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Both theories are fairly reasonable, as tuberculosis can kill quickly (in weeks), or very slowly (many years).
However, one should note that people rarely survived the disease longer than a year once it progressed to the point that they would collapse, and Okita did not die until four years after the affair.
He died from tuberculosis on July 19 (the 30th day of the fifth month, by the lunar calendar), 1868.
Later that night, he was buried at Sensō-ji Temple in Tokyo, under his birth name (with Okita Sōji listed in the death records.) Today, Okita's grave is not open to the public, except for one day each year in June The claim that Okita died when he was 25 is based on the theory that he was born in 1844 and therefore was 25 by East Asian age reckoning when he died in 1868.
Even though he was often commented to be honest, polite, and good-natured by those around him, he was also known to be a strict and quick-tempered teacher to his students.
He was one of the Shieikan members involved in the Serizawa Kamo (one of the original commanders of the Shinsengumi) and the Uchiyama Hikojiro assassinations in 1863.
He is the protagonist of the manga oneshot Because Goodbyes are Coming Soon, by Yukimura Makoto.
Okita is mentioned in the anime/manga series Rurouni Kenshin, which takes place during and after the Meiji Revolution in Japan.
In the Japanese dub the unknown Shinsengumi member correctly refers to him as: 組長 Kumichô.
During his brief appearance in the anime, he is shown coughing and having pain in his chest, a reference to his death by tuberculosis.In the OVA English dub, Okita is portrayed as a subordinate of Saito Hajime, when in fact he was his equal or superior in rank and kenjutsu skills.