Herod the Great in the news

ASKING THE IMPORTANT QUESTIONS: Mark A. Clarfield asks in the Montreal Gazette: What killed Herod the Great? Excerpt (do not read if you have a weak constitution):

The grand mausoleum is still being excavated and is not yet open to the public — unless you happen to be accompanied by the archeologist who discovered it. (Sadly, in 2010, a few months after our tour, Netzer died as a result of a fall suffered at his beloved site.) As I took in the place, I couldn’t help but wonder what illness Herod died from. In the case of most ancient personages, we haven’t got a clue. But here, once again, Josephus steps into the breach. Quoting more contemporary sources (Herod had died several decades before Josephus wrote his own account), he describes the king’s symptoms:

“He had a fever, though not a raging fever, an intolerable itching of the whole skin, continuous pains in the intestines, tumours of the feet as in dropsy, inflammation of the abdomen and gangrene of the privy parts.” He also suffered, according to Josephus, from “limb convulsions, asthma and foul breath.”

The doctors of the day were, not surprisingly, flummoxed by this combination of symptoms. They used the contemporary therapeutic armamentarium, including immersing the patient in a bath of hot oil. But Herod received no relief, and the bath burned his eyes.

The clinically curious of today can turn to the more modern Historical Clinicopathological Conference put on by the University of Maryland, which brings experts together periodically to examine the death of a famous personage, and which recently tackled Herod’s case. The combination of symptoms was a challenging one, especially the presence of gangrene of the genitalia — something one does not see every day. The scientists used a clever bit of clinical reasoning and came to a tentative conclusion: chronic kidney failure of unknown cause complicated by the rare (thank God) Fournier’s gangrene of the testicles. There are other candidates, of course, such as syphilis or other sexually transmitted diseases, but the kidney diagnosis seemed to fit the symptoms best.

Joseph I. Lauer has also circulated a long list of earlier treatments of this question in an e-mail. One by National Geographic is here. Earlier discussions of Herod's (apparent) tomb at Herodium are here and follow the many links back.