In June 1818, Keats began a walking tour of Scotland, Ireland, and the Lake District with his friend Charles Armitage Brown. Keats' brother George and his wife Georgina accompanied them as far as Lancaster and then continued to Liverpool, from where the couple emigrated to America. They lived in Ohio and Louisville, Kentucky, until 1841, when George's investments failed. Like Keats' other brother, they both died penniless and racked by tuberculosis, for which there was no effective treatment until the next century. In July, while on the Isle of Mull, Keats caught a bad cold and "was too thin and fevered to proceed on the journey." After his return south in August, Keats continued to nurse Tom, exposing himself to infection. Some biographers suggest that this is when tuberculosis, his "family disease," first took hold. "Consumption" was not identified as a disease with a single infectious origin until 1820, and there was considerable stigma attached to the condition, as it was often associated with weakness, repressed sexual passion, or masturbation. Keats "refuses to give it a name" in his letters. Tom Keats died on 1 December 1818.