Down and almost out in Scotland: George Orwell, tuberculosis and getting streptomycin in 1948

On Christmas Eve 1947, Eric Blair (pen-name, George Orwell) was admitted to Hairmyres Hospital near Glasgow.2 George Orwell (Figure 1) was a journalist and novelist, and the publication in 1945 of his political fable, Animal Farm,3 had made him famous. He was 44 years old, and tests at the hospital confirmed that he had infectious chronic tuberculosis in his lungs.4 Orwell has been described as ‘a representative of truth-telling, objectivity and verification’.5 As with other events in his life, he carefully analysed and documented his experience of care for his tuberculosis, including his time in a private sanitorium. Orwell had been given treatments that were common for tuberculosis in Britain at that time: ‘collapse therapy’ and other painful surgical procedures to keep the lung disabled to ‘rest’ it, vitamins, fresh air, and being confined to bed. The hospital staff confiscated his typewriter and told him to stop working6—but they didn’t seem to advise him to stop smoking! (Figure 2) Orwell’s work, a novel he would struggle to complete in the coming year—1948, was Orwell’s ‘last great obsession’.7 He twisted the numbers of that year to give the book one of the most famous titles and powerful symbols from the 20th century: Nineteen EightyFour,8 introducing Big Brother and words like ‘doublespeak’ to the international political and social landscape (Figure 3). Orwell was hopeful