The syphilis of Maria Salviati (1499-1543), wife of Giovanni de’ Medici named “of the Black Bands”

The well-preserved skeleton of Maria Salviati (1499-1543), wife of Giovanni de’ Medici, named “of the Black Bands”, has been exhumed in 2012. Maria was buried beneath the floor of the Medici Chapels in Florence, together with the other members of this famous family, so important for the Italian Renaissance. Many lytic lesions were detected on the Maria’s skull. On the left antero-mesial portion of the frontal bone, on the squama and medially to the orbit, there are two evident circumvallate cavitations, irregularly elliptical in shape, with a central destructive focus and a reactive bone formation on the margins, as the CT examination also confirms. The cranial vault shows, on the parietal bones, several osteolytic lesions in form of circumvallate cavitations and fine, radial scars from the centre of the shallow depressed areas. The CT verifies the nature of the lesions, which morphologically are inter-nodular stellate depressions. The combination of a crater-like lesions as circumvallate cavitations on the frontal bone (phase 4 in the Caries Sicca sequence of Hackett) and of circumvallate cavitations with radial scars on the parietal bones (phase 5 in the Caries Sicca sequence of Hackett) is pathognomonic for syphilis. The present study discusses the syphilitic lesions observed in the skeletal remains of this important member of the Medici family, reconstructs the nosography of Maria Salviati by the written and iconographic sources, and analyses the gender social impact of the venereal syphilis in the aristocratic groups of the Renaissance.