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God Bless Us Everyone... with Some Vitamin D?
December 25, 2003 7:26 PM   Subscribe

Diagnosing Tiny Tim An interesting parlor game among pediatricians is to determine the ailment that afflicted the character Tiny Tim from a Christmas Carol. The most likely suspects include renal tubular acidosis or a vitamin D deficiency due to excessive London industrial smog, both of which result in rickets. (This would explain why Tiny Tim needed a crutch). Given that Tiny Tim's condition was likely curable if Scrooge paid Cratchit more money, this has inspired one right-wing contrarian to argue that Scrooge should have worked a little Malthusian magic by letting Tiny Tim die.
posted by jonp72 (9 comments total)

 
Sounds like a reasonable hypothesis. Off to take my CLO (Cod Liver Oil). However vitamin D was not discovered until 1919 well before Tiny Tim so I question the diagnosis that he could have been cured with therapy of the time.
posted by stbalbach at 8:30 PM on December 25, 2003


*- Vitamin D discovered well after Tiny Tim
posted by stbalbach at 8:33 PM on December 25, 2003


but wouldn't his brothers and sisters also have been afflicted?
posted by amberglow at 8:35 PM on December 25, 2003


The history of rickets is fascinating, in that it not only inspired modern collaborative medicine but also, through the discovery of the Vitamin D connection, the science of nutrition itself, and parallelling the development of public health as a discipline.

I think we have to conclude, given the knowledge of the mid-19th century, that Dickens may have indulged in wishful thinking. Certainly the children of rich families would have been less afflicted, with time spent in outdoor recreation outside the cities, but it ultimately took more than just having money to fix it. Our society today has vast wealth by Dickensian standards, as well as tremendously higher access to sunlight even in high-pollution areas due to early attention to particulate make-ups of smog, not to mention Vitamin D in milk, breakfast cereal, and even orange juice -- but vitamin D deficiency is on the rise due to dairy-product avoidance and couch potatoism.
posted by dhartung at 9:05 PM on December 25, 2003


This is also assuming that whatever afflicted Tiny Tim was what the ghost of Christmas Present predicted killed him. That's not what the spirit said. He saw a crutch in the corner of a room, unused.

"I see a vacant seat,'' replied the Ghost, "in the poor chimney-corner, and a crutch without an owner, carefully preserved. If these shadows remain unaltered by the Future, the child will die.''

It is presumptuous to assume whatever caused Tiny Tim to be lame also killed him. If the shadows remain unaltered the child will die, granted. Even if the shadows were altered, the child would die anyway. Everybody dies, eventually.

The vision from the Spirit indicates the crutch is without an owner. This could just as well be because the previous owner no longer needed it. That whatever caused Tim to be lame was put in remission and the crutch was left in the corner because it was no longer needed.

Dickens didn't dwell on the details of Tim's medical condition. Firstly because Dickens wasn't a doctor and hadn't the knowledge, secondly because it wasn't necessary for purpose of plot. It was sufficient to say he wasn't well and his future was uncertain. The details were not required for the author to get the point across.

So there's simply not enough data to make any sort of conclusive diagnosis on the fictional patient.
posted by ZachsMind at 9:48 PM on December 25, 2003


I thought for a second that this post was about the REAL Tiny Tim - guess not.
posted by troutfishing at 10:24 AM on December 26, 2003


Yeah, me too, troutfishing. It seemed like an entertaining proposition in my head, especially compared to the actual Dickensian one.
posted by krinklyfig at 11:14 AM on December 27, 2003


Oh, btw, Tiny Tim is not lame, but the ukulele is an acquired taste.
posted by krinklyfig at 11:15 AM on December 27, 2003


Good link & interesting stuff ... reminds me a bit of Pathology in the Hundred Acre Wood
posted by anastasiav at 11:08 PM on December 28, 2003


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