Plutarch described the last days of Alexander the Great in his book "Life of Alexander" based on records kept by Eumenes, Alexander's general secretary. Alexander had a high temperature for at least 5-6 days, and at the last day he couldn't speak. Is malaria the cause of his death, or did he have leukemia due to injuries sustained in battle?
There are several claims in the Wikipedia article "Death of Alexander the Great" but it's not clear how valid each claim is. Are there any clearer source?
The mystery has not been solved and will probably remain open for the foreseeable future. As the Wikipedia article explains, there is a long list of theories but no decisive evidence to clearly support any one of them.
The official story or "Court" tradition (associated with a Royal Diary or journal) asserted natural causes. Many of Alexander's own contemporaries suspected a plot, but had no direct evidence. This view is linked to what is known as a "Vulgate" or "Romance" tradition. Ancient historians were divided. Modern historians prior to the 1950s were inclined to accept the Court account of natural causes as the correct one, but the question has been reopened in recent decades and both traditions have been deeply re-examined by medical experts.
A 2017 article lists and summarizes twelve of the key ancient sources, seven of them from Alexander's contemporaries and the others from between 50 BCE and the 4th century CE. That article also provides an overview of modern medical perspectives. A 2019 survey of the available evidence summarizes the medical analyses in somewhat more detail:
Proposed natural causes include alcohol poisoning, malaria, typhoid fever, septicemia, and accidental physician error; deliberate murder theories focus on aconite, arsenic, fermented hellebore, and strychnine.
Some of these theories may be more plausible than others. Among the natural causes, malaria or typhoid seems particularly influential. A poison based on a false hellebore (Veratrum) is also a popular theory. But on the fundamental question of whether it was a disease or a murderous plot, there is currently no consensus.
According to the University of Maryland School of Medicine report of 1998, Alexander probably died of typhoid fever (which, along with malaria, was common in ancient Babylon). Wikipedia
Alexander died in June, 323 BC. By accounts.... 1: Plutach says 2 weeks before his death; he entertained an Admiral and Medius, to which he developed a fever. Was unable to speak. 2: Historian Diodorus argues Alex was struck with pain after drinking huge bowl of unmixed wine and died of stomach pain. Drinking undiluted wine, worse wine spoiled can be exceptionally bad.
More scenarios suggest foul play, given lengthy history of aristocracy propensity for assassination in Macedonian culture......suggest he may have been poisoned.
1998 New England Journal of Medicine suggested he died of Typhoid, disease common in Babylon where he last was resided. another is Sepsis from bowel perforation (obsessive alcohol consumption and stress).
