The Keats-Shelley house by the Spanish Steps in Rome

Keats spent his last months in Rome, before succumbing in February 1821 at the age of 25 to consumption - tuberculosis. He had earlier nursed his brother Tom until the latter's demise from consumption at the age of 19. Keats had trained as an apothecary and had studied medicine at St Thomas' Hospital: surviving records mention treatment given by a "Mr Keats".

As a remarkable example of individual differences in susceptibility to the disease, the artist

Photo © Donald Singer: Keats-Shelley House and Spanish Steps, Rome

Joseph Severn survived until the age of 85, despite living with Keats for 3 months in Rome and nursing Keats' during this final illness. Severn painted Keats on his deathbed.

Shelley travelled to Rome after Keats' death and wrote the poem Adonaïs: An Elegy on the Death of John Keats. Whether for effect or real belief, Shelley is reported to have attributed the major cause of this final illness to bleeding from ruptured lungs in response to poor critical reception of Keats' poetry. Keats was more sanguine. He was confident in future recognition, writing to his brother George in 1819: "‘I have no doubt of success in a course of years if I persevere ..."

The Vatican authorities were pragmatic,  aware in 1821 of consumption as a potentially transmissable disease. They gave instructions that all contents of Keats' rooms at Piazza di Spagna were to be removed and destroyed by burning - including his boat bed and the wallpaper.  

This was in the tradition of the germ theory of disease, which dated at least from Varro in 36BC, to microscope inventor Van Leeuwenhoek’s reports in the 17^th Century, with firm evidence reported later in the 19th Century by Semmelweiss in Vienna, Koch in Berlin and Pasteur in Paris. 

Robert Koch was the first to describe the causative tubercle bacillus, supported by his formulation of postulates about evidence to confirm disease causation. Koch's investigations and discoveries in relation to tuberculosis lead to his receipt of the 1905 Nobel Prize in Physiology and Medicine. 

Read further historical notes about tuberculosis

The Tempest and Prospero's curse : magic, pleurisy, and other thoughts

Tuberculosis, Bel Ami and the Belle Epoque

More on the Keats-Shelley House: 26 Piazza de Spagna in Rome

 
 
 

The Father - remarkable play portraying decline into dementia

In recent decades, Alzheimer’s disease has become an epidemic cause of dementia, typically now affecting increasingly older patients than in the initial encounter in 1901 between German psychiatrist and neuropathologist Alois Alzheimer and a 51 year old woman suffering from progressive short-term memory loss. In 1906, he was the first  to relate the finding of amyloid plaques and neurofibrillary tangles in the brain to clinical symptoms of pre-senile dementia, abnormalities which are still the focus of research into causes, biomarkers and clues to treatment of this currently inexorable dementia syndrome.

Although families and health and community care services around the world are increasingly pressed by the condition, it is only recently that Alzheimer’s disease and other common causes of decline into dementia, such as vascular disorders of the brain, have been portrayed to public audiences in print and on the screen, for example in Iris, Amour, Still Alice, and The Iron Lady. 

A new remarkable addition on this theme is 2014 Molière award winning The Father (Le Père), by 35 year old French playwright Florian Zeller, now on stage in the West End in a translation by Christopher Hampton: moving, faithful to the condition and its wider consequences, and well acted by an outstanding cast led by Kenneth

Cranham and Claire Skinner. The play was first produced in France in 2012 at the Théâtre Hébertot in Paris and is due for transfer to Broadway in March 2016.

Important not to say too much so as not to spoil the impact on a future audience of the many themes of the play and the dramatic effects used by the writers, scene designers and musical director. Zeller is very effective, with a surprising amount of humour, in involving the audience directly in the confusing experiences of the failing protagonist Andre, his family and carers, and in the natural history of the condition. He is also excellent at describing interactions between the relative with dementia and relatives who take on the caring role, as well as possible attitudes and the behaviour of a carer’s partner.

The programme notes – and interviews in the French and English press – give little away on Zeller’s inspiration for the themes of the play. In interview, the translator Hampton – around twice Zeller’s age – alludes to universal concerns about the significance of senior moments, such as forgetting a name, as hints of the possibility of much worse to come. The programme notes also provide beautiful colour scans of the brain in health and in patients with dementia. The images are left to the reader to interpret. However little effort is needed to decipher the dramatic general and local effects of dementia shown in the images.

Public domain image from the Center For Functional Imaging, Lawrence Berkeley National Laboratory Alzheimer’s Disease Neuroimaging Initiative (ADNI)

The Father merits adapting for film as soon as possible, so that the play can be seen as widely as possible by all health professionals dealing with patients with dementia, their family and carers. Despite the many poignant facets of The Father, it will also be appreciated by the increasing many with direct experience of a family member or friend with the syndrome.

120th Anniversary of Freud's studies on hysteria

To mark the 120th anniversary of Sigmund Freud's first book - Studies on Hysteria - academic

Freud Museum, Hampstead - London

psychiatrist Dr Tim Nicholson held a public understanding event at the Freud museum, Freud's old London house in Hampstead. The book both launched Freud's career and the field of psychoanalysis. 

Hysteria, the subject of Dr Nicholson's research, is now known as a conversion disorder or a functional neurological disorder. Although both common and severe, hysteria remains highly stigmatised and widely misunderstood. 

You can find out more about Freud's role in hysteria and subsequent developments by viewing a trio of YouTube videos from the event:

- a talk explaining what hysteria is

- a talk on what Freud discussed in his book 'Studies on Hysteria' 

- a debate on the subject by a panel of world experts discussing  whether the book is still relevant today

Coffee and herbal ‘cigarettes’ once popular treatments for asthma: talks from PMJ 90th Anniversary

Condition used to be regarded as psychosomatic and brought on by stress

Strong black coffee and herbal ‘cigarettes’ were once popular treatments for asthma, which used to

be thought of as a psychosomatic condition, brought on by stress, reveals a review of the evolution of common respiratory diseases over the past century.

The review, presented by Peter Barnes, Professor of Thoracic Medicine and Head of Respiratory Medicine at the National Heart and Lung Institute, Imperial College London, is one of a series of historical perspectives on key aspects of health and medicine, and their relevance to future practice, delivered by distinguished clinicians at a symposium in London today for the Fellowship of Postgraduate Medicine (FPM).*

See programme and speaker abstracts and biographies

The lectures mark the 90th anniversary of Postgraduate Medical Journal, which began publishing in 1925, the year television pictures were first transmitted by Logie Baird and enclosed double decker buses were introduced to London’s streets.

In ancient times, asthma used to be treated with various herbal extracts, derived from horsetail, thorn-apple, and deadly nightshade (belladonna), and available as a tincture or in “asthma cigarettes.”

By the 1850s the use of strong black coffee was recommended to treat symptoms, and by the early 20th century adrenal gland extract, from which adrenaline is derived, emerged as an effective airway opener (bronchodilator) followed by the discovery in the 1920s that theophylline, which occurs naturally in tea, was similarly effective.

The adrenal gland was a source of another treatment for asthma—steroids, the precursor to the mainstay of treatment today. Glucorticosteroids were first extracted in the 1940s, when adrenaline also became available as an inhaled treatment for the first time.

During this period in history, asthma was thought of as a largely psychosomatic condition, brought on by stress. It wasn’t until the 1980s, when chronic inflammation was recognised as a key factor in the airway restriction that characterises the condition.

In 1925 patients with chronic obstructive pulmonary disease (COPD), which includes emphysema and bronchitis, were treated with the same bronchodilators used for asthma. Now long acting bronchodilators and their combination are the treatments of choice, although they don’t work as well in COPD as they do in asthma.

But oxygen was considered to be dangerous and only became available in the 1980s. New treatments for COPD that dampen down the underlying inflammation are urgently needed but have proved difficult to develop.

In another presentation, looking towards the future, Professor Karol Sikora, Medical Director of CancerPartnersUK, points out that cancer could well become a long term condition in 20 years’ time. But this promise critically depends on sustained investment in innovative diagnostics and therapies, such as robotics, genomics, biosensors, and personalised medicine.

He suggests that as the population continues to age, and the prevalence of cancer rises, the interaction of four factors will determine the future success of curbing deaths from the disease: new technology; society's willingness to pay; evolving healthcare delivery systems; and the financial mechanisms that underpin them.

Other speakers include Professor Dame Carol Black, principal of Newnham College Cambridge and past president of the Royal College of Physicians, who will talk about the opportunities to improve public health by focusing on workplace health; Professor Sir Munir Pirmohamed, David Weatherall Chair in Medicine at the University of Liverpool who will outline progress in the use of personalised medicine; and Dr Paul Nunn, former Coordinator, WHO Tuberculosis Programme, who will cover  the epidemiology and treatment of TB.

Details of all the other speakers and the topics they will be covering are available here: http://fpostgradmed.blogspot.co.uk

Commenting on the relevance and significance of the symposium, FPM President, Professor Donald Singer said: “Today’s symposium showcases many of the tremendous advances in medicine over the past 9 decades. Yet many of the medical challenges present in the 1920s still need further research and more global investment in health systems in developed and less developed regions. “

He added “The Postgraduate Medical Journal continues to play an important role in publishing new medical research and in educating young doctors and their teachers around the world.”

Notes for editors:

*90th Anniversary of the Postgraduate Medical Journal: Medicine from 1925 to 2015 One Day Symposium - 1st October 2015, Medical Society of London

Postgraduate Medical Journal is one of more than 50 specialist journals published by BMJ, which publishes the title on behalf of the Fellowship of Postgraduate Medicine.

http://pmj.bmj.com

The Fellowship of Postgraduate Medicine, founded in 1918, pioneered educational programmes in all branches of postgraduate medicine. The FPM publishes 2 international journals: the Postgraduate Medical Journal since 1925 and Health Policy and Technology since 2012.

Further information (including contact details for the speakers)

Emma Dickinson, Media Relations Manager, BMJ, BMA House, London, UK

Tel: + 44 (0) 207 383 6529

Email: edickinson@bmj.com

Coull Quartet concert for children’s cancer charity CLIC-Sargent: 15th September, Packington Hall

The internationally renowned Coull Quartet are to perform works by Haydn and Debussy on Tuesday 15th September, 2015 in support of the children’s cancer charity CLIC Sargent at the second in a series of annual charity musical evenings organised by the Worsted Weavers Guild. The concert on 15th September 2015 will be in the Pompeiian Hall at Packington Hall in Warwickshire (~ 20 minutes north of Kenilworth).  Packington Hall is an 18th-century Grade II* listed mansion set in 300 acres of parkland designed by Capability Brown and situated within a remnant of the original Forest of Arden. Use of the Pompeiian Hall is by kind permission of Lord Aylesford. The Hall is not normally open to the public. 

Order tickets for concert and reception

The  children’s cancer charity  CLIC Sargent is the UK’s leading cancer charity for children and young people, and their families.  CLIC Sargent provides clinical, practical, financial and emotional support to help them cope with cancer and get the most out of life. CLIC Sargent aims to help the whole family deal with the impact of cancer and its treatment. CLIC  Sargent is active nationally, and locally in the Warwickshire and Coventry area. 

Detail: Pompeiian Room

Pompeiian Room

The performance will be followed by a reception on Packington Hall Terrace with wine/soft drinks and canapés. TIckets for the concert and the reception are £35 per person.

Map of Packington Hall

Programme

6.30 pm Packington Hall – arrival 

7 pm Coull Quartet – performance in the Pompeiian Hall
Haydn Op. 74 No.2 in F Major
Debussy Quartet Op.10 in G minor

8 pm   Reception: wine and canapés

9 pm Close

THE COULL QUARTET are Roger Coull violin, Philip Gallaway violin, Jonathan Barritt viola and Nicholas Roberts cello.
‘…the magnificent, seasoned ensemble of the Coull’. (The Strad)
This year the Coull Quartet celebrates its 40th anniversary. Formed in 1974 by students at the Royal Academy of Music under the guidance of renowned quartet leader, Sidney Griller, they rapidly achieved national recognition, and were appointed Quartet-in-Residence by the University of Warwick in 1977, a post which they still hold today.

The Quartet, which includes two of its founder members, has performed and broadcast extensively throughout the UK, and has made tours of Western Europe, the Americas, Australia, China, India and the Far East. Since the mid-1980s the Coull Quartet has made over 30 recordings featuring a wide selection of the repertoire closest to their hearts, from the complete Mendelssohn and Schubert quartets to 20th century and contemporary British chamber music.

Their CD of quartets by Maw and Britten on the Somm label has received universal acclaim; in addition to being featured in ‘Editor’s Choice’ in The Gramophone, it was also described as the ‘Benchmark Recording’ by BBC Music Magazine. Their recordings of music by Sibelius and Ian Venables have also received excellent reviews in the major musical publications. Their impressive and unusual list of commissions includes works by Sally Beamish, Edward Cowie, Joe Cutler, David Matthews, Nicholas Maw, and Robert Simpson.

These include string quartets, quintets with piano or wind player, works with solo voice or choir, and even a piece for quartet and table tennis players! The rare combination of maturity and freshness which characterises the Quartet’s performances is often singled out by reviewers: “Here the playing is so brimful with enthusiasm and commitment, and at the same time so infused with the accumulated wisdom of three decades, that the music simply reinvents itself as it should”.  (The Strad)

Worsted Weavers’ Guild of Coventry 
The history of merchant guilds in Coventry goes back at least to 1267. The original roles of the guilds included providing training for their professions and ensuring the quality of what was produced. The National Archives record a Company of Worsted Weavers, Coventry, from circa 1448; and a Company and Fellowship of Worsted Weavers and Silk Weavers, City of Coventry, from 1628. In 1703 the worsted weavers of Coventry, whose trade had then lately improved, were separated from the silk weavers to form their own company as a member of the guilds of the city. In modern times the Worsted Weavers and other guilds of the city continue in a charitable role.

Update on biosimilars from the European Medicines Agency

The European Medicines Agency has just released an update on biosimilars - the latest in its series of  multimedia briefing sessions. The videos were recorded at a joint briefing session for EMA's Human Scientific Committees' Working Parties with Patients’ and Consumers’ Organisations (PCWP) and Healthcare Professionals’ Organisations (HCPWP). 

Sessions include
- an introductory briefing by Professor Sir Kent Woods
- an overview of the science behind biosimilars
- how they are evaluated by regulators
- how to bridge the scientific evaluation with clinical reality
- public acceptability of biosimilars
- promoting better understanding of biosimilars 

View the videos:

 

The European Association for Clinical Pharmacology and Therapeutics (EACPT) was founded 22 years ago and now includes as members all national organisations for clinical pharmacology in Europe, as well as organisations from further afield internationally.
 
The EACPT aims to provide educational and scientific support for the more than 4000 individual professionals interested in clinical pharmacology and therapeutics throughout the European region, with its congresses attended by a global audience. The EACPT also advises policy makers on how the specialty can contribute to human health and wealth.

The 12th biennial Congress of the EACPT is being held in Madrid from 27th to 30th June 2015.

New York poet Maya C Popa in Hippocrates evening reading in London - 24th June

New York poet Maya C Popa joined a panel of poets at a Hippocrates evening reading in London on 24th June. Maya Popa won the £5000 2015 Hippocrates Open Prize for Poetry and Medicine for her poem A Technique for Operating on the Past. 

Hear Maya discussing poetry, medicine and her 2015 Hippocrates Open First Prize.

Poets who contributed to the readings included 4 poets commended in the 2015 Hippocrates Prize: Cate Bailey, Valerie Fry, Molly Garbutt, Sandy Goldbeck-Wood, and Norbert Hirschhorn; Wendy French, who won the inaugural first prize in the 2010 Hippocrates NHS awards, and poet and artist Lynne Hjelmgaard. 
Maya Popa was among 9 poets from the US named in the 2015 Hippocrates Prize for Poetry and Medicine announced on Friday May 22nd at an Awards Ceremony in London at the close of an International Symposium on Poetry and Medicine. 

The Hippocrates Prize is an annual award with a closing date of 31stJanuary. There are 3 categories: an Open International award, First Prize £5000, with entries from over 60 countries since 2010; a UK NHS award, First Prize £5000; and a Young Poet award of £500. 

About her poem A Technique for Operating on the Past, Maya said: "There is something pleasantly elliptical about the fact that a neuroscientist relies on the very instrument that is the subject of his study. I had long wanted to write a poem about Gr.T. Popa, my great-grandfather, after whom the Medical University in Iași, Romania, is named. 

Maya Catherine Popa

He worked on neuro-morphology in the 1930s and 40s, but his remarkable research was ultimately cut short in light of his anti-fascist, and anti-communist affiliations. That he was forced into hiding and died of a routine ailment while escaping the communists still seems a dark irony. In a way, writing this poem felt like a letter to him, an acknowledgement of that unfairness." 

Maya Popa is a teacher and writer living in New York City. She holds degrees from Oxford University, where she was a Clarendon Scholar, NYU, and Barnard College. Her poetry appears in Tin House, Kenyon Review, Poetry London, and elsewhere. Her essays and criticism appear widely, including in Poets & Writers Magazine, PN Review, The Rumpus, and The Huffington Post. Her first collection of poems, Severe Clear, was completed this year.

Cate Bailey

Cate Bailey is an Academic Clinical Fellow in Old Age Psychiatry and trainee psychiatrist in East London by day (and often night). At present most of her writing is restricted to systematic reviews, posters and discharge summaries though occasionally she scrawls illegible ramblings on post-it notes and in margins, whilst commuting (if she gets a seat). She has previously won the Mslexia short story competition (2011) and her poetry has been published in Popshot and the Lightship Anthology (2011). 

She said: "Restraint was written after a series of seclusion reviews with a patient seen during a night shift. It attempts to capture the challenge of balancing containment of highly agitated patients with the risk of repeating traumatic experiences in an effort to manage harm to self and others." 

Wendy French is Poet in Residence at the Macmillan Cancer Centre at University College Hospital, London. She also developed healthy heart poems within the Healthy Heart Awards founded by the Healthy Heart charity the Cardiovascular Research Trust. Wendy was head of the Maudsley and Bethlem Hospital School for fifteen years and now works with people with aphasia/dysphasia, helping them to recover their use of language through poetry. She also facilitates writing in other healthcare settings. 

Lynne Hjelmgaard, Dannie Abse and Wendy French at the 2013 Hippocrates Summer reading evening

She has won prizes in international competitions, including first prize in the NHS category of the Hippocrates Prize in 2010 and second prize in 2011. She co-authored Born in the NHS with poet Jane Kirwan, published by the Hippocrates Press in 2013. More about Wendy French.

Valerie Fry is part of the duo, Wind and Words, which takes clarinet and poetry recitals into care homes. Using themes, (including love, weather, travel, World War I, Christmas) to integrate the music and the words, the duo also give recitals in churches, WIs and libraries. Valerie's play, A Game of Two Halves won BBC Radio Five Live’s playwriting competition in 2006; she has also been commended in Rottingdean, Ware and South Bank poetry competitions.  Last year she was joint second in the first Carers UK poetry competition. This is her second Hippocrates commendation, the first being in 2013. Valerie lives in London. 

She said: “Nourishment was inspired by my mum, Ruby, whose feet and legs I used to massage regularly.  It was something we both used to enjoy, but it became doubly nurturing when she decided to reciprocate. I used to love her thumbs on the soles of my feet.  Ruby died just over a year ago.”

Molly Garbutt

Molly Garbutt was commended in the Hippocrates Young Poet category for her poem Crystal Violet. She is from Worcestershire and primarily writes on the themes of mythology, feminism and current affairs. Despite her love for all things Literature-related, she will, if all goes well, be taking up an offered place at veterinary school this autumn. She was recently a finalist in the Worcestershire Young Poet Laureate competition, and was also a commended Foyle's Young Poet last year, and hopes to continue her endeavours into the world of poetry in the future. 

She said: "My inspiration for Crystal Violet came, as many of my ideas do, from being a little too daydream-y in Biology, and letting the knowledge I garnered in the lesson loose on my subconscious. From that rose a poem I love simply because it intertwines the complicated and emotional aspects of a terminal diagnosis with the pure, blank results of a medical test, which parallels the deep contrast between humanity and science that I've been seeing for the past three years as a work experience student in various veterinary situations."

Sandy Goldbeck-Wood

Sandy Goldbeck-Wood is a psychosomatic gynaecologist, poet, and international medical journal editor currently living in arctic Norway. She has published poems in anthologies, poetry magazines, medical journals and national newspapers, many of which explore medical language and experience. Several have received prizes or commendations since 2010. 

She has recently completed a first full collection, as part of a doctorate exploring the relationships between medicine, poetry and narrative from a psychoanalytic standpoint (University of East Anglia,Tromsø). With research interests in biopsychosocial approaches to medicine and medical humanities, Sandy is a regular contributor to international medical journals, media commentator on sexual health, and member of international research networks in medical humanities.  

Her commended poem was Anosmia.

Norbert Hirschhorn

Norbert Hirschhorn (photo credit: Cynthia Myntti) is a public health physician, commended by President Bill Clinton as an “American Health Hero.” He lives in London and Beirut.  He has published four collections: A Cracked River (Slow Dancer Press, London, 1999), Mourning in the Presence of a Corpse (Dar al-Jadeed, Beirut, 2008), Monastery of the Moon (Dar al-Jadeed, Beirut, 2012), and To Sing Away the Darkest Days. Poems Re-imagined  from Yiddish Folksongs (Holland Park Press, London, 2013). His poems have appeared in numerous US/UK publications, several as prize-winning (see www.bertzpoet.com).  

He said: "The tragedy described in my poem Even If He Can't Answer Maybe He Can Hear You happened to my father with whom I had had an awkward relationship, one just beginning to resolve when he was struck.  I thought of him increasingly as my own children reached adulthood.  The poem took shape in the 40th year after the event -- anniversary dates have a way of intruding on the mind."  

Lynne Hjelmgaard (see photo above) was born in New York city and moved to Denmark in 1971. She studied at the Aarhus Art Academy and graduated from Frøbel Seminarium in Copenhagen. She taught Creative Art for children before becoming a full time sailor. As a result of crossing the Atlantic in a sailboat with her husband she wrote poems that were later published in the chapbook, Distance Through the Water in 2002. (I Want Press, France). 

Jane McLaughlin

Her first collection, Manhattan Sonnets was published in 2003. (Redbeck Press, U.K). In 2007 she received a Residency grant for the Danish Academy in Rome. Manhattan Sonnets was recorded in CD format with Brockhoff’s Arhiv in Denmark in 2008, as was her 22 page poem The Coconut Rat Diary. Her work has appeared in many literary magazines such as Acumen, The Rialto, Poetry Wales and Shearsman. She divides her time between London and Copenhagen. 

Jane McLaughlin has been successful in several national competitions including the Hippocrates Prize, in which she was commended in 2014 for her poem All Clear. Her poems and stories have been widely published in anthologies and magazines, and her first collection of poetry will be published by Cinnamon Press in 2016. 

David Morphet

David Morphet has published eleven collections of poetry.  He has taken a keen interest in mental health and aftercare.  In 1972 he was a founder member of the National Schizophrenia Fellowship (now RETHINK) and was its Chairman from 1977-82.  For the first part of his career he worked in the Diplomatic Service.  Subsequently he became an Under-Secretary in the former Department of Energy, and he has also worked in the private sector.  

About He Has Turned Within he said that over the years he has written poems inspired by the plight of sufferers from severe mental illness, and in particular that of a (now deceased) younger brother.  He Has Turned Within comes from his 2003 collection The Angel and the Fox.