Did Tainted Cow’s Milk Kill Jane Austen?

New York City’s Morgan Library and Museum, which began as financier J.P. Morgan’s private collection, is offering a comprehensive look at the life and works of esteemed English novelist Jane Austen. The new exhibit, entitled A Woman’s Wit: Jane Austen’s Life and Legacy, includes the only surviving complete draft of an Austen novel, early editions of her published books, and many personal letters, most of which the Morgan Library has not made publicly available in over 25 years.

A part of the exhibit focuses on Austen’s mysterious illness and eventual death on July 18, 1817 at age 41. The display is small, but its contents are the subject of great contention among Austen devotees and scholars of literature and medicine.

In some of her final letters, Austen complained of nausea and vomiting—which she calls “bilious attacks”—as well as fatigue, fever, knee pain and discolored skin that was “black and white and every wrong colour,” as she wrote to her niece Fanny Knight. For nearly the past fifty years, biographers, literary experts and doctors have offered various diagnoses of Austen’s declining health, attempting to piece together the clues in her personal correspondence.

First was surgeon Zachary Cope, whose 1964 diagnosis of Addison’s disease is still widely accepted by medical experts and Austen fans alike. Addison’s is a rare disorder in which the adrenal glands—walnut-sized hormone factories that sit atop the kidneys—fail to produce sufficient amounts of hormones necessary for normal health. Skin discoloration, severe vomiting and fatigue are usually observed.

Few voices disagreed until 1997, when biographer Claire Tomalin alternatively suggested lymphoma, a cancer of the immune system. With the guidance of physician Eric Beck, Tomalin argued that Austen’s illness progressed too irregularly to be Addison’s. Several literary and medical experts supported her new analysis.

Now, British medical researcher Katherine White says her fresh examination of Austen’s correspondence shows neither Addison’s nor lymphoma is the correct diagnosis. She thinks Austen died after drinking some tainted cow’s milk.

White, coordinator of the Addison’s Disease Self-Help Group in the United Kingdom, centers her argument on two observations. The first is that neither Austen nor her family mentioned any serious weight loss—a hallmark of Addison’s. White also points to a particular quote from Austen’s letters: “My head was always clear and I had scarcely any pain,” which Austen wrote only two months before her death, after recovering from a particularly severe episode of her illness. Austen even dictated 24 lines of comic verse to her sister Cassandra 48 hours before her death. According to White, these clues don’t fit with the intense migraines, slurred speech, confusion and loss of concentration that characterize Addison’s.

Although she concedes that other features of Austen’s illness do point to failure of the adrenal glands, White thinks the most likely cause of death is tuberculosis (TB), a lethal bacterial infection. TB—or the consumption, as it was called—claimed many lives in Jane Austen’s time, including that of her contemporary John Keats, the Romantic poet.

As pasteurization was not yet standard practice at the time of Austen’s death, White speculates that unpasteurized cow’s milk is a likely source of the bacteria. Tuberculosis could explain all of Austen’s symptoms, except perhaps her discolored skin—which White and some Jane Austen fans suggest is nothing more than dark circles under the eyes brought on by the exhaustion of illness.

White’s new hypothesis is certainly intriguing, but there are a few problems. An often bloody chronic cough afflicts the vast majority of those with tuberculosis, but coughing doesn’t feature in Austen’s surviving letters. It is also rather odd that Austen—a writer of extremely precise language in both her fiction and letters—would describe her skin as “black and white and every wrong colour” merely because of dark circles under the eyes.

The real difficulty here is that no one can be sure what Austen and her family simply left out of their letters—or what was deliberately concealed. Cassandra Austen infamously burned the majority of her sister Jane’s personal correspondence and censored many other letters by cutting out lines—as can be seen at the Morgan exhibit.

If Austen could witness the debate her illness has inspired she would likely disapprove—probably with some taut little retort of subtly balanced irony and wit. Her novels routinely mock characters that are too preoccupied with poor health, especially those who complain excessively about minor ailments or pretend to be sick when it suits them.

But Austen was not unaware of the swift and unexpected consequences that can accompany genuine illness. She saw several friends and family members buried in her own lifetime.

“I must not depend upon ever being blooming again,” Austen wrote to her niece in a March 1817 letter. “Sickness is a dangerous indulgence at my time of life.”