The death of Alexander the Great - poisoning hypothesis

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The death of Alexander the Great - poisoning hypothesis

Post by ViaNocturna »

There are a few hypotheses concerning Alexander's death. One of them points out that he fell ill suddenly, after an all-night feast. Apparently not having enough fun, he arranged an after-party for himself and his closest companions. He took a cup of wine and while drinking he suddenly moaned "as if a spear had pierced him". The first thing that comes to mind is poison. Alexander was a great leader, but he was not loved by everyone.

During his stay in Babylon, he assimilated the local tradition that the subjects worshiped the rulers. This was unthinkable for the Macedonians or for the Greeks. So they began to oppose. The old warriors, who still remembered Alexander's father, Philippe the Macedonian, did not like the new order. And Alexander began to smell the conspiracy. He sentenced the experienced leader Parmenion and his son Filotas to death and killed Cleitus defending the veterans. Cassander, who laughed, seeing the Greeks falling on his face, was simply beaten by him.

And it was Cassander who became one of the suspected poisoners. He was the son of Antipater, ruling on behalf of the Macedonian conqueror in the European part of the empire. Called by the ruler to Babylon, Antipater sent Cassander there. Upon his arrival, Alexander was dead not before long. So is Cassander and the poison, probably brought from Europe, guilty?

Source of the material is the book by Jurgen Thorvald "Science and Secrets of Early Medicine"
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Re: The death of Alexander the Great - poisoning hypothesis

Post by Alexias »

Hi, and welcome. As you can imagine, this topic has been touched on many times on this forum, most recently here viewtopic.php?f=12&p=46932#p46932.

Alexander's cry may have been caused by a sudden cramp on drinking chilled wine, or a rupture of a something internal. In itself it is not an indication of poisoning. Most poisons do not cause a high fever and take 10 days to kill someone, which we know happened to Alexander. There may be some but you would need to consider whether at that point in time the Macedonians knew of them or had access to them. However, no one at the time suspected poisoning as the cause of Alexander's death. This was a later invention. If you do some searching, you should be able to find out exactly when the theory was first put forward.

If Cassander did poison Alexander then he was a bigger fool than subsequent history showed him to be because he gained nothing by it. He was newly arrived in Babylon and had no control over the army, the Treasury or Alexander's wives. He had no power base in Babylon to take control and he takes no part little or no part in the immediate aftermath of Alexander's death. Thus, in throwing the whole situation in Babylon into chaos, he would have risked losing all the Macedonians had gained in the previous 10 years. And he, and others, were too mercenary and power-hungry to do that.

If Cassander did feel that he needed to assassinate Alexander because he insulted him by banging his head against a wall, the Macedonians seem to have adopted an honour code in such cases. You killed a man face to face with a knife so that he, and everyone else, knew by whom and why, he was being killed. If Cassander had poisoned Alexander, he would also have been putting his own brother Iollas in danger as, being Alexander's cupbearer, he would have been immediately suspected.

Alexander may have been angry that Antipater sent Cassander to Babylon rather than coming himself, but Cassander would have been aware that Alexander could have dispatched Antipater in the same way he had Parmenion, so his job was to appease Alexander, not assassinate him.
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Re: The death of Alexander the Great - poisoning hypothesis

Post by MichaelCohen1970 »

Here's what I found and it's very interesting.

The proposed causes of Alexander's death included alcoholic liver disease, fever and strychnine poisoning, but little data support these versions. According to a 1998 report from the University of Maryland School of Medicine, Alexander probably died of typhus (which, along with malaria, was common in ancient Babylon). In the week before Alexander's death, bills mention chills, sweat, fatigue and high fever, typical symptoms of infectious diseases, including typhus. According to David W. Oldach of the University of Maryland Medical Center, Alexander also had "severe abdominal pain, causing him to scream in agony. The tied account, however, comes from an unreliable Alexandreid . According to Andrew N. Williams and Robert Arnott, in the last days of Alexander the Great stood mute. He has become mute because of an earlier neck injury since the siege of Cyropolis.

Other popular theories maintain that Alexander either died of malaria or was poisoned. Other retrodiagnoses include diseases and non-communicable. According to author Andrew Chugg, there is evidence that Alexander died of malaria, having been infected two weeks before his death while sailing in the swamp for flood control. Chugg based his argument on ephemera by the otherwise unknown Diodotus of Eritrea, although the authenticity of this source was questioned. It was also noted that the lack of Plasmodium falciparum signature curve fever (an expected parasite, given the history of Alexander travel) reduces the possibility of malaria. The malaria version was nevertheless supported by Paul Cartledge .

Over the centuries, suspicions of possible poisoning have fallen on many of the alleged perpetrators, including one of Alexander's wife, his generals, his illegitimate stepbrother, or the royal cup-shaker. The version of the poisoning is described in particular by the politically motivated Liber de Morte Testamentoque alexandri (a book on Alexander's death and will), who is trying to discredit the Antipatra family. It was claimed that the book was written in the Polyperchon circle "s, not earlier than approx. 317 BC.

In Alexander the Great: Death of God , Paul C. Doherty claims that Alexander was poisoned with the arsenic of his possibly illegitimate half brother Ptolemy and Soter . However, this has been challenged by the New Zealand National Poison Centre toxicologist Dr. Leo Schep who discounted the arsenic poisoning and instead suggested that he could have poisoned the wine made from the plant Veratrum album , known as white hellebore. This plant was known to the ancient Greeks and can produce long-lasting symptoms of poisoning that correspond to the course of events described in Alexandreida . The article was published in a peer-reviewed medical journal of Clinical Toxicology and suggested that if Alexander was poisoned, Veratrum album offers the most probable cause. This theory is supported by the writings of the ancient Greek historian Diodor , who recorded Alexander becomes "affected by the pain after drinking a large bowl of wine.

Epidemiologist John Marr and Charles Calisher put West Nile Fever as a possible cause of Alexander's death. This version was considered "quite convincing" by the University of Rhode Island epidemiologist Thomas Mather, who nevertheless noted that West Nile virus tends to kill the elderly or people with a weakened immune system. The version of Marr and Calisher was also criticized by Burke A. Cunha from Winthrop University Hospital. According to the analysis of other authors in response to Marr and Calisher, West Nile virus cannot have infected people before the 8th century AD.

Other causes that have been raised are acute pancreatitis provoked by "heavy alcohol consumption and a very rich meal", acute endocarditis, schistosomiasis brought by a blood spike and porphyria. Fritz Schachermeyr proposes leukemia and malaria. When Alexander's symptoms were introduced into the Global Infectious Disease Epidemiology Network, influenza gained the highest probability (41.2%) on the differential diagnosis list. However, according to Cunha, the symptoms and course of Alexander's disease are incompatible with influenza, as well as malaria, schistosomiasis and poisoning in particular.

Another theory departs from the disease and the hypothesis that Alexander's death was related to congenital scoliosis syndrome. It was discussed that Alexander had neck deformities and a structural periarticular deficit, and this may be related to Klippel-Feil syndrome, a rare congenital scoliosis disorder. His physical deformities and symptoms leading to death are what experts believe. Some believe that as Alexander fell ill in his last days, he suffered progressive epidural compression of the spinal cord, which left him paralyzed. This hypothesis, however, cannot be provided without a full analysis of Alexander's body.
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Re: The death of Alexander the Great - poisoning hypothesis

Post by Alexias »

Hi, thanks for this.

Just FYI, Andrew Chugg didn't come up with the malaria theory. This has been around since at least the early 1970s when Peter Green and Robin Lane Fox were writing their biographies, and they both speak as though it is already a well accepted theory. Peter Green also mentions pleurisy as a complication, although Mary Renault, who was a nurse with medical training, prefers pneumonia. Pneumonia is often a disease that finishes off those already weakened by a previous condition.

Alexander was not mute in his final days, as we have several things he was reputed to have said, although he had difficulty making himself heard. I wouldn't count the failure to greet hundreds or thousands of soldiers who filed through his bedroom as this would have been exhausting for any sick person, let alone one close to death. However his difficulty in speaking can easily be explained by shortness of breath due to a lung infection. There is no need to explain it by an injury or a congenital disease, neither of which would have killed him.

In addition, if Alexander's illness in Cilicia caused by plunging into an ice-cold river, were pneumonia, this would have scarred his lungs and, along with his chest wound from India, would have made him more susceptible to a chest infection. Pleurisy, which causes sharp pain, might well have been the cause of Alexader crying out at Medius's banquet, as he was already feeling unwell before he was persuaded to go to the party. As Mary Renault points out, any poison that was so strong that it immediately caused Alexander to cry out in pain, would have been so strong that it would have had him dead from convulsions within an hour. It would have not have taken him 10 days to die from it.

According to Peter Green, the theory of slow strychnine poisoning was first put forward by R D Milns in the early 1970s.

PS If Alexander had bathed in cold water to bring his fever down, then slept in the cool bathhouse, possibly even on cold stone benches, he might well have developed pneumonia in addition to his existing illness..
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Re: The death of Alexander the Great - poisoning hypothesis

Post by Jeanne Reames »

Some while back the University of Mary School of Medicine took this on. What made their analysis a bit different was that they actually called in a historian to help them understand the biases in the texts, instead of taking everything at face value...something a lot of medical people don't do, resulting in some kinda WILD theories.

"A Mysterious Death." You can read it at the link below, although to get it as a free article, you'll have to register. If you have access to JSTOR, you can also get it that way: ... 6113382411

Gene and I wrote a follow-up on this, available (free) on, here: ... _the_Great

Just a reminder, also, of Thomas Africa's excellent article, "Worms and the Death of Kings," on WHY we can't trust ancient symptomology:
(He doesn't discuss ATG, but his remarks about Sulla, Herod, others, still pertain.)

I've really seen nothing to convince me it was poison, and the sources are such a muddled mess, it's difficult to say what set of symptoms is genuine, what a latter insert, thanks to the Success Wars.
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Re: The death of Alexander the Great - poisoning hypothesis

Post by Taphoi »

At the International Symposium on Disease and the Ancient World - University of Oxford - 23rd September 2017 I gave a presentation on Disease and the Death of Alexander the Great which is downloadable here: ... esentation
I used data on the diseases suffered by the British & Indian armies in Mesopotamia during the First World War and other disease and death statistics to calculate the relative probabilities of Alexander having died of falciparum malaria, typhoid, poisoning or something else. The answers were 90%, 3%, 2% and 5% respectively.
My paper on the Journal of Alexander the Great in the Ancient History Bulletin referred to in this thread regarding Diodotus of Erythrae was about why the extracts of Alexander's Ephemerides that have come down to us have to be genuine. It incidentally bolsters the case against poisoning because it shows that Alexander's fatal illness lasted 11 days, which is really unlikely for poisoning. Actually however the Liber de Morte in the Metz Epitome also gives about 11 days even though it is the main source for poisoning. In order to make this credible, it comes up with a really incredible story of Alexander being re-poisoned with a feather.
Nothing can be completely ruled out however, without autopsy of the remains. But that might not be impossible. :D
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Re: The death of Alexander the Great - poisoning hypothesis

Post by sikander »

Greetings Taphoi,
Thank you for posting the link. Looking forward to reading it!
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