By Brenda S. Cox
“God grant me patience, Pray for me Oh Pray for me.” –Jane Austen’s last recorded words, from Cassandra’s letter to Fanny Knight, July 20, 1817
You probably know that Jane Austen died young, at age 41, on July 18, 1817.
What did she die of? We don’t know, but many scholars have speculated. Most of these conditions had not even been identified in Austen’s time.
Her Symptoms
From letters we learn that Austen had:
- Fluctuating symptoms, better, worse, better, worse
- Pain in her face (Sept. 15 and 24, 1813, exacerbated by cold air), back (Sept. 8, 1816), and knee (Feb. 21, 1817), though not much pain near the end
- Discoloration of skin, especially face, “black and white and every wrong color” (March 25, 1817)
- Pale skin (from her niece Caroline’s observations)
- Recurrent fevers (March 25, April 6, 1817)
- Sleepless nights
- A clear mind (she wrote a poem on Winchester Races shortly before her death)
- Fatigue, weakness, langour, often needing to lie down (May 22, 1817, as well as months before that)
- A “Discharge” for a week, which the “applications” of a Winchester doctor alleviated (May 22, 1817)
- A seizure near the very end; when repeated, Cassandra describes it as faintness (July 20, 1817)
Her Self-Diagnosis
What did Austen think she had? On Jan. 24, 1817, she wrote, “I am more & more convinced that Bile is at the bottom of all I have suffered, which makes it easy to know how to treat myself.” And again on April 6, “I have been suffering from a Bilious attack, attended with a good deal of fever.”
Bile is often mentioned in Austen’s letters as a source of disease for her family and friends. The liver produces bile as part of the digestive process. She implies that she has a digestive disorder.
On Feb. 21, 1817, Austen wrote, “I am almost entirely cured of my rheumatism, just a little pain in my knee now & then, to make me remember what it was, & keep on flannel.” March 26, 1817, she wrote, “I have still a tendency to Rheumatism.” So at this point she attributed her pain and weakness to rheumatism in her joints.
Contemporary Treatments
In Austen’s time, doctors considered that the “humours” in the body: blood, phlegm, yellow bile, and black bile, had to be in balance. In Dr. Buchan’s popular Domestic Medicine (11th ed., 1790), he writes, “Jaundice, indigestion, loss of appetite, and a wasting of the whole body” are “the consequences of a vitiated state of the liver, or obstructions of the bile” (56).
For an intermittent fever, Dr. Buchan recommends ipecac, which will cause the patient to vomit up bile and clean out the system (150). For stomach issues caused by bile, he recommends bleeding, liquids and light foods (such as Mr. Woodhouse’s gruel), and warm baths (290-291).
For jaundice (probably what we would call hepatitis, which turns the patient’s skin and eyes yellow, from excess bile), Buchan says “numberless British herbs” supposedly cure it, but he observes that generally the disease goes away by itself, so the herbs don’t necessarily cause the cure. He goes on to recommend hempseed and several other herbs that he thinks work. He also describes other diseases as connected with bile.
John Wesley, the Methodist preacher, wrote a very popular book called Primitive Physic: Or, An Easy and Natural Method of Curing Most Diseases. It went through many editions and is still available today (I bought mine at the Wesley Museum in London). His goal was to list “cheap, safe, and easy medicines” available to “plain, unlettered” people. He marked those he had tried himself. Wesley started with lifestyle recommendations, such as, eat and drink moderately, and exercise regularly. Then he gave remedies for many diseases.
For “bilious cholic” (upset stomach ejecting bile), he recommends drinking warm lemonade or taking “sweet oil.” He gives nine remedies for rheumatism, including cold baths, warm steams, and eating barley-gruel with currants, roasted apples, fresh whey, and light pudding.
We don’t know what remedies Austen might have tried for her “bile” or rheumatism.
Mr. Curtis, her apothecary in Alton, and Mr. Lyford, her doctor in Winchester, tried to cure her, but we don’t know what diagnoses they made. For some possibilities, as well as more modern ideas, see “Did Jane Austen die from Nervous Consumption on July 18, 1817?”
Modern Theories
Many modern scholars and doctors have speculated on what might have caused Jane’s death. Here are a few of their ideas:
Addison’s disease (tuberculosis of the adrenal glands)
This theory was put forward by Sir Zachary Cope in 1964. Austen’s langour, fatigue, skin discoloration, and stomach irritability fit with Addison’s. However, her niece described her as pale, while Addison’s generally gives a tanned appearance, according to Claire Tomalin in Jane Austen: A Life. The National Organization for Rare Disorders says, though, that Addison’s can cause white patches and darker patches, including black freckles on the face, so that might fit. However, her clear mind and lack of pain towards the end do not fit with Addison’s, apparently.
Lymphoma, such as Hodgkin’s Disease, a form of cancer
A study in June 2005 gives Hodgkin’s Disease as a more likely diagnosis. This causes an immune deficiency. The article considers Austen’s medical history of recurrent infections, including possible conjunctivitis which gave her eye problems, typhus when she was a child, and the whooping cough she contracted as an adult. She may have had an immune deficiency and lymphoma for years. Jane Austen’s birth, a month late, could have made her more susceptible to an immune deficiency. Trigeminal neuralgia, causing her face pain exacerbated by cold, could also be associated with a lymphoma.
Tuberculosis, or consumption
Another writer, K.G. White, suggested in 2009 that tuberculosis, or consumption, was much more widespread in Austen’s day than Addison’s, and is another possible cause of her death. It may have been a secondary infection on top of a lymphoma.

Lupus (an autoimmune disease)
An even more recent theory claims that all Austen’s symptoms were consistent with systemic lupus erythematosus. Joint pain, skin discoloration, fever, fatigue, and fluctuating symptoms that come and go are all consistent with lupus. See “Black and White and Every Wrong Colour.”
Accidental Arsenic Poisoning
The British Library suggests that Austen may have died of accidental arsenic poisoning, from arsenic in medications or the water supply. They tested three pairs of spectacles from Austen’s writing desk, which are believed to be hers. Based on the prescription strengths, the researchers speculate that she may have gotten cataracts due to arsenic poisoning. Arsenic could also have caused her facial discoloration. See Dr. Sandra Tuppen’s article and “Jane Austen Poisoned.”
Breast Cancer
Another possibility is breast cancer, which Carol Shields suggests in Jane Austen: A Life (NY: Penguin, 2001), 173-174. Austen’s Aunt Philadelphia (her father’s sister) apparently died from breast cancer, and estrogen fluctuations might have caused Austen’s fevers.
Typhus
Another theory is that she died of a recurrence of the typhus which almost killed her as a child, while she was in Southampton. See Linda Robinson Walker, “Jane Austen’s Death: The Long Reach of Typhus?”
Overdose?
Helena Kelly, in Jane Austen: The Secret Radical, thinks that whatever Austen was sick with, “a dose of opiates strong enough to knock her out completely for nine hours has to have at least hastened her death” (282). The laudanum Dr. Lyford gave her may have been too high a dose, which caused her to eventually stop breathing.
In the end, we don’t really know what took Jane Austen away—to heaven, as her sister Cassandra strongly believed. We know she left this world before she could finish all the works we wish she might have done. But we’re thankful for those works she did complete and the legacy she left to us all.
What’s your favorite theory about what happened to our beloved Jane? Can you add any information about the possible diagnoses above?
Jane’s obituary in the Salisbury and Winchester Journal says, “Her manners were gentle, her affections ardent, her candour was not to be surpassed, and she lived and died as became a humble Christian.” (Candour at this time meant that she thought the best of people, as Jane Bennet did.) (Quoted in Claire Tomalin, Jane Austen: A Life.)
For spiritual and religious aspects of death in Austen’s novels and in her experience, see my article in Persuasions On-Line, “Preparation for Death and Second Chances in Austen’s Novels.”
You can connect with Brenda S. Cox, the author of this article, at Faith, Science, Joy, and Jane Austen or on Facebook.
204 years ago! It sounds as if whatever killed her must have been draining her energy for a while; it’s amazing she was as productive and as cheerful as she was.
🤍 204 years, to the day, since the dear soul passed. Thank you Jane, your work has kept my spirit up at darker times, for like thirty of my years. You bring love in a sentence, really long and beautiful ones.. Bless you forever! 🤍
Such a fascinating dive into detection of her mortal illness.
I sympathise with Jane, I live with constantly fluctuating malaise, fatigue, muscle and joint pain, headaches, internal inconsistency and a poor immune system. My symproms however are caused by Myalgic Encephalomyelitis, also called ME, Chronic Fatigue Syndrome and linked by some doctors to Fibromyalgia. It doesn’t kill you but it sure makes life hard. And as it compromises the immune system, I make suggestion that she may have had some chronic illness which made her more susceptible to something which proved fatal [especially if helped along by too much laudanum.] ME is a disease of a relatively affluent society as it is often found in people who would have died of a childhood ailment early in life [mine was rheumatic fever] which Jane had with the typhus. The regency fiction trope of the fading woman surrounded by patent nostrums on a day bed suffering mysterious and invisible symptoms doe actually fit ME very well…
… and she did say that stress or shock made her iller. this is classic for ME….
You mention John Wesley. I am not sure whether he was the Wesley that Beau Nash confronted when he was speaking in Bath.Everytime I read about how Beau Nash tried to confront him I cringe. Nash had not prepared any sort of argument . He hadn’t read or heard any of Wesleys sermons and writings. I don’t think Wesley too to be fair knew a lot about Nash’s thoughts and beliefs. However because Nash was the protagonist he failed, as he should have done. Any good debator should know their stuff. What i think is that the so called debate set up the two sides in opposition. Really a coming together of ideas and an acknowledgement of the strengths and weaknesses of both sides should have been a better result. As for eating healthily and being fit, Wesley had some obviously good sensible ideas. But I think many cultures and groups came to similar conclusions. If you look at the Ancient Romans diet or the Ancient Greeks or the Egyptians Mediterranean cultures have always had healthier diets than us lot. Some great points and issues above Brenda that could be explored more. All the best, Tony Have you ever visited Winchester and the JA sites including the house her Dr lived in and where she died?
I believe she had an auto-immune disease of some type, a type of rheumatoid disease which can affect the bones and organs of the body.
LUPUS has been known to cause skin darkening when the skin is exposed to sunlight. More than likely, physicians of the time would have her be in the fresh air as part of her medical therapy and a parasol or bonnet can only cover up so much skin.
Thanks for this great post! This is such an interesting question. Her relatively early death has always seemed to me such a tragic loss to literature. If only someone could have traveled back in time to figure out what was wrong with her! :)
Thanks to all of you for sharing your thoughts.
Yes, Tony, I’ve been to Winchester and the cathedral, though I only saw the house she died in from the outside.
Flynn, yes, I love the Jane Austen Project ideas on her death; and particularly what might have happened if she hadn’t died then!
It is amazing to me also that, sick as she was, she was able to start Sanditon, writing about hypochondriacs, and that she wrote a poem about Winchester races. An amazing lady, all the way to the end!
Also, yes, Tony, it’s the same John Wesley who Beau Nash confronted in Bath. Wesley wrote about quite a range of topics. For those who aren’t familiar with Wesley, John Wesley was an Anglican clergyman who led the Methodist movement in England, which eventually resulted in the Methodist denominations. He often preached outdoors, as many clergymen would not allow him to preach in their pulpits. Here’s the story of his encounter with Nash, as I’ve found it and written about it for my book:
‘In 1739 in Bath, Beau Nash, arbiter of fashion, attempted to stop John Wesley from preaching to a crowd of rich and poor.[1] Nash accused Wesley of breaking the law, and frightening people “out of their wits” with his preaching. Nash admitted, however, that he had not heard Wesley preach, but judged “by common report.” Wesley responded that he would not judge Nash by common report. That silenced Nash briefly. Nash then challenged the crowd, asking what they had come for. An old woman told him they had come for food for their souls. Nash left, outdone by John Wesley. Wesley and his friends then prayed for Nash and for “all the despisers.”’

[1] John Wesley, Journal, June 5, 1739.
The last bio on Jane Austen had been solved by the writer. Something I knew myself. Doctors still did not know what to do with a patient. One of hers gave her arsenic, which kills rats…with enough.They were given from doctors for all kinds of symptoms…She was in a great deal pain in her stomach. Sounds like poison to me.
catching up after vacation…
as someone trained as a non-clinical facilitator for an autoimmune disease support group, I’ve learned that speculation isn’t science, so I will refrain from picking a potential diagnosis.
denise
oh speculate! it may be bad science, but debate is also good
Denise, I can see that speculation isn’t science–however, when we’re looking at history (not science), all we can do at this point is speculate! :-) We can’t come to any real conclusions. Mostly, to me, though, it’s amazing to see what a range of speculations are out there on this topic!