Expert disease detective unravels mysterious illness that killed famed 12th century sultan

May 4, 2018, University of Maryland School of Medicine
Credit: CC0 Public Domain

Saladin may not be well known in the West, but even 800 years after his death, he remains famous in the Middle East. Born in 1137, he rose to become the Sultan of an enormous area that now includes Egypt, Syria, parts of Iraq, Lebanon, Yemen and other regions of North Africa. He successfully led armies against the invading Crusaders and conquered several kingdoms. Historians have described him as the most famous Kurd ever.

Even today, however, Saladin's death remains a mystery. The illness began in 1193, when he was 56. After two weeks, the Sultan was dead. Some have speculated that fever was a prominent symptom of the illness.

After closely examining a range of evidence about Saladin's condition, Stephen J. Gluckman, MD, professor of medicine at the University of Pennsylvania School of Medicine, has developed a diagnosis. Dr. Gluckman theorizes that typhoid, a bacterial disease that was very common in the region at the time, is the most likely culprit. Today of course, antibiotics could have greatly helped Saladin. But in the 12th century these medicines did not exist.

Dr. Gluckman will deliver his diagnosis at the 25th annual Historical Clinicopathological Conference, held Friday, May 4 at the University of Maryland School of Medicine. The conference is devoted to the diagnosis of disorders that afflicted historical figures; in the past, experts have focused on the diseases of luminaries such as Lenin, Darwin, Eleanor Roosevelt and Lincoln.

Dr. Gluckman, an expert on parasitic disorders, has provided care and taught in many countries around the world. He carefully reviewed what is known about the Sultan's medical history. "Practicing over the centuries required a great deal of thought and imagination," he says. "The question of what happened to Saladin is a fascinating puzzle."

Saladin is known for destroying King Guy's army at the Horns of Hattin in 1187 and reclaiming Jerusalem for Islam after it had been ruled for nearly a century by Christian crusaders. He is also famed for treating his enemies generously.

Typhoid fever is a potentially deadly disease spread by contaminated food and water. Symptoms of typhoid include , weakness, stomach pain, headache, and loss of appetite. It is common in most parts of the world except in industrialized regions such as the United States, western Europe, Australia, and Japan. About 300 people get in the United States each year, and most of them have recently traveled. Globally, infects about 22 million people a year, and kills 200,000.

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4.8 / 5 (4) May 04, 2018
If this Typhoid was indeed common at the time, why was the Kings death considered a Mystery?
5 / 5 (4) May 04, 2018
@BrettC common but the descriptions of deaths aren't clinical, if they exist at all.
5 / 5 (1) May 05, 2018
How about "The Crown rest uneasy upon His brow."

In other words, especially for a Warrior Leader like Saladin, a violent death was expected. Not often they got to die quietly in a bed.

No refrigeration or antibiotics? Without modern chemistry, how do you tell the difference between poisoning and food poisoning? The death of Temujin's father is still argued if the Merkit leader was murdered or not.

For that matter, appendicitis or cancers were basically a death sentence. It was convenient to accuse your competitors to the throne of being poisoners.

If herbal medicines failed? Guess who volunteered to be burned at the stake as a witch? Deaths during pregnancy & childbirth were common enough to bring down dynasties.

Hippocrates oath "To cause no harm." was disregarded by bleeding wounded or ailing patients. Look up the death of George Washington. That nightmare of incompetency would eventually have a radical effect leading towards modern medical practices.
5 / 5 (1) May 05, 2018
Oops! Went off subject.

Before antibiotics such as penicillin and sulfa drugs. Before vaccinations. More armies died from the scourge of diseases and wounds then ever were killed in combat.

The great influenza pandemic of 1918 killed more people than fighting World War One.

Even today, meningitis stalks barracks and dormitories alike. Idiots refusing inoculations are racking up the rising numbers of epidemiological deaths. The adults gullible enough to believe rumors and quackery. Placing their children and yours in harms way.

And though the religious deny the possibility? Microorganisms continuously prove the process of evolution never stops. Yesterday's cure, is barely capable against today's diseases. And futile against tomorrow's epidemic.

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