Here's where the inspiration came from:
It’s fairly well known that Poe married his cousin Virginia and that her subsequent illness inspired much of his work, but perhaps one of the most direct correlations to his work came with the first signs of her tuberculosis. While singing for the family, Virginia’s lungs hemorrhaged and she began bleeding from the mouth. Soon after, in a deep denial about the severity of her illness, Poe wrote the tale of decadent Prince Prospero, locked in his castle and trying, in vain, to keep the specter of pestilence, disease and injury from his doorstep.
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