Alexander The Great - Death and Succession

Death and Succession

On either 10 or 11 June 323 BC, Alexander died in the palace of Nebuchadnezzar II, in Babylon, at age 32. Details of the death differ slightly – Plutarch's account is that roughly 14 days before his death, Alexander entertained admiral Nearchus, and spent the night and next day drinking with Medius of Larissa.

He developed a fever, which worsened until he was unable to speak. The common soldiers, anxious about his health, were granted the right to file past him as he silently waved at them. Diodorus recounts that Alexander was struck with pain after downing a large bowl of unmixed wine in honour of Hercules, and died after some agony. Arrian also mentioned this as an alternative, but Plutarch specifically denied this claim.

Given the propensity of the Macedonian aristocracy to assassination, foul play featured in multiple accounts of his death. Diodorus, Plutarch, Arrian and Justin all mentioned the theory that Alexander was poisoned. Plutarch dismissed it as a fabrication, while both Diodorus and Arrian noted that they mentioned it only for the sake of completeness.

The accounts were nevertheless fairly consistent in designating Antipater, recently removed as Macedonian viceroy, and at odds with Olympias, as the head of the alleged plot. Perhaps taking his summons to Babylon as a death sentence, and having seen the fate of Parmenion and Philotas, Antipater purportedly arranged for Alexander to be poisoned by his son Iollas, who was Alexander's wine-pourer. There was even a suggestion that Aristotle may have participated.

The strongest argument against the poison theory is the fact that twelve days passed between the start of his illness and his death; such long-acting poisons were probably not available. In 2010, however, a new theory proposed that the circumstances of his death were compatible with poisoning by water of the river Styx (Mavroneri) that contained calicheamicin, a dangerous compound produced by bacteria.

Several natural causes (diseases) have been suggested, including malaria and typhoid fever. A 1998 article in the New England Journal of Medicine attributed his death to typhoid fever complicated by bowel perforation and ascending paralysis. Another recent analysis suggested pyrogenic spondylitis or meningitis. Other illnesses fit the symptoms, including acute pancreatitis and West Nile virus.

Natural-cause theories also tend to emphasise that Alexander's health may have been in general decline after years of heavy drinking and severe wounds. The anguish that Alexander felt after Hephaestion's death may also have contributed to his declining health. The most likely possible cause is an overdose of medication containing hellebore, which is deadly in large doses.