The Death of Alexander the Great: Mystery and Legacy
The death of Alexander the Great on 10 June 323 BCE in the palace of Nebuchadnezzar II in Babylon is one of the great mysteries of the ancient world. Alexander was thirty-two years old, at the height of his power, in the middle of planning a new campaign to Arabia and the west, when he fell ill after a long banquet and died ten days later. The cause of his death has been debated for more than two thousand years. The ancient sources offer a range of possibilities: natural illness (typhoid, malaria, fever), poisoning by one of his generals, alcoholic excess, and even (in one modern theory) the cumulative effect of multiple battle wounds. Whatever the cause, his death changed the course of history. The empire he had built split apart, and the Hellenistic world that emerged from the ruins would dominate the Mediterranean and the Near East for the next three centuries.
This page is a complete guide to the death of Alexander. It explains the historical background, the illness, the ancient theories, and the modern theories. It links back to the Alexander the Great cluster, the Battle of Gaugamela page, and the Greek Philosophy cluster.
The Last Months of Alexander
In 324 BCE, Alexander returned to Susa in Persia after his exhausting campaign in India. He spent the winter there, and in the spring of 323 BCE he moved to Babylon. He had been planning a new campaign to the west, to Arabia and the Mediterranean, and Babylon was to be the staging base.
The last months of Alexander’s life were marked by a series of troubling events. He had ordered the Macedonian veterans to be sent home, and many of them had taken this as a sign of his disaffection. He had executed several of his senior officers for various reasons, including Parmenion, the veteran general who had served his father Philip. He had ordered the Greek cities to recognize him as a god, and the Greeks had been reluctant. He had also taken to heavy drinking, especially at the great banquets that he loved to host.
The Banquet of Medius
On the night of 6 June 323 BCE, Alexander attended a banquet at the house of Medius, a Macedonian nobleman who had been a friend of his since childhood. The banquet was a long, drunken affair. According to the ancient sources, Alexander drank heavily, then left the banquet feeling ill. He was given a cup of unmixed wine to settle his stomach, drank it, and soon developed a severe fever.
The fever worsened over the next several days. Alexander continued to give orders, conduct business, and even lead a sacrifice, but the fever did not break. The Macedonian generals were summoned to his bedside, and the army was assembled outside the palace to pay its respects. The soldiers filed past his bed one by one, in silence, and Alexander, who could no longer speak, raised his head weakly to acknowledge them.
On 10 June 323 BCE, Alexander died. He was thirty-two years old, and he had been king of Macedon for twelve years and eight months. According to the Roman historian Justin, the Macedonian soldiers were so grief-stricken that they refused to eat or drink for three days, and they kept vigil over his body for the entire period.
The Theories of the Cause of Death
The ancient sources offer a wide range of theories about the cause of Alexander’s death. The most important are:
1. Natural Illness
The ancient historian Plutarch, writing in the first century CE, listed the most common theories: natural fever, excessive drinking, poison, and the cumulative effect of his many battle wounds. The most common ancient explanation was that Alexander died of a fever, possibly typhoid, malaria, or some other infectious disease. The presence of a large army in Babylon, the heat of the summer, and the unsanitary conditions of the city would have favored an epidemic.
2. Poisoning
Several ancient sources accused the Macedonian general Antipater of having arranged the poisoning of Alexander. Antipater had been left behind as regent of Macedon, and he had been the target of several of Alexander’s recent purges. The story of the poisoning involved a son of Antipater, Iollas, who was the royal cupbearer, and who was said to have slipped a poison into Alexander’s wine. The poison was sometimes said to be the icy water of a sacred spring in Macedonia, which had a delayed effect.
The poisoning theory has been the subject of intense modern scholarly debate. In 2010, a New Zealand toxicologist, Leo Schep, published a study arguing that the symptoms of Alexander’s death were consistent with poisoning by hellebore, a plant known to the ancient Greeks and used as a medicine. The theory is controversial.
3. Excessive Drinking
Several ancient sources blame Alexander’s heavy drinking. The Greek historian Theopompus claimed that Alexander drank huge quantities of unmixed wine, and several sources report that he had been drinking heavily in the days before his death. The combination of alcohol and the hot climate of Babylon could certainly have contributed to a serious illness, but it is unlikely to have been the sole cause.
4. Cumulative Battle Wounds
A modern theory, advanced by the British surgeon and Alexander scholar W. W. Tarn and later by the New Zealand toxicologist Leo Schep, holds that Alexander was killed by the cumulative effect of his many battle wounds. Alexander was wounded at least five times in battle — at the Granicus, at Issus, at Gaugamela, at the siege of Massaga, and at the siege of Cyropolis — and the long-term effects of these injuries, combined with the strains of his many campaigns, may have weakened him fatally.
5. Modern Medical Theories
Modern scholars have proposed a number of medical explanations for Alexander’s death. The most prominent is that he died of typhoid fever, complicated by the poor conditions in Babylon and the long-standing effects of his battle wounds. Other theories include malaria, acute pancreatitis, and (in the most extreme theory) Guillain-Barré syndrome, a rare neurological condition.
The Aftermath
The death of Alexander triggered the immediate struggle for his empire. Alexander’s wife Roxana was pregnant, and the succession was unclear. The Macedonian generals gathered in Babylon and divided the empire among themselves, appointing Perdiccas as regent and Alexander’s half-brother Philip III Arrhidaeus as king. Almost immediately, a series of wars of succession broke out among the generals, the so-called Diadochi (“Successors”). Within forty years, the empire had been divided into three great Hellenistic kingdoms: the Ptolemaic in Egypt (founded by Ptolemy I Soter), the Seleucid in Syria and the east (founded by Seleucus I Nicator), and the Antigonid in Macedon (founded by the Antigonid dynasty).
The Funeral and the Burial
Alexander’s body was preserved in Babylon and then transported to Egypt by Ptolemy I, who wanted to legitimize his rule by associating himself with Alexander. The body was first interred in Memphis, and then in Alexandria, where Alexander’s tomb, the Sema, became one of the most famous sites of the Hellenistic world. Visitors to the tomb included Julius Caesar, Augustus, Caligula, and the Roman emperor Septimius Severus. The tomb was destroyed in late antiquity, and its location is no longer known.
The Legacy of Alexander
Alexander’s death was a turning point in the history of the world. Had he lived, he would have continued his campaigns and might have created a single world-state stretching from Greece to India. His death led to the breakup of the empire and to the long Hellenistic age, in which Greek culture spread from Egypt to India. The death of Alexander also marked the beginning of the long, slow decline of the Macedonian world and the rise of Rome as the dominant power in the Mediterranean.
Alexander’s death has been the subject of poetry, drama, painting, and film for two thousand years. The Greek historian Arrian, the most reliable ancient source, wrote the Anabasis, a careful and sympathetic account of Alexander’s campaigns. Plutarch’s Life of Alexander and Life of Caesar are paired in the Parallel Lives. The Roman poet Lucan wrote a long epic on the civil war between Caesar and Pompey that was inspired by Alexander’s career. The modern fascination with Alexander — the romantic, doomed hero, the conqueror of the world — has been a constant in Western culture since antiquity.