Good Reading : November 2006
18 goodreading ı NOVEMBER 2006 The description of the signs and symptoms of Smike’s tubercu- losis given by Charles Dickens in his 1839 book Nicholas Nickelby was regarded as being so accurate that at least two medical textbooks of the era, Miller’s Principles of Surgery, published in 1850, and Aitkins’s Science and Practice of Medicine, published in 1864, quoted it verbatim in their texts. Dickens called it the ‘dread disease’, most people referred to it as ‘consumption’ or ‘phthisis’; both mean wasting. Quite apart from his tuberculosis, Smirk was a tragic figure in his own right. Intellectually impaired, he was beaten mercilessly by Wackford Squeers at his educational hell-hole, Dotheboys Hall, until he ran away with Nickelby. His health slowly deteriorated, and his malady was described by Dickens in these ter ms: ‘It was no complaint or mur mur on the part of the poor fellow himself that disturbed them. ... But there were times ... when the sunken eye was too bright, the hollow cheek too flushed, the breath too thick and heavy in its course, the frame too feeble and exhausted, to escape their regard and notice ... the mortal part wastes and withers away, so that the spirit grows light and sanguine.’ That is a great description of the chronic and, at the time, usually fatal dis- ease.What Dickens did not mention was the coughing up of blood, a symptom which poor old Smirk would probably have suffered before his eventual demise. As evidenced in the infected and deformed bones from archaeological sites, up to about World War II tubercu- losis, or the White Plague as it was often styled, was the single greatest killer in the civilised world.With the discovery of streptomycin in the late 1940s by the Russian-born American Selman Waksman, the disease met its match. Incidence has faded since, but in the recent past it has had something of a renaissance, mainly in AIDS victims due to the suppres- sion of their body’s defence mechanism. Another of Dickens’s characters who was probably a sufferer was Tim Crachett, better known as Tiny Tim. The youngest of four children, Tiny Tim is well described in Dickens’s 1843 novella, A Christmas Carol, during Ebenezer Scrooge’s second spiritual visit. Dickens categorical maladies&madness JIM LEAVESLEY has specialised in writing about the afflictions suffered by the rich and famous throughout history. Here he turns his gimlet medical eye onto the symptoms of illness described by writers of classic fiction: Charles Dickens, Victor Hugo and Charlotte Brontë. Main image from cover of Notre Dame De Paris by Victor Hugo; left Selman Waksman; right Prosper Ménière.
December / January 2007