I keep track of the questions that bring readers and other curious parties to my website. A surprising number of people are interested in Anne de Bourgh’s inheritance, a scheme which I outlined in a 2014 blog post. A 2015 blog post considered Anne’s arranged marriage to her cousin Fitzwilliam Darcy. With this blog post I address one of the first questions I asked when writing Anne’s story for my novel Rosings Park: What sort of illness made Anne “sickly and cross”?

What We Know about Anne from Pride and Prejudice

Miss Elizabeth Bennet had no very good opinion of Miss Anne de Bourgh, the heiress of Rosings Park. Here is what she tells Maria, Mrs. Collins’s sister, when the two of them are observing Anne and her companion, Mrs. Jenkinson, talking with Charlotte Collins out on the drive:

“I like her appearance,” said Elizabeth, struck with other ideas. “She looks sickly and cross. Yes, she will do for him very well. She will make him a very proper wife.”1

Miscellaneous pollen, obtained from the Dartmouth College Elect Microscope Facility (Source: Wikimedia Commons)

Miscellaneous pollen that might contribute to rhinitis (Image obtained from the Dartmouth College Electron Microscope Facility) (Source: Wikimedia Commons)

So here we have it: Anne de Bourgh’s character is forever fixed as sickly. But why is she sickly? What physical problems might beset her? Answering these questions proved a challenge. I read snippets of medical books published between 1795 and 1830 looking for a likely culprit. My thinking went like this: the illness must be fairly serious, perhaps one that nearly killed her. But so many illnesses were deadly then, the illness could not be too deadly. It should have lingering aftereffects—symptoms that would come and go. Perhaps infectious rhinitis would do, but I found no evidence that doctors recognized rhinitis back then. (Dr. Buchan’s popular treatise, Domestic Medicine, does not mention rhinitis.2) I must search for something suitable, but where to start? Ah, I should examine the reports of diseases in London, where Anne was residing when she became ill.

The Backstory to Anne’s Illness

In thinking about Anne’s illness, I had to work backwards from Jane Austen’s novel Pride and Prejudice (P&P), which was published in 1813. In my novel, titled Rosings Park, Anne is twenty-six years old. The action in Rosings Park is built around the action in Pride and Prejudice and begins in March, when Miss Elizabeth Bennet, along with Sir William Lucas and his daughter Maria, arrive in Hunsford, Kent, to visit Sir William’s newly married daughter, Charlotte Collins. Rosings Park is the de Bourgh’s estate situated near Hunsford, you may recall.

In my second novel—Cousin Anne—Miss de Bourgh is seventeen. Cousin Anne is a prequel to Pride and Prejudice. Its story, set in London, includes many familiar characters: Mr. Darcy, Colonel Fitzwilliam, Mr. Wickham, and, of course, Anne’s mother, Lady Catherine. Cousin Anne also brings to life several other characters: Anne’s father, Sir Lewis de Bourgh, and Darcy’s parents. I knew when I sat down to write this prequel that Anne would suffer a serious illness. But what sort of illness?

Diseases Reported by the Public Dispensary

Diseases in Eastern London, 1803

Diseases in Eastern London, Nov/Dec 1803 (screen shot)2

I began by browsing for information about diseases in London. I found, for instance, this list of acute, chronic, puerperal and infant diseases in an eastern district of London between November 20, 1803 and December 20, 1803.

Among the acute diseases, note that ten individuals were diagnosed with “pneumonia,” a category divided into two parts: Pneumonia and Peripneumonia Notha. Five persons had dysentery, five had smallpox (Variolae) and four presented with acute rheumatism. The leading chronic cases included tussis (cough) and tussis cum dyspnoea (a cough plus other symptoms, such as a hard and fast pulse, side stitches, and bleeding).3 There were increased cases of coughs and catarrhs (common colds), as was expected during the autumn months. More worrisome was the increase in smallpox cases, for which the mortality remained “very considerable.”

The table provides a good example of how hard it can be to understand how diseases were classified in the early 1800s. The disease Peripneumonia Notha was not described in the 1803 journal from which the table was taken, but I stumbled across a summary of diseases for April and May of 1812 that mentioned Peripneumonia Notha. Dr. Fothergill described this condition as “an urgent and dangerous disease” and lamented the use of the term because its meaning—”bastard pneumonia”—was barbarous. Interestingly, Google Translate converts the Latin to English in this manner: “counterfeit pneumonia,” which doesn’t sound quite so disreputable.

Reports of Diseases at the Public Dispensary in London

Diseases Observed by the Public Dispensary, London, 1804

Diseases Observed by the Public Dispensary, London, 1804 (screen shot)3

The Public Dispensary in London also reported diseases. The table at right shows the acute and chronic diseases listed by the Dispensary for the months of September through November, 1804. Among acute diseases, catarrhs or colds led the list with 40 cases, followed by Synochus (a type of fever), pneumonia, cholera, typhus, and scarlatina. (Today the word “scarlatina” is synonymous with “scarlet fever,” but in Jane Austen’s day, scarlatina was considered a less severe form of scarlet fever.5) Acute rheumatism affected two individuals. Thirty people were ill with asthenia or general weakness.

Organizing My Thoughts on Anne’s Illness

My first thought was this: how lucky I am to live in the 21st-century! I am not likely to contract typhus or cholera—both caused by bacteria—because I live in the US where public sanitation is very good. I was inoculated against smallpox and had rubeola (measles) and pertussis (whooping cough) as a child. But what about Anne? After studying the list of common diseases in London during the early 1800s, I became interested in rheumatism. Had I found a likely cause of Anne de Bourgh’s sickliness?


1Austen, Jane. Pride and Prejudice. London: Penguin Books, p. 156 (chapter 28).

2Buchan, William. Domestic Medicine. (Boston, 1811).

3Anon. Medical and Physical Journal, vol XI (January-June), 1804, p. 83 (PDF p. 106).

4Dr. Fothergill’s table. The Monthly Magazine, vol. XXXIII, 1812, p. 499 (PDF p. 510).

5Clark, John. Observations on Fevers, Especially Those of the Continued Type; and on the Scarlet Fever Attended with Ulcerated Sore-Throat. (London, 1792), pp. 354-355 (PDF pp. 387-388).