Alexander the Great fell ill at Tarsus (all sources)

[Alexias]

Thanks for your response. Unfortunately I am not convinced.

So I hypothesize that Parmenion wanted to kill Alexander before Issus because he wasn't sure who was stronger, the Persians or the Macedonians. Also, Parmenion probably didn't like Alexander's risky tactics which might have endangered his sons Philotas and Nicanor.

There is nothing to indicate a crisis of confidence in Parmenion before Issus, or indeed after. He was a very good and experienced commander, and he would have known it, not least because Philip made no secret of his admiration of Parmenion's talents as a general. The army was on a roll, with confidence and expectations high, and Memnon, their only adversary of any note, was recently dead.

There is also a literary device going on here. Not only is Parmenion's opposition to Alexander's plans being used to undermine his abilities (as previously mentioned), it is also a device used to explore the nature of Alexander's kingship. The kingship Alexander inherited from Philip was one of being 'the first among equals'. His generals were free to speak their mind to him, and Parmenion's advice is used to show that Alexander sought counsel from more experienced commanders, but was able to trump it with his daring leadership. It is interesting that after Parmenion's death, we don't seem to hear of this advice being given to Alexander, and it may be being used to be indicative of an increasingly autocratic style of kingship - certainly part of Plutarch's theme of Alexander's rise and fall on the wheel of Fortune.

Parmenion probably made a secret deal with Darius.

Unlikely. Alexander's treatment of the Greek mercenaries who fought for the Persians at the Granicus (he sold them into slavery in the silver mines), is indicative of the bitterness and contempt in which the Macedonians held those who collaborated with the Persians. Parmenion was actually in advance of Alexander's position at Tarsus, guarding the Syrian Gates, a pass from the coast to the interior plains over which Darius was advancing. As such, he likely had knowledge of Darius's numbers and that may have concerned him, but he would also have had confidence in the superior training and discipline of the Macedonians over a large portion of Darius's army.

If he eliminated Alexander at Tarsus, Parmenion would have given himself two problems instead of one: Darius's army and convincing the Macedonian army to accept him as commander. Alexander of Lyncestis was still alive at this point and there would have been those who would have advanced his claims to the kingship, or Arridaheus. Parmenion was not of royal blood, so it is unlikely he would have been successful in making himself king, and he wouldn't have held the army together without the authority of a king, never mind what would have happened in Greece as soon as they found out Alexander was dead. Parmenion was too good a general to realise that giving in to Darius without a fight would cause more damage than it would achieve.

Later Parmenio probably conspired against Alexander with his son Philotas:

Very unlikely. There has obviously been lots written about this by every historian, but on the face of it, it would seem that at the least Philotas was guilty of laziness, stupidity, and opportunism in not reporting the plot. If he did know of the plot beforehand, then he clearly wasn't very well prepared. As I said before, Parmenion was in a position of power at this point, and if he decided to oppose Alexander, then Alexander had a major problem. Parmenion was executed, not because he was involved in the plot - and there is no indication that he was - but because it was normal practice to eliminate family members in a case of treason, assuming guilt by association and to prevent a blood feud from developing. Alexander had no option but to get rid of Parmenion as he would never be able to trust him again.

[AdamKvanta]

First of all - why would Parmenion warn Alexander about Philip the Acarnanian if he wanted Alexander dead? If Philip were going to poison Alexander, then he would surely have been happy about it.

We know Philip didn't poison Alexander so Parmenion was wrong. He might have been mistaken or he himself poisoned Alexander and he didn't want anyone to cure him.

Second - prior to the events at Tarsus, why did PArmenion send news to Alexander about the plot involving Alexander of Lyncestis. Surely he would have supported the Lyncestian plot against Alexander.

Maybe it was after this incident with Alexander of Lyncestis that Parmenion decided to poison Alexander. He realized that he could make a deal with Darius.

Parmenion was quite capable of suggesting 'rash' tactics, so he can't have had a problem with Alexander's rashness:

Arrian 3.10.1
[1] These and other such brief exhortations brought in return assurances from the commanders that he could rely on them. So he ordered his army to take their meal and rest. They say that Parmenio went to him in his tent and advised him to attack the Persians at night; they would be surprised, confused and more prone to panic in a night attack.

I disagree that this night attack was a rash tactic, I think it was the opposite. He wanted to surprise the opponent and thus minimize the casualties.

Parmenion had been completely in favour of the Asian campaign.

Yes, and then he changed his mind when he saw Alexander's recklessness.

Parmenion was completely devoted to Alexander ... Parmenion was the most faithful of Alexander's officers ... It was inconceivable to Antipater that Parmenion could have plotted against Alexander.

Yes, but it turned out that it was probably just a pretense. Alexander killed him after all. And also Callisthenes thought otherwise.

Parmenion fought superbly at Gaugamela.

That was long after Issus and other battles. Parmenion had no reason to support Darius anymore. But that doesn't mean he abandoned his plan to assassinate Alexander. Especially after his son Nicanor died.

[AdamKvanta]

There is nothing to indicate a crisis of confidence in Parmenion before Issus, or indeed after. He was a very good and experienced commander, and he would have known it, not least because Philip made no secret of his admiration of Parmenion's talents as a general. The army was on a roll, with confidence and expectations high, and Memnon, their only adversary of any note, was recently dead.

Darius had a much bigger army than the Macedonians and even though Parmenion was a very good and experienced commander, he wasn't making the decisions. Alexander was. Also, Alexander often disagreed with Parmenion about the battle tactics. So Parmenion must have been at least concerned.

Alexander's treatment of the Greek mercenaries who fought for the Persians at the Granicus (he sold them into slavery in the silver mines), is indicative of the bitterness and contempt in which the Macedonians held those who collaborated with the Persians.

It's a different thing to fight against Macedonians and just collaborate with the Persians to stop the campaign. Parmenion had no problem telling Alexander that he would take Darius' peace offer.

Parmenion was actually in advance of Alexander's position at Tarsus, guarding the Syrian Gates, a pass from the coast to the interior plains over which Darius was advancing. As such, he likely had knowledge of Darius's numbers and that may have concerned him ...

Exactly.

... but he would also have had confidence in the superior training and discipline of the Macedonians over a large portion of Darius's army.

If he was the main commander but he wasn't. It was reckless Alexander.

If he eliminated Alexander at Tarsus, Parmenion would have given himself two problems instead of one: Darius's army and convincing the Macedonian army to accept him as commander. Alexander of Lyncestis was still alive at this point and there would have been those who would have advanced his claims to the kingship, or Arridaheus. Parmenion was not of royal blood, so it is unlikely he would have been successful in making himself king, and he wouldn't have held the army together without the authority of a king, never mind what would have happened in Greece as soon as they found out Alexander was dead. Parmenion was too good a general to realise that giving in to Darius without a fight would cause more damage than it would achieve.

We know that Parmenion wanted to make a deal with Darius so if Alexander died he would have made the deal. Parmenion was already second-in-command and was held in very great respect by all the army so I don't see any problem convincing the Macedonian army to accept him as commander:

Moreover he was held in very great respect both by Alexander himself and by all the army, having great influence not only among the Macedonian troops but also among the Grecian auxiliaries, whom he often used to command according to Alexander's order, both in his own turn and out of his turn, with his sovereign's approbation and satisfaction.
https://topostext.org/work/205#3.26

[chris_taylor]

as a doc, I'm always interested in discussions on Alexander's illnesses. they are Sherlock Holmes style diagnostic puzzles where the clues are not just in the texts, but in the wide contextual field that spans the actual event (set within its own time and place), the aspects of the story considered worthy of recording for posterity, those that weren't, but can be inferred from that context and the potential of translation muddling things up two millenia later.

in medical terms, chills and convulsions are two very different things. ancient physicians knew which one was which, but non-medical writers may have used words that give rise to confusion, which is confounded by translation.

Does anyone here know which words Arrian / Diodorus / Curtius actually used and what they imply?

[Alexias]

You can find the original Greek for the Arrian passage quoted by Adam here https://www.perseus.tufts.edu/hopper/te ... ection%3D7 and subsequent pages. By clicking on each word you can, in most cases, get a translation. Whether these translations are contextually accurate in this case, I'm not qualified to say.

Thus in section 7, we get
κάματοςtoil = toil, trouble
ἐνόσησεν = 3rd person singular of to be sick, ail
τόνποταμον = sweat, perspire
καῦμα = burning heat

Section 8
σπασμός = convulsion, spasm
θέρμα = heat
ἰσχυρός = strong
ἀγρυπνία = sleeplessness, wakefulness

Google translate gives a literal translation as:
Section 7

"And Alexander, as it is said by Aristobulus, conceived under the sun, but they call the river Kydnos [the] river nyxastai, desirous of water, sweating and burning. but the Kydnos flows through the middle of the city: but where from the Taurus mountains of the springs the weak and through a space of clean rivers, it is cold and the water is clean:"

Section 8

"spasmῷ te oὖn ehesthai Alexander and you are strong [p. 61] and he continues with vigilance: and the other doctors are not seen as sustainable, but Philip Acarnana, the doctor, who is a physician to Alexander, and the two medical things are believed and the others are not accepted in the army, he wants Alexander active medicine: and the they are clean."

- not terribly helpful!

PS - could the convulsion/spasm actually mean shaking?

[system1988]

' Σπασμός' in ancient greek means also ,convulsione ,agitazione violenta ,rottura di fibre muscolari ,crisi di epilessia , e priapismo Sorry for the italian ( its late ),qualcuno forse sa tradurre dall italiano in inglese

[AdamKvanta]

in medical terms, chills and convulsions are two very different things. ancient physicians knew which one was which, but non-medical writers may have used words that give rise to confusion, which is confounded by translation.

I totally agree, I wanted to exclude pneumonia at first but I guess, a non-medical writer could describe shaking chills as spasms (σπασμός).

... I'm always interested in discussions on Alexander's illnesses.

Yes, let's talk some more about his illness. Let's assume that Alexander had pneumonia, so what would be the likelihood that his lungs were scarred extensively? He recovered within a week, so the presumed pneumonia was relatively short. Now, in general, people usually recover from pneumonia without any lasting damage:

Pneumonia usually does not cause permanent damage to the lungs.
https://www.health.harvard.edu/a_to_z/pneumonia-a-to-z

Amazingly, even with severe pneumonia, the lung usually recovers and has no lasting damage, although occasionally there might be some scarring of the lung (rarely leading to bronchiectasis) or lung surface (the pleura).
https://www.breathingmatters.co.uk/info ... pneumonia/

Moreover, if Alexander's lungs were scarred extensively at age 22, it seems unlikely that he would die from it only after 10 years, at 32. And it is also unlikely that he would have no apparent breathing problems during these 10 years.

Anyway, as I wrote in another thread I consider severe pneumonia in a young (this time only 22 years old) healthy man very unlikely. His illness was also out of pneumonia season, probably in the summer.

I also question the connection between his cold plunging into the cold river and pneumonia. People do cold plunging all the time (in Scandinavia) and it is even more extreme (from sauna to ice bath). I don't think we see these people having pneumonia often. I don't even think pneumonia is prevalent in the cold months because of the cold itself but more likely because people are more crowded inside the buildings so the disease spreads more easily. And of course, Alexander wasn't living in a crowded space, it was quite the opposite.

[Alexias]

Sorry, Adam, but I am going to have to disabuse you of the seriousness of pneumonia. This is the case history of a real person. X had pleurisy as a child, which left scarring on his lungs - not extensive. In 1960, X caught pneumonia and was off work for six weeks. Despite being a smoker, X was never short of breath or had a persistent cough, and was physically strong and active. He was not prone to subsequent chest infections, though he did have bronchitis once or twice. X's father died in 1968 of pneumonia caught when being moved between hospitals after a stroke. Pneumonia was a very serious illness. People may be able to recover within a week with modern antibiotics, but not even in the recent past.

Nothing in the sources says that Alexander recovered in a week. We don't know how long it took him to recover his full strength, though some of his recovery time may have been on the move.

It is also possible that Alexander was already carrying a fever when he jumped into the river to cool down as he was hot and sweaty. None of his companions with him seem to have been unduly hot and jumped in with him, though they did jump in to pull him out.

Pneumonia at 22 may have left some scarring on his lungs (it doesn't have to be extensive), but that doesn't have to have incapacitated him. It may have left him with a pre-disposition for subsequent chest infections however.

[marcus]

That was long after Issus and other battles. Parmenion had no reason to support Darius anymore. But that doesn't mean he abandoned his plan to assassinate Alexander. Especially after his son Nicanor died.

It would have been too long to quote the whole of your last post.

The problem is, that you are not providing any evidence. I produced source material that contradicted your source material ... then you just say "and then Parmenion changed his mind" or some such. Obviously you are perfected entitled to your interpretation of events, but you have to substantiate them, otherwise they are just assertion.

Anyway, you have your interpretation. I don't buy it (for many reasons, not least the historiographical ones that Alexias has gone into in more detail than I have had time to). I would need to see much more compelling evidence to be swayed.

M

[chris_taylor]

in medical terms, chills and convulsions are two very different things. ancient physicians knew which one was which, but non-medical writers may have used words that give rise to confusion, which is confounded by translation.

I totally agree, I wanted to exclude pneumonia at first but I guess, a non-medical writer could describe shaking chills as spasms (σπασμός).

The penny on this one dropped when I read Alexias & System1988 translations. it's the other way around: spasms *was* the medical term. They were describing what they saw, the "rhythmic contractions of muscle groups, usually but not always symmetrial and generalized, either synchronous or asynchronous, but always occurring against the patients will and not stopped by applying force to the limb". well, near enough. and it's the same in rigors and convulsions, but the cause is difference.

The confusion arises because there's no word in the English language for "spasms". nowadays, all words we use are composites of "spasms" AND the implied cause - rigors, fever chills, convulsions, fitting.

spasm + fever = rigor. it's a non-specific symptom, caused by infectious material or toxins suddenly swamping the bloodstream.

I also question the connection between his cold plunging into the cold river and pneumonia. People do cold plunging all the time (in Scandinavia) ...

as medical students, we all had lists of common diagnostic pitfalls. today, I'd add "internet" to the list

[chris_taylor]

It is also possible that Alexander was already carrying a fever when he jumped into the river to cool down as he was hot and sweaty.

Yes. Kathleen Toohey pointed it out, too. It's very astute.

Curtius description of what happened *in* the river is that of cold water shock. It's so textbook, he couldn't have made that one up

the incredible detail suggests that he got it from a source who was within a few meters of Alexander when it happened, possibly one of the rescuers.

[AdamKvanta]

Sorry, Adam, but I am going to have to disabuse you of the seriousness of pneumonia. This is the case history of a real person. X had pleurisy as a child, which left scarring on his lungs - not extensive. In 1960, X caught pneumonia and was off work for six weeks. Despite being a smoker, X was never short of breath or had a persistent cough, and was physically strong and active. He was not prone to subsequent chest infections, though he did have bronchitis once or twice. X's father died in 1968 of pneumonia caught when being moved between hospitals after a stroke. Pneumonia was a very serious illness. People may be able to recover within a week with modern antibiotics, but not even in the recent past.

I'm also sorry, I'm all for disabusement but I can't see the similarity with the case of Alexander. I'm not saying it wasn't possible for Alexander to have pneumonia or die from it, I'm just saying the probability of the pneumonia hypothesis is very low.

Nothing in the sources says that Alexander recovered in a week. We don't know how long it took him to recover his full strength, though some of his recovery time may have been on the move.

Even though we can't be really sure what happened, based on Curtius' report I think we can deduce that Alexander recovered his strength in a week:

For the king could endure anything except delay [the day he got ill he wanted a remedy]; arms and armies were before his eyes, and he thought that victory depended merely upon his ability to take his place before the standards, impatient only because he was not to take the draught until the third day should have come [he had to wait for 3 days] - for so the physician had directed.

But as the drug spread into the king's veins and gradually its healing power could be felt in his whole body, at first his mind regained its vigour and then his body also, more speedily than could have been expected; for after the third day [so 6th or 7th day from the illness] which he had spent in that condition, he appeared in sight of the soldiers.

But Darius, after having received news of Alexander's illness, with all the speed of which so heavy an army was capable hastened to the Euphrates, spanned it with a pontoon bridge, but still got his army across within five days, in his haste to obtain possession of Cilicia. Already Alexander had recovered his physical vigour and had arrived at the city of Soli; ...
https://babel.hathitrust.org/cgi/pt?id= ... 15&seq=135

Justin also confirmed this:

Seeing him unmoved, he became more cheerful, and recovered his health on the fourth day after.
https://www.attalus.org/translate/justin11.html#11.8

[AdamKvanta]

The problem is, that you are not providing any evidence. I produced source material that contradicted your source material ... then you just say "and then Parmenion changed his mind" or some such. Obviously you are perfected entitled to your interpretation of events, but you have to substantiate them, otherwise they are just assertion.

It's true that I don't have explicit evidence for all my assertions but that doesn't mean it's not plausible. Parmenion might have changed his mind and we know that he later wanted to stop the Asiatic campaign because he wanted to take Darius' peace offer (I already quoted the source of that).

Moreover, there is some evidence that Parmenion's son Philotas was plotting against Alexander in Egypt or even before they were in Egypt (in Tarsus perhaps):

Here also Alexander discovered the conspiracy of Philotas, son of Parmenio. Ptolemy and Aristobulus say that it had already been reported to him before in Egypt; but that it did not appear to him credible, both on account of the long-existing friendship between them, the honour which he publicly conferred upon his father Parmenio, and the confidence he reposed in Philotas himself.
https://topostext.org/work/205#3.26

And we know Philotas didn't really like Alexander and that his friendship was only a pretension:

Moreover, for a very long time accusations against himself [Philotas] had been brought to Alexander himself. For when Dareius had been defeated in Cilicia and the wealth of Damascus had been taken, among the many prisoners brought into the camp there was found a young woman, born in Pydna, and comely to look upon; her name was Antigone.

This woman Philotas got; and as a young man will often talk freely in vaunting and martial strain to his mistress and in his cups, he used to tell her that the greatest achievements were performed by himself and his father, and would call Alexander a stripling who through their efforts enjoyed the title of ruler.

Now, Philotas was ignorant of the plot thus laid against him, and in his frequent interviews with Antigone would utter many angry and boastful speeches and many improper words against the king.
https://topostext.org/work/172#Alex.48.5

[AdamKvanta]

Curtius description of what happened *in* the river is that of cold water shock. It's so textbook, he couldn't have made that one up

the incredible detail suggests that he got it from a source who was within a few meters of Alexander when it happened, possibly one of the rescuers.

Yes, that's exactly what I thought. The problem is that people usually recover from shock relatively soon (in hours) and there are usually no adverse after-effects like high fever or sleepless nights. So again I can't see a connection with pneumonia.

Actually, I have a suspicion that historians conflated two incidents: the river incident and the taking of Philip's medicine incident. We see that Arrian had two accounts of Alexander's illness. One from Aristobulus (without the river) and then the other accounts (with the river). Diodorus also didn't mention the river incident, just the medicine incident. So it's possible these incidents are not connected at all.

[chris_taylor]

on cold water shock ...

Yes, that's exactly what I thought. The problem is that people usually recover from shock relatively soon (in hours) and there are usually no adverse after-effects like high fever or sleepless nights. So again I can't see a connection with pneumonia.

I applaud your enthusiasm, but occasionally one can learn from older folk. they've seen a lot and learnt that when the truths of textbooks enters the complexity of reality, it looks unexpectedly different. not wrong. different.

we buried many along the way

chris