Does wealth lead to health? — Prof Tim Stephenson — 19th Oct 2020

Once again high­light­ing the depth of know­ledge within our own mem­ber­ship, we were treated to the second half of Tim Stephenson’s explor­a­tion of the immensely power­ful and wealthy Medici family.


Prior to his retire­ment Tim, a pro­fessor of patho­logy, was Clinical Director of Laboratory Medicine at Sheffield Teaching Hospitals and an hon­or­ary pro­fessor at Sheffield Hallam University. Another excel­lent audi­ence of 40 mem­bers, plus three guests from our wait­ing list, watched our latest Zoom present­a­tion, eager to hear the con­clu­sion of the Medici talk which Tim had star­ted on 3rd August.

The answer to the ques­tion posed in the title of Tim’s present­a­tion is a resound­ing “No.” The wealth side of the equa­tion wasn’t a prob­lem for the Medicis, the bank­ing and polit­ical dyn­asty who first came to prom­in­ence under Cosimo de Medici in the Republic of Florence in the first half of the 15th cen­tury.

The family, as Tim poin­ted out, was richer than most mon­arch­ies, most nations and the papacy. But their health became decidedly ‘iffy’ through a com­bin­a­tion of over-rich diet, over-protection from the out­side world and nat­ural sun­light, and over-selective breed­ing (rich fam­il­ies only inter-married with other rich fam­il­ies, in the hope of increas­ing their wealth even fur­ther).

The sub­title of Tim’s con­clud­ing talk was ‘Part 2: The Diseases, the Suffering,’ and he explained how the Medici family has been the sub­ject of medico-historical interest as many of its most prom­in­ent fig­ures were known to have suffered from debil­it­at­ing ill­nesses through­out their lives.

The risks of wealth included assas­sin­a­tion; in 1478, Guliano Medici was assas­sin­ated by the rival Pazzi family in front of 10,000 people during an Easter church ser­vice.

Although the defi­ciency of vit­amin D that causes rick­ets is often linked to the mal­nu­tri­tion and pol­luted, cramped and sun­less living envir­on­ments of the urban poor, scions of the Medici family, Grand Dukes of Tuscany, suffered from rick­ets.

In 2003, research­ers at the uni­ver­sit­ies of Pisa and Florence began the exhuma­tion of 49 Medici family buri­als in the Basilica of San Lorenzo in Florence. Nine small coffins held the remains of Medici chil­dren who had died between birth and five years of age. X-ray and osteo­lo­gical ana­lysis of the remains found that six of them had the dis­tinct­ive signs of rick­ets – curved arm and leg bones – even in very early infancy.

So these chil­dren of great priv­ilege, raised in the lap of Renaissance luxury, not only suffered from vit­amin D defi­ciency as they were grow­ing up, but were afflic­ted by it prac­tic­ally from birth. Rickets, Tim poin­ted out, is easily pre­ven­ted by eating foods such as eggs and cheese, and by spend­ing short amounts of time exposed to sun­light, which trig­gers vit­amin D pro­duc­tion. Breast milk was sup­ple­men­ted with ‘paps’ made of soft bread and apples. Neither cer­eals not breast milk con­tain much vit­amin D, and fruit con­tains none.

The Medici chil­dren, wrapped in many heavy layers of swad­dling and cocooned in grand houses, prob­ably didn’t get the same amount of sun­light as their ‘less for­tu­nate’ peers. The research­ers con­cluded that the moth­ers them­selves might have had low-level vit­amin D defi­ciency because of low light expos­ure of high-status women, or as a result of fre­quent child­bear­ing.

The ladies of the house­hold would be heav­ily made up, often using white lead and ver­mil­ion which, at that time, was derived from cin­nabar, or mer­cury sulph­ide, and — with an SPF (sun pro­tec­tion factor) of 1,000 — blocked out vir­tu­ally all ultra violet.

The Italian Renaissance princes had a much wider choice of food than other classes, but appar­ently did not avail them­selves. Historical records reveal that after meat and wine, which con­sti­tuted the nuc­leus of the nobles’ diet, eggs and cheese appear – but infre­quently. In the aris­to­cratic diet, veget­ables occu­pied a sec­ond­ary place, with an almost total absence of fruit. Gout, gen­er­ally believed to be caused by an over-rich diet, was also pre­val­ent.

Since the aver­age age of the mem­ber­ship of Stumperlowe Probus Club is well over twice the life expect­ancy of the aris­to­cratic 15th cen­tury Florentine, one can only pre­sume that we’ve all been eating our greens.