Tiny Tim, from A Christmas carol, is one of Charles Dickens’ most recognizable characters and scholars, especially medical doctors, have attempted to diagnose his condition for many years. Tiny Tim was described by Dickens as wearing leg braces and using a crutch, and stated that Scrooge’s financial assistance could save Tim’s life.

Some scholars think that Tim suffered from a combination of tuberculosis and rickets. Rickets is a bone disorder caused by vitamin D deficiency. The deficiency leads to softened bones, and leg braces were used in the 1840s for this condition. Vitamin D deficiency can also contribute to tuberculosis by weakening the immune system. Tuberculosis was prevalent in Dickens’ London. Tiny Tim lived in impoverished, cramped housing and a polluted neighborhood in which coal soot blocked the sun’s ultraviolet light needed to help the body synthesize vitamin D. Sixty percent of working-class children had rickets in London during Dickens’ time. Both conditions could have been improved with sunshine, a better diet and cod liver oil.

Other scholars suggest Tim had polio, cerebral palsy or a kidney disease called renal tubular acidosis.