This essay is the eighth in a series of twelve, describing some of the places associated with Jane Austen, although it is not a comprehensive gazetteer.


(i) Medicine in the Early Nineteenth Century

Jane Austen’s health was deteriorating in her later years in Chawton Cottage. She was clearly unwell by early 1816, when she was forty-one. Her condition gradually declined, and she was frequently confined to bed through weakness, but made light of it, being glad that she “had scarcely any pain.”

Some effort is needed to grasp the nature of medicine in the late eighteenth and early nineteenth century when Jane was ill. Anatomy was well-advanced, so that surgery for broken bones and superficial wounds was normally successful. In the absence of anaesthetics, surgeons were judged by the speed at which they could perform simple operations, and they were literally timed by a stop-watch.

The idea that bacteria or “germs” caused many infectious diseases was then unknown, and fifty years away, in the future. Illnesses due to malfunction of organs was still a mystery, because the general physiology of major organs like the liver, pancreas, kidneys, spleen, thyroid and adrenal glands was not understood. There was some suspicion of the scientific advances being slowly made, as illustrated by a popular contemporary of Jane Austen, the cartoonist James Gillray, (1757 – 1815), satirising the new development of vaccination.

It had long been known that milkmaids never seemed to develop the pockmarks of the skin disease “variola” or smallpox. It was theorised that the reason was because they became infected by “vaccinia”, the much milder disease, cowpox, from the cattle they milked. This theory was tested by deliberately giving patients a cowpox infection. A new medical term was invented, and “vaccinia- inoculation” became contracted to “vaccination” eventually becoming a general word, meaning inoculation against a wide variety of other illnesses.

Vaccination sounded like a very strange practice, but it was no worse than some of treatments used by doctors of the time, that were almost always useless or even harmful. Drinking seawater brought no benefits, and, if it was contaminated with sewage, it would cause illness. Blood-letting was still practised, often by “cupping” with wine glasses, and this was completely useless, and could lead to needless skin infections. Within the pharmacopaeia of compounds, to be prescribed as medicines, only a few were of any use. Opiates, like laudanum, (morphine) were freely available, and useful for pain relief, but were addictive.

(ii) Lodging in Winchester

Poor Jane would have been safer to avoid the ministrations of supremely confident, but woefully ignorant doctors. However, it always seems cruel to deny current medical attention to suffering patients, and as Maggie Lane sympathetically explains, “If she had to die, she would surely have preferred to do so at home, in her beloved Chawton, amid the peace of the countryside. But in May, 1817, she was advised to go to Winchester for the sake of the medical attendance there.” (Ref B)

She was in lodgings at No. 8, College Street (3) and seemed content with her new surroundings. Maggie Lane quotes a letter from Jane, ‘Our lodgings are very comfortable. We have a neat little drawing-room with a bow-window overlooking Dr Gabell’s garden’ and Maggie went on, “Beyond the garden rose the towers of the cathedral (1, 4). It was to be her final resting-place.” (Ref B)

(iii) What was Jane’s Illness?

The nature of Jane Austen’s illness has been a subject of interest for retrospective pathologists, trying to diagnose it from the known symptoms. Dr Vincent Cope, in 1964, suggested that it was Addison’s disease, but other physicians have thought that Hodgkin’s lymphoma was more likely. Medical sources for these opinions are given in greater detail in Reference D.

Addison’s disease is named for Dr Thomas Addison (1793 – 1860), and is an endocrine disorder, caused by a deficiency of secretions by the adrenal cortex. It causes low blood pressure, anaemia, low blood sugar, muscular weakness, and intestinal upsets. Hodgkin’s lymphoma is named for Dr Thomas Hodgkin (1798 – 1866) and is a cancer of the lymph nodes, causing their enlargement, and involving the blood producing tissues like bone marrow. These definitions are simplified from Reference C.

Had Jane Austen’s physicians in Winchester known the cause of her illness, whether AD or HL, there was nothing they could have done about it, because the appropriate medical technology was not available at that time. The wisest course would have been to make her comfortable, ease her pain, and allow her to die quietly, in the happy surroundings of her Chawton home in the Hampshire countryside.

(iv) Marking Jane’s Passing

Jane Austen died on the 18 July 1817, and was buried in the Cathedral, after a short ceremony. The memorial slab (5) mentions her father, and the Rectory of Steventon, but there is no reference to her as an author. Visitors are often surprised at this, but at the time of her death, although Jane had been published, she had not achieved the world-wide fame she has today. Consequently, the Cathedral authorities have placed an upright memorial board, close to the grave slab, explaining that this is indeed the resting place of the now famous author.

Jane had the close support of her sister, Cassandra, in her final days in Winchester. An excellent silhouette picture of Cassandra (6) still exists, but there is no good contemporary image of Jane herself. In my humble opinion, this picture gives us a better feel for Jane’s appearance and style, as the two sisters were only two years apart in age; Cassandra being the older.

The best image we have of Jane herself is a water-colour made by Cassandra (7). Both portraits exhibit similar features; a small neat head, long, slim neck, small chin and mouth, slightly prominent straight nose, and a broad flat brow.

(v) The County of Hampshire

I want to close with a personal appreciation of Jane Austen’s much loved home county of Hampshire. Over the years it has become one of my favourite English counties too. My first visit to Hampshire was as a teenager in the fifties when I hitch-hiked to Winchester and Southampton. In the sixties I was living and working in West Sussex, the neighbouring county and I often visited Hampshire in connection with my job. I had a friend in Steep, a Hampshire village close to the market town of Petersfield, and having stayed with him, and his young family, many times, I came to know the area well. The villages of Selborne (1) and Chawton (9) are not far away.

Steep is a quite pretty village, but the photograph shows perhaps the dullest part, known as “Steep Crossroads”. My friend’s house was directly opposite “The Cricketers Inn”, out of the picture on the left. In the background are the thickly wooded steep chalk hills giving the village its name.

In the eighties, I was doing some family history research in the pre-digital age of microfiche records. I stayed in a small B&B in the St Cross Road in Winchester, a short walk from the Hampshire Records Office. I had found that my paternal ancestors came from Hampshire, mainly in villages like Michelmersh and Mottisfont, west of the small market town of Romsey.

Many years before, I had read about the Hospital of St Cross, in HV Morton’s book, “In Search of England”. It is not a modern hospital but a medieval retirement home. As it was only a short walk down the St Cross Road I made my first visit there, and demanded the “Wayfarer’s Dole”, a slice of bread, and a quarter pint of beer in a china mug, given freely to anyone who asks.

The elderly pensioners of St Cross live in the individual bed-sitting rooms, facing the quadrangle lawn. Each has its own fireplace, and a centrally-facing stone chimney stack. The Gatehouse is on the right, and the Porter’s Lodge, where the “Dole” is given, is under the arch, to the right. Their Church is behind the viewer. All the residents wear a formal uniform coat, which they wear as a matter of pride.

Later on, in the nineties, I had joined the National Trust and visited such Hampshire houses as Mottisfont Abbey, which were no doubt well-known to my ancestors as, “the big house”, where they may have worked as maids, gardeners or estate labourers on the farms.

I close with a picture of the glorious rolling wooded hills above the village of Steep; a scene which would have been very familiar to Jane Austen in the pre-industrial world, two hundred years ago.



A. “Britain – The Mini-Book of Aerial Views” Photographs by Adrian Warren and Dae Sasitorn, Last Refuge, 2007

B. “Jane Austen’s England”, by Maggie Lane, Robert Hale Ltd, 1986

C. Churchill Livingstone Nurses’ Dictionary, editor Nancy Roper, Ch. Li. 1978

D. “Jane Austen” Wikipedia article

E. “Treasures of Britain”, Everyman, 2002


1. Winchester Cathedral (Ref A)

2. The alarming effects of vaccination, according to James Gillray (Google images)

3. No. 8, College Street, Winchester, Jane Austen’s final lodging in 1817 (Author)

4. Winchester Cathedral (Ref E)

5. The tomb of Jane Austen in Winchester Cathedral (Ref D)

6. Silhouette of Cassandra Austen (Ref D)

7. Jane Austen as seen by her sister Cassandra (Ref D)

8. “The Cricketers Inn”, Steep, Hampshire (Google images)

9. The Quadrangle of the Hospital of St Cross, Winchester (Google images)

10. Mottisfont Abbey, Hampshire (Author)

11. Hampshire countryside, seen from hills above Steep (Google images)





A Hampshire Childhood Introduction-Reminders of the Past
B Kent Country Houses “Improvements”, and Garden Design
C City Elegance History of Bath, Neo-Classical Architecture
D Coastal Scenes Sea Drinking and Sea Bathing
E The Bristol Avon
F The Warwickshire Avon and the Cotswolds Adlestrop
G Return to Hampshire Portsmouth Point
H Winchester Days Medicine in the Early Nineteenth Century
I Locations “Sense and Sensibility” The Regency Period
J Locations –”Pride and Prejudice” The Picturesque
K Locations – “Mansfield Park” and “Emma” The Ha-Ha Boundary, “Lovers’ Vows” play
L Locations-“Northanger Abbey” and “Persuasion” The Gothic Novel, Irish History
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