Tiny Tim’s Ailment

In the December 1992 issue of the American Journal of Diseases of Children Dr. Donald Lewis, an assistant professor of paediatrics and neurology at the Medical College of Hampton Roads in Norfolk, Virginia, theorized that Tiny Tim, Bob Cratchit’s ailing son in Charles Dickens’ classic A Christmas Carol, suffered from a kidney disease that made his blood too acidic.

Dr. Lewis studied the symptoms of Tim’s disease in the original manuscript of the 1843 classic. The disease, distal renal tubular acidosis (type I), was not recognized until the early 20th century but therapies to treat its symptoms were available in Dickens’ time.

Dr. Lewis explained that Tim’s case, left untreated due to the poverty of the Cratchit household, would produce the symptoms alluded to in the novel.

According to the Ghost of Christmas Present, Tim was supposed to die within a year. The fact that he did not die, due to Scrooge’s new-found generosity, means that the disease was treatable with proper medical care. Dr. Lewis consulted medical textbooks of the mid 1800’s and found that Tim’s symptoms would have been treated with alkaline solutions which would counteract the excess acid in his blood and recovery would be rapid.

While other possibilities exist, Dr. Lewis feels that the treatable kidney disorder best fits “the hopeful spirit of the story.”

Source – AP Science Writer Malcolm Ritter-1992

Dickens scorned the sectarian spirit in religion. In summarizing the articles of his own simple faith, he wrote to a clergyman on Christmas Eve 1856:

[51/52] There cannot be many men, I believe, who have a more humble veneration for the New Testament, or a more profound conviction of its all-sufficiency, than I have. If I am ever . . . mistaken on this subject, it is because I discountenance all obtrusive professions of and trading in religion, as one of the main causes why real Christianity has been retarded in this world; and because my observation of life induces me to hold in unspeakable dread and horror, those unseemly squabbles about the letter which drive the spirit out of hundreds of thousands.

The failure of religion to redeem the age from materialism Dickens laid especially to the inherence in the middle class of that sour Puritanical strain which equates salvation with worldly prosperity. Cheerless itself, it was bent on suppressing the instinct for joy in others. The type is most memorably presented in the guilt-ridden and life-denying Mrs. Clennam of Little Dorrit. Arthur Clennam places her among those whose “religion was a gloomy sacrifice of tastes and sympathies that were never their own, offered up as a part of a bargain for the security of their possessions. Austere faces, inexorable discipline, penance in this world and terror in the next…nothing graceful or gentle anywhere….” For Dickens the dismal gloom of Sundays in London epitomized all that was most forbidding in the religious temper of Victorian England. As far back as 1830 he had written under the pseudonym of Timothy Sparks a fervid pamphlet entitled “Sunday under Three Heads: As it is; As Sabbath Bills would make it; As it might be.” The immediate occasion for this diatribe was Sir Andrew Agnew’s Sunday Observance Bill, which the writer regarded as a conspiratorial measure on the part of the governing classes to deprive the populace of its one day in the week of carefree pleasure.

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