A MEDICAL-HISTORICAL EXAMINATION OF THE DEATH OF ALEXANDER THE GREAT
Abstract
Alexander the Great’s cause of death has been contentious since antiquity. Historians and physicians alike have proposed a multitude of hypotheses. However, neither party is without their analytical flaws. The historians often neglect obvious medical refutations. Meanwhile, the physicians often err by forsaking disciplined historical methodology. Therefore, the authors of this paper subject these prior hypotheses to both medical and historical criticism, in order to provide a multidisciplinary approach to a longstanding mystery. Some hypotheses have more weight than others, as is discussed. The most probable of the poisoning hypotheses, which aligns with the Vulgate tradition of Alexander’s death, cites the use of Veratrum album, a plant derived bane. When the Court tradition is considered, i.e. that no foul play occurred, acute pancreatitis induced by alcohol abuse holds greatest credence as a hypothesis. It is hoped that the approach used will not only increase clarity regarding Alexander’s death and challenge weak ideas but also provide an approach by which speculation about other medical diagnoses in history may be tempered and critiqued.
Keywords
DOI: 10.14795/j.v4i3.269
References
ALLISON/MCCURDY 2014
Allison, M. G./McCurdy, M. T., Alcoholic metabolic emergencies, Emergency Medicine Clinics of North America 32, 293-301.
APPLEBY et alii 2014
Appleby, J./Mitchell, P./Robinson, C./Brough, A./Rutty, G./Harris, R./Thompson, D./Morgan, B., The scoliosis of Richard III, last Plantagenet King of England: diagnosis and clinical significance, The Lancet 383, 1944.
ASHRAFIAN 2004
Ashrafian, H., The death of Alexander the Great--a spinal twist of fate, Journal of the History of the Neurosciences 13, 138-142.
BATTERSBY 2007
Battersby, C., What Killed Alexander the Great?, ANZ Journal of Surgery 77, 85-87.
BENGTSON 1997
Bengtson, H., History of Greece: From the Beginning to the Byzantine Era, Dt./En., “Author.” (Trans.) (Ottawa: University of Ottawa Press).
BOSWORTH 1971
Bosworth, A. B., The Death of Alexander the Great: Rumour and Propaganda, The Classical Quarterly 21, 112-136.
BOSWORTH 2008
Bosworth, A. B., Conquest and Empire: The Reign of Alexander the Great (Cambridge: Cambridge University Press).
BOUSSER 2004
Bousser, M. G., A stone at the Siege of Cyropolis: why it is unlikely that Alexander had a carotid dissection causing his death 6 years later, Journal of the History of the Neurosciences 13, 157-158.
BRUNT 1983
Brunt, P. A. (Trans.), Arrian, Anabasis of Alexander: Books 1-4, Gr./En. (Cambridge: Harvard University Press).
CAMPBELL/MARFIN/LANCIOTTI/GUBLER 2002
Campbell, G. A./Marfin, A. A./Lanciotti, R. S./Gubler, D. J., West Nile virus, The Lancet Infectious Diseases 2, 519-529.
CHANDRA/KASSENS-NOOR 2014
Chandra, S./Kassens-Noor, E., The evolution of pandemic influenza: evidence from India, 1918-19, BMC Infectious Diseases 14, 510.
CRAIG/GOVENDER 1992
Craig, J. B./Govender, S., Neurofibromatosis of the cervical spine. A report of eight cases, Journal of Bone & Joint Surgery 74, 575-578.
CUNHA 2004
Cunha, B. A., The death of Alexander the Great: malaria or typhoid fever?, Infectious Disease Clinics of North America 18, 53-63.
DAWSON/GRANT/LI 2005
Dawson, D. A./Grant, B. F./Li, T. K., Quantifying the risks associated with exceeding recommended drinking limits, Alcoholism: Clinical and Experimental Research 29, 902-908.
FELNER/SMITH 2012
Felner, K./Smith, R. L., Chapter 138. Sepsis, In: McKean, S. C./Ross J. J./Dressler, D. D./Brotman, D. J./Ginsberg, J. S. (Ed), Principles and Practice of Hospital Medicine (New York: McGraw-Hill Companies), 1099-1109.
FREIS/STANTON 1948
Freis, E. D./Stanton, J. R., A clinical evaluation of veratrum viride in the treatment of essential hypertension, American Heart Journal 36, 723-738.
GILOTTA/BRVAR 2010
Gilotta, I./Brvar, M., Accidental poisoning with Veratrum album mistaken for wild garlic (Allium ursinum), Clinical Toxicology 48, 949-952.
HAMILTON 1953
Hamilton, J. R., Alexander and His 'So-Called' Father, The Classical Quarterly 3, 151-157.
HAMMOND 1993
Hammond, N. G. L., Sources for Alexander the Great (Cambridge - New York: Cambridge University Press).
HOFFMAN et alii 1984
Hoffman, S. L./Punjabi, N. H./Kumala, S./Moechtar, M. A./Pulungsih, S. P./Rivai, A. R./Rockhill, R. C./Woodward, T. E./Loedin, A. A., Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone, New England Journal of Medicine 310, 82-88.
HORT 1916
Hort, A. F. (Trans.), Theophrastus, Enquiry into Plants: Books 6-9, Gr./En. (Cambridge: Harvard University Press).
HUBÁLEK/HALOUZKA 1999
Hubálek, Z./Halouzka, J., West Nile fever--a reemerging mosquito-borne viral disease in Europe, Emerging Infectious Diseases 5, 643-650.
KRESHAK 2012
Kreshak, A., Chapter 66. Ethanol, In: Olson, K. R. (Ed.), Poisoning & Drug Overdose, Sixth Edition (New York: McGraw-Hill Companies), 204-206.
LANKISCH/APTE/BANKS 2015
Lankisch, P. G./Apte, M./Banks, P. A., Acute pancreatitis, The Lancet 386, 85-96.
LANKISCH/BANKS 1998
Lankisch, P. G./Banks, P. A., Pancreatitis (Berlin - New-York: Springer).
LIAPPAS/LASCARATOS/FAFOUTI/CHRISTODOULOU 2003
Liappas, J. A./Lascaratos, J./Fafouti, S./Christodoulou, G. N., Alexander the Great's relationship with alcohol, Addiction 98, 561-567.
LIGTENBERG 1999
Ligtenberg, G., Regulation of blood pressure in chronic renal failure: determinants of hypertension and dialysis-related hypotension, Netherlands Journal of Medicine 55, 13-18.
LODE et alii 1998
Lode, H. N./Reisfeld, R. A./Handgretinger, R./Nicolaou, K. C./Gaedicke, G./Wrasidlo, W., Targeted therapy with a novel enediyene antibiotic calicheamicin theta(I)1 effectively suppresses growth and dissemination of liver metastases in a syngeneic model of murine neuroblastoma, Cancer Research 58, 2925-2928.
LUNDSTRÖM et alii 2013
Lundström, J. N./Mathe, A./Schaal, B./Frasnelli, J./Nitzsche, K./Gerber, J./Hummel, T., Maternal status regulates cortical responses to the body odor of newborns, Frontiers in Psychology 4, 597.
MARCINIAK et alii 2016
Marciniak, S./Prowse, T./Herring, D.A./Klunk, J./Kuch, M./Duggan, A./Bondioli, L./Holmes, E./Poinar, H., Plasmodium falciparum malaria in 1st–2nd century CE southern Italy, Current Biology 26, R1205–R1225.
MARR/CALISHER 2003
Marr, J. S./Calisher, C. H., Alexander the Great and West Nile virus encephalitis, Emerging Infectious Diseases 9, 1599-1603.
MAYOR/HAYES 2011
Mayor, A./Hayes, A., The Deadly Styx River and the Death of Alexander, Princeton/Stanford Working Papers in Classics. Version 1.3, 30 pages
MILNS 1968
Milns, R. D., Alexander the Great (London: Robert Hale), 256.
NAVEAU et alii 2005
Naveau, S./Raynard, B./Ratziu, V./Abella, A./Imbert-Bismut, F./Messous, D./Beuzen, F./Capron, R./Thabut, D./Munteanu, M./Chaput, J. C./Poynard, T., Biomarkers for the prediction of liver fibrosis in patients with chronic alcoholic liver disease, Clinical Gastroenterology and Hepatology 3, 167-174.
NEEDLEMAN 2004
Needleman, H., Lead poisoning, Annual Review of Medicine 55, 209-222.
NEUMANN/SIGRIST 1978
Neumann, J./Sigrist, R. M., Harvest dates in ancient mesopotamia as possible indicators of climatic variations, Climatic Change 1, 239-252.
OLDACH/RICHARD/BORZA/BENITEZ 1998
Oldach, D. W./Richard, R. E./Borza, E. N./Benitez, R. M., A mysterious death, New England Journal of Medicine 338, 1764-1769.
ORTON/STRAMER/DODD 2006
Orton, S. L./Stramer, S. L./Dodd, R. Y., Self-reported symptoms associated with West Nile virus infection in RNA-positive blood donors, Transfusion 46, 272-277.
PAPAGRIGORAKIS et alii 2006
Papagrigorakis, M. J./Yapijakis, C./Synodinos, P.N./Baziotopoulou-Valavani, E. DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens, International Journal of Infectious Diseases 10, 206-214.
PAULA et alii 2010
Paula, H./Asrani, S. K./Boetticher, N. C./Pedersen, R./Shah, V. H./Kim, W. R., Alcoholic liver disease-related mortality in the United States: 1980-2003, The American Journal of Gastroenterology 105, 1782-1787.
PEARSON 1952
Pearson, L., Aristobulus the Phocian, The American Journal of Philology 73, 71-75.
PEPPERELL et alii 2003
Pepperell, C./Rau, N./Krajden, S./Kern, R./Humar, A./Mederski, B./Simor, A./Low, D. E./McGeer, A./Mazzulli, T./Burton, J./Jaigobin, C./Fearon, M./Artsob, H./Drebot M. A./Halliday, W./Brunton, J., West Nile virus infection in 2002: morbidity and mortality among patients admitted to hospital in southcentral Ontario, Canadian Medical Association Journal 168, 1399-1405.
PERRIN 1919
Perrin, B. (Trans.), Plutarch, Lives: Demosthenes and Cicero, Alexander and Caesar, Gr./En. (Cambridge - London: Harvard University Press).
PETERSEN/MARFIN 2002
Petersen, L. R./Marfin, A. A., West Nile virus: a primer for the clinician, Annals of Internal Medicine 137, 173-179.
PFIZER 2011
Pfizer. Material Safety Data Sheet: Gamma Calicheamicin (2011)
RETIEF/CILLIERS 2006
Retief, F. P./Cilliers, L., The death of Alexander the Great, Acta Theologica 26, 14-28.
ROLFE 1946
Rolfe, J. C. (Trans.), Quintus Curtius Rufus, History of Alexander, Books I-V, Lt./En. (Cambridge: Harvard University Press).
ROMEO et alii 2007
Romeo, J./Wärnberg, J./Nova, E./Díaz, L. E./Gómez-Martinez, S./Marcos, A., Moderate alcohol consumption and the immune system: a review, British Journal of Nutrition 98 Suppl 1, S111-115.
ROSEN 1995
Rosen, A. M., The Social Response to Environmental Change in Early Bronze Age Canaan, Journal of Anthropological Archaeology 14, 26-44.
RUSSELL 2004
Russell, G. A., The 'horns' of a medical dilemma: Alexander the Great, Journal of the History of the Neurosciences 13, 159-165.
SCHEP/SCHMIERER/FOUNTAIN 2006
Schep, L. J./Schmierer, D. M./Fountain, J. S., Veratrum poisoning, Toxicology Reviews 25, 73-78.
SCHEP/SLAUGHTER/VALE/WHEATLEY 2014
Schep, L. J./Slaughter, R. J./Vale, J. A./Wheatley, P., Was the death of Alexander the Great due to poisoning? Was It Veratrum album?, Clinical Toxicology 52, 72-77.
SHAKESPEARE 2012
Shakespeare, W., The Tragedy of Hamlet, Prince of Denmark, Mowat, B. A./Werstine, P. (Eds.) (New York, Simon & Schuster).
SHERIDAN et alii 1995
Sheridan, R. L./Ryan, C. M./Quinby, W. C. Jr./Blair, J./Tompkins, R. G./Burke, J. F., Emergency management of major hydrofluoric acid exposures, Burns 21, 62-64.
SVENSON/MACLEAN/GYORKOS/KEYSTONE 1995
Svenson, J. E./MacLean, J. D./Gyorkos, T. W./Keystone, J., Imported malaria. Clinical presentation and examination of symptomatic travelers, Archives of Internal Medicine 155, 861-868.
VISWANATH/GHOSH 2009
Viswanath, D. S./Ghosh, T. K., Chemical Terrorism: Classification, Synthesis, and Properties, In: Ghosh, T. K./Prelas, M. A./Viswanath, D. S./Loyalka, S. K. (Eds.), Science and Technology of Terrorism and Counterterrorism (Boca Raton: CRC Press), 329-353.
VONLAUFEN/SPAHR/APTE/FROSSARD 2014
Vonlaufen, A./Spahr, L./Apte, M. V./Frossard, J. L., Alcoholic pancreatitis: A tale of spirits and bacteria, World Journal of Gastrointestinal Pathophysiology 5, 82-90.
WALDRON 1973
Waldron, H. A., Lead poisoning in the ancient world, Medical History 17, 391-399.
WELLS 1963
Wells, B. (Trans.), Diodorus, Library of History 17.117. (Cambridge, 1963).
WILLIAMS/ARNOTT 2004
Williams, A. N./Arnott, R., A stone at the Siege of Cyropolis and the death of Alexander the Great, Journal of the History of the Neurosciences 13, 130-137.
YANG/VADHAVKAR/SINGH/OMARY 2008
Yang, A. L./Vadhavkar, S./Singh, G./Omary, M. B., Epidemiology of alcohol-related liver and pancreatic disease in the United States, Archives of Internal Medicine 168, 649-656.
YARDLEY 1997
Yardley, J. C. (Trans.), Justin, Epitome of the Philippic History of Pompeius Trogus: Volume I: Books 11-12: Alexander the Great, (Oxford: Clarendon Press).
YOST 2002
Yost, D. A., Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas, Postgraduate Medicine 112, 14-16, 21-22, 25-26.
YULE/WILENS/MARTELON/SIMON/BIEDERMAN 2013
Yule, A. M./Wilens, T. E./Martelon, M. K./Simon, A./Biederman, J., Does exposure to parental substance use disorders increase substance use disorder risk in offspring? A 5-year follow-up study, The American Journal on Addictions 22, 460-465.
ZAGLER et alii 2005
Zagler, B./Zelger, A./Salvatore, C./Pechlaner, C./De Giorgi, F./Wiedermann, C. J., Dietary poisoning with Veratrum album--a report of two cases, Wiener klinische Wochenschrift 117, 106-108.
ZINNANTI/LAZOVIC 2012
Zinnanti, W. J./Lazovic, J., Interrupting the mechanisms of brain injury in a model of maple syrup urine disease encephalopathy, Journal of Inherited Metabolic Disease 35, 71-79.
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