Carlo Sacco (1844-1926), of humble origins, reaches a remarkable wealth, creating with a partner the "Ditta Lombardini e Sacco", which represents important foreign manufacturers in the cotton yarn trade in Italy. Widowed, in his last wishes he appoints the Ospedale Maggiore as heir to build "a pavilion of eighty or a hundred beds for sick and poor sick people suffering from acute medical forms that will bear the name Coniugi Sacco". The will also includes legacies for the home of the nurses of the Maggiore hospital, for the embellishment of the dermosyphilopathic pavilion of the same hospital, for the Istituto dei Ciechi in Milan and the citizenship of Blevio (Como) and the payment of an annual pension in in favor of the Sant'Anna Hospital in Como. The portrait was initially commissioned from Ubaldo Oppi, but later painted by Felice Casorati. The Ospedale Maggiore still retains the photograph in the Archive which served as a model for the portrait, with the letters written by Casorati to the hospital secretary to update him on the execution. In one, the artist describes the work: "Two figures seated in front of a window from which you can see an architectural detail of the hospital, which I studied in Milan".