BTW if you want to know exactly how bad income inequality was in Victorian London, Bob Cratchit's "15 bob a week" is about as much purchasing power as $75 a week today, or $4,000 a year

When Scrooge bitches about having to pay Bob for his day off he's bitching about $15 https://twitter.com/AlexandraErin/status/1342563628214607879
You can argue about how accurate this is - his salary, though low, was considered within the "normal range" for the time period - but people back then were objectively poor

The Cratchit household only functions because their three oldest kids all also have jobs
And one proposal for what exactly Tiny Tim's disease is is rickets, which was very common among children in that era and is a form of vitamin D deficiency

I.e. he's sick because he never gets the chance to go outside and he (and his mom when breastfeeding) has a very poor diet
The "medical treatment" he needs but can't afford could be as simple as a spoonful of cod liver oil every day
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