Chapter 1 examines the interpretations of children’s language of pain, particularly screams and cries, by different professional bodies between 1870 and 1900. The chapter connects Charles Darwin’s evolutionist perspective inaugurated in ‘A Biographical Sketch of an Infant’ with the theoretical curiosity that informed embryologists’ and psychologists’ instrumental approach to pain, contrasting this with the practical paediatric challenge of understanding children to diagnose and treat them. This chapter also considers the photographic representations of sick children used for fundraising by the Great Ormond Street Hospital.