Ribera's (1591–1652) “The Clubfooted Boy”, has long been recognised as showing hemiplegia.1The note's message (translated) “Give alms for the love of God.” may have lost its force in our secular age, but it does not weaken the central point of a disabled child begging for a living.

The message also suggests he was unable to speak. Whether his disability was congenital or occurred later, affecting his speech, we can never know. Medicine has given us a greater understanding of the causes of disability but, as yet, hardly any effective treatments to reverse it.

Pictures of disability, even in our apparently more enlightened times, still make up a small minority of the whole corpus of modern art. This picture sharply reminds us that the disabled child's lot can be far worse, especially within the developing world, where the majority of the world's disabled live and where resources are far poorer than in the United Kingdom.

Too often, a parent's dream dies on the lips of the medical messenger delivering the diagnosis. “Elimosinam” (the word for alms) is fractured—metaphorical perhaps of a life of broken promise or of promises broken. This mute boy brings into mind other images: the lack of a single clear voice responsible for children and advocating on their behalf or, as the litany of child abuse enquiries continue to relate, voices that were not heard.

The mute hemiplegic beguiles us with a myth idealising a disabled child begging for a living. Whatever challenges we face in our paediatric practice—the abolition of child poverty being one—it is our duty as paediatricians to meet them. Whether we are ultimately successful, only future Archives readers, accidentally stumbling across this article, will be in a position to know.

• Download figure
• Open in new tab
• Download powerpoint

Figure 1

“The Clubfooted Boy” by Jusepe de Ribera (1591–1652), Musée du Louvre. © Photo RMN-Gérard Blot.