During 1820 Keats displayed increasingly serious symptoms of tuberculosis, suffering two lung haemorrhages in the first few days of February.[62][63] On first coughing up blood, on 3 February 1820, he said to Charles Armitage Brown, "I know the colour of that blood! It is arterial blood. I cannot be deceived in that colour. That drop of blood is my death warrant. I must die."[64][65]
He lost large amounts of blood and was bled further by the attending physician. Hunt nursed him in London for much of the following summer. At the suggestion of his doctors, he agreed to move to Italy with his friend Joseph Severn. On 13 September, they left for Gravesend and four days later boarded the sailing brig Maria Crowther. On 1 October the ship landed at Lulworth Bay or Holworth Bay, where the two went ashore; back on board ship he made the final revisions of "Bright Star".[66][67] The journey was a minor catastrophe: storms broke out, followed by a dead calm that slowed the ship's progress. When they finally docked in Naples, the ship was held in quarantine for ten days due to a suspected outbreak of cholera in Britain. Keats reached Rome on 14 November, by which time any hope of the warmer climate he sought had disappeared.[68]
Keats's house in RomeKeats wrote his last letter on 30 November 1820 to Charles Armitage Brown; "Tis the most difficult thing in the world to me to write a letter. My stomach continues so bad, that I feel it worse on opening any book – yet I am much better than I was in Quarantine. Then I am afraid to encounter the proing and conning of any thing interesting to me in England. I have an habitual feeling of my real life having past, and that I am leading a posthumous existence".[69]
On arrival in Italy, he moved into a villa on the Spanish Steps in Rome, today the Keats–Shelley Memorial House museum. Despite care from Severn and Dr. James Clark, his health rapidly deteriorated. The medical attention Keats received may have hastened his death.[70] In November 1820, Clark declared that the source of his illness was "mental exertion" and that the source was largely situated in his stomach. Clark eventually diagnosed consumption (tuberculosis) and placed Keats on a starvation diet of an anchovy and a piece of bread a day intended to reduce the blood flow to his stomach. He also bled the poet: a standard treatment of the day, but also likely a significant contributor to Keats's weakness.[71] Severn's biographer Sue Brown writes: "They could have used opium in small doses, and Keats had asked Severn to buy a bottle of opium when they were setting off on their voyage. What Severn didn't realise was that Keats saw it as a possible resource if he wanted to commit suicide. He tried to get the bottle from Severn on the voyage but Severn wouldn't let him have it. Then in Rome he tried again.... Severn was in such a quandary he didn't know what to do, so in the end he went to the doctor, who took it away. As a result Keats went through dreadful agonies with nothing to ease the pain at all." Keats was angry with both Severn and Clark when they would not give him laudanum (opium). He repeatedly demanded, "How long is this posthumous existence of mine to go on?"[71]
