Death of Alexander

[Taphoi]

I have an article on, "The Death of ALexander the Great" and a short news article, "Is the body of ATG in Venice?", in the Sept-Oct 2004 issue of Minerva.On Alexander's death I argue that the typhoid theory, preferred by the University of Maryland's conference in 1996, is flawed because it relies on the comment in the Alexander Romance that ATG experienced a spasm of pain "as if he had been struck through the liver". The Greeks considered the liver to be the seat of the passions the same way we regard the heart (this is why Greek augurs examined the livers of sacrificial victims). The author of the Romance intended a poetic simile, rather than a specific symptom. Conversely, Plutarch knew a source who mentioned a stabbing pain in ATG's back and Justin suggests ATG was agonised by being touched. Sharp back and limb joint pain are initial symptoms of falciparum malaria, which seems to be the only diagnosis which reconciles the "vulgate" accounts of pains at Medius' party with the escalating fever of the Journal account. I also show that the Journal account indicates an initially intermittent fever by stating that ATG "no longer had any rest from the fever" 4 or 5 days into the illness. The Journal emphasises fever episodes in the evenings. Experiments with real mosquitoes at Horton Hospital have shown that quotidian (peaking every 24 hrs) and sub-continuous fevers are highly characteristic of falciparum malaria. Falciparum malaria commonly terminates in cerebral malaria, leading to delirium and coma. Its incubation period is consistent with the timing of ATG's trip to the marshes in mid-May. In short, falciparum malaria is a perfect fit to all the known symptoms, but other recent favorites are flawed.

[susan]

Not really relevant - but I'm scanning in Chinnock's Arrian and should have it done in a couple of weeks. It's only had two issues since 1927, and is in a small fontsize but it scans surprisingly well. Susan

[Taphoi]

That's really excellent. (I wonder how Chinnock translates "no longer had any rest from the fever" at 7.25.4?)Best wishes,Andrew

[susan]

"The fever now raged the whole night without intermission"Susan

[Taphoi]

That's not too bad actually. My translation is a more literal version, but Chinnock captures the sense that there had been intermissions between bouts of fever. Some translations miss this altogether. For example, the most widely read translation of all would be the Penguin, which derives from Aubrey de Selincourt: it just says Alexander "was afterwards in constant fever". This is an excellent example of how vital information can be edited out by a bad translation.

[xxx]

Actually, 'was afterwards in constant fever' suggests that at first he was not, therefore, intermittent, but it is typical for fevers to abate somewhat in the early morning and rise as evening approaches.

[Taphoi]

The Greek in Arrian is "ouketi elinuein puressonta", which is literally "no longer had any rest from the fever". The Journal (via Arrian) is implying that the fever had come and gone up to that point, not merely undulated in intensity. Such marked variations are only commonly encountered for malarial fevers. However, falciparum malaria often becomes sub-continuous as different generations of the parasite start to overlap in the later stages.We know that Alexander had visited marshes that are currently malaria infested and almost certainly were then too. Falciparum malaria is overwhelmingly the strongest suspect for an intermittent fever terminating in delirium and coma in such circumstances. There is no contrary evidence, because even the supposed symptoms of poisoning (pains at Medius' party) are actually perfectly consistent with the onset of falciparum malaria. Statistically it accounts for over 99% of deaths with such symptoms today - it is still believed to kill between one and two million people annually in the third world. We have simply forgotten how common and deadly it is in the West, because of the effectiveness of prophylactic medicine.

[iskander_32]

Here we go with the descriminatory Malaria that supposedly killed Al;exander.All ilnesses bein associated by where he went and the contacts he made,throughout all this he was acompanied by on average 80 000 other people soldiers auxileries ans hangers on, why was it that these ilnesse chose Al;exander we hear nothing in the sourses of pockets or any cases of this so called killer disease, surely Ptolemy would have noticed such losed and made a note, if any general had cases of Malaria in his forces Im sure ther would be cause just to note it down.Alexander was killed by the biggoted and self centred Macedonian Generals who liked the way things were and got rod of Alexander, Nepheastion too for good measure.Common sence and elimentary must prevail here Alexander was nailed by any heroes worse enemy....The fifth column
RegardsKenny

[marcus]

Hi Kenny,If Ptolemy wrote his history towards the end of his life, 30-40 years after Alexander's death, then it doesn't surprise me at all if he fails to mention when other people were struck by illnesses. I don't see his (and therefore Arrian's) failure to mention other casualties as an indication that any particular disease did or didn't kill Alexander.All the bestMarcus

[xxx]

We cannot know for certain what killed Alexander. I might add his symptoms as described in the journal fit any one of a number of diseases, but nothing in particular rules falciparum malaria out. That is also because this malarial variant has several different ways of terminating a person's life and has about every symptom one could possibly ascribe to a disease. Nor would I say the type of fever as described could only be malaria. What we do have is written evidence of a fever that worsens in intensity and becomes constant. I'd be somewhat more cautious in backreading what kind of fever he had before it became constant. There is a noted lack of other symptoms, which should not be taken to mean that there weren't any others. These diaries were certainly edited so that any symptom that would possibly suggest poison would have been removed. Horrible sophist that I am, I could argue malaria or not malaria very convincingly. Although there are some other things in the diaries you haven't mentioned that would bolster your case.However, IMHO this is the most likely diagnosis, with secondary complications due to his physical state, but since I'm not writing an article I'll keep that to myself. This dagnosis had already been suggested before in an article by a historian some years ago, but no one had a particular interest in repeating what has already been said, hence the new theories. Regards,Tre

[Taphoi]

You probably need to read my actual article in Minerva, which agrees with you that a definite diagnosis is not possible without Alexander's remains. It also gives the history of the malaria explanation, referencing the article by Donald Engels which you allude to and mentioning that the diagnosis was first proposed by Emile Littre in the 19th century.
I even agree with you that other diseases can be argued to fit the symptoms. However, such arguments tend either to refute some parts of the ancient evidence (without any good reason) or they pursue extraordinarily rare diseases or symptoms. For example, the recent typhoid argument invokes an extremely rare complication of ascending paralysis and coma. Statistically, I would be safe in saying that this is at least a thousand times rarer as a cause of death than falciparum malaria. It is astonishing that anyone even bothers to consider such rareties, when a really high probability explanation fits the symptoms so perfectly. In other words, it is not just a matter of what is possible, but also what is remotely probable. On this basis falciparum malaria stands head and shoulders above any rivals I have yet heard. I feel, however, that we are beginning stridently to agree with one another.