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J R Soc Med. 2007 March; 100(3): 153–154.
PMCID: PMC1809168

The diagnosis of art: Lowry's Cripples

Lawrence Stephen Lowry (1887-1976) is best known for his naïve-style ‘matchstick’ people in the industrial north of England. In the later stages of his career, he became increasingly fascinated by misfits, down and outs, and cripples. Perhaps the attraction stemmed from his depression after the death in 1939 of his mother, to whom he was very close, or it may have arisen in the aftermath of World War II. His job as a rent collector with the Pall Mall Property Company in Manchester, until his retirement in 1952, allowed him to wander through the streets and record ‘his people’.1

Lowry was also interested in crowds.

‘Accidents interest me—I have a very queer mind you know. What fascinates me is the people they attract. The patterns those people form, and the atmosphere of tension when something has happened... Where there's a quarrel there's always a crowd... It's a great draw. A quarrel or a body.’

In The Fever Van (1935) he shows a large crowd drawn by the sight of an ambulance arriving to collect a patient, probably a child with diphtheria or scarlet fever, from a small terraced house.2 However, despite his interest in the scene, Lowry avoided excessive sentimentality and detached himself both emotionally and physically. This is also true of The Cripples (1949), a social commentary on the able-bodied beholding the disabled, painted in a distinctive mono-chrome, with tinges of red, ochre, and pale blue (Figure 1).

Figure 1
The Cripples (1949); oil on canvas, 76.3 cm×101.8 cm; The Lowry, Salford Quays. In colour online

Attracted to the painting as voyeurs, we are tempted to essay fanciful diagnoses of the problems that afflict some of the ‘cripples’ that Lowry assembled in this composite painting, derived from sketches made at different times.

At the bottom right of the picture we see a man with no legs (an above-knee amputation on the right and a likely hindquarter amputation on the left) riding on a home-made cart. He is probably a war amputee and was well known in Manchester, where he used to sell small items on the corner of Deansgate and St Mary's Gate. Immediately above him in the middle background is a man in a grey coat and red scarf whose gait suggests that he may have a disorder such as cerebellar ataxia or Huntingdon's chorea. To his right is a very tall man with retrognathia, perhaps due to Marfan's syndrome.

In the middle foreground we see a man with crutches, who may have had a stroke—he has an extended, perhaps spastic, left leg with a possible equinus deformity and may have a contralateral facial palsy. Just behind him is a woman with hunched shoulders or a short neck; she looks as if she is wearing a permanent coat-hanger and has facial asymmetry, characteristics of Klippel-Feil syndrome, in which torticollis is also common.

At the bottom left is another man with crutches, this time because of a left above-knee amputation, also probably a war victim. Above him is a man with a left-sided hook prosthesis, presumably another war amputee. Talking to him is a man with a well-rounded gibbus, for which many possible causes can be suggested—tuberculosis, severe osteoarthritis, Forestier's disease (diffuse idiopathic skeletal hyperostosis), Scheuermann's disease (adolescent kyphosis) or ankylosing spondylitis.

In the middle ground a man in a bowler hat with varus knees walks away from the viewer, complemented by a lady to his right, facing the viewer, with valgus knees. The underlying pathology is likely to be osteoarthritis.

Of course, the point of Lowry's painting is not what the cripples are suffering from, but their very existence and the way in which the healthy on-lookers, mostly children, gaze at them with curiosity. Lowry once said, ‘I feel more strongly about these people than I ever did about the industrial scene. They are real people, sad people. I'm attracted to sadness and there are some very sad things. I feel like them.’ And look at the man in the focal centre of the painting, walking his dog. It has been suggested that this is Lowry himself, who may have suffered from Asperger's syndrome.3,4 Here he is depicted lost in thought, an emotional cripple, studiously not looking at all the physical cripples around him.


Competing interests None declared.

Funding None.


1. Rohde S. A Private View of L S Lowry. Part One. London: Collins, 1979: 55.
2. Sarginson J, Guppy L. The fever van, by L S Lowry. J R Soc Med 2003; 96: 197-8. [PMC free article] [PubMed]
3. O'Connell H, Fitzgerald M. Laurence Stephen Lowry and Asperger's syndrome. Ir J Med Sci 2003;172: 147-8. [PubMed]
4. Fitzgerald M. The Genesis of Artistic Creativity: Asperger's Syndrome and the Arts. London: Jessica Kingsley, 2005: 221-30.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press