![]() ![]() “The story doesn’t say if he was cured or just better,” she said. Jani said he doesn’t think that a sanitorium would have made a big difference in Tiny Tim’s disease progression, but O’Connor pointed out that better nutrition and access to vitamin D could have made the disease progress slower. At that time, most people were treated by sending them to sanitoriums and people without enough money would not have been able to afford that.” “There were no good treatment options back then. “The skeleton had similar changes of someone infected with tuberculosis of the spine,” Jani said. Callahan, DO, the discovery created a stir when the skeletal remains beneath the stone were of a man “approximately 40 years of age wearing a frame of metal and leather on his legs and lower back.” Jani referred to a 1997 article in the Journal of Infectious Diseases that reported the discovery of a gravesite marked by a stone with the name “Timothy Cratchit” and the years “1839-1884.” According to the article’s author, Charles W. Other symptoms of tuberculosis include weight or appetite loss, fever, and fatigue, according to the National Library of Medicine. Tuberculosis of the spine, known as tuberculosis spondylitis or Pott’s disease, can result in bone destruction, weakness in the legs, and deformity. “The primary organ involved in tuberculosis is the lungs, but when it gets into the bloodstream, it can affect other organs including the brain and spine.” “I think he did have tuberculosis of the spine,” said Pushan Jani, MD, MSc, associate professor of pulmonology in the Department of Internal Medicine at McGovern Medical School. A more likely scenario is that rickets also would have made him more susceptible to severe infectious diseases, like tuberculosis, which affected 50% of children of working-class parents. O’Connor said that in severe cases of rickets, children can die from complications such as hypocalcemic seizures and cardiomyopathy. Since vitamin D is the treatment for rickets, Scrooge’s money could have allowed Tim to go to a sanatorium in the country away from London’s smog, eat fresh fruits and vegetables, and take cod liver oil, which is rich in vitamin D. ![]() Poor growth, pain in the spine and legs, and muscle weakness are symptoms. Rickets affects bone development, leading to soft, weak bones. “They thought it was a transmittable disease, so they would keep children in the house and bundle them up, making it worse.” O’Connor, MD, assistant professor in the Department of Pediatrics with McGovern Medical School at UTHealth Houston. They used to call rickets ‘the English disease’ because it was so prevalent in London,” said Kristine A. “Tiny Tim could definitely have had rickets. That lack of natural sunlight and nutritional sources of vitamin D could lead to rickets, which affected 60% of children in working-class London families at that time, and it seems logical that Tiny Tim might have suffered from it. Many people, including children, worked 10-hour days, arriving and leaving in the dark. ![]() The skies were dark and heavy with pollution from burning coal during the Industrial Revolution, blocking out much of the sun’s ultraviolet light that is critical for vitamin D synthesis. The environment of London at that time was not conducive to good health for anyone, much less the child of hardworking, but financially stretched, parents. We put it to the experts at UTHealth Houston to help us sort out what Tim might have had and how Scrooge could have changed the course of his life. Over the decades, medical experts turned sleuths have theorized that it might have been tuberculosis, rickets, or cerebral palsy, according to articles like a 2021 review in the Archives of Pediatrics and Adolescent Medicine. We watch as Scrooge battles his demons – and spirits – to find the way in his heart to save Tiny Tim from a premature death, which was all too common in the period of the story’s setting in the mid-1800s.ĭickens never names the crippling disease that hindered Tiny Tim’s ability to walk and left him weak, but could be overcome through treatment made possible by Scrooge. With his little single crutch and sweet smile, Tiny Tim has been stealing our hearts year after year in “A Christmas Carol,” the quintessential holiday story written by Charles Dickens and published in 1843. Three UTHealth Houston experts discuss what might have ailed Tiny Tim, portrayed here in Alley Theatre's 'A Christmas Carol' written by Charles Dickens. ![]()
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