Tuesday, December 01, 2009

Jane Austen 'died of tuberculosis not hormonal disorder'

Jane Austen probably died of tuberculosis after drinking unpasteurised milk rather than falling victim to a rare hormonal disorder as is generally assumed, research shows.

 

By Matthew Moore
Published: 8:00AM GMT 01 Dec 2009

 

 

The Pride and Prejudice novelist's premature death aged just 41 has long fascinated medical historians, with several explanations offered for her assorted and curiously mild symptoms.

 

Most biographers have accepted a posthumous diagnosis published in 1964 that she was one of the first known sufferers of Addison's disease, in which patients' adrenal glands fail to produce sufficient steroid hormones.

 

But a new reading of Austen's letters indicates that the Emma and Persuasion author was far too lucid in her final days in 1817 to have been dying of Addison's, whose victims usually endure a loss of concentration bordering on delirium as their condition worsens.

 

Austen was part way through her seventh novel Sandition when she succumbed to the sickness that had dominated her past two years, and was cogent enough to dictate lines of comic verse from her sick bed just 48 hours before her death.

 

Two months earlier she had written to a friend: "My head was always clear, and I had scarcely any pain."

 

Katherine White, a scholar and Addison's sufferer, wrote in the Medical Humanities journal that this evidence alone appears to rule out Addison's.

 

"While Austen was undoubtedly an exceptional intellect, this clarity of thought is not typical of advanced adrenal failure," she wrote.

 

"Extreme sleepiness, slurred speech, confusion or a semi-conscious state of characteristic of adrenal crises."

 

Addison's was first proposed as the cause of Austen's death by Sir Zachary Cope, a respected surgeon who specialised in abdominal conditions.

 

He based his diagnosis – proposed nearly 150 years after her death – on letters sent by the author in which she lamented her bed-ridden exhaustion, bilious attacks and rheumatic pains. Austen's skin also changed tone, turning "black and white and every wrong colour" as she wrote in a letter to her niece.

 

While acknowledging that these symptoms could indicate Addison's, Mrs White argues that an apparent improvement in Austen's condition as death approached pointed to alternative explanations.

 

"The absence of pain during her final months is revealing: intense migraine-like headache and generalised arthralgias are the norm for contemporary patients." she wrote.

 

That the comic writer did not appear to suffer severe weight loss further undermines the Addison's diagnosis, according to White.

 

She suggests that disseminated tuberculosis affecting the joints and liver – which Sir Zachary proposed as a possible cause of the Addison's – offers a "simpler" and sufficient explanation for Austen's symptoms, particularly as it was rife in the early 19th Century.

 

The infection likely had bovine origins, she adds, suggesting Austen may have ingested bacteria by drinking milk that had not been treated, like many of her contemporaries.

Austen died in the Hampshire town of Winchester where she had travelled for medical treatment. She was buried in Winchester Cathedral.

 

Historians have struggled to decipher the private life of the woman behind some of the most enigmatic characters in English literature because her sister Cassandra burned many of her letters and documents after her death.

 

Tuberculosis was the biggest killer in 19th century Britain, but today almost all strains can be controlled by antibiotics. Addison's disease used to be fatal but steroid replacement therapy now allows most sufferers to live a normal life.

 

From http://www.telegraph.co.uk/culture/books/booknews/6692503/Jane-Austen-died-of-tuberculosis-not-hormonal-disorder.html

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