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?

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    You seem to have looked at the Wikipedia article Death of Alexander the Great already, but I'm not sure what we can add to that. There is a lack of consensus among historians on the cause of death due to conflicting contemporary accounts. Feb 28, 2021 at 13:05
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    Leukemia is a type of blood cancer, right? How can you contract leukemia from battle injuries?
    – F1Krazy
    Feb 28, 2021 at 13:06
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    This kind of question is impossible to answer because we do not have enough information. One plausible theory says that he was poisoned, another that he dies of a decease related to alcoholism.
    – Alex
    Feb 28, 2021 at 14:00
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    @LarsBosteen - After reading what that WP page had to say, it seems like someone could do better at making sense of the claims, and what is based on better sources. It seems like every theory they devoted significant electrons to ends with "but the source for that is really bad." So the info on that page is a mess right now. I could totally understand how someone after reading that might come here and ask us about it.
    – T.E.D.
    Feb 28, 2021 at 16:17
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    A high temperature for 5 to 6 days looks like an infection. Raising the temperature is one way the body uses to kill a pathogen, whether bacterial or viral.
    – Fred
    Mar 1, 2021 at 0:19

3 Answers 3


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

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    Can you expand a little on this? For, example, what reasons does this report give for this conclusion? Feb 28, 2021 at 23:52
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    @LarsBosteen: I am not a doctor but apparently, according to Wikipedia, his simptoms were consistent with this. Other versions are discussed in the article too.
    – user47593
    Feb 28, 2021 at 23:56

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).

  • Did you read the other answers before posting this? Your answer may be perfect, but there is no need to post data other people have already posted. Also SE requires references. You could delete the third paragraph and expand the other two.
    – RedSonja
    Dec 9, 2021 at 9:36

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