Spiridovitch "Les Derniers Annes..." V2, Ch. 12 "The Year 1912":
However a new misfortune soon arrived. Immediately after some bumps that he took while on a promenade in a caleche with the Empress, his health worsened. The internal bleeding was even worse, and the swelling in his groin increased in size so much so that the child was confined to his bed. He suffered incredibly. His cries and moans echoed often throughout the Palace, and his fever steadily grew. Botkin never left him for a moment, but did not know what he could do to bring him relief. His pain grew so bad that the sick child would not permit the swelling to be touched. He slept on his side, leg folded, pale, thin and never stopped moaning.
They called the surgeon Serge Petrovitch Fyedorov from Petersburg, and the old Rauchfuss. They arrived on October 4th, the night before Alexis Nicholaiovitch's Name's day. The illness got worse. October 6th, his temperature rose to over 39 degrees (102 F.) and would not go down. After a consultation, the doctors declared that that the situation was desperate. Fyedorov said that he had decided not to open the swelling, given that they would be operating on the inheritor of the throne, and the operation would bring on fatal bleeding. Only a miracle could save the child's life, he said. And when they asked him what that miracle might be, he responded by shrugging his shoulders and said that the swelling might spontaneously be reabsorbed, but that the chance of that actually happening was only less than one in a hundred.
After this diagnosis, the Minister of the Court was permitted to publish bulletins on the health of the Tsarevitch. The first bulletin was dated October 8th. They began to hold services in Spala to pray for a cure for the Tsarevitch. In the Palace they would hear of no other help from the doctors, and only believed in God. They gave the last rites to the child. The catastrophe was expected from one day to the next. The suffering child was plainly aware that his death was near.
They KNEW the difference between Hemophilia and Leukemia.