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What killed Alexander the Great? Maybe typhoid fever

Web posted June 11, 1998

Associated Press

BOSTON -- Alexander the Great has been thought over the centuries to have died from poisoning or malaria, but a new analysis of the skimpy historical record suggests the real culprit was typhoid fever.

Alexander died in 323 B.C. in Babylon at age 32 after conquering much of the civilized world that was known at the time to Europeans.

Dr. David W. Oldach and others from the University of Maryland laid out the case for typhoid fever in a report in Thursday's issue of the New England Journal of Medicine.

One difficulty in reaching a definitive conclusion is that the earliest surviving account of the events surrounding Alexander's death was written three centuries after the fact.

According to the historical writings, Alexander suffered chills, exhaustion and high fever in the week before he died. These symptoms are typical of a variety of infectious diseases.

Another important clue is that he suffered severe abdominal pain. This could have been the result of a perforated bowel caused by untreated typhoid fever.

The ill that best fits the symptoms, they said, is Salmonella typhi, the intestinal bug but that causes typhoid fever.

Historical reports said Alexander's body did not decay until several days after his death. The doctors said this could have been a disorder in which muscle paralysis starts at the feet and moves slowly up the body, eventually slowing breathing. People with this condition, called ascending paralysis, look dead even though they are still alive.