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Jane Austen’s Autopsies

Watercolor and pencil portrait of Jane Austen by Cassandra Austen

I confess I have not watched the much-maligned adaptation of Persuasion that dropped on Netflix yesterday. But wait, there’s more: I have never read Persuasion. I know. I know. Just as soon as I am finished here, I will slam this laptop closed in trepidation and shame and await the revocation of my English PhD. The truth is, I know almost nothing about Jane Austen other than that she once maybe, allegedly, fainted and that she is now certainly, for one reason or another, dead.

In December 1800, Jane Austen fainted—shocked into prostration, apparently, upon learning that her family would be leaving their native Steventon and relocating to Bath. However apocryphal, as life writing scholar Hermione Lee observes, the episode has long been a touchstone for those invested in Austen’s life narrative. “No biographer of Jane Austen leaves out the faint,” Lee writes, “but all of them have to decide what to do with the story” (83). In other words, Austen’s chroniclers must determine whether and how to assign meaning to the twenty-five-year old author’s loss of consciousness—a fraught task, since Austen herself relentlessly satirized fainting in her fiction, along with the “cult of sensibility” it represented. As Naomi Booth notes, “by the time Austen was writing, the swoon had become a specifically feminine and eroticized impasse under the rubric of sensibility,” and Austen seized the opportunity to excoriate it (576). (In a Guardian list of “The top 10 literary swoons,” Booth places Persuasion’s at #5).

Persuasion was published posthumously, the year after Austen died of—well, something. Scholars have squabbled over diagnostics, in what Lee refers to as the “long and continuous battles for possession of the posthumous body of Jane Austen” (94). What is clear is that, in the summer of 1816, Austen fell rather suddenly and mysteriously ill. She complained of weakness and fatigue, fevers, and pain in her back and knees that sometimes rendered her unable to walk. Despite reporting herself “almost entirely cured of my rheumatism” in February 1817, and “tolerably well again” in mid-March, by the end of the month, she confessed, “I certainly have not been well for many weeks, and about a week ago I was very poorly. I have a good deal of fever at times, and indifferent nights; but I am considerably better now and am recovering my looks a little, which have been bad enough—black and white and every wrong colour. I must not depend upon being ever very blooming again. Sickness is a dangerous indulgence at my time of life” (Austen-Leigh 383).  She was forty-one.  

Austen fell deeper into the “dangerous indulgence” almost immediately; by July, she slipped into an oblivion from which she would not awaken. “She felt herself to be dying about half an hour before she became tranquil and apparently unconscious,” her sister Cassandra wrote to a mutual friend days later. “During that half-hour was her struggle, poor soul! She said she could not tell what she suffered, though she complained of little fixed pain. When I asked her if there was anything she wanted, her answer was she wanted nothing but death.” Cassandra had run an errand, returning to find her sister “recovering from faintness and oppression.” Later that evening, after Jane “was seized again with the same faintness, which was followed by the sufferings she could not describe,” her physician arrived and “applied something to give her ease,” ultimately leaving the author of Sense and Sensibility “in a state of quiet insensibility” (Austen-Leigh 396). Austen lingered like this through the night; in the pre-dawn hours, she slipped out of the world without further struggle. “Her dear remains are to be deposited in the Cathedral,” Cassandra Austen wrote; “her precious soul, I presume to hope, reposes in a far superior mansion” (Austen-Leigh 397).

Austen’s body may have been buried at Winchester Cathedral in the summer of 1817, but it has been metaphorically resurrected numerous times in the two centuries since, interrogated for intimations of some illness or other. “What Killed Jane Austen?” asks a post on the blog Jane Austen’s World, rehearsing the assiduous list of symptoms scholars have culled from her letters and subjected to scrutiny: pain, fatigue, fevers, sleeplessness. Perhaps it was tuberculosis, some have suggested; perhaps typhus. In her 2011 book The Mysterious Death of Miss Jane Austen, crime novelist Lindsay Ashford spins the actual details of Austen’s illness into a fantastical whodunit, imagining a case of arsenic poisoning. Six years after Ashford’s novel was published, after testing several pairs of Austen’s spectacles in their collection, the British Library suggested that there might in fact be some credence to the arsenic hypothesis: arsenic was a common ingredient in in nineteenth-century medicine, and could result in the development of cataracts (Was Jane Austen Poisoned?” a headline in the Washington Post tantalized, after getting wind of the library’s findings. “New Evidence About the Writer’s Weakened Eyes Raises Questions”).

Deliberations over Austen’s body began in earnest in 1964, when Sir Zachary Cope published a brief article in The British Medical Journal hypothesizing that Austen had suffered from Addison’s disease, an endocrine disorder sometimes occurring secondary to tuberculosis, first described by British physician Thomas Addison in 1855, more than three decades after Austen’s death. Cope’s article reads like a courtroom transcript, with the author’s body on trial Chief among the evidence Cope presents is Austen’s own description of her symptoms—in particular, her claim of having been “black and white and every wrong colour.” Here, Cope asserts, “in Jane Austen’s pathetic lament,” we can see the “true significance of that symptom which is almost pathognomonic of Addison’s disease”: an idiosyncratic skin discoloration triggered by the pituitary gland’s overcompensation for waning cortisol and aldosterone with increased production of melanocyte-stimulating hormone. “If our surmise be correct,” Cope concludes, “Jane Austen did something more than write excellent novels—she also described the first recorded case of Addison’s disease in the adrenal bodies” (183). Beyond producing a body of work, Cope marvels, Austen produced her own body as evidence, submitted unwittingly to postmortem examination.

Others have demurred. In a brief appendix to her biography of Austen, Claire Tomalin takes issue with Cope’s diagnosis, proposing Hodgkin’s lymphoma as an alternative culprit—a conclusion also maintained by Annette Upfal in a 2005 Medical Humanities article. Like Addison’s, Hodgkin’s—which may be associated with pre-existing immunodeficiency, and is now considered one of the most curable kinds of cancer—was not identified until after Austen’s death, named for Addison’s contemporary, pathologist Thomas Hodgkin.

Men attach their names to diseases; diseases attach themselves to women.

In each postmortem report, Austen’s own accounts of her “sad complaint”—the litany of indefinite symptoms that might signify any number of things—are scrutinized for meanings that medicine might make retrospectively, eager to assign language that Austen and her contemporaries did not have. Unable to know, we might speculate endlessly, leveraging this phrase or that as the indispensable indicator. While Cope interpreted apparent hyperpigmentation as a knock-down argument for Addison’s, Tomalin’s rejection of this theory hinged on the fact that many of the other symptoms Austen described—such as recurrent fevers—are not characteristic of this diagnosis. But in addition to reminding readers of symptoms Cope ignores, Tomalin also attends to what isn’t present in Austen’s account of her illness: namely, she notes, while Addison’s does not typically produce fever, “It does, on the other hand, lead to what is known as postural hypotension, meaning that the blood pressure drops when the patient stands up, causing sudden faintness and collapse on standing. This was not noted in Jane Austen’s case,” Tomalin affirms (283). For a writer who persistently satirized gendered fainting fits, for whom a single swoon became a requisite, if contested biographical anecdote, it is a conspicuous lack of fainting that exonerates her here.

 In her biography, Carol Shields takes a different tack, instead declaring breast cancer “a very likely cause” (173) of Austen’s death, though she offers conspicuously little evidence for this hypothesis other than the fact that Austen’s aunt and cousin had both died of the disease, and “Breast cancer does appear in exactly such family clusters. The supposed “fevers” Austen suffered, Shields speculates, may in fact have been “hot flushes” brought on by an “imbalance of estrogen” (174). Last year, an article authored by emeritus consultants at London’s St Thomas’ Hospital has attempted to argue the case for systemic lupus erythematosus (SLE), yet another disease identified decades after Austen’s death. It is the disease from which Flannery O’Connor would ultimately die at the age of thirty-nine—and one, the declarers of Jane Austen’s latest retrodiagnosis note, that has “a marked female preponderance of 9:1 with age of onset from late teens, and death often occurring in the 30s or 40s” (Sanders and Graham 552). Like Shields, bent on breast cancer and its estrogenic implications, these researchers seem particularly attached to distinctly gendered explanations of Austen’s illness, as if Austen, so insistently circumscribed by the identity of woman writer, must also necessarily suffer a woman’s disease. 

On rage the battles for women’s bodies, posthumous and otherwise.

Note: The above is taken from a larger essay in progress about the phenomenology, pathology, and literary significance of fainting. I promise I will read Persuasion. Don’t @ me.

Cover Image

Cassandra Austen, Portrait of Jane Austen in watercolor and pencil. CC BY-NC-ND 3.0. © National Portrait Gallery, London

Works Cited

Austen-Leigh, William, and Richard Arthur Austen-Lee. Jane Austen, Her Life and Letters: A Family Record. Smith, Elder & Co., 1913. Google Books, 16 July 2022.

Booth, Naomi. “Feeling Too Much: The Swoon and the (In)Sensible Woman.” Women’s Writing, vol. 21, no. 4, 2014, pp. 575-591.

Cope, Zachary. “Jane Austen’s Last Illness.” The British Medical Journal, vol. 2., no. 5402, 1964, pp. 182-183.

Lee, Hermione. “Jane Austen Faints.” Virginia Woolf’s Nose: Essays on Biography. Princeton University Press, 2005,pp. 63-94.

Sanders, Michael D., and Elizabeth M. Graham. “‘Black and white and every wrong colour’: The medical history of Jane Austen and the possibility of systemic lupus erythematosus.” Lupus, vol. 30, no. 4, 2021, pp. 549-553.

Shields, Carol. Jane Austen: A Life. Penguin, 2005.

Tomalin, Claire. Jane Austen: A Life. Alfred A. Knopf, 1997.

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