What disease did Alexander have?

What disease Alexander the Great had at his death is not known for certain, and historians and doctors have debated his cause of death for over 2,000 years. Alexander died in Babylon in 323 BC at age 32 after a sudden illness lasting about 10 to 14 days, with symptoms including fever, abdominal pain, chills, and progressive paralysis, according to ancient sources like Plutarch and Arrian. Many theories exist. The most common modern medical theories include typhoid fever, which was common in ancient Babylon due to contaminated water, malaria, which was endemic in the region, and poisoning, possibly by arsenic or strychnine-laced wine given by political rivals, though this is less favored by scholars. Other theories include acute pancreatitis from heavy drinking, West Nile virus, and Guillain-Barré syndrome, which could explain his ascending paralysis. Some historians suggest he had a perforated ulcer or cholangitis. Recently, a 2019 theory proposed that Alexander suffered from Guillain-Barré syndrome and was actually misdiagnosed as dead while still paralyzed. Ancient sources mention he drank heavily in his final days, which may have worsened any infection. Because no body or DNA evidence exists, the true disease will never be known, but most scholars believe an infectious disease like typhoid fever or malaria complicated by heavy alcohol use and possibly pneumonia is the most plausible explanation for his rapid decline and death.

The exact disease that killed Alexander the Great is unknown and debated by historians and medical experts, with theories including typhoid fever, malaria, West Nile virus, poisoning, pancreatitis, and Guillain-Barré syndrome, as no definitive medical records survive from 323 BCE. Alexander the Great, born in 356 BCE in Pella, capital of ancient Macedon, died at age 32 in Babylon in June 323 BCE after a 12-day illness following a banquet and heavy drinking, with ancient sources like Plutarch and Arrian describing symptoms of fever, chills, progressive weakness, abdominal pain, and eventual paralysis and inability to speak, but no clear diagnosis. Leading theories include typhoid fever, a bacterial infection common in ancient Babylon due to contaminated water, causing prolonged fever and abdominal symptoms, which matches his fever and decline. Malaria is another theory, as Babylon was marshy and malaria was endemic, causing relapsing fever. Some propose West Nile virus from mosquito bites, causing fever and neurological symptoms. Poisoning theory suggests he was poisoned by political rivals, though most historians doubt this due to prolonged 12-day course inconsistent with most ancient poisons. Acute pancreatitis from heavy alcohol consumption has been suggested, causing severe abdominal pain. A 2019 theory proposed Guillain-Barré syndrome, an autoimmune paralysis, causing ascending paralysis and making him appear dead before actually dying, possibly leading to premature burial declaration. So disease is unknown, with typhoid, malaria, and infection being most plausible, not definitively known.