In her beguiling comic plots, Jane Austen often ridicules characters who fuss excessively about the state of their health.

The 19th-century novelist would therefore be perplexed – and perhaps amused – to discover that nearly 200 years after her death, the precise nature of her mysterious final illness has become a subject of enduring literary fascination.

Fresh, retrospective analysis of her symptoms, published today, suggests that the author of Pride and Prejudice may have died prematurely of tuberculosis caught from cattle.

Examination of Austen's correspondence and the recollections of her family prove, it is claimed, that she was not, as previous medical experts hypothesised, a victim of Addison's disease, a once-fatal hormone-disrupting condition.

With her book sales still buoyant and her fiction repackaged as popular television mini-series, Austen's very private life still intrigues her modern readership, while physicians and biographers have been in dispute for the last 40 years about the precise cause of her death in 1817.

Writing in the British Medical Journal's Medical Humanities magazine, Katherine White, of the Addison's disease self-help group, presents evidence aimed at exploding one of the more widely accepted medical theories of her demise.

"Jane Austen died at the age of 41, leaving her seventh novel, Sanditon, unfinished," White says. "While she outlasted many of her peers in Regency England – she saw four of her sisters-in-law buried from childbirth complications – the cause of her death … remains tantalisingly open to posthumous speculation."

In her youth and throughout most of her adult life, Austen enjoyed a relatively robust constitution. While still a young teenager, she wrote her first satirical, comic novel, Love and Friendship, in which the protagonists are repeatedly mocked for their indulgent, emotional fainting fits.

Her mature works, Sense and Sensibility, Pride and Prejudice, Mansfield Park and Emma were all published anonymously – signed "By a Lady" – and appeared from 1811 onwards.

Austen's last two works, Persuasion and Northanger Abbey, were released posthumously and were the first to identify her as the true author.

Austen travelled in May 1817 to Winchester to seek medical help but died in the Hampshire city two months later. As one of the many literary websites dedicated to her life and works records: "Jane Austen died in the dawn of Friday 18 July 1817, her head cradled on a pillow on Cassandra's lap; her sister had kept a vigil by her bedside for most of the night.

"Cassandra wrote afterwards: 'She was the sun of my life, the gilder of every pleasure, the soother of every sorrow. I had not a thought concealed from her, and it is as if I had lost a part of myself.'"

Jane Austen is buried in Winchester Cathedral.

White writes: "In 1964, [the surgeon Sir] Zachary Cope proposed that tubercular Addison's disease could explain her two-year deterioration into bed-ridden exhaustion, her unusual colouring, bilious attacks, rheumatic pains and the absence of more specific indicators of disease."

By contrast, one of Austen's most recent biographers, Claire Tomalin, suggested in 1997 that lymphoma (cancer of the lymphatic system) would be a better fit for the novelist's reported symptoms.

Examining her symptoms, as described in the novelist's letters, White agrees that Cope's diagnosis of Addison's disease could be correct, but notes: "Most patients with the disease experience mental confusion, generalised pain, weight loss and loss of appetite. None of these symptoms appears in Miss Austen's letters."

Less than two months before her death, Austen wrote: "My head was always clear, and I had scarcely any pain."

She even dictated 24 lines of comic verse from her sickbed to her sister in her last days.

Contemporary reports of Austen's skin discolouration, White adds, may have referred to the dark circles under her eyes. "Therefore, we can conclude that it is most likely she did not die from Addison's," she writes.

"While lymphoma would be one possible cause of the exhaustion, recurrent fever, bilious attacks and rheumatic pains described by Austen ,disseminated tuberculosis affecting the joints and liver – probably of bovine origin – would offer a simpler explanation for her symptoms.

"As to that troublesome skin colouring – black and white and every wrong colour – it was a Jane Austen fan who replied to Cope in 1964 suggesting that perhaps she simply meant the dark circles under the eyes that accompany illness. Thus, it is likely that Cope's hypothesis of infective tuberculosis as the source of her illness was at least partially correct, after all."

Critic's view

John Mullan Jane Austen's characters are preoccupied with illness. Mr Woodhouse shudders at every draught; Mary Musgrove fancies herself ill whenever there is no good dance or dinner invitation; Marianne Dashwood enacts an impressive psychosomatic illness when she is jilted by Willoughby. It is no accident that Mr Perry, the apothecary in Emma, can afford a hugely expensive coach. He has rich pickings among the local hypochondriacs.

But illness in Austen can also be quick and dangerous. Everyone assumes Frank Churchill's adoptive mother is always pretending to be ill – until she suddenly dies.

The vulnerability of flesh is taken for granted. We laugh at Mrs Bennet for being so delighted when her daughter Jane's illness keeps her at Netherfield, home of Mr Bingley. But it is real alarm that sends her sister Elizabeth across the fields to nurse her.

Austen's last completed novel, Persuasion, written when she herself was ailing, is a record of physical frailty. Mrs Smith, Anne Elliot's gossipy friend, is reduced by illness to an impoverished invalid. Captain Harville's sister Fanny has just died as has Dick Musgrove. Austen makes illness the stuff of comedy, but only in the knowledge that every affliction might end in death.

John Mullan