Among the wicked caricatures that people Jane Austen’s novels, the hypochondriac, in various guises, makes regular appearances. They are often fairly prominent characters, such as one of the protagonist’s parents in Pride and Prejudice and Emma or her sister in Persuasion, but their ceaseless complaining is rarely allowed to bore the reader. Yet Jane Austen, despite ruthlessly infecting her characters with unidentified complaints as necessary plot points, also portrays real illness with a warmth of sympathy untroubled by her lack of medical understanding.
Although the Georgian period saw many medical advances, there was also a great deal of medical ignorance and quackery. The period that pioneered inoculation in Europe owing to the descriptions of its success in Turkey from Lady Mary Wortley Montagu, also swore by bloodletting – through ‘cupping’ or with leeches – as a remedy for nearly everything, and built a society season around drinking and bathing in water with supposed healing or purifying qualities.
Like most other matters in feudal Georgian society, health and medicine were strongly linked to differences in class and gender. Clean water was not always available, particularly to the urban poor; and with the rise of industrialisation leading to overcrowding in the cities, personal hygiene was difficult to maintain. Whilst labourers in the countryside might be able to grow some produce, the poor in the cities did not have access to a balanced, or even sufficient, diet. For the wealthy, although they had better supplies of clean water and fresh vegetables, personal hygiene and healthy nourishment were simply not a great priority. The difficulties of obtaining clean water also meant that a great deal of ale and wine was drunk, which caused many alcohol-related complaints, with many elderly people of the wealthier classes incapacitated by gout.
With sources of infection everywhere, disease could strike suddenly and with devastating effects, such as the rheumatic fever that crippled the still relatively young Mrs Smith in Persuasion, or the influenza that follows Marianne Dashwood’s broken heart. These cases, with Marianne’s romantic tossing and turning and Mrs Smith’s cheerful forbearance, are very sympathetically treated by Jane Austen, as are the family’s fears after the accidents suffered by Mary Musgrove’s son, or Louisa Musgrove, in Persuasion: with inexpert bone setting or inadequate aftercare, a bad fall could easily lead to infection or fever which could snatch away a child or healthy young woman.
One matter which Jane Austen is careful not to address, but which comes to mind in the context of the fragile health of young Georgian women, is childbirth, which was the primary cause of death for women for centuries. There was no official training for midwives and nurses, and home remedies were heavily relied on. In case of complications, medical personnel were often helpless, as in the case of Princess Charlotte, daughter of the Prince Regent and heir to the British throne, who died after giving birth to a still-born son in 1817, in the same year as Jane Austen, and three years before her father would become king.
Jane Austen herself, although she never had to endure the strains of childbearing, died of still unidentified causes at the early age of 41, at the height of her fame and creativity. For a long time, the most popular suggestion for her cause of death was Addison’s Disease, although cancer has also been suggested. The most recent and controversial ideas about Jane Austen’s death, however, have come from crime writer Lindsay Ashford, who discovered in the dying Jane Austen’s letters clues which, she claims, are indicative of arsenic poisoning. This is not impossible since, frighteningly, arsenic was a popular Georgian medicine, and it is quite likely that Jane Austen may have had it prescribed to her as a cure for some other disease. Ashford’s ominous suggestion of murder does not seem to apply to the domesticated spinster at her writing table in secluded Chawton, but the theory of arsenic poisoning must remain a plausible mystery since, as Ashford points out, ‘it wasn’t until the Marsh test was developed in 1836 that human remains could be analysed for the presence of arsenic’.