Causes of Jane Austen's death
[2] The story of Jane Austen's illness has been reconstructed by Annette Upfal, who indicates at the end of her work that she has received the approval of Australian immunologist Ian Frazer.
[4] The retrospective diagnosis of the illness that led to the novelist's death is based on the following symptoms and clinical signs, which relate only to the last year of Jane Austen's life.
[9] The cardinal signs included asthenia, low blood pressure, anorexia (with weight loss) and melanoderma, with hyperpigmentation of the skin at friction points and of the mucous membranes.
Only the latter sign was specific to the disease, and Zachary Cope underlined the fact that melanoderma was not always uniform, and that "in some cases the dark patches of the skin were mingled with areas showing a lack of pigment – a true black and white appearance".
However, important associated signs that do not belong to the classic picture of Addison's disease remain poorly explained, as Claire Tomalin,[7] with the medical endorsement of Dr. Eric Beck, Fellow of the UK Royal College of Physicians,[11][N 6] was quick to point out.
In recent years medical opinion has put forward the theory, based on Jane's own description of her symptoms, that early in 1816 she fell victim to the then unrecognized Addison's Disease.
[13] Finally, some academics, such as Australian English literature professor John Wiltshire in his book Jane Austen and the Body (1992), also advocated Addison's Disease.
Bevan, only one month after the publication of Cope's article in the British Medical Journal, in the form of a short 22-line reply in which this general practitioner provides no argument other than the recollection of a personal case in which the disease ("lymphadenoma"), proven by biopsy, had had as its initial manifestation a "pain in the back" without any superficial lymphadenopathies being noted during the course.
[N 8][13] The hypothesis that Jane Austen died of Hodgkin's disease was taken up and defended 41 years after Bevan by an Australian academic, Annette Upfal, with the medical support of her compatriot, immunologist Ian Frazer.
However, A. Upfal was forced to appeal to a rare complication of Hodgkin's disease, thrombocytopenic purpura, to explain such dramatic changes in Jane Austen's skin coloration.
[6] Arguments in favor of this hypothesis include a history of severe typhus in childhood, digestive disorders ("bile"), skin signs (discoloration) and recurrent febrile attacks interspersed with free intervals.
Cope cited Jane Austen's letter of March 23, 1817 to Fanny Knight, in which she reported some improvement in her condition: as she put it, "I have recovered some of my appearance, which has been rather ugly, black and white and all colors askew".
