The Mysterious Death of Alexander the Great: What Really Happened in Babylon?

Alexander’s Final Days in Babylon

In the spring of 323 BCE, Alexander was in Babylon, planning new military campaigns. He intended to expand his empire further into Arabia and possibly the western Mediterranean. Despite years of relentless warfare, Alexander remained ambitious and energetic.

According to ancient sources, Alexander attended a series of banquets and celebrations with his companions. Shortly after one such feast, he developed a high fever, weakness, and severe pain. Over the next 10 to 12 days, his condition worsened.

He gradually lost the ability to speak, move, or command his army. By the end, he could only communicate through gestures. On June 10 or 11, 323 BCE, Alexander died.

Ancient Accounts of His Death

Most information about Alexander’s death comes from ancient historians such as:

Arrian

Plutarch

Diodorus Siculus

Curtius Rufus

While these sources agree on the general timeline, they differ in details. Some describe a slow decline from fever, while others suggest sudden collapse. None provide a definitive cause, leaving room for speculation.

Theory 1: Natural Illness

The most widely accepted explanation is that Alexander died from a natural disease.

Possible illnesses include:

Typhoid Fever

Many modern historians believe Alexander died from typhoid fever, a bacterial infection common in ancient cities with poor sanitation. Symptoms such as prolonged fever, weakness, abdominal pain, and delirium closely match historical descriptions.

Malaria

Malaria was widespread in Mesopotamia. However, malaria usually causes recurring fever cycles, which are not clearly described in the records.

Pneumonia or Infection

Alexander had numerous battle wounds, which could have weakened his immune system. A severe infection could have developed rapidly.

This theory suggests that Alexander’s intense lifestyle—constant campaigning, injuries, heavy drinking, and exhaustion—made him vulnerable to disease.

Theory 2: Poisoning

One of the most dramatic theories is that Alexander was poisoned.

According to ancient rumors, enemies within his own circle feared his growing power and unpredictable behavior. Some accounts blame:

Antipater, a Macedonian regent

Members of the royal court

Even trusted companions

Possible poisons suggested include arsenic or strychnine, though these substances usually act quickly. Alexander’s illness lasted several days, which makes traditional poisoning less likely.

However, some historians argue that slow-acting toxins, possibly derived from plants, could explain the prolonged decline.

Despite its popularity, the poisoning theory lacks solid evidence.

Theory 3: Alcohol and Lifestyle Effects

Alexander was known to drink heavily, especially in his later years. Some scholars believe his death resulted from:

Alcohol poisoning

Liver failure

Pancreatitis

Combined with stress, injuries, and exhaustion, long-term alcohol abuse may have contributed to his collapse.

This theory does not explain all symptoms but may have played a supporting role.

Theory 4: Guillain-Barré Syndrome (Modern Theory)

A more recent medical hypothesis suggests Alexander may have suffered from Guillain-Barré Syndrome, a rare autoimmune disorder that causes paralysis while leaving the mind alert.

Supporters of this theory point to:

Gradual loss of movement

Preserved consciousness

Delayed declaration of death

Some ancient sources mention that Alexander’s body did not decay for several days, leading to speculation that he may not have been dead when declared so. While intriguing, this theory remains speculative.

The Problem of the Body

One of the strangest details surrounding Alexander’s death is that his body reportedly did not show signs of decomposition for days. In the ancient world, this was seen as proof of divine origin.

From a scientific perspective, possible explanations include:

Cool storage conditions

Certain illnesses slowing decomposition

Embalming attempts

Regardless, this detail added to the mystery and reinforced Alexander’s mythic status.

Political Consequences of His Death

Alexander died without naming a clear successor. When asked who should rule, he reportedly said:

“To the strongest.”

This single statement led to decades of warfare among his generals, known as the Wars of the Diadochi. His empire fractured into several kingdoms:

Ptolemaic Egypt

Seleucid Empire

Antigonid Macedonia

The unity Alexander fought to create collapsed almost immediately.

How His Death Changed History

Had Alexander lived longer, history might have unfolded very differently. A longer reign could have meant:

Stronger administrative systems

A lasting unified empire

Further cultural integration between East and West

Instead, his early death ended one era and began another defined by division and conflict.

Why the Mystery Endures

The mystery of Alexander’s death endures because:

Ancient medical knowledge was limited

Historical records are incomplete

His status invites legend and speculation

Each theory reflects humanity’s attempt to understand how such an extraordinary life could end so suddenly.

Conclusion

The death of Alexander the Great remains one of history’s greatest unanswered questions. Whether he died from disease, poisoning, or a rare medical condition, his passing marked the abrupt end of an unmatched career. At just 32, Alexander had reshaped the world, but death proved that even the greatest conquerors are mortal.