The Case of the Middle-Aged General With a Fatal Postnuptial Hemorrhage

Albert B. Lowenfels, MD; Doris B. Lowenfels, MLS

Disclosures

April 20, 2006

Summary

Because it happened so many centuries ago, we cannot be sure what caused Attila the Hun's death. The historical sources are few, and seem to focus on death from a massive hemorrhage. We cannot be sure whether the bleeding source was from the nose or from the digestive tract, but death from epistaxis is rare, whereas gastrointestinal hemorrhage, particularly from esophageal varices, is often fatal. Attila was known to consume substantial amounts of alcohol, and the timing of his death after a wedding banquet with lots of drinking is compatible with a massive gastrointestinal hemorrhage.

An epidemic of malaria originating in the marshy region surrounding Rome was the probable reason why Attila did not attack the city. After his death, his numerous offspring were unable to sustain the might of the Hun Empire, but persistent attacks by other tribes led to the fall of the Roman Empire a few decades after Attila's death.

Additional Sources

Gibbon E. The Decline and Fall of the Roman Empire. Vol II. New York: The Modern Library; 1993.

Heather P. The Fall of the Roman Empire, a New History of Rome and the Barbarians. London, United Kingdom: Oxford University Press; 2006.

ATTILA MCA Home Video [videotape]. Los Angeles, Calif: Universal Studios; 2003.

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