In the heart of Winchester, England, the significance of No. 8 College Street is marked by an oval plaque stating, “In this house Jane Austen lived her last days and died 18th July 1817.” The location is a pilgrimage site for devoted fans of the author, who seek to understand the final chapter of her life. For eight weeks, Austen resided there with her sister, Cassandra, while battling a mysterious illness that ultimately led to her untimely death at the age of 41.
The cause of Jane Austen’s demise remains a subject of scholarly debate as the 250th anniversary of her birth approaches on December 16, 2025. Despite extensive research, no definitive diagnosis has surfaced. According to Devoney Looser, a regents professor of English at Arizona State University, “There is, as of yet, no clear answer about what caused Jane Austen’s death at age 41.” Scholars rely on Austen’s letters and novels to piece together her health history, revealing new interpretations of her works, particularly “Persuasion.”
Several hypotheses have emerged over the decades regarding her condition. A 1964 paper by Zachary Cope posited that Austen suffered from Addison’s disease, a rare chronic condition affecting hormone production in the adrenal glands. Subsequent theories suggested stomach cancer, tuberculosis, or Hodgkin’s lymphoma as potential causes. These conditions, while differing significantly, share common symptoms like fatigue, weight loss, and intermittent fevers, as noted by Dr. Dacia Boyce, an internal medicine physician at the Carl R. Darnall Army Medical Center in Texas.
Despite the various theories, none fully encapsulate Austen’s health issues, leaving the door open for further exploration.
Unraveling Austen’s Last Months
The late neuro-ophthalmologist Dr. Michael D. Sanders, a long-time admirer of Austen, undertook his own investigation into her decline. After retiring from the medical eye unit at St. Thomas’ Hospital in London, he partnered with colleague Dr. Elizabeth Graham to examine Austen’s letters meticulously. Their collaboration culminated in a publication in the journal *Lupus* in January 2021, outlining a timeline of Austen’s health deterioration, which began in the spring of 1816.
Austen’s letters from late August 1816 reveal her struggle with various symptoms, primarily rheumatism, along with fatigue and skin rashes. She often wrote of feeling “tolerably well,” yet her health consistently fluctuated. In a letter dated March 1817, she expressed her concerns about her health, stating, “Sickness is a dangerous indulgence at my time of life.” By May 1817, she was under the care of surgeon Giles King Lyford in Winchester.
The letters provide a wealth of information about Austen’s final days. As her condition worsened in June and July, she experienced a weak pulse and spent much of her time sleeping. On July 15, she dictated her last poem, “Venta,” before her health rapidly declined. By July 18, she had succumbed to her illness, passing away at 4:30 a.m. with her head resting on Cassandra’s lap. Cassandra later wrote, “I have lost a treasure, such a sister, such a friend as never can have been surpassed.”
The Challenge of Historical Diagnosis
Despite the wealth of letters detailing Austen’s symptoms, direct medical evidence is lacking. Graham notes that there is no known death certificate for Austen, and the specifics of her treatment remain unclear. “Nobody said what she died of,” she remarked. The absence of concrete medical documentation complicates any definitive diagnosis.
Sanders and Graham explored various potential conditions. They concluded that Austen’s face rash was not consistent with Addison’s disease, which typically results in widespread skin discoloration. Given the prevalence of tuberculosis in the 18th and 19th centuries, her physicians would likely have recognized its symptoms; however, Austen did not present the typical respiratory or orthopedic issues associated with it. Lymphoma was also ruled out due to the absence of swollen lymph nodes in her letters.
Instead, the researchers proposed that Austen may have suffered from systemic lupus erythematosus (SLE), an autoimmune disease characterized by joint pain, skin rashes, and fatigue. This condition, which often affects young women and can be fatal in their 30s and 40s, aligns more closely with the symptoms Austen described.
While the idea of analyzing Austen’s hair samples was considered, the researchers ultimately decided against pursuing this route. Lizzie Dunford, director of Jane Austen’s House, confirmed that previous studies showed contamination in two of the three known samples, making further analysis unlikely to yield conclusive results.
Debate about Austen’s health continues among scholars, with some leaning toward lymphoma and others supporting the lupus hypothesis. The challenge lies in interpreting her letters, which may not provide an accurate medical picture for modern understanding. Richard Foster, fellows’ librarian and keeper of collections at Winchester College, acknowledged that the cause of Austen’s death may remain an unsolved mystery.
Despite the uncertainty surrounding her health, Austen’s final works reflect her experiences with illness. Themes of health and injury pervade “Persuasion” and “Sanditon,” where characters seek cures amid their struggles. As noted by Dr. Boyce, “Mentions of illness are common across Austen’s novels,” indicating her acute awareness of health issues during her lifetime.
Austen’s exploration of strength and weakness resonates with readers even today. Her characters often grapple with health anxieties, reflecting societal attitudes towards illness during her era. The shift in tone from her earlier works to her later writings illustrates a growing complexity in her narratives, revealing a deeper understanding of life’s challenges.
As scholars continue to analyze Austen’s life and works, her legacy endures. Her ability to connect across time and circumstance remains a source of comfort and inspiration for many, highlighting her status as more than just an author, but a companion through the complexities of life.
