THE SULLA SYNDROME

Various reasons have been advanced to account for Sulla's surprising decision to resign the dictatorship in 80 BC. It is the contention of the authors that illness was the reason. Sulla's medical history is examined. Four distinct disease entities can be discerned in the accounts of ancient authors: disfigurement of his facial complexion, discomfort in his feet, a generalised infestation with vermin, and a final episode of massive haemorrhage following on the rupture of an abscess. Syphilis, arising from Sulla's dissolute way of life, has been suggested, but it is now agreed that this disease first appeared in Europe at the end of the 15th century. It is doubtful that a single etiology can account for the whole syndrome. It is thus suggested that tuberculosis, present since 86 BC, could have been responsible for Sulla's facial lesion, the presence of discharging skin ulcers (which could even have harboured vermin from time to time), and a lung abscess which caused fatal haemorrhage. The transient nature of the numbing pain in his feet suggests a minor and temporary affliction.