Scholars still searching for the cause of Jane Austen's early death

As the world marks the 250th anniversary of Jane Austen's birth on 16 December, researchers are still debating what killed the novelist at just 41, more than two centuries after her death at 8 College Street, Winchester, on 18 July 1817.

With no surviving medical records or death certificate, researchers have had to reconstruct Austen's decline from her own letters, Ashley Strickland writes for CNN.

A 1964 paper first proposed Addison's disease, a rare adrenal disorder; later theories pointed to stomach cancer, tuberculosis or Hodgkin's lymphoma, conditions that share symptoms such as fatigue, weight loss, poor appetite and intermittent fevers.

Devoney Looser, an English professor at Arizona State University, said Addison's remains the most cited answer, partly because it has been repeated so often, while a slow-growing lymphoma has more recently gained support – though neither fully explains the evidence.

The late neuro-ophthalmologist Dr Michael Sanders, a long-time Jane Austen Society member who lived near Austen's Hampshire home for more than 20 years, spent his retirement investigating the case with fellow consultant Dr Elizabeth Graham.

The pair, who had treated many young patients with lymphoma, lupus and tuberculosis during their careers, reviewed every surviving Austen letter and consulted the late Austen scholar Deirdre Le Faye before publishing their findings in the journal Lupus in January 2021, months before Sanders' death in 2022.

Austen's most persistent complaint was rheumatism – pain in her back and knees – alongside fatigue, fevers and a discoloured facial rash she described as leaving her “black and white and every wrong colour”.

Her symptoms eased periodically before returning, and by March 1817 she was writing that “sickness is a dangerous indulgence” at her age. She and her sister Cassandra travelled to Winchester in May 1817 to see surgeon Giles King Lyford, and by mid-July, Austen's condition had sharply worsened; she dictated her final poem on 15 July, fell unconscious on 17 July, and died in her sleep in the early hours of 18 July, her head resting on Cassandra's lap.

Sanders and Graham concluded that none of the earlier theories fitted well: Austen's rash was confined to her face and came and go, unlike Addison's permanent skin discolouration; she lacked the chest or joint complaints typical of tuberculosis; and lymphoma, unusually, would not explain her spontaneous periods of improvement.

Instead, drawing on their own clinical experience, the pair proposed systemic lupus erythematosus – an autoimmune condition, first described only after Austen's death, that commonly causes joint pain, facial rash, fever and fatigue in young women and can prove fatal in their thirties or forties.

The researchers considered testing a lock of Austen's hair, held at Jane Austen's House museum, but concluded a DNA sample without its follicle would show only genetic predisposition, not confirm the disease, and decided not to pursue it.