ALBERT L. FREEDMAN, M.D.
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To the editor: Although I found Markel's argument (1) of interest, that young Dombey died of acute lymphatic leukemia and that Dickens described its course with great accuracy, I must take issue with his diagnosis.
Paul Dombey had always been a sickly child obsessed with intimations of death. He was "not yet five" (2) when sent by doctor's recommendation for "sea-air" to Mrs. Pipchin's establishment, where he grew stronger. He remained there for "nearly twelve months" and he was "six years old" when transferred to Dr. Blimber's establishment for more rigorous education. At Blimber's, Paul "might have answered [the ticking
FREEDMAN AL. Dickens, Dombey, and Diagnostics. Ann Intern Med. ;102:271. doi: 10.7326/0003-4819-102-2-271_1
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Published: Ann Intern Med. 1985;102(2):271.
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