In late May of 323 BC, Alexander re-entered the city of Babylon after taking a journey down the marshy Tigris-Euphrates delta. A few days later he became seriously ill and died about June 10.1 Since antiquity, much controversy has arisen about the king's death: was he poisoned, or did he die of natural causes? It is the purpose of this brief note to suggest that Alexander died of natural causes, perhaps malaria, and not from poisoning. The theory that Alexander was poisoned has been most persuasively argued by AB Bosworth; 2 RD Milnes3 even suggested that strychnine was administered at Medius' banquet in unmixed wine, a procedure which Theophrastus allegedly recommended. 4 However, it is the nonlethal variety of strychnine which Theophrastus wrote was added to unmixed wine; the lethal variety has a readily detectable, extremely bitter taste. The symptoms recorded by our sources before Alexander's death (a violent intermittent fever, loss of voice, and severe back pains) do not resemble the symptoms of strychnine poisoning, either slow or fast. 5 With large doses of strychnine, the victim suffers a series of muscular convulsions within fifteen to thirty minutes of ingestion, followed in a short time by unconsciousness and death. Slow poisoning-caused by repeated small doses over a long periodcauses subfebrile temperatures (below 100? F.), muscular rigidity, photophobia, hypersensitivity to noise, and lassitude. Subfebrile temperatures are scarcely consistent with Alexander's violent fever as described by our sources; and lassitude is not decisive, since, whatever the cause of death, one cannot expect great feats of intellectual or physical vigor from a man who is terminally ill. Furthermore, the administration of repeated, small doses of poison to Alexander would greatly increase the probability of detecting the culprit. In fact, Alexander himself is curiously overlooked in poisoning theories. Surely, if anyone suspected poisoning, it would be the intended victim himself, and Alexander's swift action against other conspiracies against his life-real or alleged6-