The Puzzling Death of Sultan Saladin: A 12th Century Medical Mystery Solved?
Here’s a 12th century medical mystery for you: What malady killed well-known Sultan Saladin? Was it small pox, tuberculosis, typhoid, or maybe malaria? Look at his symptoms – some of them were recorded 800 years ago. For two weeks, the ruler suffered from a high fever and sweated buckets. He was extremely weak, had unbearable headaches and continuously felt indigestion, eventually to the point that he lost his appetite. Can you guess which of the four illnesses led to the sultan’s demise? A medical sleuth thinks he’s solved the puzzle.
Cold Case Diagnosis
The sultan’s story was analyzed by Dr. Stephen Gluckman, a professor at the University of Pennsylvania's Perelman School of Medicine and an expert on parasitic disorders. Dr. Gluckman said, “Practicing medicine over the centuries required a great deal of thought and imagination. The question of what happened to Saladin is a fascinating puzzle.”
Live Science reports that Gluckman gave his diagnosis at the 25th annual Historical Clinicopathological Conference at the University of Maryland School of Medicine. He concluded that the medical report for Sultan Saladin suggests the Muslim leader most likely died of typhoid.
‘Saladino’, by Cristofano dell'Altissimo, before 1568. (Public Domain)
These are some of the details of Sultan Saladin’s fatal sickness:
“The patient then seems to have done well until overtaken by his final illness at age 56. He was feeling old then, and complained of loss of appetite, weakness, lassitude, and indigestion. Though the weather was damp and cold, he eschewed the quilted tunic he always wore in public and “seemed like a man awakening from a dream.” In the evening, his lassitude increased, and “a little before midnight he had an attack of bilious fever, which was internal rather than external.” The next day his fever was worse. However, when it was suppressed (by unknown means), he seemed to improve and to take pleasure in conversation with associates. However, from that time, his illness grew more and more serious, with headaches of mounting intensity. Those in attendance began to despair for his life.”
Folio from an Arabic manuscript of Dioscorides, ‘De materia medica’, 1229. (Public Domain)
That’s the scanty account of the sultan’s symptoms, which apparently didn’t improve despite bloodletting or enemas (common treatments used by 12th century physicians). “It’s difficult to work it out because there is essentially no information – there are no tests and the historical accounts are a little questionable, and there isn’t much anyhow,” Dr. Gluckman said. Thus, Gluckman united the documents on Saladin’s symptoms with other details on the sultan’s life and environment.
Saladin and the Crusaders
Saladin was born to a Kurdish family in Tikrit, modern day Iraq, in 1137 or 1138. He began his rule as sultan of Egypt, Syria, Yemen, and Palestine in his late 30s. Sultan Saladin is most remembered for his role in the Crusades. This is the leader who took Jerusalem from the Franks and defeated King Guy’s army at the Horns of Hattin in Palestine in 1187. Sultan Saladin is also recognized for his chivalry, compassion, and generosity to friends and enemies alike. He died aged 55 or 56 in 1193 after two weeks of an illness that baffled doctors at the time.
Saladin and Guy de Lusignan after battle of Hattin in 1187. (Public Domain)
An Uncertain Conclusion
According to Live Science, two of the illnesses Gluckman ruled out were smallpox and the plague - because they kill quicker. Tuberculosis was also seen as unlikely (there were no reports on respiratory issues), and malaria probably didn’t take the sultan’s life either (the accounts don’t mention the disease’s characteristic chills). But the symptoms combined with the prevalence of typhoid in the region at the time to send it to the top of Gluckman’s list. A high fever, weakness, stomach pains, headaches, and loss of appetite are all symptoms of this illness.
“It is really based on what the common diseases were at that time, and of those which were fatal, and of those, which were fatal in a time period of around two weeks,” Gluckman said, though he noted that typhoid isn’t the only possibility - typhus is another option.
Sultan Saladin’s tomb in Damascus. (Godfried Warreyn/CC BY SA 3.0)
Top Image: A possible portrait of Saladin, found in a work by Ismail al-Jazari, circa 1185. Source: Public Domain