Kendrick asserts that the key to diagnosing  Alexei's condition Thrombocytopenia vs Hemophilia should be based on historic allegations about Rasputin's capabilities.
If I understand the article correctly, Kendrick contends that if it could be proven that Rasputin did not heal Alexei, then Alexei must have suffered Thrombocytopenia, and not Hemophilia. IMHO this is a very broad statement to present to the medical community.
Surely a reasonable starting point to help cement his assertions would have been to examine the medical records of all known affected members of the Royal Houses, compare lifelong symptomologies and including causes of death of each individual.
Documented historic information informs us that there was a bleeding disorder passed down from Queen Victoria. The condition at the time was little understood, since the causative factors for Hemophilia only became known in 1937 (by the research of Patell & Taylor at Havard). Certainly the Royal Disease could have been attributed much later to a form of Congenital Thrombocytopenia and not to some form of Hemophilia. Â However the type of symptoms now known to be attributed to Congenital Thrombocytopenia were not described when Alexei was born. He appeared normal for the first several weeks, and it was not until several weeks had passed that spontaneous bleeding was observed seeping from his umbilicus. From these documented descriptions, coupled with subsequent episodic hemorrhaging into his joints, the ease of bruising etc., he was correctly diagnosed as suffering Hemophilia.
Alexei's initial diagnosis was made well before the trip to Spala, which Kendrick believes was the starting point of Alexei's actual condition (without proof) could have been attributed to an underlying viral infection, despite the trauma of a fall. Â Even if this conjecture was remotely accepted to have any veracity, then it might be plausible to suggest that Alexei may have begun to show symptoms of viral induced Thrombocytopenia. Â
But it it is difficult to accept this proposal on a number of points:
1. There was no evidence of any viral (or bacterial) infection contracted in the autumn of 1912,
2. Family genetics clearly describe otherwise,
3. Early diagnosis of a bleeding dysfunction in the first few months (not days) after birth.
4. His condition was episodic, with periods of reasonable health and appearance. Â
Furthermore, to discuss a sample of one (knowing that there was some kind of familial genetic predisposition), is neither credible nor scientific. His proposals could only be considered as highly speculative.
The paper was presented as a Historical Perspective having the status of a curiosity, which sets it apart from the more meritorious scientific endeavors published in the same journal, which are subject to peer review.