Tiny Tim Cratchit is the captivating soul of one of the English language’s most beloved stories, Charles Dickens’ A Christmas Carol. His mysterious crippling disorder is quite the medical enigma, being intermittent, unilateral and fatal if left untreated. His tiny stature can also be counted amongst his symptoms. However, the most startling aspect of his condition is its ability to be cured in 1840s London with Ebenezer Scrooge’s limitless funds.
While Tim is saved after Scrooge’s reformation, Dickens never mentions what disease afflicted the little youngster. Upon examining Dickens personal health and previous literary talent of describing diseases unknown to medical science at the time, the ailment is validated as an accurate depiction of a real malady.
Two major theories exist as to the nature of the disease. Tuberculosis and renal tubular acidosis are offered as explanations to the interesting symptoms Tim experienced. The debate hinges on the interpretation of the original manuscript that, ‘Tiny Tim did not die.’ While survival is possible from the more common tuberculosis in 1843, a full cure was available from renal tubular acidosis via the alkali tonics available at that time. The debate may rage on indefinitely.
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Lewis D. What was wrong with Tiny Tim? Am J Dis Child 1992; 146:1403-1407.
HEPARIN-INDUCED RENAL TUBULAR ACIDOSIS MASQUERADING AS HYPERKALEMIA IN A PATIENT WITH SARS-COV-2
