Hephaiston's death

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hiphys
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Re: Hephaiston's death

Post by hiphys »

Thank you, Alexias, for your kind words. My friend had embolism five days after a surgical operation. She only should have been back home next day.
tei
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Re: Hephaiston's death

Post by tei »

So sorry about your friend, that's terrible.

An interesting comment on Hephaestion's death that was in a footnote of the Landmark edition of Arrian— iirc, it pointed out that malaria is often characterized by extreme thirst in the final stages, which would explain him supposedly guzzling wine.
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chris_taylor
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Re: Hephaiston's death

Post by chris_taylor »

Hephaiston was cremated, so we will never know, but I'll chip in as someone who spent 40 years in emergency rooms: remember if this happened today, Hephaiston would be bluelighted to the nearest ER, just like thousands of others each year. For ER docs, a case like his is bread & butter stuff. so today, the event would unfold like this:

Hephaistion collapses. Glaucias panics and instead of giving CPR, he calls 911 and sends for Alexander. Paramedics arrive at the same time as
Alexander, say 30 minutes after the event. Hephaistion is not responding, has no pulse and isn't breathing = he is dead already. They
start CPR, bluelight him to hospital. To alert the ER, they phone ahead, giving them all the details Arrian provided us with, or which we can
infer:

male, late thirties
previously fit & well
unwell with non-specific symptoms & fever for a week
started feeling better today
well enough to eat a whole chicken and drink a bottle of wine
collapsed shortly after meal
DOA on arrival some 30 minutes later
nothing suspicious on scene (no drugs /suicide notes)
no evidence of trauma
partner (Alexander) doesn't think its poison


What'll be going through the mind of the ER doc taking the call?

1) There is no infectious disease that kills a patient in the recovery phase that fast because that's not how infections work. The feverish
illness is a red herring.

2) The speed of deterioration - from eating a meal to dead in 30 minutes - limits potential causes to 5 large diagnostic groups: acute airway
obstruction, irregular heart beat or a vascular event in a vital organ (brain, heart, lung). Within those 5 groups, the top common causes that kill fit young males are:

* choked on a piece of meat (= airway obstruction, but uncommon with white meat)
* irregular heart beat (patients are often born with the defect, definite possibility)
* brain haemorrhage (subarachnoid - right age, right gender)
* pulmonary embolus (period of incapacity)
* heart attack (common, but less likely as he's the wrong age)

3) But I'll give narcan anyway, in case he overdosed on opium and nobody knew ...
All men by nature desire understanding. Aristotle.
Alexias
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Re: Hephaiston's death

Post by Alexias »

An interesting post, thanks.

Some historians such as Badian think that Hephaestion basically drank himself to death, so maybe alcohol played a part. However there is a clue in Arrian that the doctor may have played a significant part in administering something that caused an adverse reaction.
Others again say that he hanged the physician Glaucias, for having indiscreetly given the medicine; while others affirm that he, being a spectator of the games, neglected Hephaestion, who was filled with wine.
Sweetmemory41
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Re: Hephaiston's death

Post by Sweetmemory41 »

Death by choking on vomit in sleep is another possibility.
Alexias
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Re: Hephaiston's death

Post by Alexias »

I doubt he was sleeping. He was in distress, which was why Alexander and the doctor were sent for. Unless the doctor gave him a very powerful opiate, which I don't think they had.

Just out of interest, as far as I am aware, this is all we know of Hephaestion's death:

Arrian Chapter XIV
He also held drinking parties with his Companions. At this time Hephaestion fell sick; and they say that the stadium was full of people on the seventh day of his fever, for on that day there was a gymnastic contest for boys. When Alexander was informed that Hephaestion was in a critical state, he went to him without delay, but found him no longer alive. ... Others again say that he [Alexander] hanged the physician Glaucias, for having indiscreetly given the medicine; while others affirm that he, being a spectator of the games, neglected Hephaestion, who was filled with wine. Translated 1884

Alternative translation

About this time Hephaestion fell sick. One the seventh day of his illness it so happened that there was a big crowd at the stadium to watch the boys' races, which were then taking place. During the races a message was brought to Alexander that Hephaestion's condition was serious; he hurried away, but his friend was dead before he could reach him. ... Some have said that he had Glaucias, the doctor, hanged for giving the wrong medicine; others because he had seen Hephaestion drinking too much and had made no attempt to stop him. Translated 1971
Diodorus Chapter XVII
Here he refreshed his army for some time and staged a dramatic festival, accompanied by constant drinking parties among his friends. In the course of these, Hephaestion drank very much, fell ill, and died.
Plutarch Chapter 7
When he came to Ecbatana in Media and had transacted the business that was urgent, he was once more much occupied with theatres and festivals, since three thousand artists had come to him from Greece. But during this time it chanced that Hephaestion had a fever; and since, young man and soldier that he was, he could not submit to a strict regimen, as soon as Glaucus, his physician, had gone off to the theatre, he sat down to breakfast, ate a boiled fowl, drank a huge cooler of wine, fell sick, and in a little while died. ... he also crucified the wretched physician, translated 1919

Alternative translation

At this time it happened that Hephaestion had caught a fever, and being a young man who was accustomed to a soldier's life, he could not bear to remain on a strict diet. No sooner had his physician Glaucus gone off to the theatre, than he sat down to breakfast, devoured a boiled fowl, and washed it down with a great cooler-full of wine. His fever quickly mounted and soon afterwards he died. translated 1973
Maybe Badian was right to state that Hephaestion basically drank himself to death, but he would have had to be seriously drunk to die of alcohol poisoning, and this doesn’t seem to have been his intention, or there to have been enough time for him to drink about a gallon of wine.

The final translation says ’his fever quickly mounted’. I don’t know Greek, but I tried looking here https://www.perseus.tufts.edu/hopper/te ... ection%3D1 where you can look up the definition of each word. It doesn’t seem to actually say fever, but that his meal quickly caused distress and he died soon after.

So, either, Hephaestion's illness affected his digestive system and meant the doctor kept him off solids; or the doctor was simply applying the old adage 'Feed a cold; starve a fever'; or the doctor wanted to keep him off alcohol, which would have been bad for him in any case. His meal placed his body under stress and caused a crisis. We don't know how long the crisis took to become critical, or at what stage the doctor and Alexander were sent for, or whether they were sent for separately, or together, but it looks as if things happened quite quickly.

If they were sent for together, chances are, Alexander got there before the doctor as he would have been easy to find in the stadium, whereas the doctor may have been difficult to find in the crowd. If he were sent for first, as Renault points out in The Nature of Alexander, there may have been a critical delay in finding him in the crowd. Alexander only seems to have been sent for when it became apparent that Hephaestion might not survive.

I quite liked my theory that the doctor, deducing that it was the meal and wine that was causing Hephaestion distress, and giving him an emetic and/or a purge to get it out of his system, may have caused his death by choking on his own vomit, but now I am not so sure. Hephaestion was clearly in serious trouble well before the doctor got there, if he did at all.
Sweetmemory41
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Re: Hephaiston's death

Post by Sweetmemory41 »

Thank you, Alexias, for such a detailed and educational reply. I had read the (translated) descriptions of Hephaestion’s death by Arrian, Diodorus, and Plutarch separately over the years. However, seeing them together with alternate translations is very educational.
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