pothos.org

thanks for that. it's an unusually good article on the topic because the docs who wrote it stick to the sources and have a clear understanding of how diseases do - and do not!! - manifest themselves. don't entirely agree with their conclusions, but it's a very good summary, written by doctors who actually know how to approach a differential diagnostic puzzle.

one for the reference library.

Chris, you may also like my favorite article on the topic - https://archive.hshsl.umaryland.edu/bit ... sequence=2.

Please see Dr. Jeanne Reames’ article on the death of Alexander, which also references the University of Maryland School of Medicine conference at https://www.academia.edu/2512445/Some_n ... _the_Great

loved the article !!

the language of is spot on. that's exactly how the layman's description of the sources translate into the language of modern medicine - which helps tremendously to visualize the course of Alexander's illness. and yes, the events of this final days are typical of the ascending form of Guillan Barre.

the syndrome wasn't identified as a distinct entity until 1916, because Guillan Barre & Strohl saw a cluster of cases and described it. it's rare and few doctors outside specialist neurological units ever get to see a case. those who do, will recognize it from the pages of Arrian: there is no other disease that gives you that striking disconnect between rapidly (= days), relentlessly progressive weakness culminating in the inability to speak, *with preserved cognitive function throughout*.

so I advocate to work backwards: Guillan Barre is a syndrome, not a disease. It develops as a complication of another disease. If Arrian is to be believed, Guillan Barre was the fatal complication that killed Alexander. So any disease that doesn't cause Guillan Barre, can be crossed off the list.

chris.

chris_taylor wrote: ↑Tue Aug 08, 2023 10:48 am so I advocate to work backwards: Guillan Barre is a syndrome, not a disease. It develops as a complication of another disease. If Arrian is to be believed, Guillan Barre was the fatal complication that killed Alexander. So any disease that doesn't cause Guillan Barre, can be crossed off the list.

Or maybe Alexander suffered from something indistinguishable from Guillain-Barré syndrome, like arsenic poisoning:

The ingestion of large quantities of arsenic can cause extensive transmural inflammation of enteric mucosa, severe abdominal pain, hemorrhagic gastroenteritis, and hepatic necrosis. Systemic endothelial injury can develop, with capillary leak, pulmonary edema, hypotension, and shock. If these events are not fatal, a progressive neuropathy, which may be indistinguishable from the Guillain–Barré syndrome, may yet claim the patient’s life. This scenario mirrors our patient’s [Alexander's] illness in certain respects and must therefore be given serious consideration.
https://archive.hshsl.umaryland.edu/bit ... pdf#page=3