Chapter I

The Final Banquet

In 323 BC Alexander III, king of Macedonia, ruled a dominion that stretched from the Balkans to the Himalayas and from Egypt to the Caspian Sea.  It was the largest empire the world had yet seen.  Possibly the most brilliant soldier in history, Alexander had led a small and poorly equipped European army on a campaign of over 32,000 kilometres to conquer the mighty Persian Empire.  Originally from Iran, the Persians held sway over a domain which also included all of what are now Iraq, Afghanistan, Syria, Jordan, Israel, Egypt, most of modern Turkey.  In addition, he even went as far as to conquered part of India.  It had taken him twelve years and he was still only thirty-two.  With such an astonishing achievement to his name, it is little wonder that history would know him as Alexander the Great.  However, Alexander may have been the undisputed master of the much of the known world, but he was a slave to destiny.  He did not die a warrior’s death in battle, but expired as helpless as a baby in his own bed.

In the summer of 323 BC, Alexander had finished his conquest of the Persian Empire and returned to Babylon: the greatest city on earth.  Situated on the banks of the River Euphrates, in what is now central Iraq, the city was to be the capital of the new empire that Alexander even intended to expand.  However, his conquering days were over.  On the night of June 1, Alexander was holding a memorial banquet to honour the death of a close friend.  Suddenly, late that evening, he was seized with intense pain and collapsed. Alexander was taken to his bedchamber where, after suffering agony, convulsions and delirium, he eventually fell into a coma and died.

The death of Alexander the Great is one of history’s most enduring mysteries.  What caused this strong young ruler of half the known world to die so unexpectedly at the very height of his power?  Historians have proposed malaria, typhoid and alcohol poisoning as possible causes of death, but none of these completely match the symptoms described.  There have also been those who have suggested murder, but until now no one has seriously investigated the possibility.  There was no official allusion to assassination at the time Alexander died, but his successors had good reason to avoid raising the question of regicide.  Alexander had been considered a living god and such a suspicion would have seriously damaged the credibility of the generals who took over the empire after his death.  However, according to Hieronymus of Cardia, one of Alexander’s officers who wrote a personal account of his reign, Alexander’s mother Olympias went to her grave believing that her son had been poisoned by someone at the feast that night. Was the Queen Mother right?  Was Alexander the Great really assassinated?

Orthodox historical opinion tends to discount assassination, contending that those present at the feast had everything to lose by the death of their powerful, unifying leader.  However, the more I read the historical accounts of Alexander’s life, the more I became convinced that over half a dozen of the guests that evening had ample motive for murder.  Although there is no longer a body to examine, five separate accounts have survived giving details of the king’s death.  Modern forensic examination of the symptoms they record now provides compelling evidence that the cause of death could only have been poison.

In the real-life historical detective story that follows, a fascinating trail of clues, preserved for over two thousand years, leads us finally to discover who killed Alexander the Great.

*   *   *

Before examining the circumstances surrounding Alexander’s death, we should first put the year of his demise into a global, chronological perspective.  323 BC was over a thousand years since the reign of the Egyptian pharaoh Tutankhamun, but over two centuries before the birth of Julius Caesar.  It was around a hundred years since the height of Athenian culture in Greece, but some three hundred years before the building of the Roman Coliseum.   On the religious front, it was around millennium since the time of Moses, almost two and a half centuries after the birth of Buddha, and some 228 years after the birth of the Chinese sage Confucius.  Conversely, it was over three centuries before the birth of Christ and almost nine hundred years before the birth of the prophet Mohamed.  When Alexander sat down to his last banquet in Babylon, Rome was a prosperous city, but it was still some half century before it would start to build its empire; and on the north coast of Africa, the city of Carthage (in modern Tunisia) was the most prosperous trading centre in the Mediterranean. The Iron Age had spread throughout Western Europe, where Celtic tribes had settled in areas such as Britain, France and Spain; while at the same time, from Arabia, the Nabateans had migrated west and had founded the rich city of Petra in what is now southern Jordan.  Western civilization had only just come into direct contact with India but it was still completely unaware of the advanced culture of China.  The Macedonians knew little about the Germanic peoples of Scandinavia and the Baltic, who were moving progressively south, and absolutely northing about the Olmec civilization in Central America which had existed for almost a thousand years.  This, then, was the world at the time Alexander died.

Alexander may have been a Macedonian but, for all intents and purposes, he was a Greek king.  Macedonia, in south-east Europe, lay just to the north of Greece and over the years it had completely adopted Greek culture.  So also had Sicily, the islands of the Aegean and much of what is now Western Turkey.  In 323 BC, Alexander intended that Greek civilization should be embraced by his entire new empire in Asia.  However, this was something that he never lived to see.

Unlike many events in ancient history, the details of Alexander’s death have been preserved.   Five people present at the ill-fated banquet were to write accounts of the events: Ptolemy, Alexander’s bodyguard, Nearchus, his admiral, Eumenes, his secretary, Chares, his chamberlain, and Aristobulus, his military engineer. Although the original accounts no longer survive, they were cited by a number of writers from the later Roman Empire whose works have been preserved.  These were Diodorus, a Sicilian historian who wrote in the mid-first century BC; Plutarch, a Greek biographer who wrote around AD 100; and Arrian, a Roman historian who wrote in the first half of the second century AD.  Additionally, there survives an anonymous Latin work known as the Historia Alexandri Magni (‘The History of Alexander the Great’) dating from around AD 250, and the work of Justinus, a Roman historian who lived in the late second century AD.  It is from these classical writings that the circumstances surrounding Alexander’s death can still be gleaned.

            Although Alexander is said to have fallen sick on the seventeenth day of the Macedonian month of Daesius – June 1, according to the modern calendar - there is some disagreement about where and precisely when Alexander first became ill.  Diodorus’ account of Alexander’s life is contained in two volumes of his work, the Universal History.  According to Diodorus, the banquet was a funeral feast for Alexander’s friend and senior minister Hephaestion who had died some months earlier.  The funeral was being held late because Alexander had sent a deputation to consult with an oracle of the god Ammon in Egypt about the nature of the funeral and to ask if Hephaestion could be deified.

As a matter of fact, it happened just at this time that Philip, one of the friends [in the deputation], came bearing a response from Ammon that Hephaestion should be worshipped as a god. Alexander was delighted that the god [Ammon] had ratified his own opinion, was himself the first to perform the sacrifice [of animals], and entertained everybody handsomely… After the funeral, the king turned to amusements and festivals, but just when it seemed that he was at the peak of his power and good fortune, fate cut off the time allowed him by nature to remain alive.

In Arrian’s account of Alexander’s death, in his work The Campaigns of Alexander, the author fails to give a specific reason for the feast, but he does add a few more details.

A few days later Alexander was sitting at dinner with his friends and drinking far into the night. He had previously celebrated the customary sacrificial rites in thanks for his success, adding certain others in obedience to his seers’ advice, and had also, we are told, distributed wine and sacrificial victims [meat from the animal sacrifices] among the various units and sections of the army.  According to some accounts, when he wished to leave his friends at their drinking and retire to his bedroom, he happened to meet Medius, who at that time was the companion most closely in his confidence, and Medius asked him to come and continue drinking at his own table…

The Medius mentioned in the passage was a Greek army officer who acted as Alexander’s adjutant and personal assistant.  In Arrian’s account, Medius seems to have arrived late at the feast and persuaded Alexander to stay later than he intended.  However, in Plutarch’s version of events, in his Life of Alexander, the banquet was more of a drinking binge which had actually been organised by Medius.

At the request of Medius he went to hold high revel with him; and here, after drinking all day, he began to have a fever.

In the Historia Alexandri Magni, Medius is again mentioned, but here the adjutant is responsible for having organised a proper funeral feast, rather than a drinking party:

And when Alexander had received the embassy from Ammon, he sent word that Medius of Larissa should prepare a great dinner to honour Hephaestion…

In Justinus’ work, Philippic History, Medius is also the host, but Alexander does not become ill until after the banquet when he retires to the man’s home.

As he [Alexander] was leaving the banquet, Medius, a Thessalian, proposing to renew their revelling, invited him and his attendants to his house.

What, then, were the real circumstances in which the feast was held and where exactly was Alexander when he first became ill?  As three of these sources fail to mention the reason for the celebration and the two that do specifically say that it was to honour Hephaestion, we can safely assume that the banquet – or drinking party, as Plutarch has it - was held as part of Alexander’s friend’s funeral proceedings.  Medius was clearly the host, as four of the sources specifically refer to him.  This would make sense, as it was the adjutant’s job to organise such festivities.  However, it seems most unlikely that Alexander went back to Medius’ house after the banquet, as Justinus contends.  Alexander was in the heart of what had been the Persian Empire and his life was constantly under threat.  As such, the banquet would almost certainly have been held within the secure confines of the Babylonian royal place.  It is most improbable that Alexander would have left the building to wander the city in the middle of the night and then end up at his adjutant’s house, or, as Plutarch suggests, held the celebration in Medius’ home.  Justinus and Plutarch may have wrongly assumed that, as Medius was hosting the celebrations where Alexander fell ill, that the king must have become sick in the man’s house.

            There is no discrepancy in these sources as to why the banquet was held and, apart from Justinus; they all agree that Alexander first fell sick at the feast itself. It is safe to assume, therefore, that the banquet was to honour Hephaestion and that Alexander became ill at the event which probably took place in the royal palace.  However, there are two very different versions of the symptoms Alexander exhibited when he first became ill.

According to the Historia Alexandri Magni, late in the evening, Alexander started showing signs of growing unease and began pacing around the room.  After what appears to have been half an hour or so, his condition became acutely worse:

Alexander again sat down beside Medius and, with his hands trembling, complained that it was as if a heavy yoke were upon his neck.  When he stood again to drink to Heracles, he shouted with pain as if struck through the stomach with an arrow.

Heracles was the Greek name for the mythical hero more famously known by the Roman version of his name, Hercules.  The reference here of a toast to the hero confirms the date of the feast, as the traditional day of Heracles’ death was celebrated each year by the Macedonians on the seventeenth day of Daesius – June 1.  In fact, Diodorus, in his work, specifically refers to the commemoration of Heracles’ death during his account of Alexander’s sudden pain.

There he drank much unmixed [strong] wine in commemoration of the death of Heracles, and finally, filling a huge beaker, downed it at a gulp. Instantly he shrieked aloud as if smitten by a violent blow.

Justinus also refers to the sudden, stabbing agony, but adds that pain soon spread through Alexander’ entire body.

Taking up a cup, he suddenly uttered a groan while he was drinking, as if he had been stabbed with a dagger, and being carried half dead from the table, he was excruciated with such torture that he called for a sword to put an end to it, and felt pain at the touch of his attendants as if he were all over with wounds.

The other two accounts differ considerably from these first three, portraying Alexander’s initial symptoms as being more gradual and less violent.  Arrian says that Alexander did not become really ill until he actually went to bed:

The Royal Diaries confirm the fact that he drank with Medius after his first carouse. Then he left the table, bathed, and went to sleep, after which he supped with Medius and again set to drinking, continuing till late at night. Then, once more, he took a bath, ate a little, and went straight to sleep, with the fever already on him.

Plutarch also portrays Alexander’s initial symptoms as milder and, aware of the accounts of Alexander’s sudden and unbearable pain, he even went so far as to claim they were invented:

[Alexander] was attacked with a fever, which seized him, not as some write, after he had drunk of the bowl of Hercules, nor was he taken with any sudden pain in his back, as if he had been struck with a lance, for these are the inventions of some authors who thought it their duty to make the last scene of so great an action as tragic and moving as they could.

So which version of events is correct?  Was Alexander seized with sudden and severe pain as the first three accounts assert, or was it a less spectacular fever which these authors dramatised, as Plutarch purports?  To answer this, we need to examine the sources that each author used.  Although, throughout their works, these writers used a variety of ancient historical documents that still survived, and often use the same material as each other, for their accounts of Alexander’s death they each used a different testimony from one of the five witnesses present at the banquet.  The first three witnesses, who evidently described Alexander’s acute pain, appear to have been reliable.

The account of Alexander’s death in the Historia Alexandri Magni was taken from the work of Chares of Mytilene, Alexander’s chamberlain.  He was a Greek, originally appointed as head of the royal household, but towards the end of the war with Persia, impressed by the man’s learning and his eloquent manner with words, Alexander also appointed him as his official biographer.  After Alexander’s death Chares retired to the Greek island of Lesbos where he wrote ten books, dealing mainly with the private life of the king.  As Chares appears to have been an honest writer, dealing candidly with Alexander’s personality (even his negative traits), and he had no political affiliations with any of Alexander’s successors, his account of Alexander’s death is generally considered to be trustworthy.

The same seems to be true of Aristobulus, the source for Diodorus’ account of Alexander’s death.  Aristobulus was an old but astute man who served as Alexander’s military engineer, building such constructions as catapults, fortifications and bridges.  After Alexander’s death he lived in Egypt where he compiled his memoirs.  As he was eighty-four when he wrote and had played no part in the power struggles that followed Alexander’s death, there is no obvious reason for him to have invented anything concerning his account of Alexander’s illness.

Justin’s account too, appears to have employed an objective source.  His work on Alexander’s life was taken exclusively from a book by the Roman historian Pompeius Trogus, who wrote in the early first century AD.  Trogus’ original work only survives in fragmentary form.  Nevertheless, from what still exists, we learn that his source for the later part of Alexander’s life had been the admiral Nearchus.  Not long after Alexander’s death, Nearchus retired to write a book about the foreign countries he had visited during the war with the Persian Empire, ending with a description of Alexander’s last days.  As far as we can tell, like the previous two witnesses, Nearchus has no obvious motive for inventing the manner of Alexander’s death.

These three sources all give pretty much the same account of the initial symptoms that Alexander suffered.  Why, therefore, do the other two differ so dramatically?

In his version of events concerning Alexander’s death, Arrian specifically cites the Royal Diaries as his source.  These were the official court records kept by Eumenes.  Eumenes had been an officer in the army of Alexander’s father Philip and had continued to serve with Alexander during the war with Persia.  However, by the end of the campaign, Eumenes was an old man and, although he held an honorary commission in the cavalry, he now served as Alexander’s secretary and chief scribe.  When Alexander died, these records were seized by Alexander’s chief minister Perdiccas, who used them in an attempt to authenticate his claim to the throne.  Many of his contemporaries accused Perdiccas of tampering with these records and altering some of them for his own ends.  What exactly was accurate and what had been falsified in the Royal Diaries is difficult to tell, but their authenticity concerning Alexander’s illness is clearly open to question.  Sudden and acute pain is often a symptom of poisoning and the last thing Perdiccas wanted was anyone believing that Alexander had been assassinated: claiming to be his successor would make him a prime suspect.  Perdiccas had every reason to alter the diaries to portray Alexander slipping quietly into a fever.

Plutarch source concerning Alexander’s death is equally suspect.  He took his account from the eyewitness Ptolemy.  Ptolemy was about ten years older than Alexander but had been his friend from childhood and throughout much of Alexander’s reign he served as his chief bodyguard.  Although he had never distinguished himself as one of Alexander’s commanders, Ptolemy rose to prominence shortly after the king’s death.  For seventeen years he served as governor of Egypt, but in 306 BC, with Alexander’s empire having fragmented, he proclaimed himself Egyptian pharaoh.  Shortly after, he wrote a narrative of the whole of Alexander’s life, in which he often depicts himself in a more significant role than other contemporary writings report.  For example, Ptolemy has himself playing a heroic role in the battle of Issus in 333 BC, whereas all the other sources fail to mention it.  It is generally agreed amongst historians that Ptolemy’s work is a reliable source concerning Alexander’s life, apart from when the author is personally involved in events.  There could be no more important event at which Ptolemy was present than Alexander’s death.  Not only had he attended the banquet where Alexander fell ill, he was the chief bodyguard and so ultimately responsible for keeping his king alive.  If Alexander was assassinated, then Ptolemy had failed miserably to do his job.  Such stigma was hardly fitting for a pharaoh of Egypt; particularly one who had founded a dynasty that would not end until the death of Cleopatra in 30 BC.  Even if Plutarch himself did not falsify the account of Alexander’s illness, then his Egyptian copyists certainly had every reason to portray Alexander as dying from natural causes.  As such, any classical historian, such as Plutarch, who used Ptolemy’s work as his source for the symptoms of Alexander’s fatal sickness, would have to accuse the other witnesses of dramatising events.

            When everything is taken into consideration, the first three accounts of Alexander’s initial symptoms seem to have been taken from reliable eyewitness testimony.  It appears that Alexander first became agitated, before starting to shake and complaining of stiffness or discomfort in the neck.  Soon after, he experienced an intense pain, seemingly in the area of the stomach.  As two of the accounts liken the pain to a wound inflicted by a sharp weapon, we can suppose that Alexander described it as a stabbing pain. In fact, the pain was so intense that it made him scream.  Immediately, Alexander collapsed and had to be carried from the table, although he was still conscious.  The pain, it seems, quickly spread to his entire body and he suffered extreme discomfort wherever he was touched.

            Unlike the descriptions of the initial symptoms, there are no major disagreements between the accounts concerning Alexander’s condition after he was taken to his bed.  Diodorus tells us that Alexander continued to get worse during the night:

His servants put him to bed and attended him closely, but the pain increased and the physicians were summoned. No one was able to do anything helpful and Alexander continued in great discomfort and acute suffering. 

Diodorus gives no specific details, but the Historia says that Alexander spent the night suffering what appear to have been repeated convulsions, followed by periods of delirium and unconsciousness.

Throughout the night the king would writhe and shake upon his bed, then he would become still. At other times he would ramble with meaningless words, speaking as it seemed with spirits around his bedchamber.

Plutarch not only refers to the delirium, but also an intense thirst:

In the rage of his fever and a violent thirst, he took a draught of wine, upon which he fell into delirium 

The following day Alexander’s condition improved, although he was still too ill to leave his bed unaided.  According to Arian:

Next day he was carried out on his bed to perform his daily religious duties as usual…  From there he was carried on his bed to the river [Euphrates], and crossed in a boat to the park on the further side, where he took a bath and rested. 

According to Plutarch, ‘he slept in the bathing-room all day on account of his fever’. (Bathing was the usual way to attempt to alleviate many ailments.) Alexander appears to have been left by himself in the bathing-room as, according to the Historia, ‘he bade his attendants to leave him alone in darkness, as he was distressed at both their presence and by the light’.

            The following day, Alexander’s condition had vastly improved. Plutarch tells us that he was even able to move around, play dice and was eating again:

He bathed and removed into his chamber, and spent his time in playing at dice with Medius. In the evening he bathed and sacrificed, and ate freely.

The sources agree that for the next couple of days Alexander continued to get better.  By the fifth day he was even planning a new campaign and issuing orders to his officers.  However, soon after, Alexander took a dramatic turn for the worse.  According to the Historia:

As if a knife had been thrust in and turned beneath his stomach, the pain returned and the king was beside himself with agony and again he fell into fits and delirium.

There appears to have been some confusion as to when exactly this happened.  Justinus says that it was the sixth day after Alexander’s illness began, making it the June 7; by Arian’s reckoning it was the following day; while Plutarch says it was the day after that.  Nevertheless, they all agree that somewhere between June 7 and June 9 Alexander had relapsed into a far worse condition than before.  According to Plutarch, Alexander’s generals decided that their king was close to death and decided to visit him one last time.

On the twenty-fifth [day of Darius – June 9] he was removed to his palace on the other side the river, where he slept a little, but his fever did not abate, and when the generals came into his chamber he was speechless and continued so the following day.

According to Arrian, although Alexander was unable to speak, he was still conscious:

Lying speechless as the men filed by, he yet struggled to raise his head, and in his eyes there was a look of recognition for each individual as he passed.

The Historia gives pretty much the same account:

He recognised his officers and raised his head to speak to them, but could utter no word.  From that moment until the end he spoke no more. 

Justinus also says that Alexander was unable to speak.  However, he was able to sit up and give Perdiccas his ring:

Being unable to speak, he took his ring from his finger, and gave it to Perdiccas, an act which tranquillized the growing dissension among his friends; for though Perdiccas was not expressly named his successor, he seemed intended to be so in Alexander’s judgment.

For another day Alexander lingered on, his breathing becoming more laboured, until he fell into a coma and died the following evening.  The traditional date of Alexander’s death is June 11, although it could have been a couple of days earlier if Justinus is right, and a day or so later if Plutarch is to be believed.

Alexander the Great had been the most successful soldier in history and his empire had been the largest the world had ever seen.  However, his end was no warrior’s death and what happened to his body was hardly the kind of obituary he would have hoped for.  As Alexander had died without publicly naming an heir, his generals spent the best part of a week arguing over his successor.  Plutarch tells us that during this time Alexander’s body was unceremoniously left to lie in a storeroom somewhere.  Strangely, although it should have begun to decompose in the hot Babylonian summer, the body remained preserved.

During the dissensions among the commanders, which lasted several days, the body continued clear and fresh, without any sign of such taint or corruption, though it lay neglected in a close, sultry place.

Alexander’s body was eventually despatched to a tomb that had been prepared in Macedonia's religious capital of Aegae. However, once it arrived in the Syrian city of Damascus, it was hijacked on the orders of the new Egyptian governor Ptolemy and taken back to Egypt to be buried in Alexandria.  However, the precise location of the tomb has been long forgotten.

            So how did Alexander die?  Modern science could probably discover much from his remains, but unfortunately his tomb has never been found.  We are left, therefore, with the eyewitness testimony alone from which to postulate a verdict.

            The most popular theory for the cause of death has been malaria.  Alexander had travelled to part of India where malaria was common, and some of his symptoms do indeed match the disease.  With malaria, the patient experiences chills which cause shaking, as Alexander is said to have done, and they develop a high fever, which comes and goes every few days for a week or so.  Alexander is described as initially having a fever which abated until he relapsed a few days later.  Malaria can also induce delirium and periods of unconsciousness, which it also seems Alexander suffered.  And in cases where malaria is fatal, the cause of death is usually a ruptured spleen: an agonising condition that would result in excruciating pain in the area of the stomach, such as described in Alexander’s case.  For years, malaria was widely accepted by historians as the cause of death, until a tropical disease specialist, Dr James Maynard of London University, examined the accounts of Alexander’s fatal illness in the 1970s.  He concluded that if the ancient reports were reliable, then Alexander could not have died from malaria.    

Dr Maynard seriously doubted that Alexander had suffered a ruptured spleen.  If his spleen had ruptured when he was struck down with pain at the banquet, as the malaria theory supposed, then the pain would not have subsided overnight and abated for some days, as the sources report.  Alexander would have been in persistent agony until he died from internal haemorrhaging.  Moreover, the pain would have been on the left side of the stomach and not beneath it, as described. The other way that malaria victims can die is when diseased blood cells clog the brain tissue of the patient.  Dr Maynard found no evidence that Alexander had died in this way either, as the condition would have been accompanied by severe headaches which are not mentioned once by any of the sources.  In fact, Dr Maynard was certain that Alexander not have contracted malaria at all.

Malaria is a disease carried by certain mosquitoes that can infect a person with a bite. These mosquitoes live in jungle and tropical locations, but not in desert regions such as central Iraq where Alexander died.  However, two years earlier, Alexander had been in an area of India where malaria was common.  Nevertheless, Dr Maynard seriously doubted that Alexander could have contracted the illness there.  The disease can remain dormant in the bloodstream for anything up to ten months from the time of the initial exposure.  Someone who fails to exhibit symptoms after that time is probably not infected: certainly not after two years.  Bouts of malaria, lasting some days, can and do recur, so it is possible that Alexander had previously suffered from the illness since he left India.  However, Alexander’s life from the time he was in India is well documented but there is no report whatsoever of a previous illness of this kind.

With the malaria diagnosis in question, in 1998 a team from the University of Maryland in the USA suggested that Alexander had died of typhoid.  Typhoid causes chills, high fever and delirium, from which Alexander appears to have suffered.  However, so do many other illnesses.  What convinced the team that he had specifically died of typhoid was the description Plutarch gives of the state of preservation of Alexander’s body after his apparent death.  One symptom sometimes associated with typhoid is a condition known as ascending paralysis: muscle paralysis which starts at the feet and moves slowly up the body.  Patients with this condition can eventually appear dead and, in the days before modern medicine, some unfortunate victims of typhoid were even buried before they had actually died.  As Plutarch reported that Alexander’s body failed to show any signs of decomposition for days, the team proposed that the king had been suffering from paralysis caused by typhoid and was actually still alive.

However, the typhoid theory failed to address many of the symptoms and circumstances associated with Alexander’s death.  To begin with, typhoid is caused by salmonella typhi bacteria which is transmitted by food or water contaminated by an infected person, or by sewage containing the germs.  As such, there would almost certainly have been an epidemic of the disease when Alexander fell sick.  However, there is nothing in any of the historical accounts to suggest such outbreak in Babylon at the time.  Secondly, salmonella typhi is an intestinal bug which causes severe diarrhoea and abdominal pain.  Beside the fact that diarrhoea is not mentioned in the historical accounts, Alexander’s pain is reported to have been in the area of his stomach and not his bowl which would have been the area of discomfort if he had typhoid.  In fact, the University of Maryland team proposed that Alexander’s stabbing pain suggested that he had died of a perforated bowel, which is often the cause of death in cases of typhoid fatality.  Even if the sources are wrong about the location of Alexander’s pain, a perforated bowel would have left him in constant agony until he died, rather than recovering for days as the accounts all describe.

            Perhaps the most obvious possible cause of Alexander’s death to consider is alcohol poisoning.  Not only is he reported as having been a heavy drinker, on the day he was taken ill Alexander had been consuming large quantities of strong wine.  Intense pain in the area of the stomach is a symptom of alcohol poisoning and unconsciousness is inevitable. Alexander did suffer stabbing pains in his stomach and was unconscious shortly after.  If Alexander had suffered from the toxic effects of alcohol to the point where he was in excruciating agony, as is reported, then the lining of his stomach would have been so inflamed that he would also be vomiting violently and would not be able to hold down food or liquid for many hours or even days.  If Alexander was a chronic alcoholic, as has been suggested, then this condition would be extremely serious.  Unable to hold down any alcohol, Alexander would soon suffer from dangerous withdrawal symptoms.

Serious alcoholics suffer severe withdrawal symptoms known as delirium tremens, or DTs for short.   Unless the alcohol intake is lessened gradually, or substituted by modern drugs, the person experiences fevered agitation, extreme anxiety, delirium, hallucinations and severe trembling.  Moreover, delirium tremens also include grand mal seizures that sometimes lead to death.  All of these, or similar symptoms, seem to have been suffered by Alexander.  However, as DTs occur because the body has been denied the alcohol it has become dependent upon, they do not begin until enough alcohol has left the system – usually not for twenty-four hours or more.  Even with an extremely high metabolism, DTs would not occur until at least six hours after the last drink; and even then they would be the less severe effects, such as anxiety, agitation and some shaking.  The more extreme conditions - delirium, hallucinations and seizures - would not occur until many hours later.  However, Alexander was suffering from all these symptoms the night he was taken from the banquet.  In fact, the trembling and agitation are recorded while he was still drinking.  Whatever Alexander was suffering from on the night of the banquet it was not DTs, and alcohol poisoning itself would not cause such symptoms.  Alcohol poisoning either results in complete unconsciousness or a state of stupor in which the nervous system is dangerously sedated for hours: the victim is in precisely the opposite condition to one which would produce the writhing seizures and delirium which Alexander is said to have suffered. In fact, the major effect of alcohol poisoning is continual vomiting.  Death often results from the victim choking on their own vomit or, in the days before intravenous drips, from dehydration.  Even though Plutarch does say that Alexander suffered a violent thirst on the night he was taken ill, not once does he or any of the other historical sources once mention vomiting or even nausea as one of Alexander’s symptoms.

            Whatever really killed Alexander has never been successfully explained.  Indeed, it seems to have been a mystery to Alexander’s contemporaries as no particular illness was officially named at the time the king died.  However, some years later there were suspicions that Alexander was murdered.   Justinus records that some of Alexander’s friend’s considered that drink was responsible for his death but, for some reason, he dismissed the possibility in favour of assassination.  In fact, Justinus goes so far as to suggest a cover up by Alexander’s successors.

His friends reported that the cause of his disease was excess in drinking, but in reality it was a conspiracy, the infamy of which the power of his successors threw into the shade… He was overcome at last, not by the prowess of any enemy, but by a conspiracy of those whom he trusted, and the treachery of his own subjects.

On what evidence Justinus was basing these allegations is unknown, but he could have read the work of Hieronymus of Cardia who evidently referred to the suspicions of Alexander’s mother, Olympias, that her son was poisoned.  Hieronymus was a soldier who had served with Alexander and his memoirs still survived in Justinus’ day.  In fact, copies were still in existence some half century later when the Historia was complied, as it cites Hieronymus concerning Olympias’ belief that someone had murdered her son:

Upon a story told to her in Pella [the capital of Macedonia], Olympias believed that her son had been poisoned.  Whoever had committed so grievous a crime, she seems not to have known, for it is said she killed many who were innocent in her search [for the culprit].

Plutarch, in his account, also states that Olympias came to believe that someone had killed Alexander:

At the time, nobody had any suspicion of his being poisoned, but upon some information given six years after, they say Olympias put many to death.

Who exactly provided Olympias with the information, what it was, and why it so convinced her that Alexander was murdered, is as much a mystery as the cause of Alexander’s death. Whatever Olympias was told, she obviously regarded it as proof that Alexander had been poisoned.  However, the information clearly did not include the name of the supposed culprit.  Nevertheless, Olympias’ suspicions seem to have started fingers pointing at various suspects, as the historical sources even name some of them.  Plutarch, for instance, refers to suspicions that Alexander’s general Antipater was responsible, and that he had been encouraged by the renowned philosopher Aristotle who was alive at the time.

But those who affirm that Aristotle counselled Antipater to do it, and that by his means the poison was obtained, cite one Hagnothemis as their authority.

Who this Hagnothemis was is unknown as he goes unrecorded elsewhere, but he may have been the same person who informed Olympias of a plot.  Justinus also mentioned suspicions that Antipater was responsible and refers to rumours that his youngest son Iollas, who was the royal butler, administered the poison into Alexander’s wine at the banquet.  Olympias clearly considered Iollas a suspect at one point because Plutarch says that she desecrated his grave after he died.  However, she obviously decided that he was not the guilty party as she continued to pursue others.  Another man she seems to have suspected was Medius, as Arrian says that that suspicion was also attached to him.  As the person in charge of the festivities where Alexander fell ill, he would have been an obvious suspect.  Nevertheless, Olympias eventually rejected him as the culprit too and appears to have turned her attentions to Antipater’s son eldest son Cassander. Diodorus suggests that Cassander eventually murdered Olympias around 316 BC because she had accused him of the murder.  However, it appears that Olympias died, still uncertain as to the identity of the person who was supposed to have killed her son.  According to the Historia:

The queen mother [Olympias], it is said, had good and sound proof that poison had been administered to him [Alexander], and that the assassin had been present at the revel [the banquet] as all the food and all the drink had been well tasted [tested by a food taster] earlier that evening and had since been guarded.  Though she put many to death and levelled accusations, the culprit, if indeed there was one, was never exposed for the deed.

Was Olympias right - had Alexander really been poisoned by someone at the banquet that night?

         One reason why the possibility of assassination has been largely ignored by modern historians is that they have tended to rely on Plutarch, who not only dismissed the allegations of murder but portrayed Alexander’s illness as a naturally occurring fever.  Additionally, as he cited the Royal Diaries as his source, Arian’s depiction of Alexander’s condition as a gradual fever has also been regarded as evidence negating the likelihood of poisoning.  However, as we have seen, both these author’s sources, Ptolemy and Eumenes, cannot be accepted as reliable, objective witnesses concerning the initial symptoms Alexander suffered.  Each of the other three accounts, for which there is no obvious reason to doubt the integrity of their sources on the matter, are quite specific about the violence of Alexander’s condition: one which would be consistent with various types of poisoning.  Nevertheless, the main reason why it has been generally accepted that Alexander died of natural causes is a sound one.  Namely, that there appeared to be no actual evidence to the contrary.  However, when I confronted forensic experts with the reports of Alexander’s fatal illness, it transpired that there was, in fact, every reason to believe Alexander had been poisoned.