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As his health began to give way, he aged prematurely and fell into fits of despondency.{{sfn|Cousin|1910|p=64}}
Rumours of intemperance (alleged mainly by temperance activist [[James Currie (physician)|James Currie]])<ref name=R-B-Gallery>Robert Burns: "[http://www.robertburnsgallery.com/life.htm The R.B. Gallery] {{Webarchive|url=https://web.archive.org/web/20150219052159/http://robertburnsgallery.com/life.htm |date=19 February 2015 }}." Retrieved on 24 September 2010</ref><ref>{{Cite web|url=https://inews.co.uk/news/scotland/robert-burns-who-poems-children-when-born-died-story-scottish-poet-2106318|title=From his poems and children to his death, everything you need to know about Robert Burns|first=David|last=Hughes|date=25 January 2023|website=inews.co.uk}}</ref> may have been overstated.<ref>{{Cite web|url=https://theedinburghreporter.co.uk/2023/08/the-fake-news-about-rabbie-burns/|title=The fake news about Rabbie Burns|first=George|last=Mair|date=4 August 2023|website=The Edinburgh Reporter}}</ref> Hard manual farm labour earlier in his life may have damaged Burns's health.<ref>{{Cite web|url=https://digital.nls.uk/robert-burns/final-years/|title=Final years - Robert Burns - National Library of Scotland|website=digital.nls.uk}}</ref>
Burns possibly had a long-standing rheumatic heart condition,<ref name="Hogg, Patrick Scott 2008 p. 321">Hogg, PS (2008). ''Robert Burns. The Patriot Bard''. Edinburgh : Mainstream Publishing. {{ISBN|978-1-84596-412-2}}. p. 321.</ref> perhaps beginning when he was 21, and a bacterial infection, possibly arising from a tooth abscess, may have exacerbated this.<ref>
"Burns fell ill in 1781 when he was 21 and developed what is thought to have been acute rheumatic fever. Before he died, it was noted that he had slowed down, complained repeatedly of joint pains and lost weight remarkably fast.
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