How Did Alexander the Great Really Die?

Today we know all about what happens to our bodies after we die. Changes begin immediately after death, beginning with the body temperature cooling. Within a few hours the movement of damaged blood cells causes discolouration in the skin; in the same time frame rigor mortis sets in, making the body stiff and difficult to move.

While the people of ancient Greece didn’t understand the science of these changes in the way we do today, they knew that the human body didn’t look or behave in death as it did in life. So when Alexander the Great’s body seemingly remained unchanged for six days after his death in 323 BCE, his contemporaries could offer only one explanation.

Alexander must have been a god.

So…was he?

Alexander the Great first fell ill during a days-long series of parties, during one of which he collapsed, complaining of a searing pain in his back. (One likely apocryphal account claims that this incident occurred directly after he attempted, when challenged, to drink an entire krater of wine in one sitting; a krater, a container that might be likened to a punch bowl, was typically filled with up to six quarts of wine and water.) After 10 days of intense fever, Alexander’s soldiers were brought in to see him one final time. As reported by the historian Arrian, at that point the king “could no longer speak…but he struggled to raise his head and gave each man a greeting with his eyes.”

When Alexander was declared dead on June 13, theories began forming. Had he been poisoned? Sabotaged? Had he been killed by drinking too much wine? Centuries later, modern historians gave their own opinions. Perhaps he had contracted malaria. Perhaps it was pneumonia or typhoid fever. Maybe he really was murdered.

None of those theories, though, explain what happened next. As reported by Plutarch, Alexander’s body did not begin to show the typical signs of decay: “His body, although it lay without special care in places that were moist and stifling, showed no sign of such a destructive influence, but remained pure and fresh.” During the six days that passed before the body was prepared for burial, no physical changes were noticed at all.

Today we have an explanation for Alexander’s death and his period of bodily freshness that relies less on the supernatural and more on science. In 2018 Dr. Katherine Hall, a lecturer at Dunedin School of Medicine in New Zealand, proposed that Alexander the Great had Guillain-Barré syndrome, an acute autoimmune condition that results in muscle paralysis. In other words, Alexander may have been alive when he was declared dead—a mistake that could have been made when physicians mistook the shallow breathing of a coma patient for no breathing at all. If this was the case, Alexander may have been effectively murdered during embalming—a process that would have seen him disemboweled.

While we can’t travel back in time to confirm Hall’s theory, it is the only one that takes into account all the details of Alexander’s death—and his body’s mysterious life. Unless you prefer to think Alexander was a god…in which case, why did he die at all?