Forgive me for bringing back an old thread, but I find this topic fascinating, as I'm interested in both the history of medicine and the history of Russia. There are several threads regarding this topic, it seems, but I chose to respond to this one because I am especially intrigued by Spirodovitch's diagnostic information.
"The proof of the hysterical nature of the nervous manifestations is furnished by the ease with which the Empress submits to the positive suggestions of some and the negative suggestions of others.
"The neuroasthenic manifestations are presented in her in the form of a great weakness (asthenia) of the body in general, the cardiac muscle in particular, with painful sensations in the pericardial region.
"As for the psychic troubles (loss of psychic equilibrium), this is principally expressed by a state of great depression, by great indifference to that which surrounds her, and by a tendency for religious revery.
"The neuro-vascular phenomenona which are the question here (dilation or constriction of the vessels) became more accute as she neared middle age. It is also complicated by a feeling of anguish, a weakening of the centers of inhibition and intellectual troubles bearing principally upon the logical functions and intellectual operations."
Does anyone know if Alexandra's "cardiac weakness" and "enlarged heart" were subjective symptoms? On the other hand, did her physicians come to the conclusion that her cardiac muscles were defective as a result of extensive physical examinations? Apparently, acoustic stethoscopes were used during Alexandra's lifetime, so it seems possible, if not likely, that they were used by her physicians to moniter her cardiac rhythm and lung functioning
[1]. It also seems that electrocardiograms were available at the turn-of-the-century
[2]. Does anyone know if Alexandra's heart was monitered by electrocardiogram machines? If so, are the test results available? It almost seems silly of me to ask because I'm sure they'd be posted here if they were, but I can't help wondering all the same. Such information could give us significant insight into Alexandra's conditions.
While I think that Alexandra exhibited symptoms consistent with depression and anxiety disorders (the supposition that she suffered from depression/anxiety with physical manifestations seems to be supported by those who knew her as well), I try to stay open to the possibility that she
may have had a physical, cardiac condition that was exacerbated by her mental state. Olga Alexandrovna told Ian Vorres that she once witnessed Alexandra's lips turn blue. It's possible that Olga's observations were incorrect. As an example, I suffered from a panic attack as a teenager. My parents, not knowing I was in the throes of an attack, thought my skin looked gray, and they were worried that I was suffering from something much more life-threatening. Of course, it's possible that Alexandra's lips did in fact turn blue. Cyanosis (blue lips) can be indicative of several health conditions, some of which aren't serious at all and some of which are indeed serious (and are usually cardiac in nature)
[3]. Cyanosis, along with shortness of breath, edema, chest pain, and fatigue, symptoms which Alexandra exhibited, could indicate congestive heart failure
[4]. But if Alexandra did suffer from a mild form of the condition, I'd think that her physicians would have picked up on it, no? As I'm sure you all know, Alexandra's symptoms could have been caused by a myriad of different conditions; congestive heart failure is just one of many, many possibilities.
P.S. I'm not a medical professional, so feel free to take everything I wrote with a grain of salt.
