Marble statue of Alexander, the great - National Archaeological Museum (Athens, Greece)

Alexander the great! The name alone evokes images of battlefield glory, unparalleled godlike ambition and sufficient drama to make even the most chaotic reality TV shows look tame. He was the man who never lost a battle, tamed the wild horse Bucephalus as a child, marched his armies from Greece to India and (according to some very “excited” historians) was a direct descendant of Zeus himself. At just age 32, had already conquered most of the known world. Alexander the great, was an ancient warrior-king who carved out an empire stretching from Greece to India before his untimely demise.

He was a student of Aristotle, a king of kings and a man whose name still echoes through history. But what if you get to know that the conqueror of worlds and the man who thought himself to be divine, may have suffered one of the most horrifying fates imaginable? Alexander wasn’t actually dead when his body was embalmed and entombed.

Buried. Alive.

Yes, you read that correctly. Forget the grand send-off of an emperor, the golden sarcophagus and the sacred embalming. There’s a chilling theory that Alexander wasn’t dead when he was laid to rest but merely paralysed. Let’s dissect the evidence from exploring why this ancient medical mystery might just be true. This isn’t just some over-the-top Hollywood plot twist. Some modern medical experts believe it may have actually happened. Hold onto your amphora of wine because this is about to get very dark.

A case for CSI Babylon – Alexander’s mysterious death

Alexander’s death in 323 BCE had always been shrouded in mystery. In fact, it remains one of history’s biggest mysteries. Unlike most rulers who went out in a blaze of assassination or battle, his end was…slow. Suspiciously slow. Here’s what we do know about it.

Ancient historians say that he guzzled ‘a bowl of Heracles’ which sounds like the ancient equivalent of chugging an entire keg. Alexander suddenly became gravely ill after this legendary drinking binge in Babylon.
He developed a raging fever, crippling abdominal pain and an increasing inability to move. He suffered fever, pain and then progressive paralysis.
Over a duration of 12 days, he gradually lost control of his body but remained mentally alert.
By the end, he could not even speak.
Finally, he was declared dead. His body showed no signs of decomposition for 6 days after this supposed ‘death’.

Babylonian astronomical diary with the record of Alexander the great's death in a British museum

That last part is particularly spooky. In a sweltering Babylonian climate, a corpse should have started to rot almost immediately. Babylon climate is hot and humid. Instead, Alexander remained as fresh as a daisy or in his case, a god. The Greeks took this as a sign of divinity. The fact that Alexander’s body remained ‘fresh’ is either a miracle…or a medical nightmare. Modern science, however, might have a more sinister explanation. More like “he wasn’t actually dead yet”.

Paralysed but alive – The Guillain-Barré Syndrome (GBS) theory

Fast forward to modern times. Enter Dr Katherine Hall, a clinical lecturer at the University of Otago. In the year 2018, she put forth a medical hypothesis that could make your skin crawl. She suggests that Alexander may have suffered from Guillain-Barré Syndrome (GBS) that is a rare autoimmune disorder that leads to progressive paralysis while leaving the victim fully conscious. It is a chilling medical explanation. GBS can leave a person completely paralysed but totally aware.

GBS damages the Schwann cells because of which messages won't pass through

**How symptoms of GBS could explain Alexander’s perplexing ‘death’…**

GBS is a rare autoimmune disorder where the body’s own immune system attacks the nerves. This leads the body to suffer…

Fever and weakness – He started coming up with flu-like symptoms before experiencing full-body paralysis. This is absolutely common in GBS.

Ascending paralysis – GBS causes paralysis that often begins in the legs and works it’s way up which becomes a match for historical accounts. They are the matching descriptions of Alexander’s decline.

Loss of mobility and speech – At the peak of GBS, sufferers get ‘locked in’ which means they are unable to move or speak but very aware of their surroundings. By the end, he couldn’t talk or move but his mind may have remained fully functional.

Slow breathing rate – GBS can curtail respiration so drastically that it becomes nearly undetectable and making it choiceless to mistake the patient for dead. Since GBS can cause respiration to slow to the point where it’s almost undetectable, ancient doctors could have mistaken him for dead.

The most horrifying part? People with GBS remain fully conscious just like you and me right now. Imagine that happening to Alexander. Paralysed, unable to move and unable to scream. Imagine just lying there unable to even blink as your army generals plan your funeral. You are still alive though! His mind is awake and trapped inside that motionless body. And then, the grand funeral procession begins...

This is the worst possible way for a man who controlled everything in life to lose control in death.

Did he know?

Here’s a chilling thought. if Alexander was indeed aware but paralysed, he would have heard his generals debating his succession, his soldiers mourning and the plans for his body being made. Imagine the frustration. The fear. He must be screaming in his head at the people around him to detect his life. He’d have attempted to scream a lot but no voice would come out. Unable to cry either. The absolute horror of knowing what was happening but being unable to stop it. Perhaps the greatest conqueror in history fought his last and most terrifying battle not on a battlefield but within his own body.

An unfortunate patient of Guillain-Barre syndrome undergoing treatment | Pic credit - UCHealth Today

Why the ancient Greeks got it wrong | Forensics’ biggest blunder?

Let’s be fair to the physicians of those time. Ancient Greeks weren’t exactly pioneers of modern medicine. The 323 BCE era was a world where medical knowledge was about as advanced as modern-day YouTube conspiracy theories. They believed illnesses were caused by an imbalance of bodily humours like blood, black bile, phlegm and yellow bile. Not by an autoimmune attack. If you were sick, it wasn’t because of bacteria or viruses but it was because your humours were out of whack. Need a cure? No problem! Have some leeches or let’s drill a hole in your skull to let out the "bad air". Treatments included…

Bloodletting – They’d slice a vein and let blood pour out because losing blood always fixes things, right?

Trepanation – A physician would bore a hole in patient’s skull to release "bad air" or “demons”.

A 3300 BCE trepanned human skull in German museum

Eating random herbs – and hoping for the best.

Medical science was basically just well-dressed guesswork. In other words, if you weren’t breathing much or showing movements, you were assumed dead. No fancy ECG monitors or stethoscopes, just some guy with a beard poking you and saying "Yep, he’s a goner". But what if he wasn’t? What if they embalmed him while he was still technically alive? Let’s not be too judgemental on the Greek doctors of 323 BCE. Let’s be fair to Alexander’s doctors.

Greek physicians didn’t know about bacteria, viruses or the nervous system. Given this level of expertise, it’s no surprise that Alexander’s physicians may have mistaken a paralysed man for dead. He was breathing too shallowly for them to detect. His body hadn’t decomposed yet. So, when Alexander became paralysed, stopped breathing normally and didn’t respond, they likely assumed he was dead. While in reality, his breathing and heartbeat were just too faint to detect. And that’s where the nightmare truly begins. Because he was a king, his ‘corpse’ was quickly whisked away for embalming.

The horrors of being buried alive!

If Alexander was buried alive, his suffering didn’t end at his ‘deathbed’. Now, let’s get really grim. If Alexander was indeed suffering from GBS, what happened next would be the stuff of actual nightmares. It would have been beyond terrifying.

Mummified while alive – The Egyptians and Greeks were big fans of embalming. Ancient embalming techniques often involved evisceration (removing one or all of the internal organs) and filling the body with preserving chemicals. And then, wrapping the corpse up in fine linen like a royal burrito. Evisceration was often while the body was still warm. If he was paralysed but still sentient, he felt everything and the pain would have been unimaginably excruciating. He would have felt every agonising second of the mummification process.

Being entombed or sealed in a sarcophagus and either fully aware or waking up later – If they skipped the embalming and placed him straight into a sealed sarcophagus, there’s a terrifying possibility that Alexander woke up—only to suffocate in total darkness. He might have regained some function just in time to suffocate to death. Imagine the horror of waking up in a pitch-black tomb and unable to move or call for help.

A sarcophagus is a huge stone-carved coffin and because of it's immense weight parts, it is left above ground without being buried

Either way, it’s a chilling and tragic end for a man who had conquered much of the known world. A king who had conquered the world, now trapped inside his own tomb, fully aware of his impending death. It’s the kind of horror story that would make even Stephen King lose sleep.

Other theories looming about Alexander’s death

Of course, not everyone buys into the GBS theory. While the GBS theory is compelling, other historians and medical experts have offered different explanations too.

Poisoning – A slow-acting poison like white hellebore might explain his drawn-out suffering. Some believe Alexander was assassinated using this slow-acting toxin but ancient poisons weren’t always predictable. White hellebore poisoning might explain all his symptoms to most extents.

Malaria and/or typhoid fever – Both these diseases were very common in ancient Babylon and both of them used to and still cause prolonged illness.

West Nile virus – Some believe that Alexander contracted this mosquito-borne illness during his campaigns. Few researchers insist on this. They suggest that he was bitten by an infected mosquito. A rather undignified way for a world conqueror to go.

However, none of these propositions explain the lack of decomposition very well like GBS does. Hence, this makes GBS the most terrifyingly plausible answer that caused Alexander’s death.

History’s greatest missing person’s case – Where is Alexander’s body now?

Alexander’s funeral was as grand as his conquests. After his ‘death’, Alexander’s body was placed in a magnificent golden sarcophagus and set on a journey to Macedonia. But somewhere along the way, his general Ptolemy hijacked the procession and took his body to Egypt where he was interred in Alexandria. His tomb became a sacred site. For centuries, Alexander’s tomb became one of the most visited places in the ancient world. The site was visited by figures such as Augustus, Caligula and Julius Caesar.

Then, at some point, it vanished. Today, however, Alexander’s final resting place remains a mystery. To this day, nobody knows where Alexander’s body is. His tomb was lost to history which adds yet another layer of intrigue to his already legendary demise. Some believe it was destroyed while others claim that it lies beneath modern Alexandria and is waiting to be rediscovered. Alexander’s tomb remains one of history’s many greatest unsolved mysteries. What if the real reason we’ve never found his tomb is because it wasn’t just a tomb?

The ultimate irony of Alexander’s fate

Alexander believed himself to be a god. He sought to conquer the world, define history and gain immortality. But if the GBS theory is correct, his final experience on Earth was one of total helplessness which is the exact opposite of the life he had led. A man who controlled everything in life lost control over his own body. A warrior who could inspire armies couldn’t move a single muscle. And, in a cruel twist, the world thought he was dead while he still clung to life.

Actual coins of the emperor

Alexander spent his life as the ultimate conqueror but only to become completely powerless in the end. He sought immortality and yet his body has been lost to time. Imagine the frustration. The fear. The cruel irony. For a man who reshaped history, his final moments may have been the most tragic chapter of all.

The irony is almost poetic. History is full of mysteries and Alexander’s death remains one of the most haunting. We’ll probably never know for sure what really happened to Alexander in those final days. But if the GBS theory is correct, it means that one of the greatest figures in history didn’t just die. He endured one of the most horrifying fates imaginable. And if that doesn’t give you chills, nothing will.

The GBS theory serves as a stark reminder of how little ancient medicine understood about the human body. So, next time you hear someone talking about Alexander the Great, remember his greatest challenge may not have been conquering Persia, but surviving his own funeral. And if you're ever feeling unwell in ancient Babylon, make sure they check your pulse more than once.

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