During the 18th and early 19th century, smallpox (variola) was a leading cause of death, in children especially. In Finland, the percentage of deaths among children aged 1–10 years was between 20% and 30%.1 Sixty-five to 80% of survivors displayed facial pockmarks.2 To our knowledge, there are few identified artistic depictions of patients with variola. Painters usually refer to smallpox through portrait of Edward Jenner (James Northcote, Edward Jenner, 1803, National Gallery Portrait, London) or active vaccination sessions (Vicente Borrás y Abellá, Vacuna ción de niños. ca. 1900. Museo Nacional del Prado, Madrid),3 but rarely to patients. In 1626, Sustermans painted several portraits of Grand Duke Ferdinand the Second of the Medici at various stages of the disease.4 We report here about a portrait by Finnish painter Akseli Gallen-Kallela (1865–1931) from 1893 entitled ‘Pockmarked Boy from Savo’ (Rokonarpinen savolaispoika) that currently belongs to the Turku Art Museum collection. The artist painted the motif at Vehmersalmi, near Kuopio, in the Northern region of Savonia, along with some other canvases. The portrait depicts a Finnish boy in his teenage years, probably between his 10–15 years. He sits from ¾ and avoids looking directly at the spectator. His face is riddled with medial facial skin-coloured scars, and a slightly hypertrophic red scar is notable near the left nasolabial fold. The disfiguring scars left by the infection may explain the seeming sadness of his look (Fig. 1). The first country in Europe introducing obligatory smallpox vaccination was Bavaria in 1807. In Finland, Jennerian vaccination was carried out as early as in 1802 under the impulsion of the Finnish Economic Society (Finska Hushållningssällskapet). Along with other measures, vaccination led to a decline of smallpox mortality during the early 19th century in the country.1 Smallpox may be confused with other conditions, mainly chickenpox. It is also known that, at the time, common people in Finland used to call all skin eruptions rokko or rupuli (poxes) leading to possible misdiagnoses in case of deaths.1 It can be discussed whether the sitter had smallpox or chickenpox. However, smallpox was also easily diagnosable at the time and the last ‘great’ smallpox epidemics in Finland occurred in 1880–1882, 13 years before this portrait. The scars appear also quite deep compared to those from chickenpox; therefore, there is no reason to doubt the origins of the boy’s pockmarks. At the time of the painting, smallpox mortality dropped to 3.6/10 000 inhabitants,1 and at the turn of the 20th century, smallpox was not endemic in Finland anymore.1 Akseli Gallen-Kallela may have chosen to represent the marks of a soon by-gone disease in Finland. The author is indebted to Christian Hoffmann, Curator at the Turku Art Museum, Finland, for suggesting this artwork and additional input regarding the manuscript.
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