Sir.—Humbug! Lewis postulated distal RTA type 1 as the "diagnosis" for Dickens' Tiny Tim in the December issue of AJDC.1 If he intended his article as a bit of holiday humor, Time magazine seems to have missed that intention (December 28, 1992:19). If he intended the article seriously, three major intrinsic logical errors should be pointed out.
Charles Dickens was not a physician detailing a case history; he was an author telling a story. Tiny Tim's medical condition was crafted to meet the requirements of the story. It boggles the mind to think that Dickens observed the clinical course of a rare medical condition and used it in his narrative. The real observations that Dickens made were the following: (1) The children of the poor were more likely to die than the children of the rich. (2) Weak and crippled children were more likely to die than hale