The sick child in art
=====================

* Trevor Duke

## Abstract

There are at least 12 paintings from the late 17th to the early 20th centuries titled, ‘The Sick Child’. They were painted by well-known and obscure artists from Holland, Norway, France, England, Spain, North and South America. Most depict infants, and some older children, always in their homes, most with the mother at the bedside. The Sick Child paintings are a window into the human condition before hospital treatment was the norm, and childhood illness and death were an experience common to almost all families. They depict the mother-child bond of love and protection, complex human emotions, and the hardship and vulnerability of children and families of those eras. There remains a role for art in health and medicine, even in the 21st century.

*   Child Health
*   History Of Medicine

## Introduction

There are at least 12 paintings from the late 17th to the early 20th centuries titled, ‘The Sick Child’.1–12 They were painted by well-known and obscure artists from Holland, Norway, France, England, Spain, North and South America. Some of these paintings were a natural extension of the artist’s oeuvre; from realist artists who commonly painted children in normal life, those who focused on painting peasant life where illness was commonplace. For some artists, the paintings are intensely personal, depicting loved ones at critical and often tragic moments in their lives. And for some, the provenance of the painting or link to the arc of the artist’s body of work are unknown. This article describes some of what they teach us about society, health, medicine and family life in the 250 years that these paintings span, and about the enduring role of art in paediatrics in the 21st century.

In all but three of the Sick Child paintings, the mother is with the sick child. The mothers have a look of worry, fatigue, exhaustion, searching, anxiety, despair and grief, depending on the severity of illness of the child. In three paintings, the father is also present, helping, observing and concerned. Two paintings include a doctor doing a house-call, but in most, the mother and other caregivers appear to be coping on their own. Although, apart from one of the works (by Munch), we cannot be sure of the illnesses these children had, it is likely there was little treatment available at that time.

## The Sick Child, Gabriel Metsu (1629–1667), Holland, c. 1660–1665

The earliest of these Sick Child paintings was by Gabriel Metsu, a realist Dutch artist, who painted life in Amsterdam (figure 1).1 In this painting, a mother is cradling her listless child, probably a girl, on her lap. This artistically has been likened to The Pietà: usually a painting or sculpture showing Mother Mary cradling the dead body of Jesus, with the two positioned in a way that creates a cross (note the crucifixion drawing above the child). In Metsu’s The Sick Child, the child, pale and floppy, gazes vacantly, and the mother looks over her attentively. As in many Sick Child paintings, there is a bowl or jug and spoon nearby, indicative of broth, medicine or sustenance, but the child is likely too lethargic to take any. In Holland in the 17th century, life expectancy for women was in their 40s, and child mortality was 250/1000. In the year 1663, around the time of this painting, plague killed 1 in 10 citizens in Amsterdam, and outbreaks of childhood dysentery were common throughout the 1660s.13

![Figure 1](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F1.medium.gif)

[Figure 1](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F1)

Figure 1 
The Sick Child, Gabriel Metsu, Holland, c. 1660–1665. Location and photo credit: Rijksmuseum, Amsterdam.

## The Sick Child, Edvard Munch (1863-–1944), Norway, 1896

Several paintings called The Sick Child are intensely personal, including one of the most famous, by Edvard Munch, the Norwegian artist, based on the memory of the moment before the death of his older sister, Johanne Sophie, from tuberculosis at age 15 in 1877 (figure 2).2 The adolescent girl depicted is listless and pale, with sparse orange hair. Her eyes are open looking at an older woman, presumed to be modelled on Munch’s aunt, Karen, as their mother had also passed away from tuberculosis when Munch was 5, and their aunt brought up the 4 children in the family. The woman dressed in dark clothing has her hands clasped, exhausted, overcome with emotion to the point she cannot seem to look at the child, or praying. Over 40 years (1885–1926), Munch did six paintings, hand-coloured lithographs and etchings depicting this tragic scene, which he would have seen at the impressionable age of 14, and possibly many times later. In some versions, the girl seems to have her lips open, as if whispering something to her female carer. In Europe in that era, tuberculosis was a constant threat, both in society and in Munch’s family. Edvard often accompanied his father, who was a doctor, on home visits to such patients, and he later used one of them to model the adolescent girl in the painting. Edvard was very unwell as a child, confined to bed through winters, too sick to attend school, but able to pursue his passion for drawing. Another of Edvard’s sisters was diagnosed with schizophrenia and was admitted to an asylum. Munch’s paintings depicting mental illness are well known (The Scream, 1893; Anxiety, 1894, among them),14 and the memory of his sister’s death understandably affected him throughout his life.

![Figure 2](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F2.medium.gif)

[Figure 2](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F2)

Figure 2 
The Sick Child, Edvard Munch, Norway, 1896. Location: Gothenburg Museum of Art. Photo credit: Hossein Sehatiou.

## Mother at the bedside of a sick child, Christian Krohg (1852–1924), Norway, 1880

Another Norwegian realist painter, Christian Krohg (Mother at the bedside of a sick child, 1884),3 depicted a mother sitting on a wooden and wicker chair, leaning forward in hope and anticipation while her pale daughter sleeps on a large pillow, her face illuminated by the morning sun (figure 3). Like Munch, Krogh had also experienced the death of his mother from tuberculosis or complications of childbirth when he was 8 years of age, and he too had lost his 9-year-old sister from tuberculosis when he was aged 16. In another poignant painting, Krogh depicted the solitary figure of an older girl, pale and sick in a chair, with tuberculosis (The Sick Girl, 1880). Krogh did other paintings of a mother and child, often displaying exhaustion but tender protectiveness (Mother and Child, 1883).

![Figure 3](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F3.medium.gif)

[Figure 3](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F3)

Figure 3 
Mother at the bedside of a sick child, Christian Krohg, Norway, 1880. Location: National Museum of Norway, Oslo. Photo credit: Borre Hostland.

## *Le Nourrisson (L'enfant Malade*) (The Infant (The Sick Child)): Jean-François Millet (1814–1875), France, 1858

The *Le Nourrisson (L'enfant Malade*), The Infant (The Sick Child) by Jean-François Millet is a depiction of the desperation of a young family in rural France (figure 4).4 A worried mother is tenderly cradling her sick infant, seated on a bench outside their stone cottage, and from the doorway, the young father is offering what help he can with a bowl and spoon to feed the infant. Minimalist, using a few washed-out colours, pencil and pastel on paper, one of Millet’s beautiful realist artworks of rural life in France in the 19th century (Gleaners, 1857, The Angelis 1858, among them).

![Figure 4](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F4.medium.gif)

[Figure 4](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F4)

Figure 4 
Le Nourrisson (L'enfant Malade), The Infant (The Sick Child). Jean-François Millet, France, 1858 Private collection.

## *L'Enfant malade*: Eugène Carrière (1849–1906), France 1885

Another intensely personal painting was by the French painter, Eugène Carrière: *L’Enfant malade* (The sick child) (figure 5).5 The pale child, contrasted against the dark brown background, is sitting in her mother’s embrace. The mother’s eyes are closed, as if tired, and her arms wrap tenderly around her child, described as being ‘perpetually fending off illness and death’.15 The painting is a portrait of Carriere’s wife and one of her children, who died the same year that the painting was done, aged 6 years.

![Figure 5](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F5.medium.gif)

[Figure 5](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F5)

Figure 5 
*L'Enfant malade*. Eugène Carrière, France, 1885. Location and photo credit: Musée d'Orsay, Paris.

## Trouble, The Sick Child, Alice Havers (1850–1890), England, 1882

Alice Havers was a prolific painter of children in different levels of society in 19th century England, some rural, some urban. She painted children playing together, exploring, with attentive mothers, or begging on the streets. In her painting, Trouble: The Sick Child (figure 6), Alice Havers depicts a family of poor means in a crowded grey city environment.6 A boy aged about 8 years is on his mother’s lap, pale, floppy, poorly conscious and looks close to death. The mother is stoically giving instructions to an older boy, who is listening carefully, to summon help. The look on the mother’s face and the posture of her hand and arm suggest a sense of action and authority, as well as weariness. The sick boy’s sister is kneeling, dressing him after washing him with a nearby basin, gazing at his face, conveying tenderness and love. A younger child is seen sitting on the floor behind the open door, under washing hung indoors, and another woman is about to enter from the stairs bringing a pitcher of water. Alice Havers’ paintings often depicted women’s struggles, and her own life was marred by domestic violence. Her premature death from a morphine overdose aged 40 years was said to be in response to this. Alice Havers first exhibited this painting with the Society of Female Artists, where she was praised for treating ‘the domestic sorrows of humble life with touching tenderness’. The only woman artist of the 12 Sick Child paintings, and in many ways, this work is unique: the banal, realistic detail of the home: the laundry hanging out to dry, the iron, and it is the only painting depicting a mother in an organising as well as comforting posture.

![Figure 6](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F6.medium.gif)

[Figure 6](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F6)

Figure 6 
Trouble. The Sick Child, Alice Havers, England, 1882. Location and photo credit: Southwark Art Collection.

## *El Niño Enfermo* (The Sick Child): Francisco Arturo Michelena Castillo (1863–1898), Venezuela, 1886

The only known South American Sick Child painting is by Francisco Arturo Michelena Castillo. This painting won a Gold Medal at the Paris Salon in 1887 (figure 7).7 It shows a doctor giving advice to the parents of a sick boy who is lying in bed, lethargic and pale with a moist cloth on his forehead to reduce fever, as in several of these paintings. The mother who is sitting on the bed, and the father who is in the shadow at the head of the bed, are listening attentively to the doctor, and an older sister also in shadow, listens behind the doctor, nervously trying to stay out of the way. The family members look very concerned and are dressed in dark clothing. This is the only painting that may depict care in an infirmary. Castillo died aged 35 years from tuberculosis.

![Figure 7](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F7.medium.gif)

[Figure 7](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F7)

Figure 7 
*El Niño Enfermo* (The Sick Child). Francisco Arturo Michelena Castillo, Venezuela, 1886. Location and photo credit: National Museum of Venezuela.

Other Sick Child paintings in the 19th century included that by Jean Augustin Franquelin in 1820,9 at a time when France was emerging from the Revolution, and the child mortality rate was estimated at 290/1000. The painting shows a small room, a mother seated beside the wicker cot of a sick infant. The mother looks exhausted, and the infant pale and sleeping, head is draped with a wet cloth. A bowl with broth and spoon is on the floor. Two other paintings, by Edward Bird (England, date unknown c. 1800)10 and John Bond Francisco (1893),10 11 depict an elderly female caregiver, likely a grandmother, at the bedside with the child, reading or knitting, but keeping watch, bowl and spoon with water or broth on a bench at the bedside. In Bird’s The Sick Child, the child’s head is wrapped in a wet cloth as if he has a fever, and his face and neck are pale and swollen.10 This was painted at a time in England when diphtheria was common.

The painting ‘Anxious moments; a sick child and grieving parents’11 (John Whitehead Walton, 1894) is a dark scene inside an English farmhouse, a girl rests eyes closed in a large bed, her pallor illuminated by a candle on a bedside table.12 The mother is seated on a stool at the foot of the bed slumped forward with her head in her hands, the father stands with eyes downcast, and an older woman sits at the head of the bed comforting the child, all listening to a doctor who sits on the edge of a chair at the bedside, holding a watch.

## Sick Child (Octavi, the artist’s son): Ricard Canals (1876–1931), Catalan, 1903

The twelfth of these Sick Child paintings was done in 1903 by Ricard Canals8 (although Edvard Munch painted his sister Sophie until 1925), but this one is different in that only the child is present, sitting in bed holding a toy, looking moderately unwell: pale with dark circles around his eyes and dilated pupils (figure 8). This was Canals’ son, Octavi, whose godfather was Pablo Picasso.

![Figure 8](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F8.medium.gif)

[Figure 8](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F8)

Figure 8 
Sick Child (Octavi, the artist’s son). Ricard Canals, Catalan,1903. Location and photo credit: Museu Nacional d’Art de Catalunya, Spain.

In the nearly 250-year era of these paintings, most children with severe illness were cared for at home, and the child mortality rates in these countries exceeded 100 per 1000 live births. There have been no paintings called ‘The Sick Child’ where children are depicted in hospitals, and no such titled paintings in the last 100 years. Much is different about the care of sick children in that time, and much is different about society. In this most recent century, child death became rarer, no longer within the experience of almost every family, far more medicalised, less public and far more private. Despite vast changes in science, medicine and technology, the Sick Child paintings show emotions that are universal and enduring, including compassion and grief, and the mother-child bond of love and protection. And the Sick Child paintings are a reminder of the hardship and vulnerability of children and families affected by serious illness in those eras, much of which is still common today.

The author offers one more: a sick infant with pneumonia cradled on a mother’s lap, receiving oxygen by nasal prongs, and the care of an attentive young doctor, in Papua New Guinea in 2024 (figure 9). A reminder perhaps that in some countries and cultures, childhood illness and death remain everyday experiences for many families. But it is also a hopeful scene, a reminder of the significant progress in the care of sick children, even where resources are limited: a young female doctor conveying competence and thoroughness, the life-saving benefits of modest technology, the flow-through ventilation through open louvre windows, the child-friendly mural on the walls. And it is also an enduring scene, the tender embrace of a mother, and hypervigilance displayed, even by the sick child, when approached by a stranger.

![Figure 9](http://adc.bmj.com/https://adc.bmj.com/content/archdischild/early/2025/04/30/archdischild-2025-328488/F9.medium.gif)

[Figure 9](http://adc.bmj.com/content/early/2025/04/30/archdischild-2025-328488/F9)

Figure 9 
The Sick Child. Trevor Duke, Papua New Guinea, 2024, ink and watercolour on paper.

This article is but a narrow account of the sick child as depicted in art; not covering poetry, sculpture, photography or performing art. In poetry, for example, there are many pieces on the Sick Child, including that by Robert Louis Stevenson.16 Much too is different about visual arts in the current century; to a large extent photography has replaced paintings of ordinary life, and no doubt there is art in that medium depicting the Sick Child. And art has become therapy: many recent art works are produced *by* ‘the sick child’, sometimes of themselves, but sometimes of the world they perceive. Art can help children deal with traumatic events in their past or medical conditions (as drawing did for Edvard Munch as a child); it can be beneficial where literacy is limited and can be therapeutic for sick children and adolescents of all ages and abilities.17

The author started collecting images of the Sick Child paintings in 2001, as part of an introductory talk to medical students every term, called *Recognition of the Sick Child*. These paintings illustrate the clinical signs of serious childhood illness well, but as we have seen, they tell us much more. There remains an important role for art in health and medicine, even in the 21st century.

## Footnotes

*   Contributors TD wrote the text; however, the key contributors are the artists whose work and stories are the subject of their paintings.

*   Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

*   Competing interests None declared.

*   Provenance and peer review Not commissioned; externally peer reviewed.

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