By the mid 19th century the Ottoman Empire was finding it increasingly difficult to control the nationalist revolts within its borders and, at the same time, to finance both the military commitment and bureaucracy that a large Empire required and modernise its economy to be competitive with the other Great Powers. The cost of the Empire’s involvement in the Crimean War (1853-56) also forced it into debt by borrowing heavily from its allies. After the Crimean War journalists in Europe and in the United States began to refer to the Ottoman Empire as “the sick man of Europe”.
It is not clear who first used the phrase “sick man of Europe” to refer to the ailing Ottoman Empire. However, there is strong evidence that Tsar Nicholas I of Russia in 1853 was reported to have said: “Turkey seems to be falling to pieces, the fall will be a great misfortune……We have on our hands a sick man – a very sick man: it will be, I tell you frankly, a great misfortune if one of these days he should slip away from us, especially before the necessary arrangements are made.” The British Ambassador, G.H. Seymour, is reported to have responded: “Your Majesty says the man is sick; it is very true; but your Majesty will deign to excuse me if I remark that it is part of the generous and strong man to treat with gentleness the sick and feeble man.”
Source: British Parliamentary Papers; Eastern Papers, V. Session 31 January – 12 August 1854, Vol. LXXI (London), Document 1, p.2