The 28th Historical Clinicopathological Conference
The 2022 Program
Our annual conference is devoted to the modern medical diagnosis of disorders that affected prominent historical figures. Below is the case presentation for this year’s program.
May 6, 2022 | 1:30pm
Born in 980 C.E. near Bukhara (present day Uzbekistan), this patient would become one of the towering figures of the Islamic Golden Age. He was a philosopher, poet, mathematician, expert in Islamic jurisprudence, astronomer and physician, who traveled extensively throughout Persia during the 11th century C.E. By the age of 16, he had mastered the art of medicine as it then existed. He would transform his knowledge of Aristotelian, Galenic, Arabian, Persian and Indian medicine into a Canon of Medicine, which became the most widely used comprehensive medical text of the Middle Ages.
Except for the patient’s final illness, we know little of his medical history. Other than a serious illness of unknown character in his early 20s, he appears to have enjoyed excellent health until age 55, when he began suffering with recurrent “colic,” which eventually took his life. Regarding his family, we know he had a brother 5 years younger than he and a father who died when the patient was 22. Nothing more is known of their medical history or that of his mother.
The patient never married and had no known offspring but was renowned for having exercised his “concupiscent [sexual] facilities” with uncommon regularity. Though a practicing Muslim, he was no paragon of Islamic piety. Wine, which he consumed in large amounts, helped to inspire him when confronted with some new problem or working on one of his numerous compositions.
The early stage of the patient’s final illness began 3 years before his death with recurrent attacks of colic (abdominal pain). Whether these attacks were accompanied by other symptoms is not known. His only known sick contact prior to the illness was a patron who he had treated for recurrent colic two decades earlier.
The terminal phase of the patient’s final illness began in 1034 C.E. with recurrence of his colic, while trying to escape enemy troops who were looting Isfahan, where he was then residing. Fearful that the illness would cause him to fall into the hands of the invaders, the patient tried to accelerate his recovery by administering “an enema to himself eight times in one day, to the point that some of his intestines ulcerated and an abrasion broke out on him…[and caused him to be] afflicted by seizures, which sometimes follow the colic. And in spite of that he treated himself and administered enemas to himself for the abrasion and for the resolution of the colic. Then one day, wishing to break the wind of the colic, he ordered that two [doses] of celery seed be included in the enema. But one of the doctors whom he ordered to treat him threw in five [doses] of celery seed – [It is not known] whether [the doctor] did it intentionally or by mistake…[in that] the abrasion was aggravated by the sharpness of the seed. In addition, [the patient] used to take mithridate [a paste named after Mithridates of Pontus, usually containing opium] on account of the seizures, but one of his slaves threw a great deal of opium into it…The reason for this was their stealing a great deal of money from [the patient’s] coffers; [the slaves] desired [the patient’s] death in order to be free from the consequences of their actions…[The patient] was [then] so weak he was unable to stand, so he continued to treat himself until he was able to walk…[though] he did not take care and frequently had sexual intercourse…intermittent relapses and recovery [followed]. [Ultimately]his strength wasted away and…was not sufficient to repel the illness. So [the patient] ceased treating himself…He remained like this for a few days; then he passed away [at age 58] into the presence of his Lord and was buried in Hamadan in the year 1037 C.E.”
Herbert L. Dupont, M.D., is the Mary W. Kelsey Distinguished Chair of Medical Sciences and professor of internal medicine at the University of Texas McGovern Medical School and professor of infectious diseases and epidemiology at the University of Texas School of Public Health. He is a former president of the Infectious Diseases Society of North America, the National Foundation for Infectious Diseases, the American Clinical and Climatological Association, and was the founding president of the International Society of Travel Medicine. He earned his medical degree from Emory University in 1965, trained at University of Minnesota Hospitals, and received fellowship training at Maryland where he remained on the faculty until 1973.
Mohammad M. Sajadi, M.D., is an associate professor of medicine and infectious diseases, Institute of Human Virology at the University of Maryland School of Medicine where he graduated in 1997. He is an HIV physician researcher with interests in the study of humoral immunity and HIV. Sajadi’s lab is successfully funded with grants from the NIH, Bill and Melinda Gates Foundation, and the Veteran’s Administration. He has co-authored several historical papers including “Ibn Sina and the Clinical Trial,” Annals of Internal Medicine in May 2009.