Cost of Brand-Name Prescription Medicines Soaring

The price of brand-name prescription medicines is rising far faster than the inflation rate, while the price of generic drugs has plummeted, creating the largest gap so far between the two, according to a report published Wednesday by the pharmacy benefits manager Express Scripts.

The report tracked an index of commonly used drugs and found that the price of brand-name medicines increased more than 13 percent from September 2011 to this September, which it said was more than six times the overall price inflation of consumer goods. Generic drug prices dipped by nearly 22 percent.

The drop in the price of generics “represents low-hanging fruit for the country to save money on health care,” said Dr. Steve Miller, the chief medical officer of Express Scripts, which manages the drug benefits for employers and insurers and also runs a mail-order pharmacy.

The report was based on a random sample of six million Express Scripts members with prescription drug coverage.

The Pharmaceutical Research and Manufacturers of America, the trade group representing brand-name manufacturers, criticized the report, saying it was skewed by a handful of high-priced specialty drugs that are used by a small number of patients and overlooked the crucial role of major drug makers.

“Without the development of new medicines by innovator companies, there would be neither the new treatments essential to progress against diseases nor generic copies,” Josephine Martin, executive vice president of the group, said in a statement.

The report cited the growth of specialty drugs, which treat diseases like cancer and multiple sclerosis, as a major reason for the increase in spending on branded drugs. Spending on specialty medicines increased nearly 23 percent during the first three quarters of 2012, compared with the same period in 2011. All but one of the new medicines approved in the third quarter of this year were specialty drugs, the report found, and many of them were approved to treat advanced cancers only when other drugs had failed.

Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota, said the potential benefits of many new drugs did not always match the lofty price tags. “Increasingly it’s going to be difficult for drug-benefit programs to make decisions about coverage and payment and which drugs to include,” said Mr. Schondelmeyer, who conducts a similar price report for AARP. He also helps manage the drug benefit program for the University of Minnesota.

“We’re going to be faced with the issue that any drug at any price will not be sustainable.”

Spending on traditional medicines — which treat common ailments like high cholesterol and blood pressure — actually declined by 0.6 percent during the period, the report found. That decline was mainly because of the patent expiration of several blockbuster drugs, like Lipitor and Plavix, which opened the market for generic competitors. But even as the entry of generic alternatives pushed down spending, drug companies continued to raise prices on their branded products, in part to squeeze as much revenue as possible out of an ever-shrinking portfolio, Dr. Miller said.

Drug makers are also being pushed by from companies like Express Scripts and health insurers, which are increasingly looking for ways to cut costs, said C. Anthony Butler, a pharmaceuticals analyst at Barclays. “I think they’re pricing where they can but what they keep telling me is they’re under significant pressure” to keep prices low, he said.

Express Scripts earns higher profits from greater use of generic medicines than brand name drugs sold through their mail-order pharmacy, Mr. Butler said. “There’s no question that they would love for everybody to be on a generic,” he said.

Dr. Miller acknowledged that was true but said that ultimately, everyone wins. “When we save people money, that’s when we make money,” he said. “We don’t shy away from that.”

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Regents OK raise for new UC Berkeley chief

Despite strong opposition from Gov. Jerry Brown, the UC Board of Regents on Tuesday gave the incoming chancellor of UC Berkeley a $50,000 — or 11.4% — pay raise over the current campus head. The extra money will come from private donations, not state funds, the regents said.

Nicholas B. Dirks will be paid $486,000, which officials said is $14,000 less than his current salary as a high-ranking administrator at Columbia University.

Brown, who is a regent, described Dirks as an excellent choice but said he would not vote for the salary given the austerities that the state and the 10-campus UC system still face. The university must look for more efficient ways to teach and operate and "the leaders have to demonstrate that they are also sacrificing," Brown said.

The $50,000 increase, even though it won't come from public coffers, "does not fit within the spirit of servant leadership that I think will be required over the next few years," the governor said.

Brown also cited voters' recent approval of his Proposition 30 tax increase, which spared UC from deep budget cuts. During the campaign for the measure, the governor said, he promised voters that he would "use their funds judiciously and with prudence."

Brown, who rarely attended regents meetings before the election, has since become a dramatic presence and voice against UC status quo. Since last summer, he has criticized raises for Cal State executives and suggested that all public colleges promote less expensive insiders instead of shopping for high-priced "hired guns" from across the country.

Besides noting that Dirks will take a pay cut from being Columbia's executive vice president and dean of its arts and sciences faculty, UC leaders said his UC Berkeley salary will be much lower than that of leaders at many other prestigious public and private universities.

"I try to get the very best person I can in this job to navigate the university through some very complicated times," UC system President Mark G. Yudof said.

Yudof said he and Brown do not see "exactly eye to eye" on Dirks' pay, but Yudof said he and the governor agree on nearly all other issues, including efforts to keep tuition from rising.

The regents first debated the issue privately Tuesday in a telephone conference call linking those in Oakland, Sacramento and Los Angeles. After the call went public, three regents voted against the pay increase — Brown, Lt. Gov. Gavin Newsom and Charlene Zettel — and 11 others voted for it. All 14 voted to appoint Dirks.

State Sen. Leland Yee (D-San Francisco), a frequent UC critic, issued a statement suggesting that Dirks follow the example of Timothy P. White, who recently asked for a 10% pay cut from the salary paid his Cal State predecessor. Yee said he would reintroduce legislation to limit executive pay raises in public higher education.

When he starts at the 36,000-student UC Berkeley on June 1, Dirks will receive free campus housing, along with $121,700 in relocation fees paid out in installments over four years and other benefits.

An anthropologist and historian who is an expert on India and its British colonial era, he will succeed Robert J. Birgeneau, who has been Berkeley chancellor for eight years. Dirks' wife, Columbia history professor Janaki Bakhle, is expected to receive a faculty job at UC Berkeley, but officials said her hiring and any possible salary must be reviewed by faculty panels.

After his confirmation, Dirks, who is the son of a former UC Santa Cruz administrator, said he was grateful to lead "one of the greatest universities in the world" and said he would work to boost student financial aid and encourage interdisciplinary research and studies.

He thanked Brown and California voters for passing Proposition 30, which raises the state sales tax a quarter-cent over four years and the income tax on high earners over seven years. Dirks, 61, promised that he would carefully "steward the tax dollars that are being paid by the citizens of this great state."

The regents unanimously approved an annual $245,600 salary and housing for Jane Close Conoley, who will become acting chancellor at UC Riverside next month until a permanent one is hired. That salary is below the $325,000 pay of the current Riverside campus chief, White, who is leaving to become chancellor of the Cal State system. Conoley is now dean of UC Santa Barbara's Gervitz Graduate School of Education.

larry.gordon@latimes.com

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A Google-a-Day Puzzle for Nov. 28

Our good friends at Google run a daily puzzle challenge and asked us to help get them out to the geeky masses. Each day’s puzzle will task your googling skills a little more, leading you to Google mastery. Each morning at 12:01 a.m. Eastern time you’ll see a new puzzle posted here.

SPOILER WARNING:
We leave the comments on so people can work together to find the answer. As such, if you want to figure it out all by yourself, DON’T READ THE COMMENTS!

Also, with the knowledge that because others may publish their answers before you do, if you want to be able to search for information without accidentally seeing the answer somewhere, you can use the Google-a-Day site’s search tool, which will automatically filter out published answers, to give you a spoiler-free experience.

And now, without further ado, we give you…

TODAY’S PUZZLE:

Note: Ad-blocking software may prevent display of the puzzle widget.

Ken is a husband and father from the San Francisco Bay Area, where he works as a civil engineer. He also wrote the NYT bestselling book "Geek Dad: Awesomely Geeky Projects for Dads and Kids to Share."

Read more by Ken Denmead

Follow @fitzwillie and @wiredgeekdad on Twitter.

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Robbie Williams aims to seal solo legacy with tour

LONDON (Reuters) – Still famous as the in-again/out-again member of chart-topping boyband Take That, British singer Robbie Williams says it is time to get serious as a solo artist and prove his place at the top of the pop pile.

Williams told reporters on Monday he planned a 15-date European stadium tour kicking off in Manchester on June 19, 2013 and concluding in Tallinn, Estonia on August 20.

“I’m buzzing. I’m ready to go. I haven’t done a tour of this size since 2006,” he said in London.

“I think it’s legacy time, because I’m venturing into getting my handicap down at golf and all that business.

“I’m nearly 40, that’s what I’m trying to say. I want to go and seal my place in pop history and go off and deliver a tour of great magnitude while I still can.”

The 38-year-old in fact enjoyed major success after leaving Take That in 1995, producing a string of hit albums and singles including “Angels” and “Millennium” and signing a contract with EMI in 2002 reportedly worth tens of millions.

But by the time his 2006 album “Rudebox” came out followed by “Reality Killed the Video Star” in 2009, he was seen as a dwindling force in British pop who had failed to break the key U.S. market.

Williams rejoined Take That in 2010 and they recorded the hit album “Progress” before touring together in 2011, and the singer said the experience had helped give him confidence to tour large venues again as a solo artist.

“I just ran out of ideas and ran out of a bit of creativity and ran out of energy and did the textbook ‘burnt out’,” he said of the late 2000s.

“But I’ve been working really hard and I needed to do something else, and fortunately it came in the shape of my old band. A lot of demons were vanquished from the past. A lot of wrongs were put to rights.

“That tour last summer was just absolutely incredible. It kick-started my professional career.”

Earlier this month, Williams returned to the top of the album charts with “Take the Crown”.

Asked whether he would consider rejoining Take That again, he replied: “I haven’t officially left … What I do know is that … if we all remain healthy then I will definitely be a part of Take That at some point. It’s joyful being around them.”

Williams conceded it may be too early to talk about his legacy at 38, but added he wanted to “put my stamp down.

“The fact that 40 is looming plays on my mind more than it does on anybody else’s mind. Pop stars cease to be pop stars at 40 and start being old people singing, don’t they?

“There is a forum for a male solo star to get up there in stadiums and own the place and I want that to be me, so I’ve kind of been lethargic for the last couple of albums.”

Williams recently became a father, and said his daughter would accompany him on tour. Olly Murs, who rose to fame on “The X Factor” reality TV show, will support Williams on his tour.

(Reporting by Mike Collett-White, editing by Paul Casciato)

Music News Headlines – Yahoo! News

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Amid Hurricane Sandy, a Race to Get a Liver Transplant

It was the best possible news, at the worst possible time.

The phone call from the hospital brought the message that Dolores and Vin Dreeland had long hoped for, ever since their daughter Natalia, 4, had been put on the waiting list for a liver transplant. The time had come.

They bundled her into the car for the 50-mile trip from their home in Long Valley, N.J., to NewYork-Presbyterian Morgan Stanley Children’s Hospital in Manhattan. But it soon seemed that this chance to save Natalia’s life might be just out of reach.

The date was Sunday, Oct. 28, and Hurricane Sandy, the worst storm to hit the East Coast in decades, was bearing down on New York. Airports and bridges would soon close, but the donated organ was in Nevada, five hours away. The time window in which a plane carrying the liver would be able to land in the region was rapidly closing.

In a hospital room, Natalia watched cartoons. Her parents watched the clock, and the weather. “Our anxiety was through the roof,” Mrs. Dreeland said. “It just made your stomach into knots.”

The Dreelands, who are in their 60s, became Natalia’s foster parents in 2008 when she was 7 months old, and adopted her just before she turned 2. They have another adopted daughter, Dorothy Jane, who is 17.

Natalia is a “smart little cookie” who loves school and dressing up Alice, her favorite doll, her mother said. At age 3, Natalia used the word “discombobulated” correctly, Mr. Dreeland said.

Natalia’s health problems date back several years. Her gallbladder was taken out in 2010, and about half her liver was removed in 2011. The underlying problem was a rare disease, Langerhans cell histiocytosis. It causes a tremendous overgrowth of a type of cell in the immune system and can damage organs. Drugs can sometimes keep it in check, but they did not work for Natalia.

In her case, the disease struck the bile ducts, which led to progressive liver damage. “She would have eventually gone into liver failure,” said Dr. Nadia Ovchinsky, a pediatric liver transplant specialist at NewYork-Presbyterian. “And she demonstrated some signs of early liver failure.”

The only hope was a transplant.

Dr. Tomoaki Kato, Natalia’s surgeon, knew that the liver in Nevada was a perfect match for Natalia in the two criteria that matter most: blood type and size. The deceased donor was 2 years old, and though Natalia is nearly 5, she is small for her age. Scar tissue from her previous operations would have made it very difficult to fit a larger organ into her abdomen.

Though Dr. Kato had considered transplanting part of an adult liver into Natalia, a complete organ from a child would be far better for her. But healthy organs from small children do not often become available, Dr. Kato said. This was a rare opportunity, and he was determined to seize it.

But as the day wore on, the odds for Natalia grew slimmer. The operation in Nevada to remove the liver was delayed several times.

At many hospitals, surgery to remove donor organs is done at the end of the day, after all regularly scheduled operations. The Nevada hospital had a busy surgical schedule that day, made worse by a trauma case that took priority.

At the hospital in New York, Tod Brown, an organ procurement coordinator, had alerted a charter air carrier that a flight from Nevada might be needed. That company in turn contacted West Coast carriers to pick up the donated liver and fly it to New York.

Initially, two carriers agreed, but then backed out. Several other charter companies also declined.

Mr. Brown told Dr. Kato that they might have to decline the organ. Dr. Kato, soft-spoken but relentless, said, “Find somebody who can fly.”

Dr. Kato used to work in Miami, where pilots found ways to bypass hurricanes to deliver organs. Even during Hurricane Katrina, his hospital performed transplants.

“I asked the transplant coordinators to just keep pushing,” he said.

Mr. Brown said, “Dr. Kato knew he was going to get that organ, one way or another.”

As the trajectory of the storm became clearer, one of the West Coast charter companies agreed to attempt the flight. The plan was to land at the airport in Teterboro, N.J. The backup was Newark airport, and the second backup was Albany, from where an ambulance would finish the trip.

The timing was critical: organs deteriorate outside the body, and ideally a liver should be transplanted within 12 hours of being removed.

Early Monday, as the storm whirled offshore, the plane landed at Teterboro. Soon a nurse rushed to tell the Dreelands that she had just seen an ambulance with lights and sirens screech up to the hospital. Someone had jumped out carrying a container.

At about 5 a.m., the couple kissed Natalia and saw her wheeled off to the operating room.

Three weeks later, she is back home, on the mend. The complicated regimen of drugs that transplant patients need is tough on a child, but she is getting through it, her father said.

Recently, Mr. Dreeland said, he found himself weeping uncontrollably during a church service for the family of the child who had died. “Their child gave my child life,” he said.

Though only time will tell, because the histiocytosis appeared limited to Natalia’s bile ducts and had not affected other organs, her doctors say there is a good chance that the transplant has cured her.

This article has been revised to reflect the following correction:

Correction: November 28, 2012

Because of an editing error, a picture caption with an article on Tuesday about a girl who received a liver transplant during Hurricane Sandy misspelled the surname of the girl’s family. As the article correctly noted, it is Dreeland, not Vreeland.

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Facebook Gift Store Urges Users to Shop While They Share

SAN FRANCISCO — Facebook is already privy to its users’ e-mail addresses, wedding pictures and political beliefs. Now the company is nudging them to share a bit more: credit card numbers and offline addresses.

James Best Jr./The New York Times

Facebook Gifts is a service that prompts users to buy things for friends on the social network.

Sharing Even More

What do you think about Facebook’s plan to have users buy gifts for their friends through the site using their credit cards?

A screenshot of Facebook Gifts.

The nudge comes from a new Facebook service called Gifts. It allows Facebook users — only in the United States for now — to buy presents for their friends on the social network. On offer are items as varied as spices from Dean & DeLuca, pajamas from BabyGap and subscriptions to Hulu Plus, the video service. This week Facebook added iTunes gift cards.

The gift service is part of an aggressive moneymaking push aimed at pleasing Facebook’s investors after the company’s dismal stock market debut. Facebook has stepped up mobile advertising and is starting to customize the marketing messages it shows to users based on their Web browsing outside Facebook.

Those efforts seem to have brought some relief to Wall Street. Analysts issued more bullish projections for the company in recent days, and the stock was up 49 percent from its lowest point, closing Tuesday at $26.15, although that is still well below the initial offering price of $38. The share price has been buoyed in part by the fact that a wave of insider lockup periods expired without a flood of shares hitting the market.

To power the Gifts service, Facebook rented a warehouse in South Dakota and created its own software to track inventory and shipping. It will not say how much it earns from each purchase made through Gifts, though merchants that have a similar arrangement with Amazon.com give it a roughly 15 percent cut of sales.

If it catches on, the service would give Facebook a toehold in the more than $200 billion e-commerce market. Much more important, it would let the company accumulate a new stream of valuable personal data and use it to refine targeted advertisements, its bread and butter. The company said it did not now use data collected through Gifts for advertising purposes, but could not rule it out in the future.

“The hard part for Facebook was aggregating a billion users. Now it’s more about how to monetize those users without scaring them away,” said Colin Sebastian, an analyst with Robert W. Baird.

He added: “Gifts should also contribute more to Facebook’s treasure trove of user data, which has the benefit of a virtuous cycle, driving more personalization of the site, leading to better and more targeted ads, which improves overall monetization.”

Facebook already collects credit card information from users who play social games on its site. But they are a limited constituency, and a wider audience may be persuaded to buy a gift when Facebook reminds them that a friend is expecting a baby or a cousin is approaching her 40th birthday.

The Gifts service, which grew out of Facebook’s acquisition of a mobile application called Karma, was introduced in September and expanded earlier this month on the eve of the holiday shopping season.

Magnolia Bakery, based in New York, was among Facebook’s early partners for Gifts. Its vice president for public relations, Sara Gramling, said the company had sold roughly 200 packages of treats since then. She counted it as a marketing success. The bakery, which gained fame thanks to “Sex and the City,” had only recently begun shipping its goods. “It was a great opportunity to expand our network,” she said.

Magnolia Bakery isn’t exactly catering to the masses. A half-dozen cupcakes cost $35, plus about $12 for shipping. Facebook, Ms. Gramling said, takes care of the billing. The bakery is eyeing Facebook’s global reach, too, as it opens outlets internationally, especially in the Middle East.

One of the appeals of Facebook Gifts is the ease of making a purchase. Facebook users are nudged to buy a gift (a gift-box icon pops up) for Facebook friends on their birthdays. They are offered a vast menu to choose from: beer glasses, cake pops, quilts, marshmallows, magazine subscriptions and donations to charity. They are asked to choose a greeting card. Then they are asked for credit card details. Facebook says it stores that credit card information, unless users remove it after making a purchase.

Facebook has declined to say how many users have bought gifts, only that among those who have, the average purchase is $25.

David Streitfeld contributed reporting.

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Egypt president meets judges, fails to 'contain crisis'

CAIRO — President Mohamed Morsi suggested Monday that he would scale back broad powers he assumed last week but failed to appease Egypt's judiciary, which would still lack oversight of some institutions including the Islamist-led assembly drafting a new constitution.

Morsi and senior judges met for nearly five hours to discuss differences resulting from the president's declaration that his office was free from judicial review. Morsi told judges that the decree was meant to be temporary, and mainly aimed at shielding the long-troubled constitutional assembly from any judicial attempt to disband it.

Presidential spokesman Yasser Ali said after the meeting that Morsi's decree was not designed to "infringe" on the judiciary, suggesting not all of the president's actions would be immune from court review. The Supreme Judicial Council on Saturday condemned Morsi's expanded powers as an "unprecedented attack" on the courts. And Monday's talks did not seem to soften the sentiment of some council members.

"Our meeting with the president has failed to contain the crisis," Abdelrahman Bahloul, a member of the judicial council, told the newspaper Al Masry al Youm. "The statement issued by the presidency is frail and does not represent the members of the council."

The Judges Club, a separate legal organization, also was not satisfied that Morsi had scaled back enough of his authority. It called on its members to continue a partial strike in Alexandria and other cities. Ziad Akl, a political analyst, said Morsi's negotiations with the judges were a move to show the public he's not a dictator, "but, in reality, his declaration has not changed."

The talks in the presidential palace did not stop anti-Morsi demonstrations in Tahrir Square on Monday. But in a sign tensions may be easing, the Muslim Brotherhood, which Morsi helped lead until his inauguration in June, announced it was canceling a scheduled demonstration Tuesday to avoid bloodshed and possible clashes with Morsi opponents.

The consequences of the nation's restiveness played out as Morsi and the judges met Monday, with mourners turning out to bury two boys from opposite political sides who were killed in recent clashes: a 16-year-old antigovernment protester reportedly shot with a rubber bullet near Tahrir Square and a 15-year-old struck by a stone when a crowd attacked an office of the Brotherhood's Freedom and Justice Party in the Nile Delta.

"The presidency mourns two of the nation's finest young men," Morsi said in a statement.

But the images of two funerals made it clear that Morsi and the Brotherhood, although still Egypt's dominant political forces, miscalculated the depth of public anger that has bristled since last year's overthrow of longtime autocrat Hosni Mubarak and subsequent government setbacks, including judicial action disbanding the Islamist-led parliament.

Last month, Morsi, who for months has held wide executive and legislative powers, attempted to fire Prosecutor-General Abdel Meguid Mahmoud, only to retreat after a backlash from judges. His most recent decree to hold his office above judicial oversight struck many as another ill-conceived bid to consolidate his authority and advance an Islamist agenda.

Morsi contended that his intent was to prevent Mubarak-era judges from disrupting the country's political transition. Many Egyptians, including opposition figures, are suspicious of the courts, Mahmoud in particular. But Morsi's unilateral decree echoed the strongman tactics of his predecessor.

One of the president's biggest challenges is to protect the assembly drafting the constitution, which will open the way for new parliamentary elections. In June, the Supreme Constitutional Court, made up mostly of Mubarak-appointed judges, dissolved parliament. The court has since been deciding the fate of the Islamist-led assembly, which Morsi feared would also be disbanded.

Activists, liberals, women and non-Muslims have boycotted the assembly, saying that it is too focused on sharia, or Islamic law, which could limit civil rights. Protesters in Tahrir Square said they will continue their demonstrations until Morsi retracts more of his power.

Jaber Nassar, a legal expert quoted on state TV, said Morsi's meeting with the judges showed that he remains adamant on keeping broad authority. He called Morsi's announcement Monday "simply a political statement meant to curb protests against" his decree.

jeffrey.fleishman@latimes.com

Abdellatif is a special correspondent.

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A Google-a-Day Puzzle for Nov. 27

Our good friends at Google run a daily puzzle challenge and asked us to help get them out to the geeky masses. Each day’s puzzle will task your googling skills a little more, leading you to Google mastery. Each morning at 12:01 a.m. Eastern time you’ll see a new puzzle posted here.

SPOILER WARNING:
We leave the comments on so people can work together to find the answer. As such, if you want to figure it out all by yourself, DON’T READ THE COMMENTS!

Also, with the knowledge that because others may publish their answers before you do, if you want to be able to search for information without accidentally seeing the answer somewhere, you can use the Google-a-Day site’s search tool, which will automatically filter out published answers, to give you a spoiler-free experience.

And now, without further ado, we give you…

TODAY’S PUZZLE:

Note: Ad-blocking software may prevent display of the puzzle widget.

Ken is a husband and father from the San Francisco Bay Area, where he works as a civil engineer. He also wrote the NYT bestselling book "Geek Dad: Awesomely Geeky Projects for Dads and Kids to Share."

Read more by Ken Denmead

Follow @fitzwillie and @wiredgeekdad on Twitter.

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Man accused of stealing Tim Allen’s Chevy Impala

DENVER (AP) — A man suspected of stealing one of Tim Allen‘s custom cars says the comedian left the keys so he could drive it to Denver.

Denver police spokesman Sonny Jackson said Monday that 34-year-old Faustino Ibarra is being held without bond while awaiting extradition to California after his arrest on Saturday.

In a jailhouse interview with KDVR-TV (http://bit.ly/TpJirK ), Ibarra claimed Allen adopted him years ago. Jackson said there is no evidence of any adoption.

Ibarra said Allen had left the door to his garage open along with the keys.

Police confirmed that the customized 1996 Chevrolet Impala SS belonged to the “Home Improvement” star but said it hadn’t yet been reported stolen when it turned up in Denver.

Allen’s publicist Marleah (mar-LEE-uh) Leslie said she wouldn’t comment because it’s a police matter.

Entertainment News Headlines – Yahoo! News

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Books: Woe Is Syphilis, and Other Afflictions of Famous Writers

The old Irishman was a swollen, wheezing mess, blood pressure wildly out of control, kidneys failing, heart fibrillating. “What we have here,” said his new Spanish doctor, “is an antique cardiorenal sclerotic of advanced years.”

In fact, what the doctor had there was William Butler Yeats: the poet had a long list of chronic medical problems and experienced one of his regular cardiac crises while wintering in Spain. He still had three poetically productive years ahead of him before he died of heart failure in 1939, at age 73.

What makes antique case histories like Yeats’s so compelling to research, so interesting to read? Admittedly, they have educational value — medicine moves forward by looking back — but their major attraction is undoubtedly the operatic vigor of their emotional punch. As we contemplate the poor health of historic notables, we can sigh gustily at the immense suffering our ancestors considered routine, wince at the lunatic treatments they so innocently underwent, and marvel over and over again that the body, the brain and the mind can take such divergent paths.

These pleasures are present in abundance in the newest addition to the genre of medical biography, “Shakespeare’s Tremor and Orwell’s Cough.” Dr. John J. Ross, a Harvard physician, writes that he stumbled into the field by accident while trying to enliven a lecture on syphilis with a few literary references. The discovery that Shakespeare was apparently obsessed with syphilis (and suspiciously familiar with its symptoms) hooked Dr. Ross.

The resulting collection of 10 medico-literary biographical sketches ranges from the tubercular Brontës, whose every moist cough is familiar to their fans, to figures like Nathaniel Hawthorne, whose medical stories are considerably less familiar.

Dr. Ross’s discussion of Shakespeare is unique in the collection for its paucity of relevant data: so few details are known of the playwright’s life, let alone his health, that all commentary is necessarily supposition. Dr. Ross is not the first to note that references to syphilis are “more abundant, intrusive and clinically exact” in Shakespeare’s works than those of his contemporaries. This observation, along with the apparent deterioration of Shakespeare’s handwriting in his last years, leads to the hypothesis that Shakespeare had syphilis repeatedly as a young man, and wound up suffering more from treatment than disease.

The Elizabethans dosed syphilis with a combination of hot baths (treating the disease by raising body temperature endured into the 20th century), cathartics and lavish quantities of mercury. The drooling that accompanies mercury poisoning was considered a sign of excellent therapeutic progress, Dr. Ross writes: “Savvy physicians adjusted the mercury dose to produce three pints of saliva a day for two weeks.”

And so, when Shakespeare signed his will a month before he died with a shaky hand, was his tremor not possibly a sign of residual nerve damage from the mercury doses of his sybaritic youth? No amount of scholarship is likely to confirm this theory, but details of the argument are gripping and instructive nonetheless.

The story of the blind poet John Milton runs for a while along similar lines. Much is known about the long deterioration of Milton’s vision and other particulars of his delicate health, but Dr. Ross observes that many of his problems seem to have cleared up once he actually became blind. Was he vigorously medicating himself with lead-based nostrums in hopes of forestalling what Dr. Ross argues was probably progressive retinal detachment, then recovering from lead poisoning once his vision was irretrievably gone? Another intriguing if unanswerable question.

Just as the competing injuries of disease and treatment battered the luminaries of English and American literature, so did pervasive mental illness.

Jonathan Swift was a classic obsessive-compulsive long before he succumbed to frontotemporal dementia (Pick’s disease). Poor Hawthorne, so forceful on the page, was in person a tortured shrinking violet, the embodiment of social phobia and depression. Emily Brontë’s behavior was strongly suggestive of Asperger syndrome; Herman Melville was clearly bipolar; Ezra Pound was just nuts.

Yet they all wrote on, despite continual psychic and physical torments. Perhaps the thickest medical chart of all belongs to Jack London, who survived several dramatic episodes of scurvy while prospecting in the Klondike (he was treated with raw potatoes, a can of tomatoes and a single lemon), then accumulated a long list of other medical problems before killing himself (inadvertently, Dr. Ross argues) with an overdose of morphine from his personal and very capacious medicine chest.

Dr. Ross has not written a perfect book. The fictionalized scenes he creates between some of his subjects and their medical providers should all have been excised by a kindly editorial hand, which might also have addressed more than a few grammatical errors. Frequent leaps from descriptive to didactic mode as Dr. Ross updates the reader on various medical conditions can be jarring, like PowerPoint slides suddenly deployed in a poetry reading. True literary scholars might dismiss the book as lit crit lite, a hodgepodge of known facts culled from the usual secondary sources.

But all these caveats fade into the background when Dr. Ross hits his narrative stride, as he does in chapter after chapter. Then the stories of the wounded storytellers unfold smoothly on the page, as mesmerizing as any they themselves might have told, those squinting, wheezing, arthritic, infected, demented, defective yet superlative examples of the human condition.

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