Jane Austen’s letters describe a two-year deterioration into bed-ridden exhaustion, with unusual colouring, bilious attacks and rheumatic pains.
In 1964, Zachary Cope postulated tubercular Addison’s to explain her symptoms and her relatively pain-free illness. Literary scholars later countered this posthumous diagnosis on grounds that are not well substantiated, while medical authors supported his conclusion.
Important symptoms reported by contemporary Addison’s patients—mental confusion, generalised pain and suffering, weight loss and anorexia—are absent from Jane Austen’s letters. Thus, by listening to the patient’s perspective, we can conclude it is unlikely that Addison’s disease caused Jane Austen’s demise.
Disseminated bovine tuberculosis would offer a coherent explanation for her symptoms, so that Cope’s original suggestion of infective tuberculosis as the cause of her illness may have been correct.
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Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Further information: Addison’s Disease Self-Help Group http://www.addisons.org.uk/.
Clinical case reports can be found at http://www.endocrine-abstracts.org/ea/0015/default.htm
↵i I am grateful to Dr Martin Farrell of the UK MedicAlert Foundation for his observations on this point, 2008
↵ii I am grateful to Professor Simon Pearce of the Royal Victoria Infirmary, Newcastle, for his views on this point, 2008.
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