{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:21:49Z","timestamp":1758759709580,"version":"3.44.0"},"reference-count":68,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Med Humanities"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:p>Jane Austen is typically described as having excellent health until the age of 40 and the onset of a mysterious and fatal illness, initially identified by Sir Zachary Cope in 1964 as Addison\u2019s disease. Her biographers, deceived both by Cassandra Austen\u2019s destruction of letters containing medical detail, and the cheerful high spirits of the existing letters, have seriously underestimated the extent to which illness affected Austen\u2019s life. A medical history reveals that she was particularly susceptible to infection, and suffered unusually severe infective illnesses, as well as a chronic conjunctivitis that impeded her ability to write. There is evidence that Austen was already suffering from an immune deficiency and fatal lymphoma in January 1813, when her second and most popular novel, <jats:italic>Pride and Prejudice<\/jats:italic>, was published. Four more novels would follow, written or revised in the shadow of her increasing illness and debility. Whilst it is impossible now to conclusively establish the cause of her death, the existing medical evidence tends to exclude Addison\u2019s disease, and suggests there is a high possibility that Jane Austen\u2019s fatal illness was Hodgkin\u2019s disease, a form of lymphoma.<\/jats:p>","DOI":"10.1136\/jmh.2004.000193","type":"journal-article","created":{"date-parts":[[2005,6,15]],"date-time":"2005-06-15T12:57:51Z","timestamp":1118840271000},"page":"3-11","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Jane Austen\u2019s lifelong health problems and final illness: New evidence points to a fatal Hodgkin\u2019s disease and excludes the widely accepted Addison\u2019s"],"prefix":"10.1136","volume":"31","author":[{"given":"A","family":"Upfal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2005,6,15]]},"reference":[{"unstructured":"Austen H . Biographical Notice of the Author. In: Sutherland Kathryn, ed. A Memoir of Jane Austen and Other Family Recollections. Oxford: Oxford University Press, 2002:138.","key":"2025092411530886000_31.1.3.1"},{"unstructured":"Tomalin C . Jane Austen: A Life. London: Viking, 1997:256.","key":"2025092411530886000_31.1.3.2"},{"unstructured":"Le Faye D . Jane Austen: A Family Record [new ed]. Cambridge: Cambridge University Press, 2004:235.","key":"2025092411530886000_31.1.3.3"},{"unstructured":"Le Faye D , ed. Jane Austen\u00e2\u0080\u0099s Letters [3rd ed ]. Oxford: Oxford University Press, 1995:xv.","key":"2025092411530886000_31.1.3.4"},{"unstructured":"Austen-Leigh JE. A Memoir of Jane Austen. Oxford: Clarendon Press, 1926:43.","key":"2025092411530886000_31.1.3.5"},{"unstructured":"Letter. Austen, George to Susanna Walter, 17 December 1775. In: Austen -Leigh RA, ed. Austen Papers: 1704\u00e2\u0080\u00931856, London: Pottiswoode, Ballantyne & Co 1942:32.","key":"2025092411530886000_31.1.3.6"},{"key":"2025092411530886000_31.1.3.7","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/00003081-198906000-00012","volume":"32","year":"1989","journal-title":"Clinical Obstetrics and Gynaecology"},{"key":"2025092411530886000_31.1.3.8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0022-3476(54)80085-0","volume":"44","year":"1954","journal-title":"Journal of Paediatrics"},{"unstructured":"Beers MH, Berkow R, eds. The Merk Manual of Diagnosis and Therapy [17th ed]. New Jersey: Merck Research Laboratories, 1999:2130.","key":"2025092411530886000_31.1.3.9"},{"unstructured":"Letter. Austen, George to Susanna Walter. 17 Dec. 1775. See reference 6 :32\u00e2\u0080\u009333.","key":"2025092411530886000_31.1.3.10"},{"unstructured":"Letter. Austen, Mrs. Cassandra. to Mrs. Walter, 20 August 1775. See reference 6 :31.","key":"2025092411530886000_31.1.3.11"},{"unstructured":"Letter, Mrs. Cassandra Austen to Susanna Walter, 6 June 1773. See reference 6 :29.","key":"2025092411530886000_31.1.3.12"},{"unstructured":"Letter, Woodman, John to Warren Hastings, 11 June 1776. See reference 6 :82.","key":"2025092411530886000_31.1.3.13"},{"unstructured":"Chapman RW. Facts and Problems. Oxford: Clarendon Press, 1948:23.","key":"2025092411530886000_31.1.3.14"},{"unstructured":"Austen-Leigh MA. Personal Aspects of Jane Austen. Folcroft, Pa: Folcroft Library Editions, 1974:22.","key":"2025092411530886000_31.1.3.15"},{"unstructured":"Macpherson G, ed. Black\u00e2\u0080\u0099s Medical Dictionary [37th ed]. London: Black, 1992:604.","key":"2025092411530886000_31.1.3.16"},{"unstructured":"Mc Phee J, Pupadakis A, Tierney L, eds. Current Medical Diagnosis and Treatment. New York: McGraw Hill, 2001:1341.","key":"2025092411530886000_31.1.3.17"},{"unstructured":"Austen Jane. Sense and Sensibility. London: Penguin Classics, 1995:287.","key":"2025092411530886000_31.1.3.18"},{"unstructured":"Letter, Jane to Cassandra Austen, 8\u00e2\u0080\u00939 January 1799. In: Jane Austen\u00e2\u0080\u0099s Letters: [3rd ed], Collected and Edited by Deirdre Le Faye. Oxford: Oxford University Press 1995:33\u00e2\u0080\u009334.","key":"2025092411530886000_31.1.3.19"},{"unstructured":"Letter. Jane to Cassandra Austen, 21\u00e2\u0080\u009323 January 1799. See reference 19 :36.","key":"2025092411530886000_31.1.3.20"},{"key":"2025092411530886000_31.1.3.21","first-page":"798","volume":"6","year":"1992","journal-title":"Infectious Disease Clinics of North America"},{"unstructured":"Letter. Jane to Cassandra Austen, 8\u00e2\u0080\u00939 January 1799. See reference 19 :35.","key":"2025092411530886000_31.1.3.22"},{"unstructured":"Letter. Jane to Cassandra Austen, 21\u00e2\u0080\u009323 January 1799. See reference 19 :36.","key":"2025092411530886000_31.1.3.23"},{"unstructured":"Letter. Jane to Cassandra Austen, 17 May 1799. See reference 19 :41.","key":"2025092411530886000_31.1.3.24"},{"unstructured":"Letter. Jane to Cassandra Austen, 16 September 1813. See reference 19 :222.","key":"2025092411530886000_31.1.3.25"},{"unstructured":"Austen C. My Aunt Jane Austen [new ed]. Winchester: Jane Austen Society, 1991:7.","key":"2025092411530886000_31.1.3.26"},{"unstructured":"Austen-Leigh W, Austen -Leigh R. Jane Austen: Her Life and Letters, A Family Record [2nd.ed]. New York: Russell, 1965:155\u00e2\u0080\u00936.","key":"2025092411530886000_31.1.3.27"},{"unstructured":"Letter. Henry Austen to Frank Austen 28 Jan 1805, and Letter, James Austen to Frank Austen 30 Jan 1805. See reference 6 :234\u00e2\u0080\u00936.","key":"2025092411530886000_31.1.3.28"},{"unstructured":"Letter. Jane to Cassandra Austen, 1\u00e2\u0080\u00932 October 1808. See reference 19 :138.","key":"2025092411530886000_31.1.3.29"},{"unstructured":"Letter. 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