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<p>[QUOTE=&quot;Bart9349, post: 2873815, member: 5682&quot;]What a great thread. I really enjoy the thought and insight that people share here in the Ancients sub-forum. Always an education. (By contrast, I&#039;ve tried to start threads in other sub-forums and have gotten very little response.)</p><p><br /></p><p>I appreciate the skepticism that people here have when assessing the ancient sources.</p><p><br /></p><p>I enjoyed the article &quot;The Fatal Disease of Emperor Galerius&#039; Death&quot; and its extensive differential diagnosis.</p><p><br /></p><p>Fournier gangrene can be malodorous, indeed. It could kill rather quickly without antibiotic therapy, however, once open sores developed. It would be unlikely that there would be enough time for infestation by &quot;worms&quot; to develop, especially in the typical patient with Fournier gangrene who has an underlying serious medical condition such as poorly controlled diabetes.</p><p><br /></p><p>As described in the article, Galerius had this condition for &quot;months.&quot; I find, therefore, Fournier gangrene very unlikely.</p><p><br /></p><p>As mentioned above, another possibility could be an injury (presumably from battle) that became necrotic and gangrenous. But an injury from battle is undocumented by the ancient sources.</p><p><br /></p><p>Carcinomas can be slower to kill, however. Any carcinoma with local extension or metastasis to the skin could cause malodorous necrotic skin ulcers. The patient, especially if otherwise healthy, could potentially linger long enough for the skin ulcers to attract infestation.</p><p><br /></p><p>Given the description of a 50 y/o man with these clinical findings, I would favor colon cancer. Colon cancer is also far more common that Fournier gangrene (which is very rare).</p><p><br /></p><p>Below is a picture of Caesar Rodney from Delaware, a signer of the Declaration of Independence. He wore bandages on his face during the convention to cover the numerous necrotic skin carcinomas on his face. These were possibly malodorous and susceptible to maggot infestation:</p><p><br /></p><p>[ATTACH=full]687534[/ATTACH]</p><p>(From HBO movie &quot;John Adams&quot;)</p><p><br /></p><p>I don&#039;t want to hijack this marvelous thread, however, so I won&#039;t continue with my pedantic drivel.</p><p><br /></p><p>Thank you, again, for this post and I appreciate the healthy skepticism when reading ancient accounts.</p><p><br /></p><p>[ATTACH=full]687519[/ATTACH]</p><p><br /></p><p>Above is my favorite &quot;cheerful skeptic,&quot; Scotsman David Hume (1711-1776).</p><p><br /></p><p><br /></p><p>g.[/QUOTE]</p><p><br /></p>

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