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Archive for the ‘medicine’ Category

After my previous article on Regency Women: Beauty Behind the Scenes, I realized that the things I really want to know more about concerning Jane Austen’s Regency women aren’t (and weren’t) discussed as much as other topics such as beauty regimes.

I wanted to know about bodily functions (where in the world did a lady relieve herself if she was, say, at a ball?), feminine hygiene (what did women do during “that time of the month?”), and pregnancy and birth (why did so many women die as a result of childbirth?).

Finding this information wasn’t as easy as some of the other information I’ve researched over the years. Why? Because some of these topics (such as menstruation) weren’t discussed openly or written about during Jane Austen’s time. Scholarly authors and bloggers even sometimes make the joke, “maybe women didn’t menstruate back then!”

The truth is, Regency women had specific needs, just as women do now, but information about those needs was shared more discreetly. Women passed information, supplies, and advice to one another—from mother to daughter, sister to sister, cousin to cousin, and even friend to friend. Additionally, terms and nicknames were used for certain topics, such as “in that way” (pregnant); “lying-in” or “confinement” (nearing her due date); and “brought to bed” (gave birth). We can imagine that in some families, young women were informed about such topics without much or any discussion; in others, perhaps a bit more instruction was provided.

Mrs. Jennings and Mrs. Palmer, Sense and Sensibility

I can’t help wishing they had not travelled quite so fast, nor made such a long journey of it, for they came all round by London upon account of some business, for you know (nodding significantly and pointing to her daughter) it was wrong in her situation. I wanted her to stay at home and rest this morning, but she would come with us; she longed so much to see you all!”

Mrs. Palmer laughed, and said it would not do her any harm.

“She expects to be confined in February,” continued Mrs. Jennings.

Lady Middleton could no longer endure such a conversation, and therefore exerted herself to ask Mr. Palmer if there was any news in the paper.

Sense and Sensibility, Jane Austen (emphasis mine)

In attempt to shed some light on these topics, the following is an overview of each, along with a few resources that go into greater detail. As always, I heartily encourage our well-read JAW readers to comment with other resources that can help provide more information on these “privy” matters (pun intended).

Bodily Functions

At home, chamber pots were frequently used and kept under the bed, out of sight, and emptied and cleaned by a servant. A privy or outhouse was outside the home, away from the house. Many times, flowers were planted near the outhouse to help cover the odor. For an in-depth history of Regency plumbing, you can read this wonderful article from The Jane Austen Centre on The Development of Regency Plumbing.

But what about when a lady was traveling or at a ball? As some of you may already know, a fully dressed lady could (carefully) relieve herself using a small chamber pot called a bourdaloue (or bourdalou) without soiling her skirts. Her maid would stand nearby to help and/or receive the pot and empty it. (Note: Men were known to relieve themselves behind a screen into a chamber pot in the dining room.) For more on this strangely intriguing topic, you can read Vic’s engaging article, Regency Hygiene: The Bourdaloue.

Ladies Bourdaloue, a personal chamber pot.

Feminine hygiene and sanitary items

And what, pray tell, did a lady to do when menstruating? In her article “On ‘Flowers’: A short but frank post on how 18thC women dealt with menstruation,” Lucy Inglis has several interesting tidbits to share: Early sanitary pads were used by women in Georgian England, made from a variety of materials. “Women troubled by particularly heavy periods wrapped a belt or bandage about their hips and wore a baby’s muslin napkin looped over the front and back, with stitched ‘sanitary pads’ lining this loincloth.  These pads could be boiled and reused…”

As for tampons, this was surprisingly not unheard of. Early handbooks discuss “‘suppositories’ for the ‘privy place’ made from a smoothed stick, wrapped in absorbent linen rags and securely stitched. A long cord was sewn in. Some disposable; some boiled and reused” (Inglis). For menstrual cramps and other issues, herbal remedies were often used. For more on this topic and others like it, check out Inglis’ book Georgian London: Into the Streets.

Regency families were often large to account for high child mortality rates.

Pregnancy and childbirth

During the Regency era, childbirth was still one of the most dangerous threats to a woman’s health and life. Up to 20% of all women died either in childbirth, or immediately following birth, most often due to infection. (Many accounts place the infant mortality rate at about the same level.) The practice of washing hands, disinfecting instruments, and providing clean linens and ventilation in birthing chambers did not become common until about the 1840s, which then lowered the mortality rate from 18% to about 6% (Jane Austen Centre). To read an in-depth discussion of birth, birthing rooms, and advances in obstetrics, read here: “Developements in Childbirth in Regency and Victorian England: Childbirth and Lying-In during the Regency” by Kathleen Charon.

Some of the issues that plagued new mothers and babies were due to limited medical practices and a lack of simple hygiene, but there were other factors at play as well. For instance, instead of having women move, walk, and get a breath fresh air, a “lying-in” or “confinement” period was observed before, during, and even after giving birth.

During the birth, a midwife would likely be in attendance; in some instances, a doctor might come. The birthing room was heated and enclosed so that women would not catch cold; however, the stifling rooms often caused a host of other issues, including an increase in infection. After giving birth, women were kept in bed, often given only weak tea and a liquid diet, instead of hearty, nourishing foods to help her heal and gain strength.

I have just received a note from James to say that Mary was brought to bed last night, at eleven o’clock, of a fine little boy, and that everything is going on very well. My mother had desired to know nothing of it before it should be all over, and we were clever enough to prevent her having any suspicion of it…

Jane Austen’s Letters, Godmersham Park, 17 November 1798.
Queen Charlotte, King George IIIs consort, gave birth to 15 children in 21 years. These are their 6 eldest.

Indeed, life for women in Jane Austen’s Regency England, even as part of the upper classes, was uncomfortable, difficult, and dangerous. When I think of my own birth, and the births of my two children, by caesarean section, with the help modern medicine, I stand amazed at the bravery of the women who came before me. To say I’m thankful for the miraculous advances in medicine and obstetrics today would be an understatement.

This, I’m sure, is only the tip of the iceberg with these topics. If you have other resources to share, such as books, articles, podcasts, or talks, please include them in the comments! Next month, check back for my upcoming article, Regency Women: Pin Money and Private Expenses.


RACHEL DODGE teaches college English classes, gives talks at libraries, teas, and book clubs, and writes for Jane Austen’s World blog and Jane Austen’s Regency World magazine. She is the bestselling author of The Anne of Green Gables Devotional: A Chapter-By-Chapter Companion for Kindred Spirits and Praying with Jane: 31 Days Through the Prayers of Jane Austen. Her newest book The Little Women Devotional is now available for pre-order and releases December 2021. You can visit Rachel online at www.RachelDodge.com.

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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

In Sense and Sensibility, Marianne Dashwood nearly dies of an illness brought on by indulging her misery and “sitting in her wet shoes and stockings.”

 

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.

 

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