The smell arrives before anything else. Not the perfume of irrigated gardens, not the wax of torches flickering along corridors, not the incense that burns on the doorposts. Another smell. One that the servants of Jericho’s winter palace have learned to ignore in public and describe in whispers when they are alone. Sweetish, heavy, the kind of smell that clings to clothes and doesn’t let go. King Herod the Great is rotting alive.
It is the year 4 BC, Jericho, the lowest city on earth, nestled almost 300 meters below sea level, where the heat hits the skin, even in January, like a wet hand that won’t let go. The palace, with marble brought from afar, frescoes on the walls, and pools fed by aqueducts that defy the arid landscape, was built to declare to the world that Herod was untouchable. Now, that same palace retains heat like an oven and traps smell like a tomb. The man who ruled Judea with a mixture of political genius and calculated cruelty for more than 30 years, has been unable to control his own body for months.
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The fever rises and falls like a tide that doesn’t respect schedules. The itching, that itching which the historian Flavius Josephus would document decades later with almost clinical precision, covers his skin as if thousands of needles were working from the inside, from a place that the fingers can never reach. His feet are swollen to the point of deformity, his abdomen is inflamed, his breathing comes with effort as if the air had weight, and something else. Something that advances in the most intimate parts of his body with an inexorable logic and without a name.
Herod is between 60 and 70 years old. He has survived palace intrigues, civil wars, an earthquake that destroyed part of Judea, and the betrayal of his own wives and children. He has executed people of his own blood when he believed they threatened his throne. He ordered the construction of the Temple of Jerusalem, the most imposing religious complex of the ancient world, and fortresses that defy physics, such as Masada hanging over the desert 400 meters high above the Dead Sea with cisterns carved into the rock capable of storing water for years of siege. This man, this body.
The question that no one in the court dares to ask aloud is the same one that modern doctors have been trying to answer for 2,000 years. What exactly destroyed Herod the Great? What disease exactly exhibits all those symptoms together in that progression? And why could the most skilled doctors of the Roman world do nothing but observe?
The answer is not in any ancient medical text; it is in the symptoms that Josephus lists one by one as if he had been in the room. And when you read them all together, the picture that emerges is so specific, so strange, and so relentless that it’s hard to believe a man could have survived so long inside that body. But Herod survived for months. And what he did in those months says everything about who he was. To understand what is happening in that palace in Jericho, you have to understand who Herod is before illness reduces him to a man trembling in his bed.
Herod should not have been king. He was not of priestly blood. That disqualified him in the eyes of the more observant Jews. He was an Idumean, descended from a people who had been forced to convert to Judaism just a generation before, when the Hasmoneans conquered Idumea and gave its inhabitants the choice between exile or circumcision. His father, Antipater, was a brilliant political operator who knew how to align himself with Roman power at the right moment, first with Julius Caesar, then with Mark Antony. Herod inherited that survival instinct and took it to extremes that his father would never have imagined.
When Rome appointed him king of Judea in the year 37 BC, he had to rule a territory that did not want him, surrounded by neighbors who threatened him within an empire that could discard him at any moment if the political winds changed. He survived 33 years in that impossible balance. First under Mark Antony, then after Actium, after Antony and Cleopatra fell, under Augustus, who came to appreciate him with a mixture of genuine respect and sardonic awe. It is said that Augustus once remarked that it was safer to be Herod’s pig than his son.
It wasn’t a baseless joke. In the year 7 BC, Herod executed his own sons Alexander and Aristobulus, born to his wife Mariamne, of Hasmonean blood. He had loved them; he had sent them to be educated in Rome. And when he believed, with or without justification, that they were conspiring against him, he ordered that they be strangled. Years earlier he had executed Mariamne herself, his favorite wife, the woman for whom he felt something bordering on obsession, after accusing her of adultery and betrayal. According to the sources, after the trial, he searched for her through the palace rooms as if he expected to find her.
Herod built cities, he built ports, he built Caesarea Maritima, an artificial port on the Mediterranean coast, technologically impossible for his time, from scratch in 12 years. He built Herodium, an artificial hill over a tomb that he himself designed, visible from miles away, as if he wanted the earth itself to remember his name.
And now he is in Jericho. The body that ordered all of that no longer obeys him. The irony that no one in court mentions: the man who ordered more deaths than any ruler of his generation cannot die. The disease has him trapped in a body that neither lives fully nor gives way. Between the court and the doctors, nobody sleeps soundly because the dying Herod is still Herod, and even from his bed, Herod can still give orders. That will be proven very soon.
Herod’s doctors were not charlatans. This is the first misunderstanding that needs to be cleared up. In the first century BC, the Greek medical tradition, which Hippocrates had systematized 400 years earlier and which Alexandria had refined in its institutions of study, was the most sophisticated body of medical knowledge in the Western world. The physicians surrounding Herod understood basic anatomy, knew the effects of hundreds of medicinal plants, could distinguish types of fevers, recognized advanced infections, and could treat complex fractures. Some had studied at the Library of Alexandria, the intellectual center of the known world. What they lacked was what we take for granted without thinking about it: the concept of a microorganism.
For them, illness was an imbalance of the four humors: blood, phlegm, yellow bile, and black bile. From that perspective, Herod’s body was in a state of catastrophic disproportion. It had too much of one thing or too little of another. The therapy was therefore for rebalancing: a specific diet, controlled rest, purges, and thermal baths. That’s how Herod ended up in the waters of Callirhoe.
Callirhoe was a complex of thermal springs on the eastern shore of the Dead Sea, in what is now the territory of Jordan, known throughout the Roman world for its healing properties. The water emerged hot from the earth, laden with minerals, and the doctors of the time believed, with reasons that were not entirely without basis, that it could relieve deep pains, calm inflammations, and stimulate what they called the body’s natural flow. Herod was transported there, a considerable journey for a man who could barely move, in the hope that the waters would accomplish what the medicines had failed to do.
It didn’t work. The itching did not subside. The fever did not go down. The feet remained swollen, taut like wet leather. Then someone suggested bathing the king in a tub of hot oil. Logic, from the perspective of the humors, had a certain coherence. The heat combined with lubrication could penetrate the skin, relieve internal pressure, and restore balance. What no one anticipated was the reaction of Herod’s body.
The moment they submerged him, the king lost consciousness. Those present believed for a moment that he had died. Panic spread through the group. Herod was rushed out of the bath. He was revived with difficulty and regained consciousness with his eyes wide open. Sources say that when he woke up he cried, not from pain. The pain accompanied him for months without bringing tears to his eyes. Josephus does not interpret it, he only records it. A man who has ruled for 30 years by the force of his will, weeping in a hot oil bath on the shores of the Dead Sea, surrounded by doctors who have exhausted their resources.
The court returned to Jericho. The doctors had no more ideas. The king’s body continued moving in its own direction, at its own pace, without asking permission. Flavius Josephus was not a doctor; he was a historian, soldier, and political survivor, a man who had seen enough real violence not to need to exaggerate it. When he documents Herod’s final agony, he does so with a sobriety that paradoxically is more disturbing than any drama. These are the symptoms he lists in his own words recomposed: a moderate but persistent fever; an unbearable itching that covers the entire surface of the body and does not subside with anything; continuous intestinal pains; edema in the feet that deforms them; swelling of the abdomen; difficulty breathing that becomes part of every moment of the day; convulsions; a fetid breath that permeates the air of the room; and then this, a putrefaction of his genital parts that produced worms.
It is the line that no reader forgets, and it is also the line that in 2002 allowed Dr. J. Hirschman, an infectious disease specialist at the University of Washington, to publish in a peer-reviewed medical journal a retrospective diagnosis of Herod the Great, based exclusively on what Josephus wrote 2,000 years earlier.
The pattern, when viewed in its entirety, is recognizable to any modern physician. The generalized and intractable itching, combined with fluid retention in the feet and abdomen, respiratory difficulty, and prolonged fever, corresponds to the clinical picture of chronic renal failure in its terminal phase. When the kidneys fail completely, the body accumulates substances in the blood that it normally filters and eliminates. One of them, urea, is deposited in the skin and generates what is now called uremic pruritus, an itching that exists in a layer of the skin that the fingers cannot reach, that does not improve with creams or with cold or heat, which modern dialysis patients themselves describe as the most exhausting form of silent torture that exists.
The respiratory distress is explained by the pulmonary edema that accompanies advanced renal failure. The fetid breath, what we now call uremic fetor, is another classic marker recognizable in any 21st-century nephrology ward. And the worms? Hirschman proposes Fournier’s gangrene, a highly aggressive necrotizing infection that attacks the soft tissues of the genital and perianal area. Without antibiotics, and the first century BC did not have them nor could have had them, this type of infection spreads unchecked through the tissue. In hot conditions, necrotic tissue can attract fly larvae. What Josephus calls worms, modern medicine identifies as the predictable consequence of an infection that no ancient physician had the tools to interrupt.
The most powerful man in Judea was being consumed by his own body from the inside by a process that had a name, but that no one in his court could pronounce because it was still 20 centuries away from being invented. Their doctors did not fail out of ignorance, they failed because they were in the year 4 before our era, doing the best that the science of their time allowed. The limit was not their intelligence, it was their moment in history.
There was a time when Herod the Great tried to die before the disease did. It was not a thoughtless gesture of desperation. According to the accounts, it was something that resembled a calculation more than anything else. If the body can no longer recover, if the end is inevitable and the agony does not subside, let it at least be on his own terms. He took a fruit peeling knife, a domestic instrument without any grandeur, without the scale of the decisions he had made for decades, and pointed it at himself.
His cousin Achiabus stopped him. There was noise in the room, shouts, the sound of someone moving urgently, and that noise was enough.
Antipater, Herod’s son, who had been imprisoned in Jericho for months awaiting his own execution, interpreted the commotion as a sign that his father had died. He tried to bribe his guard to release him.
Herod had not died, and when the report of what Antipater had done reached his bedside, the dying king issued an order. Antipater was executed that same day. Five days later, Herod was dead.
But between the suicide attempt and his own end, he made a decision that says it all about the psychology of a man who had built his entire world on control. He summoned his sister Salome and his brother-in-law Alexas. The instruction he gave them was this: they had gathered at the hippodrome of Jericho the most prominent men from every city of Judea, community leaders, notables, figures of authority summoned under pretext, without any of them knowing why they were there. Hundreds of men. The order was to execute them all at the exact moment of the king’s death.
The reason Herod gave was as lucid as it was atrocious. He knew that no one was going to cry for him spontaneously. The Jewish people had tolerated him, had feared him, had lived under his rule for three decades, but had never loved him. He was an Idumean, the king that Rome had installed, the man who had killed his most beloved wife and his own children. There would be no public mourning when he died, so he would force it. If every family in Judea mourned their dead on the same day, the country would be in mourning the moment Herod ceased to exist. It didn’t matter if they mourned others, the grief would be there, real, audible, spread over the whole land.
It is the act of a man who could never distinguish between power over people’s lives and power over their emotions, who confused obedience with affection, who even in dying believed he could rewrite reality around him.
Herod died in the spring of 4 BC, in his palace in Jericho, surrounded by doctors who could not save him and a court that silently waited for him to end. Salome, as soon as she could, freed the men from the racecourse without touching a hair on their heads. The forced mourning never happened. The king who had ruled for 33 years lost his last battle, and this time there was no one to execute for it.
The funeral of Herod the Great was, according to all available sources, magnificent. His body was wrapped in royal purple, a golden crown was placed on his head, and a scepter was placed in his hand. The coffin was made of gold. An honor guard, Thracian, Germanic, and Gallic soldiers from his personal army, escorted the procession for 25 miles, from the palace of Jericho to Herodium. The procession, accompanied by music, slowly advanced through the dry heat of the Judean desert, over the artificial hill that Herod had ordered built over his own tomb. A perfect cone visible from Jerusalem on clear days awaited him from afar.
Nobody knows for sure how many people cried. What we do know is that his kingdom fragmented almost immediately. Rome divided the territory among his sons. Archelaus received Judea and Samaria, but ruled with such ineptitude that Augustus himself exiled him to Gaul 9 years later. Herod Antipas, the son whom history will remember for ordering the execution of John the Baptist, ruled Galilee. The territory that Herod had held together for decades by sheer willpower disintegrated in a generation, and the tomb disappeared.
Herodium was known. The site had been excavated in parts, but the king’s mausoleum was not found. It was in 2007 when the Israeli archaeologist Ehud Netzer, after decades of searching, announced that he had located the remains of the tomb on the side of the artificial hill, not on the top, where everyone had searched. The sarcophagus was destroyed, smashed to pieces, with a violence that was not from time, but from human hands. Probably during the first great Jewish revolt against Rome in the year 70 AD, when the rebels who used Herodium as a fortress systematically destroyed everything that represented collaboration with imperial power. Even in death, Herod generated an emotional response intense enough that someone would want to break his bones.
Modern medicine, meanwhile, came to its own verdict. The combination of symptoms that Josephus documented—uremic pruritus, edema, respiratory failure, necrotizing infection—points to terminal chronic renal failure with Fournier’s gangrene as a fatal complication. What consumed Herod the Great was his own body failing in cascade, kidneys giving out, fluids accumulating where they shouldn’t, an infection that advanced unchecked in the darkness of an organism already without defenses. His doctors didn’t have the tools to stop it. It wasn’t ignorance, it was the limits of the world they lived in.
And here’s the part that doesn’t give up. The platforms of the Temple Mount in Jerusalem, that stone esplanade that today supports one of the most visited religious sites on the planet, were built on the foundations that Herod ordered. Every year millions of people walk on that ground, unaware that they are treading on the legacy of a man who died consumed in his own winter palace, unable to buy the only kind of immortality that was not for sale. That doesn’t leave Herod in peace, nor should it leave us.
If this story left you wondering what survives of a man when the fear he generated disappears, let me know in the comments, because the answer is more uncomfortable than it seems.
