What did Charles Dickens know about medicine?
published in Reader's Digest,
14 November 2016
Modern doctors are amazed at the way in which Dickens described medical conditions in his fictional characters long before doctors understood the diseases.
Dr Kerrie Schoffer of the Royal Brisbane Hospital rightly describes Dickens as “a writer with the eye of an expert clinician”. She describes how Dickens eloquently outlines clinical conditions such as concussion (Mrs Gargery), stroke (Mrs Skewton), senile dementia (Old Chuffey) and schizophrenia (Mr F’s aunt).
His descriptions of human disease were so breathtakingly detailed and accurate that he earned the highest respect from doctors, with his obituary appearing in the British Medical Journal. Some imagine that he would have made a brilliant doctor; others are convinced that, by remaining a writer, he actually had a greater influence on the medical world because he opened doctors’ eyes to unusual signs and symptoms.
Some imagine that he would have made a brilliant doctor.
Here we take a look at several of Dickens’ most beloved characters, using quotes from the man himself, to see how amazingly observant he was of the human condition.
Joe, the Fat Boy in Pickwick Papers
“On the box sat a fat and red-faced boy, in a state of somnolency”
“Damn that boy, he’s gone to sleep again”
Suffering from obesity and daytime sleepiness, modern doctors now call Joe’s affliction ‘the obesity hypoventilation syndrome’ (or ‘the Pickwickian syndrome’). People with this condition are overweight and do not breathe deeply enough during sleep, often having disrupted sleep and resulting daytime tiredness.
Monks, Oliver Twist’s half-brother
“Monks shook his fist, and gnashed his teeth, as he uttered these words incoherently, and advancing towards Oliver as if with the intention of aiming a blow at him, fell violently on the ground, writhing and foaming in a fit…”
In addition to this classic ‘generalised convulsion’, Dickens depicted less well known types of seizure such as the absence seizure, when Monks “remained silent for a few moments, and then removing his hands suddenly from his face, showed…that it was much distorted, and nearly blank”.
Death from seizure is very Dickensian: the demise of Josiah Bounderby (Hard Times), Anthony Chuzzlewit (Martin Chuzzlewit) and Little Nell’s grandfather (The Old Curiosity Shop) may have all been from seizure.
Mr Pancks in Little Dorrit
“He snorted and sniffed and puffed and blew, like a little labouring steam-engine…he darted about in eccentric directions and stirred up his hair”. Doctors now think he was afflicted by Tourette’s syndrome, which causes people to make involuntary noises and movements called ‘tics’.
Doctors now think he was afflicted by Tourette’s syndrome, which causes people to make involuntary noises and movements called ‘tics’.
He may also have had obsessive compulsive disorder, keeping his notebook in “dictionary order”, and endlessly biting his nails and pulling at his hair (trichotillomania is a compulsive urge to pluck hair and is often associated with OCD).
Tiny Tim in A Christmas Carol
Sweet angelic Tiny Tim supports his sickly frame with crutches. Doctors disagree over his diagnosis with tuberculosis, rickets, malnutrition, cerebral palsy and renal tubular acidosis (an accumulation of acid in the body due to kidney failure) all suggested. If rickets and TB were the cause, Scrooge could have helped the boy with an improved diet, sunshine exposure and a dose of cod liver oil.
He may have had a keen eye for disease in others, but missed it in himself. For the last five years of his life, Dickens suffered what is now thought to be a series of small strokes, resulting in loss of vision, altered sensation on his left side, dizziness and pain. He seemed unaware of the seriousness of his symptoms and collapsed suddenly at the dinner table in 1870.
We, however, remain truly grateful for his insightful, enduring writings.