The child with the varus foot

Abstract

One of the most touching and anguishing feeling neurosurgeons may experience in their professional life is the appreciation of the endurance most suffering children demonstrate towards their disease and the associated handicaps. The nice smiling of the crippled child painted by the Spanish artist Jusepe de Ribera (Jativa, Valencia 1591– Naples 1652) in 1642 on the cover picture is a further example of the extraordinary tolerance of children in coping with their sufferings. The naked pes equinus, which the child shows, gave the painting its denominations: Le pied bot, El lisiado, The child with the varus foot. However, the flexed posture of the right hand, the shorter right arm as compared with the opposite corresponding limb, and the deviated buccal rim might suggest a right hemiparesis from a perinatal occlusion of the left middle cerebral artery. The self-assured and almost amused attitude of the painted child also suggests a normal mental development, as it occurs in most cases, which are not complicated by drug-resistant epilepsy. The painting, originally painted for don Ramiro Felipe de Guzman, Naples viceroy from 1637 to 1644, was then acquired by the Flamish marchand and art collector Ferdinand Vandeneynde. In 1849, it was owned by the physician Louis La Caze to be successively donated to the Louvre museum in Paris in 1869. It is possible that the painting was originally intended for a cabinet de curiosites, one of the many private collections consisting of a variety of unusual things, from antiques to oddities of the nature, to which the cultivated and rich elites of the time liked to indulge. These cabinets might be regarded as the precursors of the modern museums. After the manner of Caravaggio, de Ribera utilized a nearly monochromatic palette; however, the perspective from below, the fierce gesture of the child holding the stick on this left shoulder, the waste expanse of the sky of the background gave the portrayal an extreme dignity. The same dignity can be found in another work of the painter: a representation of a further oddity of the nature, namely the portrait of Maddalena Ventura, nowadays at the Fundacion Duque de Lerma in Toledo, the artist painted on request by another Naples viceroy, the duke of Alcala in 1631 (Fig. 1). Childs Nerv Syst (2006) 22:1377–1378 DOI 10.1007/s00381-006-0218-0