Iconodiagnosis Recommendations

Faced with the exponential increase in publications in this ﬁeld, it was necessary to propose clear rules and a precise and rigorous methodology allowing a serious practice of iconodiagnosis.

STEP 8

Where applicable, theological meanings and pagan symbolisms that may inﬂuence the artwork should be elicited.

STEP 1

Ideally, an artwork should be observed in persona. Since this precondition cannot be always fulﬁlled, Iconodi-agnosis shall be performed exclusively on high-resolution images provided by the museums where the artworks are kept.

STEP 2

The reconstruction of the history of the artwork should be performed with help of the museum curators or previous detailed descriptions. Before proposing a series of differential diagnoses, scholars need to investigate whether the work of art underwent restoration and if so to observe pre- and post- restoration images to identify small changes that may mislead.

STEP 3

An artwork has to be examined in its entirety. In the case of sculptures, all angles need to be carefully examined to avoid misdiagnosis. After having care-fully observed the work of art, if a possible pathological sign is detected and a medical hypothesis is formulated, a diagnosis by exclusion can be proposed.

STEP 4

Whenever possible, artworks should be controlled by comparing parallel representations by the same or by different artists. This step should identify any potential peculiarity of an artist’s way to produce their art work e.g. Leonardo da Vinci did not paint eyelids, so the lack of eyelids in the Mona Lisa is not pathological.

STEP 5

An artwork needs to be contextualized in the historical-artistic period in which it was created. Artworks by the same author and by other contemporary authors have to be examined to rule out any possible stylistic wave or fashion that could be mistaken for pathological ﬁndings.

STEP 6

In the case of historical individuals, a perusal of all other available sources, especially written documents i.e. letters, biographies, medical reports and autopsy reports, should be performed to conﬁrm or discard a given diag-nostic hypothesis.

STEP 7

The medical knowledge at the time in which the work was created should be also considered, to ascertain the potential degree of medical knowledge of each artist.

STEP 9

Having accomplished the aforementioned steps, the presumed pathological lesion should be evaluated by a panel of medical practitioners with expertise in the area of the presumed disease e.g. a dermatologist should be involved in the diagnostic process of most skin disorders.

STEP 10

Ideally, after having formulated a diagnostic hypothesis and any differential diagnoses, a consensus diagnosis should be reached among the members of the iconodiagnostic team.

STEP 11

During this ﬁnal step (step 10) the expert team may provide an estimation of the ‘‘level of evidence’’ for their diagnosis in order to provide an estimation of the certainty of diagnosis. A simpliﬁed of Franco’s classiﬁca-tion is proposed (Table 1).