The Terminal Aphonia of Alexander The Great, a Silent Herald of an Ordinary Death

Even though the absence of the body prevents sure conclusions, the death of Alexander the Great remains a hot topic of retrospective diagnosis. Due to the serious mishandling of ancient sources, the scientific literature had Alexander dying of every possible natural cause. In previous works, the hypothesis that typhoid fever killed Alexander was proposed, based on the presence of the remittent fever typical of this disease in the narrations of Plutarch and Arrian. Here we provide additional evidence for the presence of stupor, the second distinctive symptom of typhoid fever. In fact, based on the authority of Caelius Aurelianus and Galen, we demonstrate that the word ἄφωνος, used to describe the last moments of Alexander, is a technical word of the lexicon of the pathology of Hippocrates. Used by him, the word defines a group of diseases sharing a serious depression of consciousness and motility. The association of stupor with the remittent fever strengthens the typhoid fever hypothesis.

Medical Writing in the Late Roman West

After Galen, the Latin literary output of the medical sciences in the Latin West consisted of translations of earlier Greek works; new books based on Greek texts, and a large group of anonymous or pseudonymous texts. Elite western Roman society was essentially bilingual through ca 200 ce. The two chief translation centers of the era were North Africa and Ravenna. The most important authors in this period are Vindicianus, around 400 ce, his student Theodorus Priscianus, and Caelius Aurelianus, around 425 ce, who composed works largely based on Soranus the Methodist: each wrote works of recipes for general use, or specifically for female ailments. Cassius Felix, around 450 ce, wrote his Latin treatise for the use of medical students. The author Mustio composed a work of gynecology around 550 ce, for midwives, based on Soranus. Other regions produced writers, such as Marcellus of Bordeaux and Agnellus of Ravenna.

COMPETENCE CONFLICTS BETWEEN PHILOSOPHY AND MEDICINE: CAELIUS AURELIANUS AND THE STOICS ON MENTAL DISEASES

It is an established Hellenistic topos that philosophy is the ‘medicine’ of the soul, in charge of ‘healing’ the soul in the same way as medicine is in charge of healing the body. The ‘diseases’ of the soul deemed to be in need of healing are its passions, that is, its fears and desires, and the moral ‘health’ that philosophers pledge to grant their followers is freedom from passions and hence peace of mind.