A
69 year-old man presented with chronic low-grade fever, edema,
abdominal pain, insatiable hunger pangs, shortness and foulness
of breath, pruritus, inability to stand, convulsions, and, according
to one source, "gangrene of his privy parts, engendering
worms." His illness had begun some weeks to months earlier,
and had caused steady deterioration of both his physical and mental
condition. The patient became convinced that his illness was terminal
and began exhibiting signs of depression. About a week before
dying, he attempted suicide with a paring knife but was restrained.
Prior to the suicide attempt, he had sought treatment for his
illness from medical experts. They prescribed total immersion
in a bath of hot mineral oil. The treatment was not beneficial,
and actually scalded the patient's eyes causing temporary blindness.
For
most of his life, the patient had enjoyed remarkably good physical
health. He was a skillful soldier and a politician with a reputation
as an accomplished builder and philanthropist, both in his own
kingdom and abroad. His only recorded prior disability was a war
injury to his side from which he recovered quickly. There is no
mention of any previous illnesses. In fact, his biographer states
that as a young man he was an outstanding archer, javelin thrower,
and hunter. He survived several military campaigns, most of which
were successful, and he showed considerable ability as a military
commander.
He
had ten wives and fourteen children, including nine sons. He also
had at least two brothers and a sister. His sister served as de
facto "first lady" of the kingdom. One of his brothers
died a violent death at the hands of foreigners; the other two
siblings died of natural causes after long lives. Otherwise, nothing
more is known of their medical histories. The cause of death of
the patient's mother is unknown. The patient's father was a politician
who was poisoned by political enemies.
Whereas
the patient's physical health had been excellent until his terminal
illness, his mental health left something to be desired. He was
suspicious, distrustful, paranoid and mean-spirited to the point
of cruelty. These qualities seemed to increase as he grew older.
During his thirty-four years as king, he had one of his wives
and three of his sons executed, and he ordered the deaths of numerous
political opponents including several religious leaders. During
the final weeks of his life, when he knew his condition was terminal,
he ordered dozens of the leading men in his kingdom brought to
his city and imprisoned. He then instructed his sister to have
all of the hostages executed upon his death, in order to ensure
"mourning throughout the land" when he died. Five days
before he died, he ordered the crown prince executed for "disloyalty."
The
patient's biographer gives the following two descriptions of the
final days of his terminal illness:
"
From this time onwards, [his] malady began to spread to his whole
body and his sufferings took a variety of forms. He had a fever,
though not a raging fever, an intolerable itching of the whole
skin, continuous pains in the intestines, tumors in the feet as
in dropsy, inflammation of the abdomen and gangrene of the privy
parts, engendering worms, in addition to asthma, with great difficulty
in breathing, and convulsions in all his limbs. His condition
led diviners to pronounce his maladies a judgment on him for his
treatment of the professors. Yet, struggling as he was with such
numerous sufferings, he clung to life, hoped for recovery, and
devised one remedy after another. Thus he crossed the [river]
to take the warm baths at Callirrhoe, the waters of which descend
into the Lake Asphaltitis and from their sweetness are also used
for drink. There the physicians deciding to raise the temperature
of his whole body with hot oil, he was lowered into a bath full
of that liquid, whereupon he fainted and turned up his eyes as
though he were dead. His attendants raising an uproar, their cries
brought him to himself, but, now despairing of recovery, he gave
orders to distribute 50 [coins] per head to the soldiers and considerable
sums to his friends."
"But
[his] illness became more and more acute, for God was inflicting
just punishment upon him for his lawless deeds. The fever that
he had was a light one and did not so much indicate symptoms of
inflammation to the touch as it produced internal damage. He also
had a terrible desire to scratch himself because of this, for
it was impossible not to seek relief. There was also an ulceration
of the bowels and intestinal pains that were particularly terrible,
and a moist, transparent suppuration of the feet. And he suffered
similarly from an abdominal ailment, as well as from a gangrene
of his privy parts that produced worms. His breathing was marked
by extreme tension, and was very unpleasant because of the disagreeable
exhalation of his breath and his constant gasping. He also had
convulsions in every limb that took on unendurable severity. Accordingly
it was said by the men of God and by those whose special wisdom
led them to proclaim their opinions on such matters that all this
was the penalty that God was exacting of the king for his great
impiety. But though he was suffering greater misery than could
well be endured, he still had hopes of recovering, and so he summoned
his physicians and made up his mind to use whatever remedies they
might suggest. He therefore crossed the river and took baths in
the warm springs at Callirrhoe, the waters of which beside all
their other virtues are also good to drink. Now these waters run
into Lake Asphaltophoros, as it is called. And when his physicians
decided to warm his body there and had seated him in a tub of
(warm) oil, he looked to them as though he had passed away. But
he was brought round by the cries of lamentation uttered by his
servants, and since he had not the slightest hope of being restored
to health, he gave orders to distribute 5-[coins] apiece to all
his soldiers. He also gave considerable sums to their officers
and to his friends."
