Abstract

Artworks focusing on children began to increase only after the Renaissance period, particularly during the 16^th and 17^th centuries. However, direct relation to pediatric health among these pieces is extremely low. In this study, artworks on pediatric health were collected, and their interesting aspects were briefly described. The examples that could be identified consist of photographs taken with permission during museum visits; publications featuring children in painting and the pieces from personal collection. In conclusion, children, and particularly their health, were not prominent topics for art when all the artistic pieces are considered throughout the history. Detecting these pieces and comparing their relation with the medical history could enlighten the improvements in not only the health status of children but also the social perception in subjects such as child abuse and infanticide attempts.

Introduction

Since the dawn of civilization, children were represented in different artistic works mainly for expressing their joy, sincerity, and love. These works illustrated the attitudes and psychological characteristics of the children but also gave hints about the customs and habits of their families and their society. When all the artistic load throughout the history is taken into consideration, the percentage of those focused solely on children and their health is not remarkable. The aim of this study was to present some examples of artistic works related with pediatric health.

When the data about children in art history is examined, it is detected that the anatomical structures, body proportions, and the facial appearances of children were depicted differently than usual in the pre-Renaissance period. They were picturized as little angels or demonic figures. The normal looking, friendly child images began to be found mostly in the post-Renaissance era, as they were depicted in their normal appearances with the change of perspective in painting.[1] In the famous “Venus and Mars” painting of Botticelli, the children were depicted as little demonic figures (Figure 1). On the other hand, again in the 15^th century, Rosso Fiorentino portrayed a child as an angel playing lute in his famous painting named “Musical Angel.”

Figure 1. “Venus and Mars” by Sandro Botticelli (National Gallery, London, 15th century). The children are depicted as little demonic figures.

ART REFLECTIONS OF MAIN ISSUES ABOUT PEDIATRIC HEALTH

- Works about infanticide attempts and child abuse

When it comes to pediatric health, it is undoubtedly necessary to mention the incidents and accidents that put children's lives at risk.

In mythology, paintings depicting Zeus' father, Cronos, eating his own children so that they would not covet his succession in the future have been a source of inspiration for many painters. Cronos' wife, Rhea, saved Zeus from this massacre.

King Herod ordered the killing of all Jewish children born in Bethlehem upon the rumor that a male baby born to Jewish community would be the messiah. This tragic event has also been the subject of many works. The valuable wall mosaic on the entrance gate of the Istanbul Kariye Museum (Figure 2) and the interesting painting by an unknown artist from the South Tyrol school can be cited as examples.[2-4]

Figure 2. Mosaic wall panel depicting King Herod killing innocent babies (pictured above the entrance gate of Chora Museum, İstanbul).

The pictures from the Middle Ages documented that, in Italy, the newborn babies were thrown into the Tiber River to test their viability, and those who showed the ability to survive without drowning were pulled out and brought back to life.[2] The famous practice of abandoning children with different characteristics to nature by their families is famous and has been the subject of many works. It is stated in Ferdowsi’s epic Shahnameh that the boy named Zal, who was born as an albino, was abandoned to nature by his father Saam at the foothills of mountain Alborz in Iran and was later rescued by a sacred bird called Simurgh (Figure 3).[2,5,6]

Figure 3. Depiction of the baby named Zal, who was born as an albino, was abandoned in nature, and was rescued by a bird named Simurgh (an example from Persian literature).

One of the most interesting examples about child abuse in mythology is the “Ganymede” issue. This is also reflected in the paintings of famous artists. Ganymede was a very beautiful Trojan shepherd boy, and Zeus fell in love with this child. Therefore, Zeus took the form of an eagle, kidnapped Ganymede, and assigned him to be his cupbearer. However, according to the information obtained, he also used him as a sex object. This incident has been shown by many historians as one of the known cases of pederasty.[7,8] In Pieter Paul Rubens' famous painting titled “The Abduction of Ganymede” (1611-1612), exhibited in the Austrian Schwarzenberk Palace, Ganymede is depicted as an older, adolescent boy. However, in Rembrant's famous painting, Ganymede is shown as a younger child and in a more erotic appearance (Figure 4).[7-10]

Figure 4. Zeus disguises himself as an eagle and kidnaps the beautiful Trojan shepherd Ganymede, with whom he is in love, to serve himself as cupbearer and realize his secret ambitions (Harmesz van Rjin Rembrant, famous painting exhibited at Gemäldegalerie Alte Meister in Dresden).

In both Western and Eastern art, there are works about surgical interventions performed on children against their wish and will. The most painful but well-known example of this is the castration of male children for various purposes. Carlo Brosci Farinelli (1705-1782), who went down in the history as the most famous male soprano, was castrated in an early age. The boys who were assigned to be “Harem Aghas” were castrated at earlier ages in North Africa and then were authorized to work in the harem in the Ottoman Palace (Figure 5).[4,11-14]

Figure 5. A Harem Agha on duty in the harem section of the Ottoman Palace.

Painting of household accidents and a known miracle, “Miracle of the child falling from the balcony” of Simone Martini (1284-1344), depicts the rescue of a child who fell from a balcony in Siena by the saint named Agostino. It is observed that the Saint grasps both the child and the broken bar of the balcony. The sense of perspective is not fully reflected in this piece, which is an example of early Italian painting. It is exhibited in Pinacoteca Nazionale Siena.

One of the most painful facts known in children's literature is the story of chimney sweeps in England. In the 19^th century, boys were intentionally kept undernourished and small so they could be used to clean chimneys. These small children could fit into the chimney and clean the institutions effectively. These children were known to suffer from skeletal problems, eye and skin lesions at early ages of their lives, and develop bladder cancer in further ages as an occupational disease. These children were represented in different images.[15,16]

- A look at pictures of child health and sick children

The painting “The Expert Midwife” by Jacob Rueff (1500-1558) dates back to the 16^th century. It was made on wood with the carving method, shows a mother lying in her postpartum bed, the baby being washed by the midwife, and the midwife who successfully delivered the birth drinking beer on the right side of the painting.[17]

In a 13^th century manuscript, the effort to give a prepared medicine to a sick child is displayed (Figure 6; anonymous, from Büyükünal's personal collection).

Figure 6. Giving medicine to a sick child (13th century, anonymous, personal collection of S.N. Cenk Büyükünal, MD).

In an anonymous work dating back to 1638, eight babies are seen lying in a baby room. It is observed that the color of two of them is paler. About a week after the completion of the painting, all the babies were lost (Figure 7). The babies most likely belonged to the Jan Gerrisz family. The painting, made in 1638, reminds us that hygiene conditions were very inadequate at that time. Many people were dying due to infectious diseases such as the plague, chickenpox, and typhus. Two older children, in addition to the possible mother and father, are also seen watching the sick babies in the painting.[1]

Figure 7. An anonymous work from 1638. The babies of the Gerrisz family are in the baby room.

In the beautiful work of an artist of French origin and representative of the Rococo style named Jean Honore Fragonard (1732-1806), the father who comes to the baby room and visits the mother giving birth and the newborn baby kneels because of a “healthy” baby, which was a crucial concept at that time. You can see the father kneeling and thanking the mother. In this painting exhibited in the National Gallery of Art, Washington, it is evident that the two older siblings are watching the father.[1,18]

The painting “Sick Child,” painted by the Dutch painter Gabriel Metsu in 1664, shows the appearance of a typical sick child (Rijk Museum Amsterdam; Figure 8).[19]

Figure 8. The painting of the famous Dutch painter Gabriël Metsu, dated 1664, is in the Amsterdam Rick Museum and depicts a completely sick child (photographed on 17.7.2016 with the permission of the museum official).

A painting of Goya school has created different comments. One of them was that the man was examining and intervening on a child suffering from diphtheria. The painting was entitled in several books of History of Medicine and also in some catalogues as the “Curaciòn del Garrotillo,” the treatment of diphtheria. On the other hand, the painting was also entitled as the “El Lazarillo de Tormes” and was accepted to depict a boy who gulped down a sausage and tried to deceive the blind old man (Figure 9).[20]

Figure 9. Painting by an anonymous painter from the Goya School showing the examination and intervention for a child with diphtheria (1802-1812).

The artist Cecilia Beaux depicted a girl named Ernesta in the hospital with a nurse accompanying her. The work named “Ernesta with a Nurse” was created in 1894.[21,22]

The metabolic problems in children have also been the subject of art pieces. One of the most famous is the portrait of an Italian painter named Bronzino. He painted the two-year-old child of the Medici family named Giovanni de Medici, who was quite obese and large for his age, in 1545. This portrait in the famous Uffizi gallery in Florence belonged to the children of Cossimo and Eleonora Medici, who were known to be very healthy and resistant to diseases.[1]

Henrik de Keyser reflected successfully the facial expression of a crying child stung by a bee in 1614 by wooden carving.[23]

There is a representative picture of a child suffering from smallpox in Keklikoğlu's article on Chinese medicine called Ying and Yang.[24]

Circumcision, which is perhaps the most commonly performed surgical procedure on male babies throughout history, can be detected in different art pieces and is also beautifully illustrated in the work of the Naples painter Luca Giordano (Figure 10).[4]

Figure 10. “The Circumcision,” oil painting by Luca Giordano. (Romanian National Museum of Art, Bucharest).

- Data regarding vaccination and physician examination

Jenner administers smallpox vaccination to a child in a sculpture made in 1878 (Figure 11). This work of the famous Italian sculptor named Giulio Monteverde (1837-1917) can be considered one of the most important sculptural works on child health.[25]

Figure 11. Jenner administering a vaccine to a child (1717). The famous sculpture of Giulio Monteverde is exhibited in Rome.

Louis Leopold Bolly (1761-1845), who is famous for his pieces depicting Parisian life, painted a doctor applying the vaccine with some hesitation and some curiosity and named the painting as “Vaccination of a little child.”[17]

The works presented in Figures 11 through 15 are lithographs, generally from the 19^th century, dealing with themes such as child examination and vaccination mainly in England, and taken from Dr. Cenk Büyükünal's personal collection. These works are usually exhibited during pediatric surgery congresses held in England, Camden City. It was purchased personally during trips to antiquities markets such as Notting Hill.

Figure 12. A doctor vaccinates children in England, 19th century (personal collection of S.N.Cenk Büyükünal, MD).

Figure 13. Children’s ward in a hospital, 19th century, England (personal collection of S.N.Cenk Büyükünal).

Figure 14. A doctor examining a child is depicted in a lithograph by Dutch painter E. Van Loo (personal collection of S.N. Cenk Büyükünal, MD).

Figure 15. England, a lithograph from 1890. “The Accident,” applying a bandage to the child whose hand was damaged (personal collection of S.N. Cenk Büyükünal, MD).

In conclusion, when all works of art are considered, the percentage of works depicting children is relatively low. Additionally, the number of works dealing with the subject of child health as a theme is even less. This number appears to have decreased further in the pre-Renaissance period. This study is dedicated to collect the art pieces such as the images, paintings, sculptures, and carvings created on issues related to child health. Child abuse, infanticide attempts, and compulsory castration attempts at childhood reflect the sad and exemplary aspects of our work. The aim is to collect as many works as possible in the coming years and to evaluate their relation with the improvements in health status of children.

Citation: Büyükünal SNC, Yeşildağ E. Reflections of child health in the field of art throughout history. Turkish J Ped Surg 2025;39(3):168-175. doi: 10.62114/ JTAPS.2025.200.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Collection of data, preparation of the manuscript: S.N.C.B.; Preparation of the manuscript: E.Y.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

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