The transition from democracy to dictatorship and tyranny is never pleasant to behold. Whatever its causes, whatever defects it sets out to remedy, it more often than not leads to blood being spilt and tears being shed. This is exemplified by the story of Cornelius Sulla, the first Roman general to seize power through force and exercise it with brutality and cruelty^1,2; he lived at a time that was “no longer an age of pure and upright manners, but had already declined, and yielded to the appetite for riches and luxury.”²

Sulla served in the Numidian War in Africa under the command of his future rival Gaius Marius. He put an end to it by capturing King Jugurtha through treachery (105 BCE), then fought in the Social Wars of the Italian peninsula (91–87 BCE), was elected consul and appointed to conduct the war against king Mithridates of Pontus (88–84). When his jealous erstwhile chief Marius sought to deprive him of his command, Sulla marched on Rome with his legions and was reinstated (88 BCE). After defeating Mithridates, he returned to Europe with enormous spoils that enriched him and his supporters, and on his return besieged and sacked Athens, which had revolted against Roman rule (86 BCE). Finding that rival generals had taken over Rome in his absence, he unleashed his troops, reestablished his power, and became dictator and absolute ruler of the city (82–80 BCE). He is remembered for initiating several notorious proscriptions in which thousands were killed, including their families, and their property confiscated.

Two years after becoming dictator for life, Sulla unexpectedly resigned his position (80 BCE). He retired to his country estate saying he was weary of war, weary of power, weary of Rome,³ and in love with rural life, enjoying hunting and fishing. He was sixty years old and seems to have been in good health upon his retirement but died two years later.¹ It is difficult to make out a diagnosis from reports written by authors who lived many years after his death. He is said to have been “fond of art and literature” in his youth¹ but there is a consensus that he mostly led a dissolute life and was “not untainted by the luxury and profligacy of the capital,”¹ keeping company with “actresses, musicians, and dancers, drinking with them on couches night and day”² Much has been made of the appearance of his face, variously described as rough blotches of fiery red mixed with white and considered compatible with psoriasis, rosacea, leprosy, even sarcoidosis, lupus erythematosus, and leishmaniasis, or tuberculosis. There has been a tendency to discount as temporary an episode of numbing pain and heaviness of his feet in 85 BCE, called by some early gout but perhaps no more than a minor orthopedic problem and apparently cured by taking the waters.³

In his final illness, according to Plutarch, he suffered from:

A disease which had begun from some unimportant cause; and for a long time he failed to observe that his bowels were ulcerated, till at length the corrupted flesh broke out into lice. Many were employed day and night in destroying them, but the work so multiplied under their hands, that not only his clothes, baths, basins, but his very meat was polluted with that flux and contagion, they came swarming out in such numbers. He went frequently by day into the bath to scour and cleanse his body, but all in vain; the evil generated too rapidly and too abundantly for any ablutions to overcome it.

Many diseases have been suggested as the cause of this final illness, including infections, parasites, scattered suppurating abscesses, lice, scabies, and tuberculosis, the latter being favored as unifying explanation for his varied symptoms.³ According to Plutarch, he ruptured an abscess (situation not stated), bled profusely, collapsed, and died within twenty-four hours. Valerius Maximus mentions that the hemorrhage occurred through his mouth and caused immediate collapse and speedy death, possibly a massive bleed from esophageal varices.³

Plutarch describes how after his death his enemies endeavored to deprive the corpse of its the accustomed solemnities, but a monument was erected with an epitaph of his own writing stating, “No friend ever served me, and no enemy ever wronged me, whom I have not repaid in full.” In the seventieth century, Sir Thomas Browne referred to that troubled period in Roman history in what has been called one of the most sonorous or well-constructed sentences in the English language: “Even Sylla, who thought himself safe in his urne [sic], could not prevent revenging tongues, and stones thrown at his monument.”⁴

References

1. WS Robinson. A Short History of Rome. London: Rivingstons.
2. Sylla. In Plutarch’s Lives. New York: Modern Library.
3. L Cilliers and FP Retief. The Sulla Syndrome. Acta Classica, 2000;43:33-43.
4. Thomas Browne. Religio Medici; Urne-Buriall, 1658.