4/5/2011 Caitlin Anderson English Department Lamia: Serpent and Disease. How John Keats’s Medical Background and Personal Experience With Consumption Imprinted Themes of Disease Onto His Poem “Lamia” Advisors: Jeff Cox (English) Paul Youngquist (English) Other Committee Members: Jane Garrity (English) Caitlin Anderson 2 Vicki Grove (Germanic and Slavic Languages and Literatures) Introduction John Keats was intimately acquainted with disease. Throughout his life he witnessed the death and physical decay of those around him. Even his career as an apothecary1 led him closer to illness. Especially later in his short life, the mark of sickens can be seen in Keats’s poetry. One significant example is the poem “Lamia” (1820). In this poem the hand of disease is seen in the serpentine form of the title character as well as in her bodily decay once she becomes human. She suffers from Tuberculosis, caused by her own humanity, and her suffering from the illness destroys the lives of those around her. Much like how Keats’s life was destroyed by illness. Before an understanding can be attained of the disease in “Lamia”, first one must understand the disease itself. Tuberculosis is now considered to be a well understood and, in 1st world countries, nonexistent disease. However, at Keats’s time in the early 19th century, much less was known. It was an aggressive disease. By first understanding what is known now, and then examining what was known then about the disease, one can better understand how tuberculosis affected Keats’s life and informed his poetry. Keats lived a life shaped by, and surrounded by death. Because of comparatively inferior medicine, loss of loved ones was much more common in the early 19th century than it is now. Even so, Keats experienced a large amount of death in his short life. This gave him an intimacy with death and disease that he put to use in a medical career. He chose to pursue a medical career before he decided to be a poet. This gave him a superior 1 The name for an individual with medical training who was in charge of dispensing medicine and advice to other medical practitioners as well as patients. The closest modern day equivalent would be a combination of a pharmacist and a family practitioner. Caitlin Anderson 3 knowledge, for the time, about health and illness. It was with this knowledge that he wrote his poems, and, more specifically, his later poems such as “Lamia”. After one learns of Keats’s life and background, one can better examine his poem “Lamia” for the presence of disease. With this lens, the poem gains an obvious plotline of disease and dying. The poem, while still a typically lyrical poem of the romantic era, also becomes a medical poem and an outpouring of the grief and anger that Keats experienced when his family members died of Tuberculosis. Through all the other aspects of this poem that are rife with disease, one stands out. That is that Lamia’s humanity is her disease. Caitlin Anderson 4 Tuberculosis or Consumption Before looking into Keats himself, one must first understand a little about the disease that so shaped his life. The disease Keats died of is known today as Tuberculosis or TB. It is a degenerative bacterial disease that usually attacks the lungs but can also settle in other organs. It is passed from person to person as aerosolized droplet form from coughing, sneezing, or even singing. It is commonly passed from person to person in groups that are living close to one another, such as within a household. If someone contracts bacterial TB today, it is easily treated with a range of antibiotics before it begins to destroy tissues (U.S. Natl. Library of Medicine). Even viral TB (which is much harder to treat) is not a death sentence with today’s medicine. However, left untreated, TB is a rather aggressive illness. TB commonly attacks the lungs, so the first symptom of the disease is a persistent cough with fluid or mucus present. This cough can be accompanied with fever and fatigue, and the presence of mucus can cause secondary symptoms such as shortness of breath or a sore throat. At this point in time, the disease can either continue its attack until it kills the host or it can become dormant. This is known as a latent TB infection. An individual with a latent TB infection “[does] not feel sick and [does] not have any symptoms” (CDC). The individual will then later become sick and die. When a person is in the later stages of a TB attack, he develops the symptoms that we now associate with the disease through movies and television. When a person is beginning to die of TB, he will have what is known as a hemorrhage. The disease weakens the walls of the lungs and, consequently, the walls of Caitlin Anderson 5 the blood vessels in the lungs. Therefore, when the individual has a particularly aggressive coughing, fit the vessels in his lungs will rupture and spill blood into the lungs. This blood is then coughed up. This causes a lot of pain in the chest and also precipitates the coughing. The disease will continue to weaken the body through blood loss, fever, loss of appetite, and the degradation of the lungs until the host dies. Sadly, not this much was known about this very common disease in Keats’s time. Known as consumption during the 19th century, TB was often thought to be a hereditary disease of the constitution. This was so because, when one person in a family contracted the illness, others in the family soon did as well because of their proximity. Because of this, diet was often restricted in those ill because it was believed that not eating would help to rebalance the constitution of the body. However, this treatment just served to make people sicker, as their bodies did not have the nutrition needed to fight off the infection. Also, because medicine was so primitive, TB was rarely diagnosed until an individual suffered their first hemorrhage. By that point in time, the disease already had a hold on their body and was in the process of breaking it down. While the stethoscope had been invented in 1816, it was usually used to listen to the heart and so was not usually used in diagnosis of a pulmonary disease (Howard Hughes Medical Institute). Also, what is now a manageable but still present disease in third world countries was the number one killer of individuals in industrialized cities and countries (Contagion). It is not surprising, then, that Keats lost two members of his family to the disease before succumbing to it himself. Caitlin Anderson 6 Life of John Keats John Keats was born to a family that belonged to what would become known as the middle class. In 1795 when he was born to parents who managed a livery stable in northern London and would later go on to manage a pub (Bate, 1). Because they were not entirely well off, it was desired that Keats not only received a sufficient education, but also the training necessary to have a profession later in life. Therefore, his parents sent him to Enfield academy when he was eight years old so that he might receive a good education. His youth, however, was marred by multiple deaths in his family. First was his father, Thomas Keats. Thomas Keats died in 1804 when he fractured his skull when his horse fell on the cobblestones (Bate, 12). Because of the death, the Keats family was suddenly without anyone to earn for them. Consequently, Keats’s mother remarried and the children went to live with their grandmother. The marriage was not a happy one, and before too long Keats’s mother had left her new husband to live with her mother and children. The actions of his mother had removed the financial strain from the family; however, it also seemed to mark the beginning in the decline of her health. Though his mother’s health was declining, it was Keats’s grandfather who next perished. In 1805 Keats’s maternal grandfather died, and, though he left money to his family in his will, it was not nearly the standard of living that they were used to (Bate, 13). The tragedies at home did not seem to affect Keats at this point in time. He was happy and well liked at his school. It was not long, though, before his mother’s health deteriorated more. By the Christmas holidays of 1809, when Keats was only 14, his mother was gravely ill. During this time Keats, the eldest of his siblings, took on the Caitlin Anderson 7 responsibility of caretaker to his mother. He was “jolted into a sudden sense of responsibility” by the illness of his mother and took to staying up wither her, giving her medicine, cooking for her, and even reading novels to her (Bate, 21). By March 1810 Keats’s mother had died. Keats took the death hard and was said to have “crept … into ‘a nook under the master’s desk’ in the schoolroom at Enfield” where he sat in an “‘impassioned and prolonged’ sense of loss” (Bate, 21).2 Though the cause of his mother’s death is not certain, her symptoms and deterioration seem to be those of consumption.3 The next major death in Keats’s life came in 1818 when his younger brother Tom Keats died of consumption. While Keats was caring for his sick brother, Keats himself fell ill as well.