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

BACKGROUND

ChatGPT was developed in November 2022 with studies showing its impressive performance in academic examinations, serving as a promising tool to answer questions even on controversial topics. Artificial intelligence (AI) achieving surface-level performance does not necessarily equate to a deep understanding of human cognition. The development of artificial wisdom, therefore, necessitates a shift from simply mimicking intelligent behavior to modeling the underlying mechanisms of human wisdom, including emotional understanding, ethical considerations, and contextual awareness. Several theories exist behind the death of Alexander the Great, but no definitive conclusion has been made.

AIM: To evaluate whether a hybrid approach, combining generative AI (ChatGPT) with human clinical judgment, can meaningfully reassess the cause of death of Alexander the Great.

METHODS

This is a cross-sectional study using ChatGPT (version 4 Pro). A search was performed with search terms describing the symptoms experienced by Alexander the Great and possible causes of his death: West Nile virus (WNV) encephalitis, poisoning, acute pancreatitis due to excessive alcohol consumption, typhoid fever, and malaria. The historical data and symptomatology were analyzed, weighing evidence and context in a manner akin to human wisdom.

RESULTS

The most likely cause of death of Alexander the Great, as generated by ChatGPT, was typhoid fever complicated by Guillain-Barré syndrome (GBS). The hypothesis was based on the alignment between Alexander's reported symptoms, such as prolonged high fever, severe abdominal pain, neurological decline, and the known clinical presentation of typhoid fever. However, after carefully reviewing the sources mentioned by ChatGPT, many did not back up the idea that typhoid caused GBS and instead pointed to Campylobacter jejuni as the more likely trigger. Other possible causes of death suggested by ChatGPT including acute pancreatitis from excessive alcohol consumption, infectious causes (WNV encephalitis, malaria), and poisoning were less likely.

CONCLUSION

While ChatGPT initially concluded typhoid fever with GBS as the most plausible cause of death, expert reappraisal of the sources and pathophysiology suggested that C. jejuni-associated GBS was more likely. This study exemplifies how incorporating AI's pattern recognition with human scrutiny can yield responsible interpretations of historical records.