally called the Creation of Adam, but which might be more aptly titled the Endowment of Adam, I believe that Michelangelo encoded a special message. It is a message consistent with thoughts he expressed in his sonnets. Supreme in sculpture and painting, he understood that his skill was in his brain and not in his hands. He believed that the "divine part" we "receive" from God is the "intellect." In the following sonnet, Michelangelo explains how he creates sculpture and painting and how, I believe, God himself gave man the gift of intellect1:
The history of maternal deaths in England from the earliest records in the 1700s to 1935, concentrating on the influence of medical practice, is recounted. The rate lay between 4 and 5 per 1000 until 1935, with the advent of sulfa antibiotics to prevent puerperal infections. The practice of midwifery by men began in the early 17th century in Britain, but attendance at normal labors by medical practitioners, that is, surgeon-apothecaries, did not become common, and then only in urban areas, until 1730. The use of forceps became widely known about that time, and lying-in hospitals were begun. Obstetrics was held in contempt by professionally educated and registered physicians and apothecaries, however, because of the immodesty and messiness of the work and the long hours involved. Estimates of maternal mortality, from the 1st recorded unselected series, in the late 18th century range from 5-29/1000. Some of the high figures are from specialists in obstetrics, who treated complicated cases. From these data the maternal death rate was estimated at about 25/1000 among unassisted women. Some institutions achieved results better than the national average in the 1920s, suggesting that by the end of the 18th century, a fairly good understanding of childbirth had been reached. At that time the overall forceps rate was conservative, less than 1% compared to 15% now. Use of the perforator, hook and crochet, and manual dilatation of the cervix had been abandoned. In the 19th century, lying-in hospitals became more common and their death rates were higher, probably due to less conservative methods, up to as high as 85/1000, until the advent of antisepsis in 1880. Nevertheless, hospital births were the minority, amounting to 15% in 1927, 54% in 1946, 87% in 1970, 98.8% in 1980. Sepsis, due to casual use of sterile technique, remained the cause of half the total deaths until 1937. It is difficult to assess the contribution of toxemia or obstructed labor in maternal deaths. Rickets was a common cause of obstructed labor, and there are recorded epidemics of both. Similarly, abortion-related deaths are even more difficult to estimate, because of poor reporting. In evaluating the undiminished maternal death rate before 1935, the author believes that maternal survival is remarkably resistant to the ill effects of socioeconomic deprivation, but is very sensitive to the good and bad effects of medical intervention. Hence, there is evidence that the rural and poor in some cases had better results that those given the best medical assistance, especially with regard to puerperal sepsis. The midwifery laws of 1902 provided for training of midwives, and slowly corrected quality of care, as well as hostility between midwives and physicians. The current maternal death rate is about 0.1/1000.