Metaphors of fever in the poetry of John Keats: A cognitive approach

Abstract There is a long tradition among Keats’s critics that links his medical profession to his poetic career, claiming that the former has influenced the latter. Some of them argue that the poet’s medical learning influenced his thought and formed a source material for his poetry. This paper continues this tradition. I argue that Keats’s knowledge of medicine has provided him with technical information to describe abstract states such as negative mood and mental states through medical language. I examine some of his medical metaphors using a cognitive approach to investigate how Keats employs medical terminology to conceptualize these negative mental states. This new approach allows me to see how concepts and structures which belong to the domain of the medical profession (source) are mapped onto the domain of negative mental states and emotions (target) through the process of cross-domain mapping. Cross-domain mapping allows the speaker to use prior knowledge of the source domain and apply it to the target domain so as to describe it in a new way. Using this cognitive approach offers a better understanding of Keats’s poetry, particularly the metaphors of negative mental states such as depression and melancholy. My analysis differs from previous studies as my approach considers Keats’s medical profession as a domain where he maps concepts and frames onto the domain of negative emotions.


PUBLIC INTEREST STATEMENT
This Article sits at the bridge between cognitive poetics and cognitive linguistics. It offers a practical connection between language and literature in disciplines such as stylistics, cognitive poetics and discourse analysis. The paper examines the way cognitive tools can help in understanding figurative language. This article makes use of the modern view of metaphor to reason about Keats's metaphorical language. Readers would see how conceptual metaphor theory can be applied to literary texts to provide new reading of these texts.

Introduction
By 1817, Keats had already decided to quit his medical career for poetry, a controversial decision that shocked some of his friends and pleased others, especially those who believed in his literary creativity. Although he abandoned medicine as a profession, his medical knowledge continued to provide material for his new profession in terms of images, metaphors and poetic expressions. Many of Keats's critics continue to establish a strong relationship between his medical career and poetic profession. For example, M.H. Abrams argues that Keats's technical knowledge of pathology, medicine, anatomy, physiology, chemistry and botany supplied him with "unprecedented metaphors for poetry" (Abrams, 1998, p. 43). Jack Siler claims that Keats's medical knowledge contributed to his poetic language, providing terms, idioms and phrases to describe physical and mental distress (Siler, 2008, pp. 47, 80). In this paper, I take this argument further. I look at the connection between Keats's medical education and his metaphorical language to examine the influence of his medical career on the articulation of his poetic metaphors. I argue that Keats's medical knowledge provided him with images and metaphors to describe many of his personas and their physical and mental suffering in a medical way. I am particularly interested in how the medical profession enabled him to conceive of negative mental states in terms of pathological conditions or states of disease. I examine how Keats structures the experience of negative mental states through concepts derived from his medical profession.
I should make it clear that this is not the first study that connects Keats's medical and poetic careers together. But it is the first study that connects Keats's metaphors to his medical training through conceptual metaphor theory. Previous work includes William Hale-White (1938) Keats as doctor and patient. The book is a brief account of the poet's life, poetry, medicine and health written by a chronicler and a physician from Guy's Hospital. There is no mention of "metaphor" in this book. Walter Augustine Wells (1959) A Doctor's Life of John Keats also provides a biographical account about Keats's medical training, teachers and fellow students in the Guy's Hospital school of medicine. It also sheds light on medicine and poetry, but nothing about metaphor is discussed in it. Hagelman (1956), in a PhD dissertation "John Keats and the Medical Profession" has also approached the issue of Keats's medical study and poetic career. He argues that Keats's metaphorical language such as "medical simile" and images show the medical influence in Isabella and "Ode to Psyche". He believes that "metaphor is the poet's tool, not his taskmaster" (Hagelman, 1956, pp. 260, 310). Donald Goellnicht's (1984) The Poet-Physician: Keats and Medical Science claims that the works of John Keats reveal a notable influence of science and medicine. He argues that "Keats's medical training also introduced him to certain images, metaphors, ideas, and ideals which, as part of his intellectual equipment, would inevitably find their way into his poetry and letters" (Goellnicht, 1984, p. 46). Hermione De Almeida (1991) Romantic Medicine and John Keats is an interdisciplinary study that provides a reading of Keats's poetry in relation to two different contexts of medicine and poetry during the Romantic period. She states that Keats's poetry contains many metaphors of health which are "outnumbered only by metaphors of disease" (De Almeida, 1991, p. 138). Joseph Epstein (1999) "The Medical Keats" provides an attempt to link ideas and images in Keats's poetry and letters with his medical education. He believes that "in the formation of key metaphors as well as glancing descriptive passages, Keats availed himself of concepts first learned in his medical studies" (Epstein, 1999, p. 59). Recent studies have continued investigating the link between his medical career and poetic heritage, for example, Caroline Bertonèche's "Bloody Poetry: On the Role of Medicine in John Keats's Life and Art" (Bertonèche, 2014) examines the impact of medicine on the poetry of John Keats. She argues that Keats, with his vision, perceived the ins and outs of the two parallel paths of the medical science and the poetic sentiment and the possibility of bringing them together (Bertonèche, 2014, p. 154). On the other hand, Nicholas Roe's John Keats and the Medical Imagination (Roe, 2017) offers a survey of the story of Keats's medical imagination. The book traces back the medical years where "medicine and medical pathology informed his poetry and thought", and images of sickness and illness contributed to his poetic imagination (Roe, 2017, p. 1).
Although some of these studies connect Keats's medical career to his use of metaphor, their use of the term "metaphor" is very general. They employ the term "metaphor" in its traditional sense as something that stands for something else. These studies were conducted before cognitive metaphor theory; none of them follow this approach. Therefore, my purpose differs from them because my research approaches metaphor from a cognitive perspective. More details about this framework will be discussed in section (3).

Key notions
Before introducing my analysis, I think it is necessary to define some of the key notions that will be used in this study such as the terms "fever" and "negative mental state" as they form the main argument of this paper. As far as the term "fever" is concerned, the study uses "fever" to refer to a pathological condition of "an abnormally high body temperature, usually accompanied by shivering, headache, and in severe instances, delirium" (Oxford English Dictionary Online, 2020). On the other hand, the study will use the term "negative mental states" as a collective term to refer to a range of various personal emotional states or states of mind which are marked by having negative influence on the individual who experience them. My analysis adopts a definition that unites the emotional with mental and cognitive aspects. In other words, the term refers to those mental or emotional states that have negative valence such as: sadness, melancholy, depression, disappointment, despair, despondence, anxiety, fear, hate, etc (Ortony & Turner, 1990, p. 318).

Methodology
In my study, I have a cognitive methodology which can help us understand Keats's metaphors better than the traditional view of metaphor. A cognitive view on semantics argues that meaning is formed from associations that start in the mind as domains are mapped onto each other. I apply insights from Conceptual Metaphor Theory (CMT) by George Lakoff and Mark Johnson (Lakoff & Johnson, 1980, 2003. Lakoff and Johnson discuss the way that conceptual metaphor consists of two domains; we structure our understanding of one domain in terms of the other (Lakoff & Johnson, 2003, p. 52).
Their main point in Lakoff and Johnson's argument is that the use of metaphor is not a property of language alone. Metaphors can work on the mental and cognitive level as well, and human conceptual system is largely metaphorical. They claim that metaphors help us to understand one concept in terms of another (Kövecses, 2009;Lakoff, 2008;Lakoff & Johnson, 2003). Metaphors connect two or more conceptual domains together to facilitate understanding one thing through associating it with another (Dancygier, 2017;Steen, 2008). By "conceptual domain" they refer to a "mental space" that contains schematic knowledge and information about a particular human experience or "any coherent organisation of experience" such as: happy, sad, pain, anger, love, hatred, etc. (Kövecses, 2010, p. 4). Lakoff and Johnson claim that conceptual metaphor consists of two domains: (source domain) and (target domain). They argue that we (human being) structure our understanding of the (target domain) which is usually of abstract quality and less familiar in terms of the (source domain) which is usually of concrete quality and more familiar to us (Lakoff & Johnson, 2003). In order to activate the process of conceptualization, the human mind makes mental correspondences between the conceptual elements contained in the (source domain) and those of the target domain. The mental correspondences between these elements are known as cross-domain mapping or metaphorical mappings (Lakoff & Johnson, 2003).
In the light of this conceptual view of metaphor, I will consider medical knowledge as a source domain from which Keats draws some structures to map them on the target domain of negative mental states. The paper looks across the poems of John Keats to study certain examples in which he conceptualizes negative mental states by means of concepts and experiences he gained from his previous education and knowledge. For this reason, the paper will deal with metaphorical expressions where concepts and structures which belong to the domain of the medical profession are mapped onto the domain of negative mental states and emotions. I argue that Keats conceptualizes these negative states by means of conceptual frames derived from the domain of medical knowledge. These conceptual domains are the representation of "any coherent organization of experience" (Kövecses, 2010, p. 4). In other words, the conceptual domains provide us with basic ideas and concepts that shape our prior knowledge of them. Through a process called cross-domain mapping, conceptual frames and correspondences are mapped from these conceptual domains (source) onto the domain of negative mental and emotional states (target). This process of mapping allows the speaker to use prior knowledge of the source domain and apply it to the target domain so as to describe it in a new way.
This study benefits from Conceptual Metaphor Theory in discussing the metaphorical expressions of fever which are used in the poetry of Keats. This cognitive framework helps in identifying the conceptual metaphors used by the poetic persona when they conceptualize emotional states or mental experiences.

Medical language in Keats
Keats's poetry contains many expressions of negative emotional states that have been communicated through medical language. For example, there are a lot of pathological images and metaphors to portray physical and mental suffering such as "morbid fancy", "fancy-sick", "brain-sick", "sick hearted", "heartsickness", "sick eyelids", "sick pride", sickly imagination', "bosom pain", "mind in pain", "pained heart", "scarlet pain", "balmy pain, 'heaving in pain' 'heart-ache', 'eyelids ache', 'aches in loneliness', 'full of ache', 'fever', 'feverous hectic', 'feverous boiling gurge', fevered parching's", "eye all pale", "pale of cheeks", "pale cheeks", "thy cheek is pale", "pale limbs", "pale mouthed", "pale faces", "pale forehead", "pale were the lips", "drowsy numbness", "drowsy hour", "drowsy noons", "drowsy gloom", "drowsy wing" and, drowsy chimes', etc. These terms and expressions usually occur within the broader scope of medical discourse. By medical discourse, I mean here the language of expressing suffering and pain as well as the language of curing or healing illnesses (Wilce, 2009, p. 199). It is, of course, not possible to determine whether Keats developed these metaphors consciously or unconsciously. It is also required to know about the usage of these metaphors, and whether they are widespread or specific to Keats. According to Donald Goellnicht, the precision with which Keats uses terminology suggests a conscious effort. Goellnicht argues that "pathology provided Keats with concepts and metaphors that were much more readily adaptable to poetic needs and meanings" (Goellnicht, 1984, p. 53). Due to my interest in negative states, I will focus only on the language expressing suffering or pain. Therefore, the terms I will be calling medical or medical terminology refer to those expressions which are associated with experiences of physical suffering or bodily illness. I will be discussing how Keats picks up these terms from the medical domain and employs them metaphorically to represent negative mental states and emotions. In this paper, I limit myself to the use of the term "fever" as a metaphor for negative mental states. There are, of course, many other medical terms and conditions such as "sick", "ache", "pain", "drowsiness", "numbness" "palsy", "pale", "ailment", and "malady" which Keats used in his writings, but for reasons of space and time I will not deal with them here in this paper. I am going to examine how the term "fever" is used in Keats's representation of negative mental states. The basic sense of this term is usually to do with physical experience but, through conceptual mapping, it is used to represent negative emotions. I am aware that this term is well known and may occur in other contexts or be used by non-specialists, yet Keats is not always using this term in its general sense. Although he returns to it, sometimes he uses it in its specific medical sense and in medical contexts. The evidence, as I will argue, is supported by linguistic clues including Keats's contemporary medical sources which were available to him during his time at Guy's hospital. It is also supported by contextual clues, for example, the given context suggests a pathological state in which a patient is suffering from symptoms of certain illness and requires treatment. It is also worth noticing that this term or keyword "fever" comes within the text in different linguistic forms (word class); sometimes it comes as a noun, a verb, an adjective or an adverb.
My main argument in this paper is more specific than that which other critics have made. I argue that through conceptual mapping, Keats links the domain of the medical profession to the domain of negative mental states and emotions. He conceptualizes a great deal of these abstract states of his characters in terms of a medical language; he adapts analogies from his medical training and knowledge to represent them. He uses metaphorical expressions whose meanings allude to a medical context. These analogies, to a certain extent, demonstrate the user's familiarity with their subject. For example, he uses physical experiences of "fever", which is-within the context of medical training and general experiences-a physical concern and applies it to negative mental states or emotions. The concept of fever is viewed as a domain from which he mapped conceptual structures onto the domain of negative mental state. Through this application, he generates metaphors that allow him to speak about such complex states and emotions. I will look at these metaphors from a cognitive perspective to see how Keats structures his understanding of negative mental states in terms of the pathological state of fever. In the following section, I will examine the metaphors of fever in which negative mental state is represented by means of a fit of fever.

Metaphors of fever
The word "fever" is referenced 21 times in Keats's poems. 1 It is employed literally and metaphorically in many of his works. As far as metaphorical language is concerned, Keats uses this morbid condition to generate many metaphorical expressions. For example, love is seen as a fever in some of his poems such as: The Eve of St. Agnes where Porphyro's heart is depicted as "Love's fev'rous citadel" (l.84). In "Ode on a Grecian Urn", "human passion" is also depicted by means of fever that causes the patient "A burning forehead, and a parching tongue" (l. 30). In Isabella, Lorenzo's love for Isabella has "Fever'd his high conceit of such a bride" (l. 46). Poetic creativity is also depicted in terms of a bout of "fever" in some other poems and letters (Goellnicht, 1984, p. 200). In regard to negative emotions and mental states-which are the main focus of this paper-there are interesting examples in which Keats metaphorically represents these negative states in terms of a fever fit. In the following account, I will discuss some of these examples. I will limit myself only to those expressions that contain the word "fever" or its related forms to denote negative mental states or emotions.
In Hyperion, Keats uses the term "fever" three times. In the book I, the term "fever" is used to describe Saturn's mental health. Saturn is depicted mourning the loss of his empire after being overthrown by Jupiter. He rouses himself to search for reason to understand what happened so that he can renew resistance against Jupiter. In the following quotation, the speaker uses a medical image to describe the defeated god: This passion lifted him upon his feet, And made his hands to struggle in the air, His Druid locks to shake and ooze with sweat, His eyes to fever out, his voice to cease. He stood, and heard not Thea's sobbing deep; A little time, and then again he snatch'd Utterance thus.-"But cannot I create? "Cannot I form? Cannot I fashion forth (I, 135-142) In the quoted passage there are several metaphorically used lexical items. To focus on "fever", it is metaphorical because in context it refers to a negative state of confusion, while the basic meaning would refer to a somatic illness. The passage contains some physical and nonphysical symptoms of this medical condition "fever" which were familiar to Keats as a medical student. The symptoms depicted in the quoted passage include struggling hand, shaking head, high temperature, low voice and impaired hearing and loss of concentration which were medically known at that time as fever symptoms. Keats probably came to know about them through a medical course entitled Practice of Medicine which was taught by William Babington and James Curry who were teaching at the medical school for Guy's Hospital by the time Keats was a student. In that course book they describe the symptoms of fever in the following way: Increased frequency of pulse,-preternatural heat, preceded by sensation of cold, -feeling of languor, lassitude, and general uneasiness:-pain of head, back, and limbs:-memory and judgement confused and indistinct; -senses of taste, smell, touch, &c. altered or impaired:want of appetite,-defect of saliva,-thirst;-discolouration of the tongue; -respiration frequent and anxious:-changes in the urine (Babington & Curry, 1811, p. 2).
The medical account in this passage provides the physical symptoms of fever that match Keats's description of Saturn. If we compare Keats's poetic discourse of fever with Babington and Curry's medical discourse of it, we find the former used it metaphorically while the latter has no metaphorical sense of the term; it only focuses on its observable physical effects. The poetic voice in Keats's passage uses this morbid condition (fever) to metaphorically represent Saturn's state of lacking selfcontrol and mental confusion that dominates the whole picture. Saturn is unable to "create", "form" or "fashion" another world to replace the one he lost. Saturn's disability is attributed to his diseased imagination as some critics argue; his mind is depicted "in a state of fevered turmoil that thwarts creativity" (Goellnicht, 1984, p. 216). Saturn's imagination is affected by a state of illness which is to do with mental suffering rather than a physical suffering. It has been embodied through images of physical disease (fever). What is interesting in Keats's passage is the expression "His eyes to fever out" which is used to describe a negative state of confusion rather than a somatic illness (fever). The speaker uses the verb "fever" metaphorically in this context and he associates it with Saturn's eyes (a physical body organ). Eyes are used metonymically in this context (a part refers to the whole). Literally, eyes do not experience fever; they are only affected by it. The implication of this expression "His eyes to fever out" is not a physical condition; it is mental. The poetic voice also uses personification in which he maps human features such as the possibility to experience fever onto Saturn's eyes. Personification is a good example of how the process of conceptual mapping works. As far as mapping is concerned, the physical symptoms of "fever" have been mapped from the domain of physical illness onto the domain of cognition so that the speaker can represent Saturn's mental pain in terms of physical illness. In other words, physical suffering is the vehicle through which the speaker conceptualizes Saturn's negative mental state of confusion. The speaker establishes analogues between the domain of negative mental states and the domain of physical illness. As the fever may affect him physically, the negative mental state of confusion affects him mentally. Through conceptual mapping, Saturn's negative mental state has been conceptualized in terms of a pathological state of disease derived from the domain of fever. What intensifies the opinion that Saturn's state is more to do with mental than physical suffering is the evidence given later in the poem by Thea, Hyperion's wife. While Thea tries to comfort Saturn, she observes that his plight is caused by a cluster of negative mental states: And sidelong fix'd her eye on Saturn's face: There saw she direst strife; the supreme God At war with all the frailty of grief, Of rage, of fear, anxiety, revenge, Remorse, spleen, hope, but most of all despair. (II,(91)(92)(93)(94)(95) This passage contains lexical clues such as: "strife", "grief",' rage', "fear", "anxiety", "revenge", "remorse", "spleen", and "despair" which prove that Saturn's problem is not of a physical nature. Physical illness, mainly fever, is only a medium through which the speaker conceptualizes these negative mental states and emotions. It is thanks to conceptual mapping that such a medium can be activated. Through conceptual mapping, the speaker picks up some conceptual structures from the domain of physical illness (fever) and maps them onto the domain of negative mental states and emotions. The outcome of this mapping is that negative mental states are structured and represented in terms of a physical experience of illness (fever). The correspondence between the two compared states is that, as the fever causes physical pain to the patient, negative mental states and emotions cause mental pain to him.
In book II of the same poem, there is another scene where Keats also uses medical language to depict the rest of the fallen Titans. After their defeat, the Titans cower in a "nest of woe" (I, 14,) and "chain'd in torture" (l.18). The location where they miserably gather has replaced that of their lost prosperous empire. This pathetic assembly shows the psychological and emotional blow they have experienced as a result of the fallen state. It also shows the impact of this blow on their mental wellbeing. Just like their ruler (Saturn), their psychological and mental sufferings are also represented in terms of physical illness. In fact, the poem contains a considerable number of medical terms and expressions that tempt me to quote some extracts here: Dungeon'd in opaque element, to keep Their clenched teeth still clench'd, and all their limbs Lock'd up like veins of metal, crampt and screw'd; Without a motion, save of their big hearts Heaving in pain, and horribly convuls'd With sanguine feverous boiling gurge of pulse.
(Book II, 23-28) … … … … … … … … … … …. As with us mortal men, the laden heart Is persecuted more, and fever'd more, When it is nighing to the mournful house Where other hearts are sick of the same bruise (Book II,(101)(102)(103)(104) Here, I am only concerned with images of fever in this scene. Other medical terms and conditions are beyond the scope of this paper. We have two important examples of how the speaker conceptualizes the suffering of the Titans in terms of the physical experience of fever. Fever is twice referred to by the speaker, and in both examples it is associated with the body organ "heart". In the first example, the Titan's "big hearts" are "heaving in pain, and horribly convuls'd with feverous boiling gurge of pulse" (l. 27-28). In the second example, the "laden heart" of the "mortal men" is "persecuted more, and fevered more" (l.101-102). Again, the speaker uses metonymy as the part (hearts) stands for the whole (Titans). In the two examples, "fever" has been employed metaphorically to represent a negative mood of the fallen Titans. Contextually, the "fever" indicates spiritual and mental suffering rather than a physical condition. The Titans are described as enduring the pain of falling which is more emotional than physical. They have lost their empire, pride and most importantly their identity. Their mental and emotional strain has been conceptualized through a physical morbidity. Again, the speaker maps some conceptual structures from the domain of physical illness onto the domain of negative mental states. This conceptualization is based on actual experiences of everyday life; watching a sick person's temperature go up indicates a state of sickness, while cooling down indicates recovery. In other words, negative emotion is hot; positive emotion is cold. Thus, by the means of conceptual mapping, the experience of physical illness (fever) is also used to represent the negative emotion of the fallen state of the Titans.
In book III of Endymion, a similar image of fever is also used to conceptualize Glaucus' negative mental state of imbalance. Glaucus comments on the scene when he saw the dead face of his beloved Scylla. He took her body into a niche in a temple under the sea to leave it there. The following lines depict him after the separation: I left poor Scylla in a niche and fled. My fever'd parchings up, my scathing dread Met palsy half way: soon these limbs became Gaunt,wither'd,sapless,feeble,cramp'd,and lame. (III,[634][635][636][637] The speaker also uses a medical imagery and terminology to describe Glaucus's suffering. Glaucus was inflicted with "fever'd parchings", "palsy" and "gaunt limbs". These morbid physical conditions can be considered as physical manifestations of the negative mental and emotional states which were experienced as a result of the separation with the dead beloved. In modern terms, the cause of Glaucus's ailment is not physiological, it is psychological. He suffers from love melancholy as well as a state of discontentment with the real world (Goellnicht, 1984, p. 184). Interestingly, the expression "fever'd parchings up" is used as a poetic realization of the physical condition of fever. Among the symptoms of inflammatory fever which were identified by Babington and Curry and known to Keats during his medical career were the following: Violent and continued dry heat,-flushed countenance,-suffused redness of eyes and skin,frequent, strong, and hard pulse;-acute pain of head and loins;-heaviness and aching of the limbs; -white and dry tongue; thirst … .etc. (Babington & Curry, 1811, p. 48).
This example shows that Keats draws upon the knowledge of this medical condition of fever which brings the body temperature up and dries both mouth and skin "sapless" which increases the patient's demand for water. It is also interesting to see the description in Keats's passage matches the description in Babington and Curry, especially concerning dryness and aching limbs. Earlier in this poem (in book II), Keats uses a similar image of "fever parches" to express Endymion's emotional state of homesickness. After being guided by the water nymph in to the unknown world of imagination, the young prince finds himself alone, grieving in solitude in a "too far strange" region which is "wonderful for sadness" and "mingled up" with "gleaming melancholy". Endymion is depicted grieving in solitude; he beseeches Diana to return him to his "native bower" of Latmos. The speaker describes him with a feverish image: Within my breast there lives a choking flame-O let me cool it among the zephyr-boughs! A homeward fever parches up my tongue-O let me slake it at the running springs! (II, 317-320) As in the case of Glaucus's, Endymion's negative emotional state is expressed in terms of a physical fever. The emotional state of homesickness is conceptualized in terms of a morbid state of fever that dries Endymion's tongue. Endymion's fevered mind is depicted through a medical account of the fevered body which can be found in Babington and Curry's medical course book. They describe a fevered body as "becoming dry burning heat all over, with great restlessness, and often violent head-ach" (Babington & Curry, 1811, p. 5). By the means of conceptual mapping, the speaker maps the physical symptoms of fever onto the domain of negative emotion. The "choking flame" and the "parches" of the "tongue" are the linguistic realization of the metaphoric fever. They are selectively picked up from the domain of this pathological illness "fever" and applied to the domain of negative emotion (home sickness).
In "Ode on a Grecian Urn", Keats uses the expression "parching tongue" in a similar sense; to describe a human passion in terms of physical illness (fever): All breathing human passion far above, That leaves a heart high-sorrowful and cloy'd, A burning forehead, and a parching tongue.
(l. 28-30) The parching tongue is also associated with fever which is implicitly referred to through the expression "burning forehead". I will not discuss this example in detail as the term "fever" is not used explicitly.
In Isabella, the language of sickness and images of decay are employed to represent the physical and mental suffering of his-characters. Keats uses medical terms such as "sick", "fever", and "malady" to portray the characters. The two young lovers are depicted suffering from "some malady"; they are both lovesick. In the words of Aileen Ward, a "string of images of medicine and disease runs through the poem like a dark vein through marble" (Ward, 1963, p. 174). In fact, fever, in particular, is a keyword in this poem. The image of "fever" is one of the most important images used to describe the nonphysical pain such as melancholy and sadness. As Goellnicht states, "the descriptions of love melancholy" are depicted through "the symptoms of paleness, fever, headache and restless sleep" (Goellnicht, 1984, p. 192). The term "fever" is used three times in the poem: once to describe Lorenzo's declaration of love to Isabella. Earlier in this paper, I mentioned this example which shows how the speaker features love in terms of fever that resolves the lover's pulse and stifles his voice: And to his heart he inwardly did pray For power to speak; but still the ruddy tide Stifled his voice, and puls'd resolve away-Fever'd his high conceit of such a bride, (l. 43-46) I will not concentrate on this example because it does not involve a negative emotion; on the contrary it denotes a positive emotion of falling in love. I would rather focus on the other two examples in which the word "fever" is used to describe a negative emotion experienced by the heroine, Isabella. In the first one, the speaker uses the expression "feverish unrest" to represent Isabella's negative mood of anxiety and worry about her absent lover, Lorenzo: She fretted for the golden hour, and hung Upon the time with feverish unrest Not long-for soon into her heart a throng Of higher occupants, a richer zest, Came tragic; passion not to be subdued, And sorrow for her love in travels rude. (l. 243-248) Isabella's state of worry is conceptualized in terms of an image of "feverish unrest". The word "fret" is an explicit linguistic clue of a negative emotion. As Rachel Schulkins puts it Isabella's "longings for his [Lorenzo] return force her into hysterical fits and melancholia" (Schulkins, 2016, p. 81). It is a state of indulgence in grief for the absent lover mixed with a creeping fear in "her single breast". The word "fever" is used to intensify the state of pathos. Isabella's negative mental state rapidly deteriorates from a state of sorrow of loneliness to a state of anxiety for Lorenzo and then to a state of madness after discovering the murder of her beloved. Some studies see that "this rapid deterioration matches the different phases of the pathological state of fever which generally starts with an elevation of the body temperature, then shivering which is followed by flush" (Al-Jumaili, 2018, p. 223). These stages are literally marked by a feeling of restlessness; this is probably the reason why the speaker calls it "feverish unrest". Through a medical image of physical illness, the speaker depicts an abstract emotional/mental suffering of Isabella. The speaker maps conceptual structures from the domain of fever onto the domain of negative mental state of Isabella. The correspondence between the two compared states is the intensity they both cause in an individual. The intensity of Isabella's negative emotion is similar to the intensity of a fever fit; they both generate a feeling of restlessness.
The other example of this febrile state is also used to describe Isabella's negative mental state after her knowledge of Lorenzo's death. As she mourns and pines over the departure of her lover, one night Lorenzo's ghost suddenly appears before her. He tells her of her brothers' deed and asks her to find his body. Isabella finds the grounds where Lorenzo had been buried; she takes a knife to bring back his head and buries it in a pot of basil. In the following quote, she is depicted as inflicted with an intense passion which is conceptualized in terms of physical illness: And, after looking round the champaign wide, Shows her a knife.-"What feverous hectic flame "Burns in thee, child?-What good can thee betide, "That thou should'st smile again?"-(l. 347-50) Again, fever is associated with intense feeling. The expression "feverous hectic flame" is used to describe a negative emotion of intense feeling of sadness mixed with rage as Isabella sees the body of Lorenzo laid in "forest tomb" that "marred his glossy hair". In the words of Charles William Hagelman, Isabella's mind is "forced beyond the limits of its endurance" (Hagelman, 1956, p. 263). By the end of the poem Isabella goes mad and dies of grief. Her disturbed mental state is conceptualized in terms of the bodily physical illness of fever. This feverish state is also medically accurate and appropriate. Medically, the word "hectic" denotes fever or flush; it is both used as a noun and adjective. According to the Oxford English Dictionary, during the eighteenth and nineteenth centuries, the word "hectic" "joined to that kind of Fever which is slow and continual, and ending in consumption" (Oxford English Dictionary Online, 2020). Hectic as a noun means "hectic fever", and as an adjective, it is "applied to that kind of fever which accompanies consumption or other wasting diseases, and is attended with flushed cheeks and hot dry skin" (Oxford English Dictionary Online, 2020). The context of this expression "feverous hectic flame" suggests metaphorical use, because literally, it is not a "flame" that "burns" inside her, it is an intense feeling. It may represent a negative mental state of hysteria or melancholia that inflicted her after she was exposed to the dead body of her lover. The effect of Lorenzo's dead body has nourished Isabella's fervent and wild passion which is analogous to a "hectic flame" (Schulkins, 2016, p. 83). As stated by Al-Jumaili, "during his years as a medical student, Keats was familiar with diagnosing some psychological ailments such as hypochondria and nervous fever (Al-Jumaili, 2018, p. 225). According to Babington and Curry, the term hypochondriasis is a synonym of spleen, vapours, and low spirits, and the "exciting causes" of Hypochondriasis include "depressing passions, e.g., Grief, Anxiety, and Fear, by whatever cause produced" (Babington & Curry, 1811, p. 204). And the symptoms of nervous fever include "confusion of thought,-sadness of mind … . But as the disease advances, the heat increases, -the tongue becomes dry, and brown, or morbidly red" (Babington & Curry, 1811, p. 58). The depiction of Isabella's negative mental state is expressed through a fevered body which is burnt by a "feverous hectic flame". Again, via conceptual mapping, the speaker structures the mental suffering of his characters through images of physical pain, namely of "fever".
There is another important example of the "fever" used in a poem entitled "Stanzas on Some Skulls in Beauly Abbey, Near Inverness", which was written in collaboration with Charles Brown in August 1818. The poem is a chronicle in which the speaker attempts to read the history of dead people through examining the outward appearance of their skulls. In this poem, the word "fever" is associated with sadness, which is already a negative emotion, to describe a mode of suffering of people of the past. The expression "fevered sadness" is used as a metaphor to describe the human world "mortal time" which is characterized by "fevered sadness": Ha! here is "undivulged crime!" Despair forbade his soul to climb Beyond this world, this mortal time Of fevered sadness, Until their monkish pantomime Dazzled his madness! (61-66) The abstract states of sadness and despair are conceptualized in terms of a pathological condition of fever. They are represented as the maladies of the soul that hinder the aspiration of a person and prevent him from climbing "beyond this world". The analogy in this metaphorical expression has a physical basis; as fever causes physical illness to the body, despair and sadness are the diseases of the soul. Through conceptual mapping, the speaker carries conceptual frames from the domain of physical illness (fever) and maps them onto the domain of an abstract state of emotion (sadness). The outcome of this mapping is that our understanding of a negative emotion of sadness is structured through physical experience of fever. Sadness causes emotional pain as fever causes physical pain.

Conclusion
In conclusion, one can confidently say that Keats's medical knowledge has influenced his thought and conceptions on a large scale. By approaching his poetry through his technical knowledge of medicine, it is possible to notice how his medical training impacted his metaphorical language. In this paper, I focused on the term fever which is employed metaphorically by the poet to draw on the analogy between physical illness and negative mental states. As we have seen, Keats's poetry offers many medical metaphors for negative mental states and emotions. For example, medical terms and concepts are adapted by Keats in formulating his thoughts about negative mental states and emotions. Keats derives images from his previous profession as a medical student and employs them poetically. For example, pathology and medicine provide Keats with knowledge of bodily and mental states. He starts to view inner aspects of life in terms of morbid and healthy states. His medical knowledge and training enable him to depict the plight of his characters and poetic persona metaphorically. It makes him think of mental and emotional states as medical issues; they are represented in terms of diseases and pathological conditions. From what has been said above, it is possible to see the way Keats uses the term "fever" in its metaphorical sense to represent negative mental and emotional states. The examples which were discussed in this paper show how important fever is in conceptualizing negative mental states. Fever, which is a physical illness that belongs to the domain of pathology, is used to conceptualize negative mental as well as emotional states. Some selected frames are picked up by the speaker from the domain of fever and applied to the domain of emotion. The result of this mapping allows us to view these abstract states in terms of experiences of physical illness. The mental and emotional pain these negative states may cause in the patient is equivalent to the physical pain caused by (fever). A great deal of these metaphors has medical precision which suggests that the poetic voice maps them from a domain he is familiar with into a domain less familiar to him. In other words, he maps conceptual structures from his previous profession (physician) to his new profession (poetic career). In all the examples I discussed above, a negative emotion or mental state is portrayed as if it involves physical experience of illness or pain. The mental or emotional pain was embedded and understood within the frame of physical pain which is caused by physical and bodily experiences of illness. Thinking through his medical career, Keats structures the understanding of negative mental states in terms of medical conditions by using conceptual mapping.