PERSONAL HEALTH : God Bless Us All, a Mystery’s Solved

Pediatrician Donald W. Lewis’ most-famous patient is a disabled English boy who’s nearly 150 years old. Generations of children know him as Tiny Tim, the “good as gold” lad who softened the hard heart of miserly Ebenezer Scrooge in “A Christmas Carol.”

But what was wrong with Tiny Tim? Despite the vivid image by author Charles Dickens of a fragile child carried through the dirty streets of 1840s London, Tiny Tim’s ailment remained mysterious.

Lewis, who practices in Norfolk, Va., spent about four years studying the clues available. His diagnosis: a potentially deadly kidney ailment known now as distal renal tubular acidosis or RTA-1.

With this condition, acid accumulates in the blood, creating a cascade of problems. If untreated, it could have caused the short stature, crippled leg, withered hand, intermittent weakness and other problems that afflicted Tiny Tim. But it was potentially reversible if Scrooge intervened in time.

Lewis’ own story was published this month in the American Journal of Diseases of Children, a specialty journal of the American Medical Assn.

Lewis began his quest after watching a film version of “A Christmas Carol” with his wife, Penelope.