Misplaced Pages

#812187

102-509: The Robert Louis Stevenson Memorial is an outdoor memorial commemorating Robert Louis Stevenson , in Portsmouth Square , San Francisco, California . This article about a sculpture in California is a stub . You can help Misplaced Pages by expanding it . Robert Louis Stevenson Robert Louis Stevenson (born Robert Lewis Balfour Stevenson ; 13 November 1850 – 3 December 1894)

204-432: A hiatal hernia . Bronchiectasis may result from congenital disorders that affect cilia motility or ion transport . A common genetic cause is cystic fibrosis , which affects chloride ion transport. Another genetic cause is primary ciliary dyskinesia , a rare disorder that leads to immotility of cilia and can lead to situs inversus . When situs inversus is accompanied by chronic sinusitis and bronchiectasis, this

306-427: A "red-hot socialist". But already by age 26 he was writing of looking back on this time "with something like regret. ... Now I know that in thus turning Conservative with years, I am going through the normal cycle of change and travelling in the common orbit of men's opinions." His cousin and biographer Sir Graham Balfour claimed that Stevenson "probably throughout life would, if compelled to vote, have always supported

408-579: A better thing to find than a five-pound note. He or she is a radiating focus of goodwill" and a practical demonstration of "the great Theorem of the Liveableness of Life". So that if they cannot be happy in the "handicap race for sixpenny pieces", let them take their own "by-road". In late 1873, when he was 23, Stevenson was visiting a cousin in England when he met two people who became very important to him: Fanny (Frances Jane) Sitwell and Sidney Colvin . Sitwell

510-402: A cruise to the southern Pacific Ocean for the following summer. Whenever I read a book or a passage that particularly pleased me, in which a thing was said or an effect rendered with propriety, in which there was either some conspicuous force or some happy distinction in the style, I must sit down at once and set myself to ape that quality. I was unsuccessful, and I knew it; and tried again, and

612-444: A darker realism. He died of a stroke in his island home in 1894 at age 44. A celebrity in his lifetime, Stevenson's critical reputation has fluctuated since his death, though today his works are held in general acclaim. In 2018, he was ranked just behind Charles Dickens as the 26th-most-translated author in the world. Stevenson was born at 8 Howard Place, Edinburgh , Scotland, on 13 November 1850 to Thomas Stevenson (1818–1887),

714-404: A detailed chronicle of the intersection of rivalries between the great powers and the first Samoan Civil War . As much as he said he disdained politics—"I used to think meanly of the plumber", he wrote to his friend Sidney Colvin, "but how he shines beside the politician!" —Stevenson felt himself obliged to take sides. He openly allied himself with chief Mataafa, whose rival Malietoa was backed by

816-632: A diagnostic evaluation for bronchiectasis are radiographic confirmation of the diagnosis, identification of potential treatable causes, and functional assessment of the patient. A comprehensive evaluation consists of radiographic imaging, laboratory testing, and lung function testing . Laboratory tests that are commonly part of the initial evaluation include a complete blood count , sputum cultures for bacteria, mycobacteria , and fungi , testing for cystic fibrosis, and immunoglobulin levels. Additional tests that are sometimes indicated include testing for specific genetic disorders . Lung function testing

918-500: A failure." His mother accounted the revelation "the heaviest affliction" to befall her. "O Lord, what a pleasant thing it is", Stevenson wrote to his friend Charles Baxter, "to have just damned the happiness of (probably) the only two people who care a damn about you in the world." Stevenson's rejection of the Presbyterian Church and Christian dogma, however, did not turn into lifelong atheism or agnosticism. On February 15, 1878,

1020-544: A grave, in the midst of the white men's sugar fields", but also in Ireland and "in the mountains of my own country Scotland". Bronchiectasis Bronchiectasis may result from a number of infectious and acquired causes, including measles , pneumonia , tuberculosis , immune system problems, as well as the genetic disorder cystic fibrosis . Cystic fibrosis eventually results in severe bronchiectasis in nearly all cases. The cause in 10–50% of those without cystic fibrosis

1122-476: A harmonious pattern of its own. Man's one method, whether he reasons or creates, is to half-shut his eyes against the dazzle and confusion of reality...Life is monstrous, infinite, illogical, abrupt and poignant; a work of art, in comparison, is neat, finite, self-contained, rational, flowing, and emasculate...The novel, which is a work of art, exists, not by its resemblances to life, which are forced and material ... but by its immeasurable difference from life, which

SECTION 10

#1733085184813

1224-437: A leading lighthouse engineer, and his wife, Margaret Isabella (born Balfour, 1829–1897). He was christened Robert Lewis Balfour Stevenson. At about age 18, he changed the spelling of "Lewis" to "Louis", and he dropped "Balfour" in 1873. Lighthouse design was the family's profession; Thomas's father (Robert's grandfather) was the civil engineer Robert Stevenson , and Thomas's brothers (Robert's uncles) Alan and David were in

1326-675: A part of the family through her charm and wit. The Stevensons shuttled back and forth between Scotland and the Continent, finally settling in 1884 in the Westbourne district of the southern English seaside town of Bournemouth in Hampshire (now in Dorset ). Stevenson had moved there to benefit from its sea air. They lived in a house Stevenson named 'Skerryvore' after a Scottish lighthouse built by his uncle Alan. From April 1885, 34-year-old Stevenson had

1428-881: A patient at the Edinburgh Infirmary named William Ernest Henley , an energetic and talkative poet with a wooden leg. Henley became a close friend and occasional literary collaborator, until a quarrel broke up the friendship in 1888, and he is often considered to be the inspiration for Long John Silver in Treasure Island . Stevenson was sent to Menton on the French Riviera in November 1873 to recuperate after his health failed. He returned in better health in April 1874 and settled down to his studies, but he returned to France several times after that. He made long and frequent trips to

1530-419: A professor, Fleeming Jenkin , whose house staged amateur drama in which Stevenson took part, and whose biography he would later write. Perhaps most important at this point in his life was a cousin, Robert Alan Mowbray Stevenson (known as "Bob"), a lively and light-hearted young man who, instead of the family profession, had chosen to study art. In 1867, Stevenson's family took a lease on Swanston Cottage, in

1632-463: A self-perpetuating "vicious cycle" of inflammation in bronchiectasis. This "vicious cycle" theory is the generally accepted explanation for the pathogenesis of bronchiectasis. Endobronchial tuberculosis commonly leads to bronchiectasis, either from bronchial stenosis or secondary traction from fibrosis. Traction bronchiectasis characteristically affects peripheral bronchi (which lack cartilage support) in areas of end-stage fibrosis. The goals of

1734-532: A spawn of inspectors, who now begin, note-book in hand, to darken the face of England". He is referring to the steady growth in social legislation in Britain since the first of the Conservative-sponsored Factory Acts (which, in 1833, established a professional Factory Inspectorate ). Stevenson cautioned that this "new waggon-load of laws" points to a future in which our grandchildren might "taste

1836-575: A stranger case still if Robert Louis Stevenson ever forgot Jules Simoneau. While in Monterey, he wrote an evocative article about "the Old Pacific Capital" of Monterey. By December 1879, aged 29, Stevenson had recovered his health enough to continue to San Francisco where he struggled "all alone on forty-five cents a day, and sometimes less, with quantities of hard work and many heavy thoughts," in an effort to support himself through his writing. But by

1938-612: A tale of European and American misconduct. His concern for the Polynesians is also found in the South Sea Letters , published in magazines in 1891 (and then in book form as In the South Seas in 1896). In an effort he feared might result in his own deportation, Stevenson helped secure the recall of two European officials. A Footnote to History: Eight Years of Trouble in Samoa (1892) was

2040-475: A technique or device is based on the frequency and tenacity of phlegm, patient comfort, cost, and the patient's ability to use the technique or device with minimal interference to their lifestyle. The active cycle of breathing technique (ACBT), which can be employed with or without a flutter device, is beneficial in treating those with bronchiectasis. Mucolytic agents such as dornase alfa are not recommended for individuals with non-CF bronchiectasis. Mannitol

2142-465: A tendency to coughs and fevers, exacerbated when the family moved to a damp, chilly house at 1 Inverleith Terrace in 1851. The family moved again to the sunnier 17 Heriot Row when Stevenson was six years old, but the tendency to extreme sickness in winter remained with him until he was 11. Illness was a recurrent feature of his adult life and left him extraordinarily thin. Contemporaneous views were that he had tuberculosis, but more recent views are that it

SECTION 20

#1733085184813

2244-491: A type of physical therapy , are also recommended. Medications to dilate the airways and inhaled steroids may be used during sudden worsening, but there are no studies to determine effectiveness. There are also no studies on the use of inhaled steroids in children. Surgery, while commonly done, has not been well studied. Lung transplantation may be an option in those with very severe disease. The disease affects between 1 per 1000 and 1 per 250,000 adults. The disease

2346-594: A young man, he mixed in London literary circles, receiving encouragement from Sidney Colvin , Andrew Lang , Edmund Gosse , Leslie Stephen and W. E. Henley , the last of whom may have provided the model for Long John Silver in Treasure Island . In 1890, he settled in Samoa where, alarmed at increasing European and American influence in the South Sea islands , his writing turned from romance and adventure fiction toward

2448-492: Is a rare symptom. The complications of bronchiectasis include serious health conditions, such as respiratory failure and atelectasis : collapse or closure of a lung. Respiratory failure occurs when not enough oxygen passes from the lungs into the blood. Atelectasis occur when one or more segments of the lungs collapse or do not inflate properly. Other pulmonary complications include lung abscess and empyema . Cardiovascular complications include cor pulmonale , in which there

2550-449: Is abnormal in most patients with bronchiectasis. Computed tomography is recommended to confirm the diagnosis and is also used to describe the distribution and grade the severity of the disease. Radiographic findings include airway dilation, bronchial wall thickening, and atelectasis . There are three types bronchiectasis that can be seen on CT scan, namely cylindrical, varicose, and cystic bronchiectasis. In preventing bronchiectasis, it

2652-423: Is also standard treatment. Regular vaccination against pneumonia , influenza , and pertussis are generally advised. A healthy body mass index and regular doctor visits may have beneficial effects on the prevention of progressing bronchiectasis. The presence of hypoxemia , hypercapnia , dyspnea level and radiographic extent can greatly affect the mortality rate from this disease. A comprehensive approach to

2754-438: Is associated with more severe bronchiectasis. Neutrophil elastase, which is an extracellular protein secreted by neutrophils to destroy pathogens as well as host tissue, is also hyperactive in many cases of bronchiectasis. An increased neutrophil elastase activity is also associated with worse outcomes and more severe disease in bronchiectasis. The initial lung injury in bronchiectasis leads to an impaired mucociliary clearance of

2856-508: Is designed and significant. It is not clear, however, that in this there was any real basis for disagreement with James. Stevenson had presented James with a copy of Kidnapped , but it was Treasure Island that James favoured. Written as a story for boys, Stevenson had thought it in "no need of psychology or fine writing", but its success is credited with liberating children's writing from the "chains of Victorian didacticism ". During his college years, Stevenson briefly identified himself as

2958-645: Is enlargement and failure of the right side of the heart as a result of disease of the lungs. Sjögren syndrome Primary ciliary dyskinesia Primary immunodeficiency HIV/AIDS Job's syndrome Mycobacterium infection Viral infection Marfan syndrome Williams–Campbell syndrome Young's syndrome Alpha-1 antitrypsin deficiency Crohn's disease Graft-versus-host disease Foreign body aspiration Lymphadenopathy Chronic aspiration Ammonia inhalation Smoke inhalation Radiation -induced lung disease Yellow nail syndrome There are many causes that can induce or contribute to

3060-465: Is ever a "compromise") and to invite "anarchy": it is "the sentimentalist preparing the pathway for the brute". In June 1888, Stevenson chartered the yacht Casco from Samuel Merritt and set sail with his family from San Francisco. The vessel "plowed her path of snow across the empty deep, far from all track of commerce, far from any hand of help." The sea air and thrill of adventure for a time restored his health, and for nearly three years he wandered

3162-427: Is known as Kartagener's syndrome . Other rare genetic causes include Young's syndrome and Williams-Campbell syndrome . Tracheobronchomegaly , or Mournier-Kuhn syndrome is a rare condition characterized by significant tracheobronchial dilation and recurrent lower respiratory tract infections . Individuals with alpha 1-antitrypsin deficiency have been found to be particularly susceptible to bronchiectasis, due to

Robert Louis Stevenson Memorial - Misplaced Pages Continue

3264-988: Is more common in women and increases as people age. It became less common since the 1950s with the introduction of antibiotics. It is more common among certain ethnic groups (such as indigenous people in the US). It was first described by René Laennec in 1819. The economic costs in the United States are estimated at $ 630 million per year. Symptoms of bronchiectasis commonly include a cough productive of frequent green or yellow sputum lasting months to years. Other common symptoms include difficulty breathing , wheezing (a whistling sound when you breathe), and chest pain . Exacerbations of symptoms may occur, these exacerbations occur more frequently in advanced or severe disease. Systemic symptoms, including fevers, chills, night sweats, fatigue and weight loss may be seen with bronchiectasis. Bronchiectasis may also present with coughing up blood in

3366-468: Is necessary to prevent the lung infections and lung damage that can cause it. Children should be immunized against measles , pertussis , pneumonia , and other acute respiratory infections of childhood. Additionally, parents should stay alert to keep children from inhaling objects such as pieces of food or small toys that may get stuck in small airways. Smoking and other toxic fumes and gases should be avoided by all patients with bronchiectasis to decrease

3468-706: Is often associated with an altered state of consciousness. The foreign body is often unchewed food, or part of a tooth or crown . Bronchiectasis that results from foreign body aspiration generally occurs in the right lung in the lower lobe or posterior segments of the upper lobe. A range of bacterial, mycobacterial, and viral lung infections are associated with the development of bronchiectasis. Bacterial infections commonly associated with bronchiectasis include P. aeruginosa , H. influenzae , and S. pneumoniae . Gram-negative bacteria are more commonly implicated than gram-positive bacteria . A history of mycobacterial infections such as tuberculosis can lead to damage of

3570-505: Is suspected based on symptoms and confirmed using computed tomography . Cultures of the mucus produced may be useful to determine treatment in those who have acute worsening and at least once a year. Periods of worsening may occur due to infection. In these cases, antibiotics are recommended. Common antibiotics used include amoxicillin , erythromycin , or doxycycline . Antibiotics, such as erythromycin, may also be used to prevent worsening of disease. Airway clearance techniques,

3672-528: Is the most common life-threatening autosomal recessive disease in the United States and Europe. It is a genetic disorder that affects the lungs , but also the pancreas , liver , kidneys , and intestine . It is caused by mutations in the CFTR protein , a chloride channel expressed in epithelial cells. Lung disease results from clogging of the airways due to mucus build-up, decreased mucociliary clearance , and resulting inflammation . In later stages, changes to

3774-413: Is to loosen secretions and interrupt the cycle of inflammation and infection. Airway clearance techniques improve difficulty breathing, cough, and help patients cough up phlegm and mucus plugs . Airway clearance usually uses an inhaled agent ( hypertonic saline ) with chest physiotherapy , such as high-frequency chest wall oscillation . Many airway clearance techniques and devices exist. The choice of

3876-537: Is too late. It is to make roads, and gardens, and care for your trees, and sell their produce wisely, and, in one word, to occupy and use your country... if you do not occupy and use your country, others will. It will not continue to be yours or your children's, if you occupy it for nothing. You and your children will, in that case, be cast out into outer darkness". He had "seen these judgments of God", not only in Hawaii where abandoned native churches stood like tombstones "over

3978-459: Is unknown. The mechanism of disease is breakdown of the airways due to an excessive inflammatory response. Involved airways ( bronchi ) become enlarged and thus less able to clear secretions. These secretions increase the amount of bacteria in the lungs, resulting in airway blockage and further breakdown of the airways. It is classified as an obstructive lung disease , along with chronic obstructive pulmonary disease and asthma . The diagnosis

4080-407: Is used for the assessment and monitoring of functional impairment due to bronchiectasis. These tests may include spirometry and walking tests. Obstructive lung impairment is the most common finding but restrictive lung impairment can be seen in advanced disease. Flexible bronchoscopy may be performed when sputum studies are negative and a focal obstructing lesion is suspected. A chest x-ray

4182-548: The Overland Monthly and author of South Sea Idylls , who urged Stevenson to travel to the South Pacific, an idea which returned to him many years later. In August 1880, he sailed with Fanny and Lloyd from New York to Britain and found his parents and his friend Sidney Colvin on the wharf at Liverpool , happy to see him return home. Gradually, his wife was able to patch up differences between father and son and make herself

Robert Louis Stevenson Memorial - Misplaced Pages Continue

4284-551: The American Civil War . Their children were Isobel (or "Belle"), Lloyd and Hervey (who died in 1875). But anger over her husband's infidelities led to a number of separations. In 1875, she had taken her children to France where she and Isobel studied art. By the time Stevenson met her, Fanny was herself a magazine short-story writer of recognised ability. Stevenson returned to Britain shortly after this first meeting, but Fanny apparently remained in his thoughts, and he wrote

4386-653: The Covenanters . Stevenson recalled this time of sickness in "The Land of Counterpane" in A Child's Garden of Verses (1885), dedicating the book to his nurse. Stevenson was an only child, both strange-looking and eccentric, and he found it hard to fit in when he was sent to a nearby school at age 6, a problem repeated at age 11 when he went on to the Edinburgh Academy ; but he mixed well in lively games with his cousins in summer holidays at Colinton . His frequent illnesses often kept him away from his first school, so he

4488-448: The elastic fibers of bronchi are affected. The result is permanent abnormal dilation and destruction of the major bronchi and bronchiole walls. Disordered neutrophil function is believed to play a role in the pathogenesis of bronchiectasis. Neutrophil extracellular traps (NETs), which are extracellular fibers secreted by neutrophils that are used to trap and destroy pathogens, are hyperactive in bronchiectasis. Increased NET activity

4590-412: The union with Britain (she had "majestically demonstrated her incapacity to rule Ireland") nor "landlordism" (scarcely more defensible in Ireland than, as he had witnessed it, in the goldfields of California). Rather he protests the readiness to pass "lightly" over crimes—"unmanly murders and the harshest extremes of boycotting "—where these are deemed "political". This he argues is to "defeat law" (which

4692-533: The 27-year-old wrote to his father and stated: Christianity is among other things, a very wise, noble and strange doctrine of life ... You see, I speak of it as a doctrine of life, and as a wisdom for this world ... I have a good heart, and believe in myself and my fellow-men and the God who made us all ... There is a fine text in the Bible, I don't know where, to the effect that all things work together for good for those who love

4794-1053: The Conservative candidate." In 1866, then 15-year-old Stevenson did vote for Benjamin Disraeli , the Tory democrat and future Conservative Prime Minister of the United Kingdom, for the Lord Rectorship of the University of Edinburgh . But this was against a markedly illiberal challenger, the historian Thomas Carlyle . Carlyle was notorious for his anti-democratic and pro-slavery views. In "The Day After Tomorrow", appearing in The Contemporary Review (April 1887), Stevenson suggested: "we are all becoming Socialists without knowing it". Legislation "grows authoritative, grows philanthropical, bristles with new duties and new penalties, and casts

4896-538: The Germans whose firms were beginning to monopolise copra and cocoa bean processing. Stevenson was alarmed above all by what he perceived as the Samoans' economic innocence—their failure to secure their claim to proprietorship of the land (in a Lockean sense) through improving management and labour. In 1894 just months before his death, he addressed the island chiefs: There is but one way to defend Samoa. Hear it before it

4998-667: The Lord. Strange as it may seem to you, everything has been, in one way or the other, bringing me nearer to what I think you would like me to be. 'Tis a strange world, indeed, but there is a manifest God for those who care to look for him. Stevenson did not resume attending church in Scotland. However, he did teach Sunday School lessons in Samoa, and prayers he wrote in his final years were published posthumously. Justifying his rejection of an established profession, in 1877 Stevenson offered "An Apology for Idlers". "A happy man or woman", he reasoned, "is

5100-539: The South Seas . Stevenson left Sydney , Australia, on the Janet Nicoll in April 1890 for his third and final voyage among the South Seas islands. He intended to produce another book of travel writing to follow his earlier book In the South Seas , but it was his wife who eventually published her journal of their third voyage. (Fanny misnames the ship in her account The Cruise of the Janet Nichol .) A fellow passenger

5202-593: The Stevensons' dinner table. Largely bedridden, Stevenson described himself as living "like a weevil in a biscuit." Yet, despite ill health, during his three years in Westbourne, Stevenson wrote the bulk of his most popular work: Treasure Island , Kidnapped , Strange Case of Dr Jekyll and Mr Hyde (which established his wider reputation), A Child's Garden of Verses and Underwoods . Thomas Stevenson died in 1887 leaving his 36-year-old son feeling free to follow

SECTION 50

#1733085184813

5304-641: The absence of sputum, which has been called "dry bronchiectasis." Exacerbations in bronchiectasis present as a worsening of cough, increasing sputum volume or thickened consistency lasting at least 48 hours, worsening shortness of breath (breathlessness), worsening exercise intolerance, increased fatigue or malaise and the development of hemoptysis. People often report frequent bouts of "bronchitis" requiring therapy with repeated courses of antibiotics. People with bronchiectasis may have bad breath from active infection. On examination, crepitations and expiratory rhonchi may be heard with auscultation. Nail clubbing

5406-497: The advice of his friends and without notifying his parents. He took a second-class passage on the steamship Devonia , in part to save money but also to learn how others travelled and to increase the adventure of the journey. He then travelled overland by train from New York City to California. He later wrote about the experience in The Amateur Emigrant . It was a good experience for his writing, but it broke his health. He

5508-573: The advice of his physician to try a complete change of climate. Stevenson headed for Colorado with his widowed mother and family. But after landing in New York, they decided to spend the winter in the Adirondacks at a cure cottage now known as Stevenson Cottage at Saranac Lake, New York . During the intensely cold winter, Stevenson wrote some of his best essays, including Pulvis et Umbra . He also began The Master of Ballantrae and lightheartedly planned

5610-518: The airways that predisposes to bacterial colonization. Severe viral infections in childhood can also lead to bronchiectasis through a similar mechanism. Nontuberculous mycobacteria infections such as Mycobacterium avium complex are found to be a cause in some patients. Recent studies have also shown Nocardia infections to been implicated in bronchiectasis. Impairments in host defenses that lead to bronchiectasis may be congenital, such as with primary ciliary dyskinesia , or acquired, such as with

5712-444: The benefits of freedom and common to all, were truly benefits of wealth, and took their value from our neighbour's poverty...Freedom to be desirable, involves kindness, wisdom, and all the virtues of the free; but the free man as we have seen him in action has been, as of yore, only the master of many helots; and the slaves are still ill-fed, ill-clad, ill-taught, ill-housed, insolently entreated, and driven to their mines and workshops by

5814-605: The capital, on which they built the islands' first two-storey house. Fanny's sister, Nellie Van de Grift Sanchez, wrote that "it was in Samoa that the word 'home' first began to have a real meaning for these gypsy wanderers". In May 1891, they were joined by Stevenson's mother, Margaret. While his wife set about managing and working the estate, 40-year-old Stevenson took the native name Tusitala (Samoan for "Teller of Tales"), and began collecting local stories. Often he would exchange these for his own tales. The first work of literature in Samoan

5916-414: The company of the novelist Henry James . They had met previously in London and had recently exchanged views in journal articles on the "art of fiction" and thereafter in a correspondence in which they expressed their admiration for each other's work. After James had moved to Bournemouth to help support his invalid sister, Alice , he took up the invitation to pay daily visits to Skerryvore for conversation at

6018-668: The development of bronchiectasis. Allergic bronchopulmonary aspergillosis (ABPA) is an inflammatory disease caused by hypersensitivity to the fungus Aspergillus fumigatus . It is suspected in patients with a long history of asthma and symptoms of bronchiectasis such as a productive, mucopurulent cough. Imaging often shows peripheral and central airway bronchiectasis, which is unusual in patients with bronchiectasis caused by other disorders. Several autoimmune diseases have been associated with bronchiectasis. Specifically, individuals with rheumatoid arthritis and Sjögren syndrome have increased rates of bronchiectasis. In these diseases,

6120-499: The development of bronchiectasis. The frequency of these different causes varies with geographic location. Cystic fibrosis is identified as a cause in up to half of cases. Bronchiectasis without CF is known as non-CF bronchiectasis. Historically, about half of all case of non-CF bronchiectasis were found to be idiopathic , or without a known cause. However, more recent studies with a more thorough diagnostic work-up have found an etiology in 60 to 90% of patients. Cystic fibrosis

6222-416: The development of infections (such as bronchitis ) and further complications. Treatments to slow down the progression of this chronic disease include keeping bronchial airways clear and secretions weakened through various forms of airway clearance . Aggressively treating bronchial infections with antibiotics to prevent the destructive cycle of infection, damage to bronchi and bronchioles, and more infection

SECTION 60

#1733085184813

6324-552: The dying sun, Smiled well content, and to this childish task Around the fire addressed its evening hours. In other respects too, Stevenson was moving away from his upbringing. His dress became more Bohemian ; he already wore his hair long, but he now took to wearing a velveteen jacket and rarely attended parties in conventional evening dress. Within the limits of a strict allowance, he visited cheap pubs and brothels. More significantly, he had come to reject Christianity and declared himself an atheist . In January 1873, when he

6426-581: The eastern and central Pacific, stopping for extended stays at the Hawaiian Islands, where he became a good friend of King Kalākaua . He befriended the king's niece Princess Victoria Kaiulani , who also had Scottish heritage. He spent time at the Gilbert Islands , Tahiti , New Zealand and the Samoan Islands . During this period, he completed The Master of Ballantrae , composed two ballads based on

6528-450: The elder Stevenson was naturally disappointed, the surprise cannot have been great, and Stevenson's mother reported that he was "wonderfully resigned" to his son's choice. To provide some security, it was agreed that Stevenson should read law (again at Edinburgh University) and be called to the Scottish bar . In his 1887 poetry collection Underwoods , Stevenson muses on his having turned from

6630-569: The end of the winter, his health was broken again and he found himself at death's door. Fanny was now divorced and recovered from her own illness, and she came to his bedside and nursed him to recovery. "After a while," he wrote, "my spirit got up again in a divine frenzy, and has since kicked and spurred my vile body forward with great emphasis and success." When his father heard of his 28-year-old son's condition, he cabled him money to help him through this period. Fanny and Robert were married in May 1880. She

6732-627: The essay "On falling in love" for The Cornhill Magazine . They met again early in 1877 and became lovers. Stevenson spent much of the following year with her and her children in France. In August 1878, she returned to San Francisco and Stevenson remained in Europe, making the walking trip that formed the basis for Travels with a Donkey in the Cévennes (1879). But he set off to join her in August 1879, aged 28, against

6834-513: The exaggerated and romantic world that, as a child, he had entered as proud owner of Skelt's Juvenile Drama—a toy set of cardboard characters who were actors in melodramatic dramas. "A Gossip on Romance" (1882) and "A Gossip on a Novel of Dumas's" (1887) imply that it is better to entertain than to instruct. Stevenson very much saw himself in the mould of Sir Walter Scott, a storyteller with an ability to transport his readers away from themselves and their circumstances. He took issue with what he saw as

6936-399: The family profession: Say not of me that weakly I declined The labours of my sires, and fled the sea, The towers we founded and the lamps we lit, To play at home with paper like a child. But rather say: In the afternoon of time A strenuous family dusted from its hands The sand of granite, and beholding far Along the sounding coast its pyramids And tall memorials catch

7038-468: The family's engineering works. In 1868, this took him to Anstruther and for a stay of six weeks in Wick , where his family was building a sea wall and had previously built a lighthouse. He was to return to Wick several times over his lifetime and included it in his travel writings. He also accompanied his father on his official tour of Orkney and Shetland islands lighthouses in 1869 and spent three weeks on

7140-537: The first editor of his letters after his death. He placed Stevenson's first paid contribution in The Portfolio , an essay titled "Roads". Stevenson was soon active in London literary life, becoming acquainted with many of the writers of the time, including Andrew Lang , Edmund Gosse and Leslie Stephen , the editor of The Cornhill Magazine , who took an interest in Stevenson's work. Stephen took Stevenson to visit

7242-449: The greater part of his boyhood holidays in his maternal grandfather's house. "Now I often wonder what I inherited from this old minister," Stevenson wrote. "I must suppose, indeed, that he was fond of preaching sermons, and so am I, though I never heard it maintained that either of us loved to hear them." Lewis Balfour and his daughter both had weak chests, so they often needed to stay in warmer climates for their health. Stevenson inherited

7344-425: The household was not strict in its adherence to Calvinist principles. His nurse Alison Cunningham (known as Cummy) was more fervently religious. Her mix of Calvinism and folk beliefs were an early source of nightmares for the child, and he showed a precocious concern for religion. But she also cared for him tenderly in illness, reading to him from John Bunyan and the Bible as he lay sick in bed and telling tales of

7446-408: The island of Erraid in 1870. He enjoyed the travels more for the material they gave for his writing than for any engineering interest. The voyage with his father pleased him because a similar journey of Walter Scott with Robert Stevenson had provided the inspiration for Scott's 1822 novel The Pirate . In April 1871, Stevenson notified his father of his decision to pursue a life of letters. Though

7548-460: The lash of famine. In January 1888, aged 37, in response to American press coverage of the Land War in Ireland, Stevenson penned a political essay (rejected by Scribner's magazine and never published in his lifetime) that advanced a broadly conservative theme: the necessity of "staying internal violence by rigid law". Notwithstanding his title, "Confessions of a Unionist ", Stevenson defends neither

7650-491: The legends of the islanders, and wrote The Bottle Imp . He preserved the experience of these years in his various letters and in his In the South Seas (which was published posthumously). He made a voyage in 1889 with Lloyd on the trading schooner Equator , visiting Butaritari , Mariki, Apaiang and Abemama in the Gilbert Islands . They spent several months on Abemama with tyrant-chief Tem Binoka , whom Stevenson described in In

7752-446: The loss of inhibition to enzyme elastase which cleaves elastin . This decreases the ability of the alveoli to return to normal shape during expiration. A causal role for tobacco smoke in bronchiectasis has not been demonstrated. Nonetheless, tobacco smoking can worsen pulmonary function and accelerate the progression of disease that is already present. The development of bronchiectasis requires two factors: an initial injury to

7854-487: The lung (such as from infection, auto-immune destruction of lung tissue, or other destruction of lung tissue (as seen in gastroesophageal reflux disease or aspiration syndromes )) which leads to impaired mucociliary clearance , obstruction, or a defect in host defense. This triggers a host immune response from neutrophils ( elastases ), reactive oxygen species , and inflammatory cytokines that results in progressive destruction of normal lung architecture. In particular,

7956-514: The lung airways, which leads to mucous stasis. This mucous stasis leads to bacterial colonization in bronchiectasis which leads to neutrophil activation. This neutrophil activation leads to further tissue destruction and airway distortion by neutrophils in addition to direct tissue destruction by the pathogenic bacteria. The distorted, damaged lung airways thus have impaired mucociliary clearance; leading to mucous stasis and bacterial colonization leading to further neutrophil activation and thus fueling

8058-426: The management of bronchiectasis is recommended. It is important to establish whether an underlying modifiable cause, such as immunoglobulin deficiency or alpha-1 antitrypsin deficiency is present. The next steps include controlling infections and bronchial secretions, relieving airway obstructions, removing affected portions of lung by surgery, and preventing complications . The goal of airway clearance therapy

8160-665: The neighbourhood of the Forest of Fontainebleau , staying at Barbizon , Grez-sur-Loing and Nemours and becoming a member of the artists' colonies there. He also travelled to Paris to visit galleries and the theatres. He qualified for the Scottish bar in July 1875, aged 24, and his father added a brass plate to the Heriot Row house reading "R.L. Stevenson, Advocate". His law studies did influence his books, but he never practised law; all his energies were spent in travel and writing. One of his journeys

8262-474: The pleasures of existence in something far liker an ant-heap that any previous human polity". Yet in reproducing the essay his latter-day libertarian admirers omit his express understanding for the abandonment of Whiggish , classical-liberal notions of laissez faire . "Liberty", Stevenson wrote, "has served us a long while" but like all other virtues "she has taken wages". [Liberty] has dutifully served Mammon; so that many things we were accustomed to admire as

8364-524: The printing of Robert's first publication at 16, entitled The Pentland Rising: A Page of History, 1666 . It was an account of the Covenanters' rebellion and was published in 1866, the 200th anniversary of the event. In September 1857, when he was six years old, Stevenson went to Mr Henderson's School in India Street, Edinburgh, but because of poor health stayed only a few weeks and did not return until October 1859, aged eight. During his many absences, he

8466-412: The prolonged use of immunosuppressive drugs . Additionally, these impairments may be localized to the lungs, or systemic throughout the body. In these states of immunodeficiency, there is a weakened or absent immune system response to severe infections that repeatedly affect the lung and eventually result in bronchial wall injury. HIV/AIDS is an example of an acquired immunodeficiency that can lead to

8568-588: The same field. Thomas's maternal grandfather Thomas Smith had been in the same profession. However, Robert's mother's family were gentry , tracing their lineage back to Alexander Balfour, who had held the lands of Inchrye in Fife in the fifteenth century. His mother's father, Lewis Balfour (1777–1860), was a minister of the Church of Scotland at nearby Colinton , and her siblings included physician George William Balfour and marine engineer James Balfour . Stevenson spent

8670-410: The structure of the lung, such as bronchiectasis, occur. An airway obstruction can be caused by either an intraluminal mass such as a tumor or a foreign body . The presence of an airway obstruction leads to a cycle of inflammation. It is important to identify the presence of an obstruction because surgical resection is often curative if obstruction is the cause. In adults, foreign body aspiration

8772-501: The symptoms of bronchiectasis usually presents later in the disease course. Other autoimmune diseases such as ulcerative colitis and Crohn's disease also have an association with bronchiectasis. Additionally, graft-versus-host disease in patients who have undergone stem cell transplantation can lead to bronchiectasis as well. Bronchiectasis could be caused by: inhalation of ammonia and other toxic gases, chronic pulmonary aspiration of stomach acid from esophageal reflux , or

8874-495: The tendency in French realism to dwell on sordidness and ugliness. In "The Lantern-Bearer" (1888) he appears to take Emile Zola to task for failing to seek out nobility in his protagonists. In "A Humble Remonstrance", Stevenson answers Henry James 's claim in "The Art of Fiction" (1884) that the novel competes with life. Stevenson protests that no novel can ever hope to match life's complexity; it merely abstracts from life to produce

8976-666: The village of Swanston at the foot of the Pentland Hills , for use as a summer holiday home. They held the lease until 1880. During their tenancy, the young Robert Louis made frequent use of the cottage, being attracted by the quiet country life and the feeling of remoteness. It is likely that the time he spent there influenced his later writing as well as his wider outlook on life, particularly his love of nature and of wild places. The house and its romantic location are thought to have inspired several of his works. Each year during his university holidays, Stevenson also travelled to inspect

9078-580: Was Jack Buckland , whose stories of life as an island trader became the inspiration for the character of Tommy Hadden in The Wrecker (1892), which Stevenson and Lloyd Osbourne wrote together. Buckland visited the Stevensons at Vailima in 1894. In December 1889, 39-year-old Stevenson and his extended family arrived at the port of Apia in the Samoan islands and there he and Fanny decided to settle. In January 1890 they purchased 314 + 1 ⁄ 4 acres (127.2 ha) at Vailima, some miles inland from Apia

9180-570: Was bronchiectasis or sarcoidosis . The family also summered in the spa town of Bridge of Allan , in North Berwick , and in Peebles for the sake of Stevenson's and his mother's health; "Stevenson's cave" in Bridge of Allan was reportedly the inspiration for the character Ben Gunn 's cave dwelling in Stevenson's 1883 novel Treasure Island . Stevenson's parents were both devout Presbyterians , but

9282-586: Was 22, his father came across the constitution of the LJR (Liberty, Justice, Reverence) Club, of which Stevenson and his cousin Bob were members, which began: "Disregard everything our parents have taught us". Questioning his son about his beliefs, he discovered the truth. Stevenson no longer believed in God and had grown tired of pretending to be something he was not: "am I to live my whole life as one falsehood?" His father professed himself devastated: "You have rendered my whole life

9384-540: Was 40; he was 29. He said that he was "a mere complication of cough and bones, much fitter for an emblem of mortality than a bridegroom." He travelled with his new wife and her son Lloyd north of San Francisco to Napa Valley and spent a summer honeymoon at an abandoned mining camp on Mount Saint Helena (today designated Robert Louis Stevenson State Park ). He wrote about this experience in The Silverado Squatters . He met Charles Warren Stoddard , co-editor of

9486-399: Was a 34-year-old woman with a son, who was separated from her husband. She attracted the devotion of many who met her, including Colvin, who married her in 1901. Stevenson was also drawn to her, and they kept up a warm correspondence over several years in which he wavered between the role of a suitor and a son (he addressed her as " Madonna "). Colvin became Stevenson's literary adviser and was

9588-453: Was a Scottish novelist, essayist, poet and travel writer. He is best known for works such as Treasure Island , Strange Case of Dr Jekyll and Mr Hyde , Kidnapped and A Child's Garden of Verses . Born and educated in Edinburgh, Stevenson suffered from serious bronchial trouble for much of his life but continued to write prolifically and travel widely in defiance of his poor health. As

9690-880: Was a canoe voyage in Belgium and France with Sir Walter Simpson, a friend from the Speculative Society, a frequent travel companion, and the author of The Art of Golf (1887). This trip was the basis of his first travel book An Inland Voyage (1878). Stevenson had a long correspondence with fellow Scot J.M. Barrie . He invited Barrie to visit him in Samoa , but the two never met. The canoe voyage with Simpson brought Stevenson to Grez-sur-Loing in September 1876, where he met Fanny Van de Grift Osbourne (1840–1914), born in Indianapolis . She had married at age 17 and moved to Nevada to rejoin husband Samuel after his participation in

9792-548: Was again unsuccessful and always unsuccessful; but at least in these vain bouts, I got some practice in rhythm, in harmony, in construction and the co-ordination of parts. I have thus played the sedulous ape to Hazlitt , to Lamb , to Wordsworth , to Sir Thomas Browne , to Defoe , to Hawthorne , to Montaigne , to Baudelaire and to Obermann . Stevenson's critical essays on literature contain "few sustained analyses of style or content". In "A Penny Plain and Two-pence Coloured" (1884) he suggests that his own approach owed much to

9894-553: Was his translation of The Bottle Imp (1891) , which presents a Pacific-wide community as the setting for a moral fable. Immersing himself in the islands' culture, occasioned a "political awakening": it placed Stevenson "at an angle" to the rival great powers , Britain, Germany and the United States whose warships were common sights in Samoan harbours. He understood that, as in the Scottish Highlands (comparisons with his homeland "came readily"), an indigenous clan society

9996-654: Was near death when he arrived in Monterey, California , where some local ranchers nursed him back to health. He stayed for a time at the French Hotel located at 530 Houston Street, now a museum dedicated to his memory called the " Stevenson House ". While there, he often dined "on the cuff," as he said, at a nearby restaurant run by Frenchman Jules Simoneau, which stood at what is now Simoneau Plaza; several years later, he sent Simoneau an inscribed copy of his novel Strange Case of Dr Jekyll and Mr Hyde (1886), writing that it would be

10098-713: Was sent to Robert Thomson's private school in Frederick Street, Edinburgh, where he remained until he went to university. In November 1867, Stevenson entered the University of Edinburgh to study engineering. From the start he showed no enthusiasm for his studies and devoted much energy to avoiding lectures. This time was more important for the friendships he made with other students in The Speculative Society (an exclusive debating club), particularly with Charles Baxter, who would become Stevenson's financial agent, and with

10200-503: Was taught by private tutors. In October 1861, aged ten, he went to Edinburgh Academy , an independent school for boys, and stayed there sporadically for about fifteen months. In the autumn of 1863, he spent one term at an English boarding school at Spring Grove in Isleworth in Middlesex (now an urban area of West London). In October 1864, following an improvement to his health, the 13-year-old

10302-423: Was taught for long stretches by private tutors. He was a late reader, learning at age 7 or 8, but even before this he dictated stories to his mother and nurse, and he compulsively wrote stories throughout his childhood. His father was proud of this interest; he had also written stories in his spare time until his own father had found them and had told him to "give up such nonsense and mind your business." He paid for

10404-425: Was unprepared for the arrival of foreigners who played upon its existing rivalries and divisions. As the external pressures upon Samoan society grew, tensions soon descended into several inter-clan wars. No longer content to be a "romancer", Stevenson became a reporter and an agitator, firing off letters to The Times which "rehearsed with an ironic twist that surely owed something to his Edinburgh legal training",

#812187