The reality of urban life was that precious few who migrated from the country ever made their fortune in the city. For the great majority life was a constant battle to avoid poverty that, in the long run, turned out to be their only reward. Just as there were social realists who painted rural poverty in the middle of the nineteenth century, so there were a few who depicted urban poverty in its closing decades.

During the mid-1870s, Jean-François Raffaëlli started painting the poorer residents of Paris and its surrounds. The Ragpicker from 1879 was a great success, and his work was promoted by the influential critic Joris-Karl Huysmans.

Raffaëlli’s elderly Garlic Seller from about 1880 is making his way across a muddy field just beyond one of the new industrial areas on the outskirts of Paris, his battered old wickerwork basket containing the garlic he hoped to sell. Behind him is his companion, a dog.

Raffaëlli painted these Parisian Rag Pickers in about 1890 using mixed media of oil paints and oil crayons.

In 1882, George Hendrik Breitner met Vincent van Gogh, and the pair went out sketching and painting in the poorer parts of The Hague. Among Breitner’s paintings of that campaign is his watercolour Distribution of Soup (1882), showing those from poor families queuing for free soup.

Most of Fernand Pelez’s paintings of the poor are deeply unsettling, often frankly depressing. His Homeless from 1883 shows a worn and weary mother and her five children living on the street. She stares from sunken eyes straight at the viewer, as her children huddle in filthy blankets and sacking around her.

Pelez’s painting became even more pointed, as in A Martyr – The Violet Vendor from 1885, showing a child of the street. One of the small bunches of violets has fallen from his tray. His eyes are closed, and his mouth agape: is he dead asleep, or simply dead?

In the late 1880s the Norwegian artist Christian Krohg had been working on his next major painting, The Struggle for Existence (also translated as The Struggle for Survival) (1889). It shows Karl Johan Street in Oslo in the depths of winter, almost deserted except for a tight-packed crowd of poor women and children queuing for free bread. This was Oslo’s main street at the time, and three years later was to be the setting for Edvard Munch’s famous painting of Evening on Karl Johan Street.

The people are wrapped up in patched and tatty clothing, clutching baskets and other containers for the food. A disembodied hand is passing a single bread roll out to them, from within the pillars at the left edge. That was yesterday’s bread; now stale, the baker is giving it away only because he cannot sell it. A policeman, wearing a heavy coat and fur hat, walks in the distance, down the middle of the icy street, detached from the scene.

Better known for his many paintings of schools and children, Henri Jules Jean Geoffroy’s painting of The Night Hostel or The Soup Kitchen (1891) shows homeless women and children being fed in what appears to be almost a prison.

In Denmark, Erik Henningsen’s Evicted from 1892 shows a family of four being evicted into the street in the winter snow. With them are their meagre possessions, including a saw suggesting the father may be a carpenter. In the background he is still arguing with a policeman.

You can’t get through life without seeing a hospital ward interior, and for most of us it’s now where we both start and end our lives. Over the centuries, hospital wards have changed from being mere dormitories to facilities for nursing and medical care of the sick. This article shows in paintings how and when those changes occurred.

Although medicine was still in its infancy at the end of the sixteenth century, it was then that hospital wards first became recognisable in modern terms.

Adam Elsheimer’s Saint Elizabeth of Hungary Bringing Food for the Inmates of a Hospital from about 1598 shows a ward run by a religious order or similar foundation. Above each bed is a religious painting, and watching over them all is a statue of the Virgin Mary holding the infant Christ. Saint Elizabeth works with her halo visible, feeding the man in the bed nearest the viewer.

With the Age of Enlightenment came the first major voluntary hospitals, funded by benefactors, charities, and public subscription. Johannes Beerblock’s painting shows the modern Wards of the Hospital of Saint John in the city of Bruges in 1778. Each bed was, in effect, its own private cubicle. There were trained medical staff, but nurses were still compassionate carers rather than professionals.

In the centre, middle distance, a group of four elegantly dressed physicians are doing the rounds of their patients. The main caring staff appear to be from a religious order, and wear its elaborate black-and-white uniforms. They are serving food, reading to comfort the sick and dying, and at the left are assisting a priest, perhaps in administering the last rites. Lay staff are cleaning and servicing the needs of patients.

One of the most important revolutions in healthcare was associated with the work of Florence Nightingale during the Crimean War. Although she is now a controversial figure, William Simpson’s illustration of One of the Wards in the Hospital at Scutari (Turkey) from 1856 gives an idea of the change that started in the middle of the nineteenth century. Towards the left is a large cabinet containing glass vessels of medication, and there’s a central stove to provide a little heat through the winter.

The hospital building shown in Luis Jiménez Aranda’s painting of Doctors’ Rounds in the Hospital Ward from 1889 isn’t modern by contemporary standards. A large and august team of physicians, no doubt with their trainees, is examining a patient’s chest during a ward round. The senior physician is bent down with his left ear applied to the back of the patient’s chest. Today, that act of auscultation would be performed using a stethoscope, almost a badge of office for medical practitioners around the world. The stethoscope was still relatively novel in 1889: simple monaural tubes were first used by Laënnec in 1816, but the modern binaural design didn’t evolve until the late 1800s, and an older physician may still have preferred to apply their ear directly to the patient, as shown.

Perhaps the first painting of what we’d recognise as a modern hospital, Jean Geoffroy’s Visiting Day at the Hospital from that same year, is all about light, cleanliness, and the clinical. Like other Naturalist paintings of the time, it also fitted in neatly with the Third Republic’s image of modernising, by applying the latest developments of science to the improvement of life, and illness.

Van Gogh’s Dormitory in the Hospital in Arles (1889) shows how, despite their improvement, mental hospitals were still a long way behind general hospitals of the day. In the foreground is a stove similar to that of Florence Nightingale’s ward in Scutari, and the carers are members of a religious order rather than specialist mental health nurses.

Anna Sahlstén’s Surgery in Hospital from about 1893 shows the dazzling whiteness of the modern hospital, with a smart professional nurse caring for a child patient in the background. On the wall is a large radiator for the hospital’s modern heating system, replacing the traditional stove at last. That’s perhaps just as well, given the winters in Finland, where this was painted.

In one of his loosest and most sketchy works, Nikolay Petrovich Bogdanov-Belsky dazzles with white and light in At the Hospital from about 1910. The nurse is taking a patient’s pulse. This ward’s windows are open wide to the countryside beyond, and there’s a large vase of flowers at the right, presumably for the healing effects of nature.

Indian Army Wounded in Hospital in the Dome, Brighton from 1919 is one of Douglas Fox Pitt’s few oil paintings, and shows the Brighton Pavilion in its role as a military hospital with two operating theatres and more than seven hundred beds, making it a unique ward interior. It was unusual for its time in supportingr a wide range of religious, ethnic and dietary needs. However, this painting was made three years after that hospital had closed, following which it had been reopened for the many amputees from the war, providing them with rehabilitation and training. That too closed in the summer of 1920.