It’s one of humanity’s most enduring fears, classic nightmare fuel that has transcended time, continents, and civilizations – and makes a killing (ahem) at the box office: fear of being declared dead when you’re not, and being utterly helpless to stop it.
The death of Alexander the Great – general, king, conqueror – has been a mystery for over 2,000 years. Was he poisoned? Too much booze? Or actually malaria or typhoid, both rampant in ancient Babylon at the time?
Now, a new theory has been put forward that is somehow even worse than all of those. Legend has it Alexander’s body didn’t show any signs of decomposing for six days after his death, a sign the ancient Greeks took that their warrior hero was a god. A new explanation is that he suffered from a rare autoimmune disorder that rendered him paralyzed and unable to communicate, although still compos mentis, right up until his death six days later than thought.
Dr Katherine Hall of the Dunedin School of Medicine at the University of Otago, New Zealand, argues in The Ancient History Bulletin that Alexander may have suffered from Guillain-Barré Syndrome (GBS), a rapid weakening of the muscles caused by the immune system damaging the nervous system, and that may explain the conflicting evidence of how and when he died.
“His death may be the most famous case of pseudothanatos, or false diagnosis of death, ever recorded,” she said.
Born in 356 BCE in the Greek ancient kingdom of Macedonia to the King, Alexander inherited the throne at the age of 20. Tutored by Aristotle in his youth, he would go on to become one of the greatest Generals and conquerors the world has ever seen, against many odds conquering the massive Persian Empire from Asia Minor to Egypt to India. This made him King of Macedon, leader of the Greek army, pharaoh, and ‘Great King’ of Persia by age 25. His empire stretched three continents and 5 million square kilometers (2 million square miles). He died in Babylon, in modern-day Iraq, in 323 BCE aged 32.
He was said to have had a fever and abdominal pain, and soon became unable to walk, move, or speak, but, Dr Hall points out, he was said to be of sound mind up until his death. This, she posits, has been overlooked, but is actually key to the mystery, and that he likely had an acute motor axonal neuropathy variant of GBS, contracted from a Campylobacter pylori infection, common at the time and a leading cause of the treatable syndrome.
"I have worked for five years in critical care medicine and have seen probably about 10 cases [of GBS]. The combination of ascending paralysis with normal mental ability is very rare and I have only seen it with GBS," Hall told Fox News.
"His sight would have been blurred and if his blood pressure was too low he would have been in a coma. But there is a chance he was aware of his surroundings and could at least hear. So he would have heard his generals arguing over the succession, hear the arrival of the Egyptian embalmers, hear that they were about to start their work."
Diagnosing death in those times relied on breath more than a pulse, and if his body was in paralysis his breathing would have been shallow, his body may have struggled to regulate temperature, his pupils may have become fixed and dilated. His body not showing signs of decomposition post-death may not have been a miracle but the simple fact he wasn't dead yet.
“The elegance of the GBS diagnosis for the cause of his death is that it explains so many, otherwise diverse, elements, and renders them into a coherent whole,” Hall said. If true, it's another infamous string to his bow, but not one that can be proven, and so the mystery endures.