Healthy Newborn Essay - 3570 Words

Healthy Newborn Submitted by Ngassa, Gratino (gngassa) on 5/15/2013 11:14:57 AM Points Awarded | 1.00 | Points Missed | 22.00 | Percentage | 4.3% | Infant Care at Birth The nursery RN places the infant under a radiant warmer and starts to dry her quickly. 1. What is the rationale for these actions? A) Heat production is increased through stimulation. INCORRECT Drying the infant may increase heat production, but this is not the best method to correct the newborns body temperature. B) Convective heat loss from evaporation is reduced. CORRECT Drying the infant quickly and placing her under a radiant warmer reduces heat loss through evaporation and radiation. C)†¦show more content†¦Carson is taken to the postpartum unit, and the infant is transferred to the transition care nursery. Transition Care The nurse checks the identification bands for both the baby and the mother upon admission to the nursery. One ID number is incorrect. 6. Which action should the nurse take to solve this problem? A) Document the presence of the incorrect number on the charts for the baby and the mother. INCORRECT Although the nurse should probably document the discrepancy, it does not solve the problem. B) Explain to the mother that there is an incorrect number on one of the bands. INCORRECT Although an explanation should be given to the mother, that will not solve the problem. C) Redo the identification bands with another nurse witnessing the process. CORRECT Identification bands must be correct to ensure the safety and security of all hospitalized clients, especially newborns. D) Mark the incorrect numbers in red to denote the correction made to the bands. INCORRECT This is not the proper action for the nurse to take to solve this problem. Upon admission to the transition care nursery, the Carson babys axillary temperature is 97.4 ° F. 7. Which action should the nurse take? A) Continue monitoring and document this finding in the record. INCORRECT Another action should be taken in this situation. B) Place the infant in a radiant warmer and monitor her temperature. CORRECT The babys temperature is not within normal range (97.5 °-99 ° F). The infantShow MoreRelatedThe Death Of Andrea Yates Essay1532 Words   |  7 Pagesher children she stated she was in a lot of pain from the surgery. Sleep deprived throughout the pregnancy, as well as from handling premature babies alone. As a mother I know how tired you can become from the care of a newborn infant. I couldn t imagine being single with newborn twins. After stating her body began to give out on her, the inability to heal from the surgery, unable to eat, and sleep, she began to consider adoption. 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Loseke (2005) notes, â€Å"Social problems are about disagreements†¦ conditions, and they are about people in these conditions† (p.4). Social problems are social ly constructed as the society dictates what is acceptable and not acceptable, what

The Relation Of Specific Psychopathology With Social...

The article presented by Gray et al (2010), thoroughly examines the relations of specific psychopathology with social perception. Autism spectrum disorder, schizotypy and psychopathy will be further inspected and researched through a transdiagnostic approach – treating these disorders as impairments of the underlying cognitive system instead of as a difference in entity. Gray et al (2010), tries to define the aforementioned disorders with both an agency (cognitive abilities and control) and an experience (primitive or animalistic behaviours) score which are underlying aspects of mind perception. Mind perception can either be defined as overperception, perceiving a nonexistent mind, or underperception, failing to perceive those with an†¦show more content†¦The research was conducted with results from Self-Report online questionnaires designed to assess Autism, Schizotypy Personality and Psychopathy. Every participant were asked to complete web versions of the Autism Sp ectrum Quotient scale (AQ), the Schizotypy Personality Questionnaire (SPQ-B) and the Self Report Psychopathy Scale (SPR-III). To encourage participants to be honest with their answers, respect for participants rights and dignity was sustained through getting rid of a subscale from SPR-III that may had confidentiality concerns. Correlations for agency and experience were adjusted to make sure no third variable influences or confounds are included in the final result. Any significant correlations were adjusted to maintain the transparency of the results. These questionnaires included questions that not only concerns men and women but of other entities such: as dogs, baby, dead women, God, robot, Superman, and trees. With assessment of these agency and experience correlation scores, the researchers can validate the influences of these mental disorders with social perception. Having a selection of different choices on the questionnaire strengthens and allows an accurate representation of how these individuals perceive the entities, especially if they can be categorized. If one were to find an outlier, then perhaps there’s a special subjective view of that entity by the

Discuss the pathogenesis of measles virus infection Free Essays

string(146) " V and C have been shown to downregulate IFN production in vitro and this includes both attenuated and wild type strains \(Fontana et al, 2008\)\." Introduction Measles virus (MV) is a member of the paramyxovirus family and has a single stranded RNA genome. The viral genome encodes for six structural proteins: Haemagglutin (H), Fusion (F), Nucleoprotein (N), Phosphoprotein (P), Large (L) polymerase protein, and Matrix (M) protein and two non-structural proteins: C and V (Griffin, 2010). The structure of the virus is shown below. We will write a custom essay sample on Discuss the pathogenesis of measles virus infection or any similar topic only for you Order Now Fig 1. The structure of the Measles virus Ref:http://www.microbiologybytes.com/virology/Paramyxoviruses.html The majority of measles cases occur in children and in those who are fit and healthy, results in life long immunity without complications. Measles virus has been eliminated in the western world since 2000 through an efficient vaccine programme, however, it is a different scenario in developing countries were deaths arise due to lack of vaccine administration and malnourishment of children (Fontana et al, 2008).For example in 2008, 164 000 people died from measles virus of these 95% were in low-income countries (www.who.int/mediacentre/factsheets/fs286/en/). Although infection with MV produces an efficient immune response that is maintained for the rest of the individuals life, it also results in a transient state of immunosuppression that can last for several weeks. This leaves the patient susceptible to secondary infections by opportunistic pathogens which account for the majority of measles associated deaths (Sevet-Delprat et al, 2000).The exact mechanism of the immunosuppressi on is still unknown however many theories have been suggested. Infection and Spread The MV is spread through aerosol transmission in the cough or sneeze of an infected person. The virus is extremely contagious and can remain in the air or on a surface for up to two hours (Stalkup, 2002). The route of entry for the virus is through the respiratory tract and once infected, the virus will incubate for an average of 10-12 days before any symptoms are seen. Infection is initiated by the attachment of the H protein to the host cell receptors, which results in the fusion of the envelope of the virus with the host cell membrane. This fusion of membranes causes the release of viral RNA into the host cell cytoplasm. After the RNA has replicated, using host cell machinery, new virus particles are assembled using the M protein and bud from the host cell membrane to infect other susceptible cells (Swart, 2008). The host cell receptors for the measles virus are CD46, a complement regulatory protein that is found on all nucleated cells and the Signalling Lymphocytic Activati on Molecule (SLAM/CD150) which is found on the surface of both T and B lymphocytes as well as macrophages and mature Dendritic cells (DC) (Yanagi et al, 2006). In vitro studies have found that vaccine strains of the measles virus use CD46 and SLAM as their receptor however wild-type MV only recognizes CD150 (Ferreira et al, 2010). There has been some debate over the exact cell that is involved in the initial infection with MV. It had previously been thought that the virus infected epithelial cells lining the nasopharynx (Stalkup et al, 2002) however more recent studies have shown that these cells do not bear the MV receptors SLAM which facilitate wild-type viral infection therefore further studies are required to identify this unknown receptor . It has been suggested that alveolar macrophages and DC lining the respiratory tract are the initial cells involved in measles infection.This was demonstrated in a study using mice that expressed humanized SLAM. These mice were infected intranasally with wild type measles virus expressing green fluorescent protein. The nasal associated lymphoid tissue (NALT) was then extracted from these mice at different time points (1,2 or 3 days). Results showed that alveolar macrophages were the first cells to be infected by the measles virus and not the epithelial cells (Ferreira et al, 2010). DC’s are the main antigen presenting cells of the immune system and are used by other viruses to infect lymphocytes for (example the HIV virus) (Witte et al, 2008). Therefore DC may provide an important route of transport for MV to secondary lymphoid tissue. The role of DCs in measles infection is further indicated by the identification of DC-SIGN which is an accessory receptor that has been identified on MV susceptible cells and is thought to assist MV infection of CD150 expressing DCs (Yanagi, 2006). Furthermore, large numbers of DC-SIGN positive DCs have been found to be present in the epithelium of the respiratory tract which demonstrates their potential primary role in MV infection of (Ludlow et al, 2010 ; Witte et al, 2008). An alternative theory is that epithelial cells are infected in the latter stages of infection by lymphoid cells facilitating viral spread by the respiratory route. This would mean that epithelial cells are infected at the basolateral cell surface rather than the apical surface. This was demonstrated by a study that looked at mutated MV strains that could not bind to the as yet unidentified Epithelial Cell receptor (EpR) but could still recognise the SLAM receptor. Results showed that the macaques developed the rash but could not shed the virus which suggests that the EpR is a basolaterally expressed protein that is important for the spread of the virus at the infective stage (Leonard, et al, 2008). A study by Ludlow (2010) supported these findings by showing that wild type MV could not infect primary columnar epithelial cells by the apical surface further demonstrating the potential role of epithelial cells in latter stages of infection rather than initial stages as previously th ought. In response to viral infection the innate immune system responds by producing inflammatory cytokines to protect cells from viral infection. These cytokines include type 1 interferons (IFN) such as IFN? and ? which are induced in response to RNA viruses. IFNs induce an anti-viral state in neighbouring cells and increase the expression of class 1 Major Histocompatibility Complex (MHC) molecules on the infected cell surface which will present the viral antigens to CD8+ T cells. CD8+ T cells clear the infection by cytotoxic T cell mediated killing of the infected cell (Abbas Ltchtman, 2005). To overcome these host cell defences, viruses have ways to evade the immune system. MV virus protein V and C have been shown to downregulate IFN production in vitro and this includes both attenuated and wild type strains (Fontana et al, 2008). You read "Discuss the pathogenesis of measles virus infection" in category "Essay examples" Through the inhibition of the proinflammatory cytokines MV can infect more host cells. MV may also use the innate immune system to enhance viral spread and pathogenesis by using Toll like receptors (TLRs) which are found on the surfaces of cells that activate the immune system by recognising bacterial and viral pathogens. The binding of TRL2 on human monocytes by MV H protein has been shown to induce production of interleukin 6 (IL-6) which upregulates expression of SLAM the primary receptor for MV (Beiback et al, 2002). Once the virus is picked up by antigen presenting cells it is carried to the secondary lymphatic tissue were it can replicate in T cell, B cells and activated monocytes with lymphocytes being the main target cell of MV infection (de Swart et al, 2007). These infected cells can be seen in the blood 7-9 days after infection (Griffin, 2010). It is thought that through these infected lymphoid cells that the virus is able to infect epithelial and endothelial cells lining organs including the liver, brain and skin (Moench et al, 1988). In order for MV to infect these organs it must overcome these endothelial cell barriers.It has been shown in cell culture that wild type MV infection may infect endothelial cells by increasing the expression and activation of leukocyte integrins which bring infected T cells into close contact with these cells leading to their infection (Dittmar et al, 2008). Symptoms The initial symptoms of MV are very similar to those of the flu including runny nose, conjunctivitis and cough which is accompanied by a fever of 104-1050F that lasts up to 4 days (Stalkup, 2002). The characteristic feature of MV is the red rash that appears beginning on the face and behind the ears, which spreads to the rest of the body (please see Fig 2 below). During this time the person is highly contagious and remains so until the rash disappears (www.cdc.gov/vaccines/pubs/pinkbook/download/meas.pdf). Fig 2 shows a child with an extensive rash caused by the Measles virus. Ref: http://www.vaccineinformation.org/measles/photos.asp Small white spots known as Koplik spots may also be seen in the inside the mouth which is a diagnostic indicator of measles and appear one day before the rash (Perry Halsey, 2004). The appearance of the rash is due to the immune systems attack of the systemic infection of epithelial cells and biopsies of the rash have shown infiltration of CD8+ and CD4+ T lymphocytes in the rhesus monkey (Permur et al, 2003). An individual who in infected with measles virus will recover within about 10-14 days but may remain vulnerable to secondary infections including pneumonia and diarrhoea for a few weeks.This was first noted by von Pirquet who noticed that individuals recently infected with the MV failed to respond to the tuberculin skin test and this has led to many studies into the reasons for this immune suppression (Griffin et al, 1994). One reason for the immunosuppression seen after a measles infection is the switch from a T helper 1 (Th1) CD4 response to a T helper 2 (Th2) CD4 response. Initial MV infection results in the production of a Th1 response which is necessary to eliminate the pathogen and is marked by increased production of IFN? however as the rash is cleared this changes to a Th2 response which is important in the production of measles specific antibodies (Moss et al, 2004). Th2 cytokines IL-4 and IL-10 have been shown to be elevated for weeks in those who have had MV (Moss et al, 2002). IL-10 suppresses the immune system by inhibiting lymphocyte proliferation and macrophage activation therefore may have a key role in failure to generate a Th1 response after MV infection (Sato et al, 2008). IL-12 is primarily produced by activated macrophages and DCs and has a pivotal role in the generation of a cell mediated immune response as well as directing CD4+ T cells to differentiate into Th1 cells (Abbas Lichtman, 2005). Studies have shown that MV infection of DCs inhibits IL-12 production which would lead to an environment favouring a Th2 cell response (Servert-Delprat et al, 2000). Furthermore peripheral blood monocytic cells taken from patients with measles have been shown to have a prolonged decrease in IL-12 (Atabani et al, 2001). Stimulation of DCs through TLR4 also results in inhibition of IL-12 in mice expressing human SLAM receptor (Hahm et al, 2007). As lymphocytes are the main targets for MV infection and replication the immunosuppression seen after infection may be due to as decrease in circulating lymphocytes. However, studies have shown that lymphocyte numbers quickly return to normal levels and therefore cannot account for the immune suppression seen weeks after infection (Griffin, 2010). Subacute Sclerosing Panencephalitis (SSPE) SSPE is a rare neurological complication of MV infection that affects 1 in a million measles cases although there is an increased risk with children infected with the measles virus before age 2 and males more than females (Norrby Kristensson, 1997). The characteristic symptoms of SSPE are deterioration of mental and motor functions as a result of destruction of brain tissue. These symptoms typically begin to manifest 7-10 years after primary viral infection and ultimately result in death within 2 years (Stalkup, 2002). Patients with SSPE have high levels of measles specific antibody circulating in their blood and cerebrospinal fluid (CSF) yet the virus is not eliminated (Barrero et al, 2003). It is thought that the virus mutates inside the neurons which allows it to evade the immune system however these mutations may alter the host cells leading to the generation of the immune response (Gutierrez et al, 2010). However the mechanism by which neurons are infected is still unknown as no receptors have been identified. There is no cure for SSPE although treatment of individuals with Interferon ? and Isoprinosine has been shown to slow down the progression of symptoms in some individuals (Gascon et al, 1993). Vaccination The first MV vaccine was produced in the 1960s which was formalin-inactivated with alum. This vaccine produced a condition known as atypical measles which resulted in some individuals experiencing symptoms which were often worse than wild-type measles, when they came into contact with someone who had measles (deSwart, 2008). In 1963, Enders measles vaccine was developed which was a live attenuated vaccine (Stalkup, 2002). This vaccine is grown in cell culture fibroblasts from chicken embryos and is unable to produce its full pathogenic effect but induces an adequate life long immune response (P?tz et al, 2003). The measles vaccine has resulted in a 99% fall in the number of measles cases that were previously seen annually in the United States (Stalkup, 2002). MV could potentially be irradicated but this is dependent on high vaccine coverage. The World Health Organization (WHO) has a policy in place which has set a goal of reducing the death rate from MV in children under 5 by 2 015 (http://www.who.int/mediacentre/factsheets/fs286). MV infection can also lead to blindness in children who are Vitamin A deficient and the WHO have recommended that all children with measles are given vitamin A supplementation to combat blindness (Semba and Bloem, 2004). The measles vaccine is part of the Measles Mumps and Rubella (MMR) vaccine that is given in two doses. The vaccine is administered intramuscularly and the first injection is given to children around 13 months (http://www.nhs.uk/conditions/mmr/Pages/Introduction.aspx). The vaccine is not given before this age because these children will have maternal antibodies which would interfere with the vaccine and not generate an appropriately high enough immune response (Moss et al, 2004). A second dose of the MMR vaccine is given to preschool children as a booster as 2-5% of individuals fail to produce an appropriate protective immunity to the first inoculation (http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmr/faqs-mmr-hcp.htm). New methods of delivery of MMR vaccine have been investigated such as the use of aerosol vaccine which would mimic natural measles infection and the use of DNA vaccine administration. Aerosol vaccine has been found to generate an effective immune response that is equal to that of the currently used vaccine and may also overcome the interference from maternal antibodies however clinical trials are still in progress (Heno-Restrepo et al, 2009). Furthermore, trials into the use of DNA vaccines have proposed a potential to vaccinate children as young as four months (Pasetti et al, 2009). The MMR vaccine has been in the public eye for many years as a result of a paper by Wakefield and colleagues in 1998 which claimed that there was a link between the administration of the MMR vaccine and the development of autism (Farrington et al, 2001). Many studies have been carried out to either prove or disprove this study as these claims led to fear amongst parents regarding vaccination of their children and uptake fell to 80% between 2003 and 2004 as a result of this (Bedford Ellimen, 2010). As stated in the introduction MV is so contagious even a minor drop in vaccine coverage can lead to a large number of cases. In 2010 after an extensive investigation by the General Medical council it was finally confirmed that the paper by Wakefield was unfounded (Godlee et al, 2001). Conclusion Although cases of MV are rarely seen in this country it results in the death of many children in the developing countries. Currently vaccination is given at 13 months of age however many studies are ongoing that could potentially provide a vaccine that could be administered earlier resulting in children being protected earlier and limiting hosts for the virus. Furthermore, malnutrition is one of the major contributing factors in the deaths from measles virus, tackling this problem would also decrease the mortality rate. As stated above MV poses a problem in that infection generates a life long immune response but also leaves the host susceptible to secondary infections. The exact mechanism for this is not yet known therefore more work is needed to answer this problem and potentially combat this immune suppression. How to cite Discuss the pathogenesis of measles virus infection, Essay examples

Symbolism in a Streetcar Named Desire free essay sample

Written in 1947, A Streetcar Named Desire has always been considered one of Tennessee Williams’s most successful plays. One reason for this may be found in the way Williams makes extensive use of symbols as a dramatic technique. This happens in all of his plays, but in this instance Williams integrates symbols very effectively with ideas and thematic content. He once explained that symbolism is a way to â€Å"say a thing more directly and simply and beautifully than it could be said in words †¦ sometimes it would take page after tedious page of exposition to put across an idea that can be said with an object or a gesture on the lighted page† . Thus Williams emphasises the theatre dimension of the symbols he uses, as well as symbolic meanings in dramatic language. In this essay, a selection of the symbolic devices used by Williams will be analysed. Owing to the pervasive use of symbolism in this play, only major symbols can be dealt with, but it should be added that the distinction between major or minor importance is open to interpretation and depends on the symbols thematic importance. We will write a custom essay sample on Symbolism in a Streetcar Named Desire or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The order of the symbols discussed in this essay is not identical with their order of appearance in the play, but is governed by a systematic approach. 2. Symbolism In literature, symbols are widely used by authors as a means of emphasising certain atmospheres and characteristic features of people and places. A symbol is an object or image that stands for itself and also for something else. All language is symbolic considering that letters form words which indicate particular and objective realities. In a literary sense, a symbol combines a literal and sensuous quality with an abstract or suggestive aspect. A symbol can be thought of as an image that evokes an objective, concrete reality and prompts that reality to suggest another level of meaning. 3. The names’ symbolic meaning 3. 1 Blanche DuBois Blanche DuBois is the main character of the play and also the most thoroughly described one. The name Blanche is French and means white or fair. Her last name DuBois is of French origin as well and   translates as made of wood. Her first name a clear connection to her character becomes quite obvious. Since the colour white stands for purity, innocence and virtue, Blanche‘s name reveals these qualities, which stand in contrast to her actual character traits. The name suggests that Blanche is a very innocent and pure person, but throughout the play it becomes obvious that Blanche cannot call any of these traits her own. Only the illusory image which she tries to create for herself suggests these traits, but her true nature is not like that at all. She constantly tries to hide her embarrassing past from all of her new acquaintances, because she fears that they might not accept her anymore. In order to maintain her apparent social status among her new neighbours and friends, she builds this intertwined net of lies which creates a false image of herself. She herself believes in this imaginary world, and as soon as there is the slightest sign of its destruction, she seems to be lost, and her nervous condition worsens. Therefore all she cares about is to keep that image alive. Her first name is therefore quite ironic since it means the exact opposite of Blanche’s true nature and character. Her last name, however, stands in contrast to her first name. Made of wood suggests something solid and hard, which is the exact opposite of her fragile nature and nervous condition Wood can also be associated with forest or jungle, and regarding her past, the connection becomes clear. Blanche used to indulge in a rather excessive lifestyle. She had sex with random strangers and was known throughout her hometown Laurel for that. So her former life was more like a jungle or a forest, because it was hard to see through all this and detect the real Blanche. As in a jungle, Blanche could not find a way out of this on her own. The term jungle appears in the play as well. In scene ten, when Stanley is about to rape Blanche, â€Å"the inhuman jungle voices rise up†. The jungle can be associated with wildness, brutality and inhuman behaviour. As already mentioned above, wood represents something hard, or hard-working. The Du in front of   that, however, suggests something aristocratic and noble. There seems to be a contradiction in these two terms which can be explained with the nature of her character. The way Blanche tries to create an aristocratic and sophisticated image of herself, but is in fact the complete opposite, displays this ambiguity. There is another way to explore her last name, and it leads to the pronunciation of it. If one pronounces DuBois with the correct French accent, there is nothing uncommon about it, but since the play was written by an American, who most likely knew about the way most Americans would pronounce it, a very obvious connection to Blanche’s past appears. Being pronounced with an American accent, Dubois sounds more like â€Å"Do boys,† which accompanies the fact that she had had an affair with a student while she was a teacher. Her kissing the paper-boy in scene five underlines the sexual symbolic meaning of that last name as well. Combined with her first name, her entire name would translate as â€Å"white wood,† which she explains to Mitch in scene three, â€Å"It’s a French name. It means woods and Blanche means white, so the two together mean white woods†. Blanche DuBois cannot only be translated as white wood but also as white and made of wood, which makes it easier for the reader to detect that she seems pure and innocent on the outside, but is really quite tough and calculating when it comes down to her image and her future, especially concerning her search for a husband. Overall, Blanche’s entire name is heavily symbolic because it reflects her true nature in a very clear way. Just as first and last name are being read out in an exact order, Blanche’s character is revealed in the same way. At first she seems to be innocent and pure, but later her past and her true nature can be discovered. 3. 2   Stella Stella is a Latin term which simply means star. Stars in general are considered to be the light which breaks through the darkness. Considering that light is the opposite of darkness, and darkness itself stands for not-knowing and intellectual dullness, the stars can be regarded as reality and knowledge shining through ignorance. Stars can also be a symbol for high ideals or goals set too high. Stella represents Blanche’s ideal concerning the fact that she is leading a contented life. The deeper significance of her name reveals her role in the play. The symbolism of star is light, hope and stability. This is quite a good description of her role and her position in the play. Stella is the connection between Blanche and Stanley, the two major characters, because she contains character traits of both of them, and can therefore relate to them better than anyone else can. Therefore she can be considered to be the stabilising element of the play. She is the negotiator between the two so very different characters. Stella and Blanche have the same rather wealthy and cultivated background, which is the connection between the two women. Stella also has several things in common with Stanley. One of them is their love for wild sex. During a conversation ith Blanche, Stella tells her about her wedding night: Stella: Why, on our wedding night – soon as we came in here – he snatched off one of my slippers and rushed about the place smashing the light-bulbs with it. Blanche: He did – what? Stella: He smashed all the light-bulbs with the heel of my slipper! Blanche: And you – you let him? Didn’t run, didn’t scream? Stella: I was – sort of – thrilled by it. 3. 3   Belle Reve Belle Reve is the name of the sisters’ family’s plantation in their hometown Laurel. The name is again of French origin and means beautiful dream, which again emphasises Blanche’s tendency to cling to her illusions. The term suggests an illusion, which is not quite true, for the plantation really once existed. On the other hand, beautiful dream suggests that something beautiful, which has once existed, faded away. Therefore, the name’s symbolic meaning became true. But in contrast to Blanche’s other illusions, this is the only one that ever truly existed, and it is the only one that Stella and Blanche are both connected to, because it is their heritage, and it was real. However, looking more closely at the name, it reveals that there is a grammatical mistake. The adjective belle is feminine, but it should be masculine, for reve is masculine. Tennessee Williams probably did this on purpose and not by mistake, because it underlines the fact that Belle Reve was just a dream which crumbled. The grammatical mistake also implies a certain imperfection, which is also apparent and true for Blanche’s beautiful dream, her net of lies and false illusions. 3. 4   Desire, Cemeteries and Elysian Fields At the   beginning of the play Williams introduces three terms which do not reveal their symbolic meaning right away, but the reader comes to realise their sense and importance later in the play. In scene one, Blanche describes to Eunice her journey to her sister’s place: â€Å"They told me to take a streetcar named Desire, and then transfer to one called Cemeteries and ride six blocks and get off at – Elysian Fields†. Blanche’s journey on New Orleans’ streetcars represents the journey of her own life. Desire is her first step, just as it was the first step of her life after her husband Allan had died. Still struggling with this loss, she was desperately longing for love and companionship, but ended up leading a life which was filled with sex with random men, who never cared about her: â€Å"Yes, I had many intimacies with strangers. After the death of Allan – intimacies with strangers was all I seemed able to fill my empty heart with†¦Ã¢â‚¬ . At this time she was hence obsessed by desire. The next step of her journey is Cemeteries, which is an obvious symbol for death. Her promiscuous lifestyle had got her into trouble. She lost her job because she had had an affair with one of her students, and was banned from Laurel: â€Å"The opposite (of death) is desire†. This underlines that her life turned into the exact opposite of what it had been. Elysian Fields is the name of the street where Stella and Stanley live. According to Roman mythology, Elysium (or Elysian Fields) was a part of the underworld and a place of reward for the virtuous dead. Elysian Fields, though, was just a temporary place of the souls’ journey back to life: The New Orleans quarter shows this feature of Elysian Field being very active as well. It is a very lively area where sounds of the streets, the locomotive and the street vendors are constantly present. The plunging of souls in waters resembles Blanches obsessive bathing in Williamss play—her cleansing too is psychic, and she hopes to wear away her habitual stains. Since Elysian Fields is the place where the souls reside before they come back to earth, it symbolises the third step of the journey of Blanche’s soul. After the rape, she is being taken away to the mental institution, which symbolises that her journey has started over again. Desire has once again sent her off to Cemeteries. 4  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The light as a symbol for truth and reality The light plays an important symbolic role throughout the play because it clearly reflects Blanche’s and Stanley’s characters. The light is considered to be the basis for sight and recognition, and, as already mentioned above, it is the opposite of darkness which symbolises intellectual dullness and ignorance. Blanche and Stanley stand in contrast concerning their attitudes towards light, which again underlines their different characters. 4. 1   Blanche’s aversion to light Blanche’s relation to light is quite obvious because she tries to avoid bright light of any kind as well as she can. Her reaction to light can be regarded as an attempt to hide her true nature as well as her vanishing beauty and youth. By hiding from the light she tries to escape reality, for light clearly represents reality in this play. The first time that Blanche’s aversion to light becomes obvious is in scene one: â€Å"And turn that over-light off! Turn that off! I won’t be looked at in this merciless glare†. In scene three, she covers the naked light bulb with a Chinese paper lantern: â€Å" I can’t stand a naked light bulb, any more than I can a rude remark or a vulgar action†. This remark shows that Blanche would rather hide behind polite phrases than accept truth and reality. The paper lantern is not very stable, though, and it can easily be destroyed, just like Blanche’s illusions. In scene six, she takes Mitch home with her and says, â€Å" Let’s leave the lights off†. Blanche thinks of Mitch as a future husband, and therefore she does not want him to know her past or her true age, and the best way to hide her age is to stay out of bright light where he could possibly see her wrinkles and fading youth in her face. Later in that scene, Blanche tells Mitch about her husband Allan: When I was sixteen, I made the discovery – love. All at once and much, much too completely. It was like you suddenly turned a blinding light on something that had always been half in shadow, that’s how it struck the world for me. Therefore, in her past, light used to represent love, but now it represents something destructive for her. Allan’s suicide erased the light or love, and thus she now does not believe in it any longer and tries to escape from the light and therefore escapes reality: â€Å"†¦electric light bulbs go on and you see too plainly†. This again shows her fear of light since for her it represents reality, and   in scene nine this becomes even more obvious. When Mitch tears off the paper lantern in order to take a closer look at her in the bright light, â€Å"she utters a frightened gasp†. Then she tells him, I don’t want realism†¦I’ll tell you what I want. Magic! Yes, yes, magic! I misrepresent things to them. I don’t tell the truth. I tell what ought to be truth. And if that is sinful, then let me be damned for it! – Don’t turn the light on. This is Blanche’s first statement concerning her true intention and nature, and it is probably the only time where she ever confesses that she builds up an illusory image of herself. 4. 2   Stanley’s affection for light Stanley has a different attitude concerning light and reality. He is very down to earth and realistic and displays this with his brutal honesty. For Stanley, the bright light exposes everything for what it is. He can only accept a literal truth, which can be experienced by his fanatic investigation of Blanche’s past: â€Å"You showed me the snapshot of the place with the columns. I pulled you down off them and how you loved it, having them coloured lights going†. In this passage, Stanley tries to remind Stella of the fact that when they met she was just like Blanche, but that he made her face reality again. As already mentioned above, light is the opposite of darkness and therefore the opposite of ignorance. Stanley considers himself to be knowing and constantly tries to increase his knowledge, especially the one concerning Blanche’s past. 5  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The use of colour symbolism The use of colours plays a very important role in A streetcar named Desire. Throughout the play, Williams makes explicit use of colour as a means of emphasising the characters and the atmosphere of the   setting. Colours in general are means which are used to express emotional moods, human qualities and hierarchical positions. The two major characters, Blanche and Stanley, are each dressed in certain coloured clothes to underline their nature. 5. 1   Blanche’s symbolic colours The first apparent use of colour in the play is the symbolic meaning of Blanche’s name, which, as already mentioned above, is French and means white. When she appears in scene one, â€Å"she is daintily dressed in a white suit with a fluffy bodice, necklace and ear-rings of pearl, white gloves and a hat†¦Ã¢â‚¬ . As already mentioned above, the colour white stands for purity and innocence, but it is also the colour of light and represents perfection and virginity. This association stands in complete contrast to her actual behaviour and actions. Blanche is a seductive and promiscuous woman, who lies in order to maintain her image, and therefore Williams’s use of this colour for her name and her outer appearance is quite ironic. In scene two Blanche talks to Stanley about honesty: Yes – yes – cards on the table†¦. Well, life is too full of evasions and ambiguities, I think. I like an artist who paints in strong, bold colours, primary colours. I don’t like pinks and creams and I never cared for wishy-washy people. This paragraph clearly shows the irony in her words, because she herself is the one who is embodying a distinct difference between her actions and her statements. She is the one who is neither straight-forward nor honest, but pretends to expect this from other people to a certain extent. In scene nine, she changes her clothes from soft colours to strong bold ones for the first time: â€Å"She has on her scarlet satin robe†. The colour red symbolises love, passion and fertility on the positive side, but also fire and blood on the negative one, so this is the first time that her outer appearance actually matches her intentions. She is meeting Mitch in this scene, and her dress certainly shows the seductress in her. Mitch refuses to marry her because of her past, and after that, in scene ten, she wears a white satin evening gown, which implies that she returned to her habit of soft colours in order to underline her pureness and virtuous nature. 5. 2   Stanley and his friends Stanley’s tendency concerning colours is the exact opposite of Blanche’s. He and his friends usually dress in rather solid materials, like cotton, or denim, and their clothes are mainly coloured in blue, and sometimes green. The first time their clothes’ colours are mentioned is in scene one: †Two men come around the corner, Stanley Kowalski and Mitch. They are about twenty-eight or thirty years old, roughly dressed in blue denim work clothes†. The colour blue is considered to be a symbol for the divine or heavenly, but also for the truth. Once again, Williams uses a certain colour to express a person’s human qualities, although, in this case, the association is not ironic, but matches the person’s behaviour. Stanley is an honest person with no sympathy for lies and superficiality. The colour blue also represents strength, masculinity, calm and authority, which clearly underlines Stanley’s character. Stanley however is not the only character displayed in this way. His friends’ colours, especially Mitch’s are being described as well. Williams points out the aspect of masculinity in the following excerpt and underlines it by mentioning the men’s clothing colours: The poker players – Stanely, Steve, Mitch, and Pablo – wear coloured shirts, solid blues, a purple, a red–and-white check, a light green, and they are men at the peak of their physical manhood, as coarse and direct and powerful as the primary colours. Later, in scene nine, Mitch â€Å"comes around the corner in work clothes: blue denim shirt and pants. He is unshaven†. In this scene he meets Blanche, who is wearing her red satin robe. The confrontation of the colours red and blue, symbolises the confrontation between femininity and masculinity. 6  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Music as a symbol for emotions Music plays an important role in A Streetcar named Desire because it appears in almost every scene and stresses the atmosphere in a very distinct way. There are two main types of music used in the stage directions: the blue piano and the Varsouviana Polka. Each one appears in scenes which are occupied by a certain emotional state of the main character Blanche. 6. 1   The blue piano The blue piano is first mentioned in the introductory stage directions of the first scene: â€Å"This ‘blue piano’ expresses the spirit of the life which goes on there† . Throughout the play, the blue piano always appears when Blanche is talking about the loss of her family and Belle Reve, but it is also present during her meeting and kissing the young newspaper man. The blue piano thus stands for depression, loneliness and her longing for love, which the adjective blue already suggests. This quality is not identical with the colour symbolism of blue. It describes Blanche’s emotions and represents her need for companionship and love, but also her hope, as the scene with the paper-boy shows. Mitch tells her in scene nine that he will not marry her due to her promiscuous past, â€Å"the distant piano is slow and blue†. Later, in scene ten, it grows louder when she is on the phone trying to get in touch with Shep Huntleigh. In this situation, her hopes are rising, and so does the piano. In the last scene, Blanche is being taken away to a mental institution, and Stanley and   his friends play poker again: â€Å"The luxurious sobbing, the sensual murmur fade away under the swelling music of the ‘blue piano’ and the muted trumpet†. The blue piano, accompanying the card game, symbolises Stanley’s victory over Blanche. 6. 2   The Varsouviana Polka The Varsouviana Polka on the other hand appears when Blanche is being confronted with her past and the truth, or when she talks about Allan. The reason for this seems obvious, for exactly this polka had been played when er husband Allan committed suicide. The polka represents death and immanent disaster. Blanche tells Mitch in scene six about Allan, and how she caught him cheating on her: â€Å"Polka music sounds, in a minor key faint with distance†. When Stanley gives her a ticket back to Laurel for a birthday presents, the situation means disaster for Blanche. She realises that she is not wanted anymore, and that she has nowhere to go, for Laurel is an unacceptable   place to go to after all the incidents there: â€Å"The Varsouviana music steals in softly and continues playing†. Again, the polka represents disaster. In scene eleven, the connection between the polka and Blanche’s state of mind and emotion becomes even more obvious. She gets totally lost in her illusions about Shep Huntleigh and runs into her room when the doctor arrives: â€Å"The Varsouviana is filtered into weird distortion, accompanied by the cries and noises of the jungle†. Therefore the polka’s weird distortion matches the confusion in her mind, and gives a further dimension to the Bois element of Blanches name as discussed earlier. 7  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Animalistic images Throughout the play, Williams often describes certain characters as being animal-like. In literature in general, animals are often used as a means to underline a person’s characteristic   traits by comparing that person to a certain animal. Animals frequently represent the power of the subconscious. 7. 1   Blanche’s connection to the moth In the first scene, Blanche is compared to an animal: â€Å"There is something about her uncertain manner, as well as her white clothes, that suggests a moth†. Since all dictionaries of symbols taken as reference guides only refer to butterfly, the butterfly will be taken into consideration and used as a comparison to the moth. The moth and the butterfly have several things in common. They are both born as a caterpillar, then create a cocoon around themselves, in which they stay for a certain period of time, transform into a moth/butterfly and finally come out in their complete appearance. In medieval times, the butterfly was the most well-known symbol for the Resurrection. The butterfly leaves the unsightly cocoon and then lives in the light. For antiquity, the butterfly was a representative for the soul. Therefore her journey can be regarded as the journey of her soul.. This clearly underlines the statement saying that the butterfly can be associated with something fickle and wandering. It is also said to have a connection to Eros, the god of love. All these attributes can be linked to Blanche’s character. Due to her promiscuous past, she can be considered to be wandering and fickle, and her connection to Eros is quite obvious, too. In contrast to the butterfly, who lives during daytime, the moth mainly lives during the night, which makes it a creature of the darkness, and the butterfly one of the light. As already mentioned above, the butterfly leaves the dark cocoon to live in the light, but the moth stays in darkness for that is the time when it is feeding. This can be adapted to Blanche as well. It seems as though—contrasting with her name—it is her fate to live in the darkness, which symbolises ignorance and the dark dungeon of the limbs in Virgil. Blanche does not find a way out of it: at the end of the play she is being taken away to the mental institution, which means that she finally does not conquer her fate. 7.    Stanley and his wild image In contrast to Blanche, Stanley displays brutal and wild behaviour—from her perspective: He acts like an animal, has an animal’s habits! Eats like one, moves like one, talks like one! There’s something – sub-human – something not quite the stage of humanity yet! Yes, something – ape-like about him, like one of those pictures†¦. Stanley is at this point compared to an ape. Ch aracteristic traits of apes are mobility, intelligence, deceit, but also lasciviousness, the drive to imitate and quarrelsome stinginess. Especially the lasciviousness matches Stanley’s character, for it can be detected in his love for wild sex, and his raping Blanche. With Stanley’s connection to the ape, Williams again builds up a link to the jungle. Apes often live in the jungle, for it is their habitat. Therefore Stanley’s habitat, the Elysian Fields, can be considered to be a jungle. It appears to be an appropriate place for Blanche to visit, when the white woods actually camouflage the noises of the jungle dominating her mind. 8  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Conclusion This essay has tried to point out several of many symbols used in A Streetcar named Desire. It should have become clear that symbols are elaborate means of emphasis in order to intensify atmospheres and people. Williams introduces most of the symbols in the first scene, obviously to create a certain atmosphere and to give the reader already a deeper insight into the characters from the beginning. The use of colour symbolism, as well as the music occur in almost every scene in order to underline the emotions and the clash between Blanche and Stanley. It should have become clear in this essay that certain symbols affect each other by emphasising contrary aspects or related qualities. The symbols discussed in this essay are only a selection, for Williams makes excessive use of symbols in this play. Blanche’s constant bathing and the poker game are just a few other symbols dealt with in the play, but due to the length and the extent of this essay they could not be discussed. The ones which were discussed can surely be explored more thoroughly, for example, a further exploration of the   symbolic allusions used in this book might have been possible but that would have likewise exceeded the dimensions of this essay.