On either 10 or 11 June 323 BC, Alexander died in the palace of Nebuchadnezzar II, in Babylon, at age 32. There are two different versions of Alexander's death, and details of the death differ slightly in each.

Plutarch's account is that roughly 14 days before his death, Alexander entertained admiral Nearchus and spent the night and next day drinking with Medius of Larissa. He developed a fever, which worsened until he was unable to speak. The common soldiers, anxious about his health, were granted the right to file past him as he silently waved at them.

In the second account, Diodorus recounts that Alexander was struck with pain after downing a large bowl of unmixed wine in honour of Heracles, followed by 11 days of weakness; he did not develop a fever, instead dying after some agony. Arrian also mentioned this as an alternative, but Plutarch specifically denied this claim.

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