Confusion surrounds the possible illness that Caravaggio suffered from at the time he painted his self-portrait Sick Bacchus ( Bacchino Malato ) in 1593. Publications from 2007 and 2022 suggested that Caravaggio suffered from jaundice based on the yellow color of the artist’s depicted skin observed in a reproduction of the painting. Addison’s disease was proposed as an alternative diagnosis considering the dark tone perceived of his complexion.

The aim of this study was to unravel the information regarding Caravaggio’s illness at the time he painted his self-portrait Sick Bacchus .

The existing literature regarding Caravaggio’s alleged jaundice and illness was reviewed along with the technical and historical documentation of the painting. A literature search included the electronic databases of Pubmed, EMbase and Google Scholar.

The search strategy revealed several publications that addressed the possible illness depicted in Caravaggio’s Sick Bacchus in limited detail, either directly or indirectly. The original canvas displayed in the Galleria Borghese shows the figure of Bacchus with a greyish complexion. Technical investigations demonstrated the presence of two grey ground layers beneath the paint surface. The premise that Caravaggio suffered from jaundice can be considered a misdiagnosis based on an inaccurate reproduction of the painting. The notion that hyperpigmentation secondary to Addison’s disease caused the dark shades of the skin, should be amended in the light of conducted technical analysis. Alcoholism also seems unlikely, given what can be deduced from Caravaggio's self-portrait in the Sick Bacchus .

Possible illnesses depicted in Caravaggio’s self-portrait were based on inaccurate reproduction of the original painting or inattention of the grey ground layers in the painting revealed by technical investigations. This case illustrates how methodological pitfalls in iconodiagnosis can lead to misinterpretations. The assumption that Caravaggio was sick when he painted Sick Bacchus needs to be reconsidered.