192 Years After Her Death, Jane Austen's Death Cause Continues to Mystify Diagnosticians

"I find it extraordinary that Austen, who died in 1817, finished "Persuasion" and that she embarked on "Sanditon," an extremely funny fragment mocking hypochondria, in her last illness. It shows what a sense of humour she had that she could do that when she was dying." - Claire Tomalin, author of Jane Austen: A Life, in "The Times of London".

In 1997, Tomalin had challenged the diagnosis made by Dr. Vincent Cope in 1964, wherein he had blamed the then supremely rare adrenal gland ailment called Addison's Disease. Tomalin in turn questioned the retrospective diagnosis and presented possibilities such a Hodgkin's lymphoma, characterized by recurring fever and subsequent enfeebling of the body, or brucellosis, a spinal problem flanked by intermittent and fluctuating fever and joints, caused maybe due to the consumption of infected milk, that could have killed Austen. Austen did in fact complain of pain in the spinal region.

Almost 12 years later, Katherine White, a victim of Addison's, has come up with another infected milk related possibility that could have killed the author. In this case however, White believes that it was the intake of unpasteurized milk that could have inflicted the 19th century author with bovine tuberculosis.

White, an active coordinator in the advisory team of the Addison's Disease Self Help Group in Britain, bases her deduction after avidly studying epistles composed and sent by the author in the last two years of her life, to various relatives. There seems to be repeated complaints of fatigue, body aches and liver problems that kept Austen glued to the bed, as per a letter addressed to her niece. However, White strengthens her argument by saying that, "In a letter written less than two months before her death, as she was recovering from a period of severe illness where she had been too weak to leave her bed, Jane Austen wrote to a close friend that 'My head was always clear, and I had scarcely any pain'." In context to this, the author explains that sufferers of Addison's generally have "intense migraine-like headache and generalized arthralgias", exemplifying it with the instance of Saint Elizabeth of the Trinity, an Addison's victim who compared her own suffering to Jesus' cruxifixion anguish.

The researcher also is of the opinion that Austen was also not a victim of "slurred speech and confusion or a semi-conscious state, characteristic of adrenal crises" and "retained her formidable lucidity to the last" as supposedly "less than 48 hours before she died, she dictated 24 lines of comic verse to her sister Cassandra from her sickbed." Her last completed novel, Persuasion is proof enough that nothing really had affected or clouded the writer's intellectual thinking powers, except for a little depression maybe given that she had been indisposed for a long time. Notably, Austen did not report of any weight loss in her letters as well, another common pointer to weaken the Addison's deduction. It is therefore, the absence of these characteristic symptoms of the Addison's disease, that White feels nullifies Cope's deduction.

Bovine tuberculosis on the other hand, was quite rampant in Austen's age and could have caused the liver and joint problems in the author, making it a "simpler" explanation for her death.

However, an Outreach Historian at the Wellcome Trust Centre for the History of Medicine, Carole Reeves feels that it is rather difficult to put your finger at the right cause of Austen's death owing to the substantial passage of time since 1817. White too, backs this in her paper "Jane Austen and Addison's Disease: an unconvincing diagnosis" saying that certain obscurities affected her research as Austen's sister Cassandra handled, emended or destroyed many of the relevant letters after the author's untimely demise.