Special Article |

Death of an Arabian Jew

Jan V. Hirschmann, MD; Peter Richardson, PhD; Ross S. Kraemer, PhD; Philip A. Mackowiak, MD, MBA
Arch Intern Med. 2004;164(8):833-839. doi:10.1001/archinte.164.8.833.
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A 69-year-old Judean man presents with chronic low-grade fever, pedal edema, and abdominal pain. His condition deteriorates over several weeks with the appearance of shortness and foulness of breath, pruritus, convulsions of every limb, and gangrene of the genitalia. Just before he dies, he orders dozens of the leading men of his kingdom imprisoned and instructs his sister to kill them all after he is gone. Who is he and what is the likely cause of his death?

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Figure 1.

Although Herod was the subject of several statues and busts, no portrait of him has been identified with certainty. This 19th-century representation offers a stereotypic impression of what his appearance might have been as a middle-aged man.

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Figure 2.

Aerial view of Herodium today, looking north toward Jerusalem, the outskirts of which can be seen at the top of the photograph. Herod's palace was in 2 sections. There were his circular, fortified upper palace (visible in the center of the photograph), and a lower complex of smaller palaces for members of Herod's entourage, which was separated from the main palace by a huge pool and garden (above and to the left of the upper palace). The upper palace sits on a natural hill raised slightly by a fill. One of its 4 towers, placed around the outside wall (on the east, to the right), was taller than the others. Somewhere among these structures Herod is believed to have built his mausoleum. (Photograph courtesy of the Israeli Embassy, Washington, DC.)

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