Decoding Alexander the Great’s gastrointestinal cause of death using artificial wisdom: An artificial intelligence-human inquiry into a medical mystery

Table 1 ChatGPT’s reasoning for rejection of alternative diagnoses in Alexander the Great’s death

Cause of death	Explanation
Poisoning theories	The symptoms of the poisons speculated do not match as closely with the full range of symptoms Alexander exhibited, especially the neurological ones. Most poisons would have caused a more rapid deterioration and death, unlike the 12 days of illness Alexander endured
Acute pancreatitis from alcohol consumption	This cause is plausible given Alexander’s history of heavy drinking. However, the progression of symptoms and his ultimate neurological signs do not align as well with pancreatitis, which typically would not lead to paralysis or a ‘locked-in’ state
Malaria	While malaria is a strong contender due to the endemic nature of the disease in the region and his symptoms, the lack of specific mention of periodic fever cycles and symptom onset typical of malaria slightly weakens this argument compared to the detailed matching of typhoid fever symptoms
WNV encephalitis	This is less likely due to the historical and epidemiological inconsistencies regarding the presence of WNV in that era. Furthermore, Alexander’s symptoms do not entirely match the typical clinical presentations of WNV

WNV: West Nile virus.