So WHY would it not have been hemophilia?

[etonexile]

The Spanish Royal family...because of Queen Ena...were visited with the curse of haemophlia...what are the chances that the family of AF didn't have this disease as well...?

[Georgiy]

That's right. The fact is, and it is verifiable, that certain descendants of Queen Victoria suffered from haemophilia. It would be most strange if all these other relatives had haemophilia, but Alexei didn't, rather having some disease that mimics haemophilia but isn't haemophilia. I reiterate, the only people that suggest that he didn't have haemophilia are those who have a vested interest to say otherwise.

[lexi4]

I have nothing against Mr. Kendrick personally, but I feel his motives in presenting the hypotheses he did were not in the least objective.  Had he arrived at his conclusions without an agenda to promote the claims of a rank impostor, I would not object to them in the least as an explanation for the boy's sufferings.  But his methodology and premise are flawed in the first place, and that is what I am DEBATING here.
But Mr. Kendrick's methods or motive have nothing to do with the topic. Mr. Kendric is a journalist and to say that he arrived at his conclusions is unfair. For all we know, he could have started out trying to disprove the claim, which again is not the topic. Please cite your source for syaing his methodolgy and premise are flawed. Where did you get any information to make that allegation? Just curious.


In defending the position that the Tsarevich DID have hemophilia, is it old-fashioned and unenlightened, or does it show a healthy dose of skepticism about the latest theories that one cannot possibly prove without a definite concrete confirmation?  This is why I called for Tammet's DNA to be tested.   If this Estonian immigrant were Alexei that would prove he did not have hemophilia.
 We would all like to see DNA results, but that isn't in our control and still isn't the topic in this discussion.

The fact that he supports a claimant disqualifies him from being objective.  But then again, the subject of the Russian Imperial Family is hard to remain objective about.
    Says who???



I assure you that that is not my intent.  But I do challenge you to defend the viewpoint that in fact Alexei did not suffer from the disease, completely independently from any reference to material that supports claimants... rather than attacking those of us that defend hemophilia as a diagnosis.

I don't think it was Mr. Kendrick who brought up the topic of claimants. I for one and interested in this theories and hope this hasn't discouraged him from posting.

[etonexile]

Besides Mr. Tammet not looking very much like Alexei or any of his relations....I can't imagine the family wanting to go through any DNA testing...they'd seem rather sad....

[lexi4]

If the question is 'did the tsesarevich have haemophilia?', then the answer is 'yes', and the only people who seem to rigourously wish to deny this are those who support claiments who have the wee problem of being non-haemophiliacs.

I support no claimants. But at least a couple of us found this discussion interesting and are open to discussing it. When I am not interested in discussing a particular topic, I just don't participate. I am interested in listening to what Mr. Kendrick has to say. I have learned some things from his posts. They have made me research more to explore for myself. And that is a good thing. So, I hope Mr. Kendrick will continue to post and I hope we can stay on topic.

[Georgiy]

Lexi, note that I said the people that rigourously wish to deny it....I think it is implausable that he could have had anything but haemophilia, and judging from what other relatives of his suffered from I think it is a fairly safe assumption. If people wish to explore other possibilities, I would wish them very good luck. It just seems interesting that the claiments without haemophilia do not get DNA tested. Maybe it's expensive, but surely their supporters could money-pool. Really then we would all know one way or the other. The fact is, the claiments won't go for the DNA testing. If they did, and the DNA showed a Romanov and Hessian and Saxe-Coburg and Gotha and Battenburg match, then we would be able to say "well, we were wrong, the Tsarevich did not have haemophilia." Until such a time, while people have every right to speculate, I think it is a kind of speculation that is a flimsy as a house of cards - the only thing holding it up is the statements of non-haemophiliac claiments and supporters.

[lexi4]

Lexi, note that I said the people that rigourously wish to deny it....I think it is implausable that he could have had anything but haemophilia, and judging from what other relatives of his suffered from I think it is a fairly safe assumption. If people wish to explore other possibilities, I would wish them very good luck. It just seems interesting that the claiments without haemophilia do not get DNA tested. Maybe it's expensive, but surely their supporters could money-pool. Really then we would all know one way or the other. The fact is, the claiments won't go for the DNA testing. If they did, and the DNA showed a Romanov and Hessian and Saxe-Coburg and Gotha and Battenburg match, then we would be able to say "well, we were wrong, the Tsarevich did not have haemophilia." Until such a time, while people have every right to speculate, I think it is a kind of speculation that is a flimsy as a house of cards - the only thing holding it up is the statements of non-haemophiliac claiments and supporters.

Well, I was interested in the discussion. However, this thread has digressed to personal attacks and we can't seem to get back on topic. I give up. Not worth the energy to continue.

[Georgiy]

Lexi, I hope you don't think I am making personal attacks, as that is not my intention, and it is a great sin which stems from pride. However, if what i have said has been taken as a personal attack, then I apologise and will try to be more careful with how I write in the future so that things aren't misinterpreted.  All I have been saying is if one can't show any irrefutable evidence that Alexei did not suffer from haemophilia, then claiments who don't have haemophilia have an enormous, uncrossable hurdle. All evidence points to him having haemophilia, so the onus of people who say no he didn't is to prove beyond reasonable doubt that he suffered from something else.

[J_Kendrick]

One can find the medical summary having to do with the Spala episode as a photocopy of the original, oddly enough in a book about another false Alexei, who happened to glom onto the thrombocytopenia theory.  It is mostly in Russian except for the Latin terms 'hematoma retroperitonale' and 'musculus ileopsas'.  There is no mention of the spleen at all, though it notes the boy's high fever.  The book claims that this report, signed by the boy's specialists, is the only medical record of the Tsarevich known to have survived.

If you can read Russian you would see that there is no mention of anything having to do with an aplastic crisis or any of the other medical terms that fit Tammet a lot better than they did Alexei.  The Latin terms mean 'hematoma of the hip joint' and 'hip muscle'.  Again I stress that newspapers leaked the doctors' conclusions in 1912, just after the Spala episode.  The word 'hemophilia' was used to describe the Tsarevich's sufferings during his lifetime.

That particular "medical record" that you have chosen to quote..  the same one you complained about me using in my analysis of the Spala episode.. is a statement released by the Ministry of the Imperial Court.  It is not a "medical record" as the retired Irish school master William Lavery, a.k.a. Blood Relative author "Michael Gray", has suggested.   While this statement certainly is the only medical information on Alexei's condition ever published by the palace, in reality, it's actually nothing more than a 93 year old press release.   This is the same kind of public statement that's traditionally found tacked to the iron gates in front of Buckingham Palace on those very rare occasions when the Palace has considered the situation serious enough to warrant a public announcement.

No press release, be it from royalty, from politicians, or be it from anyone else for that matter, will ever contain any more information than has been deemed absolutely necessary to fulfil only the very barest minimum requirements of the public's need to know.  The authors of such published statements will occasionally throw in an impressive technical term or two to give it an air of authority and make the words appear to be honest and forthright, but they will never give out anything more than the very barest of information... unless it serves to their own political advantage.

Why doesn't that same palace statement that carries the names of Drs. Raukhfus, Federov, Botkin, and Ostrogorsky, ever make any  mention of Aplastic Crisis?  The answer is simple:  For the same reason that  those very same doctors had never made any mention at all of X-linked clotting factors.   No one even knew what an Aplastic Crisis was until it had first become the subject of a research study in 1947..  a full 35 years after the Spala episode.   All four doctors whose names were on that Palace statement in October of 1912 had long since departed this world by then.   For that same reason of chronology, no one, including Robert Massie, had ever made any mention of the clotting Factors VIII and IX until many years after the first publication of "Nicholas and Alexandra" in 1967.   The clotting factors that we now know are responsible for haemophilia didn't even have names until 1964... Sixty long years after Alexei's birth.  

All that aside...

That you would even consider supporting your rebuttal with a reference from "Blood Relative" is a much more than adequate source of mirth all by itself... but ... Where on earth did you ever get the strange idea that 'hematoma retroperitoneale' is Latin for 'hematoma of the hip joint'?  

The word Haematoma we all know, but the definition of Retroperitoneal is:- Having to do with the area outside or behind the peritoneum, the tissue that lines the abdominal wall and covers most of the organs in the abdomen.  The retroperitoneal space is in front of the lower back and behind the abdominal lining (peritoneum).

Reach behind you to where your kidneys are located inside the abdominal cavity in the small of your back.... That's retroperitoneal.  Not exactly your hip joints, is it?
See:
http://powershowz.medicalillustration.com/generateexhibit.php?ID=8478&ExhibitKeywordsRaw=&TL=16353&A=63136

So.. What's the connection between retroperitoneal haematoma, the iliopsoas muscle, and a possible Splenic Trauma?... It's interesting that you should ask. :-)

Here's an example just for starters:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14723052

Retroperitoneal hematoma in children
Baeza-Herrera C, Garcia-Cabello LM, Villalobos-Ayala D, Osorio-Arguero CD.
Departamento de Cirugia General, Hospital Pediatrico Moctezuma, Mexico D.F.

INTRODUCTION: Retroperitoneal hematoma is frequently due to blunt trauma and is a challenging problem. Incidence of this complication in adults is high, but in childhood is uncommon. MATERIALS AND METHODS: Analysis of 30 cases is presented. PTS was found between 10 and 12 points, zone II, 12, zone III, 17, and zone I, only one. We observed 33 associated injuries: 17 were pelvic fractures and nine, ureteral rupture. Three patients underwent hepatic or splenic laceration. Seventy-three percent of patients had exploratory laparotomy, but did not have exploration of retroperitoneum. CONCLUSIONS: Retroperitoneal hematoma in infancy should be treated conservatively.

... and the obvious source of that blunt trauma?  To quote Alexander Spiridovich: "The Tsarevich had climbed onto the edge of the bathtub wanting to show Derevenko how the sailors on the Standardt would jump off the side of the yacht into the sea to go swimming. He jumped and fell onto the side of the bathtub."

Here's another that's easy to find:
E Medicine
http://www.emedicine.com/radio/topic645.htm
Splenic Trauma

The most common presenting complaint in a stable patient is left upper abdominal or flank pain; however, the pain is probably not significantly referable to the spleen but is related more to overlying soft tissue and/or bone injury and peritoneal irritation by the hemoperitoneum. This is supported by the prevalence of missed subcapsular hematomas with regards to more advanced degrees of splenic injury. This is not to say that the spleen contains no pain sensors. Pain fibers are present within the splenic capsule, and they can elicit a strong response as proven by the severity of symptoms displayed during splenic infarction. The degree of pain elicited by a subcapsular hematoma is usually overlooked by physicians and patients alike.

LUQ (left upper quadrant) hematoma, if sufficiently large, can displace the shadow of the inferior splenic margin caudally, simulating splenomegaly.
- Subcapsular hematoma can produce a similar appearance, and the appreciated mass has distinct borders.
- Associated displacement of the left renal shadow also may be evident

The constitution of findings present when retroperitoneal hemorrhage or free intra-abdominal blood exists contrasts those just mentioned.
- Little, if any, mass effect on LUQ organs is apparent.
- Splenic margins are obscured, but this finding is not specific.
- Retroperitoneal blood can obliterate the left renal outline and psoas muscle margin.

And here's a couple more to peruse:
Extraperitoneal hemorrhage associated with splenic injury in infants and children:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10587138&dopt=Abstract
Blunt abdominal trauma in children: (34 splenic injuries out of 57 cases studied)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11057553

Continued in the following post...

[J_Kendrick]

Disregarding all the other episodes the boy suffered because they did not fit your diathesis would have been irresponsible for a medical practitioner treating Alexei Nikolaevich.  If you had considered and dealt with the rest of the boy's medical history even at an anecdotal level, would you have drawn the same conclusions as your article did?  The real peer review is going to come from any rebuttals from those who actually deal with diseases of the blood.   The real proof will come when Heino Tammet's DNA is tested against that of the Empress-Martyr.  Then we shall see if you stand by those theories when Alexei Nikolaevich and Ernst Veerman are proven by medical science to be two separate individuals.

Let me make this perfectly clear.  Every single detail of the Tsarevich Alexei's medical history has been considered, from those first moments of August 12, 1904 to the very last moments in the Ipatiev half-cellar room in the early morning hours of July 17th, 1918.  Not one single piece of the available medical evidence has been missed, despite any other suggestions that you may chose to make to the contrary.

The symptoms that are recorded in the Tsarevich Alexei's case will never change.  They are a fact of history.  Whether there is a claimant in the shadows or not, it makes absolutely no difference whatsoever.  My conclusions would still be the same.  Only the diagnosis has changed.  The historically popular diathesis of haemophilia has never been proved by any scientific medical laboratory tests.  The symptoms in Alexei's case are still a far better fit with today's modern knowledge of the bleeding that is seen in the platelet disorders of haemolytic anemia.

Very much to the contrary of the statement you have made above, the conclusions in my paper have already passed the peer review "from those who actually deal with diseases of the blood".  Who else could you possibly imagine would be members of the review panel of the American Journal of Hematology?  That very same paper has been open to the full public scrutiny of the entire medical community at large ever since the very first day of its publication on August 11, 2004.  During the past nine months that my paper has been completely open to full public scrutiny, there has been no rebuttal whatsoever from anyone that you have described here as "those who actually deal with diseases of the blood.".

Since its first day of publication last August, the only opposition has come from those very few followers of the "holy martyrs" cult who post to this board.

And just so that you know...  The medical terms 'hematoma retroperitoneale' and 'musculus ileopsoas' that you've quoted from that single Palace statement of October 1912 are not Latin. They're Greek.

JK

[Pravoslavnaya]

Mr. Kendrick:

1.  I maintain that you assume that the medical summary in Russian signed by the Tsarevich's doctors you saw in Michael Gray's otherwise spurious book had the same text as the report by Count Fredericks, which you conveniently link to your own obfuscation of the Spala episode... unless you actually can read Russian.

2.  The terms 'hematoma retroperitonale' (literally 'bloody swelling in back of the peritoneum') and 'musculus ileopsas' are Latin.  Greek is not directly used in medical terminology.  I speak as someone in the medical field who had to take my courses in medical terminology like anyone else.  Please note that anyone involved in the care of hemophiliacs can tell you that bleeding in this region is quite serious and hard to control.  Post-hemorrhagic anemia would have been a given in the days before Factor VIII and Factor IX.  Methinks the New York Times in November 1912 did not leak the news that Alexei Nikolaevich had problems with his hip and hemophilia without sufficient reason to do so.    

3.  Interested parties may want to track down a British journal called Hospital for issues dated in October or November of 1912, where Alexei's condition is actually discussed.  Another New York Times article appearing in November of 1912 that says the young prince 'has one skin too few, as was the case with the late Duke of Albany' mentions that article, which may be crucial....

4.  You DID ignore all the other bleeding episodes suffered by Alexei Nikolaevich.   This may end up one of the more valid criticisms of your entire construct.

5.  I admit that if your hypotheses about the Tsarevich-Martyr's illness could stand up when Heino Tammet is proven not to have been Alexei then you have accomplished something.  Could you have come up with it without considering Tammet's claim,  and without claiming that a disease homologous to hemophilia could literally transform itself into a cancer of the white blood cells (a completely different sort of blood disorder altogether!) after several years in apparent remission -- a thing unheard of in medical history?   Your lack of objectivity and your inability to definitely pin this unusual and freakish combination of disorders on the real Alexei without concrete and undeniable proof makes this doubtful.  There is no way you can prove anything without the testing being done.  Another poster suggests you follow through.  

6.  The great majority of those who keep faith in the Royal Martyrs probably don't feel Heino Tammet is anything more than a blip on the radar screen, or a reason to become mildly offended.  Not all the people that remonstrate with you here are RO.  It may take a publication cycle or two to see any reaction from the readership of the American Journal of Hematology in print.  Or -- like an article of mine that once appeared in a scholarly music journal -- it may well be forgotten, like Heino Tammet, Vasily Filatov or Michael Gray.

[lexi4]

Mr. Kendrick:



5.  I admit that if your hypotheses about the Tsarevich-Martyr's illness could stand up when Heino Tammet is proven not to have been Alexei then you have accomplished something.  Could you have come up with it without considering Tammet's claim,  and without claiming that a disease homologous to hemophilia could literally transform itself into a cancer of the white blood cells (a completely different sort of blood disorder altogether!) after several years in apparent remission -- a thing unheard of in medical history?   Your lack of objectivity and your inability to definitely pin this unusual and freakish combination of disorders on the real Alexei without concrete and undeniable proof makes this doubtful.  There is no way you can prove anything without the testing being done.  Another poster suggests you follow through.  


6.  The great majority of those who keep faith in the Royal Martyrs probably don't feel Heino Tammet is anything more than a blip on the radar screen, or a reason to become mildly offended.  Not all the people that remonstrate with you here are RO.  It may take a publication cycle or two to see any reaction from the readership of the American Journal of Hematology in print.  Or -- like an article of mine that once appeared in a scholarly music journal -- it may well be forgotten, like Heino Tammet, Vasily Filatov or Michael Gray.

Continued attacks and again this topic has nothing to do with Heino Tammet.

[Pravoslavnaya]

Continued attacks and again this topic has nothing to do with Heino Tammet.

I believe my point # 5 was a point of debate:  can his hypotheses, such as they are, stand up independently of his claimant?  I also stated a particular reason for doubting they could.  IF he had come up with his ideas apart from anyone but ALEXEI, then there is a lot more plausibility in his arguments.

Point #6 was a response I made to an attack he made on those who are devoted to the Royal Martyrs of Russia.

If his theories hold no water when a man's claims are disproven, then that makes one less argument that Alexei did not have what he had.  Only those speaking on behalf of claimants have ever disputed the diagnosis so far.  If an INDEPENDENT researcher without an ulterior motive had sufficient material to present a valid argument that Alexei's illness were not hemophilia, that would be a completely different matter than this.

I'm still waiting here myself for a truly objective stance that this poor gentle child suffered from anything other than what the historical record states.   NO CLAIMANTS PLEASE!

[lexi4]

Mr. Kendrick,
I hope you will continue to post here. I am learning a lot from your remarks. I'll keep watching for your posts.

[Belochka]

 During the past nine months that my paper has been completely open to full public scrutiny, there has been no rebuttal whatsoever from anyone that you have described here as "those who actually deal with diseases of the blood.".

Since its first day of publication last August, the only opposition has come from those very few followers of the "holy martyrs" cult who post to this board.

JK

Little spare time is available in laboratories to be concerned with extraneous material published in medical journals. Spare time is used productively in medical libraries by focusing only on all publications that pertain to one's focus of concern. Historic Perspectives do not merit consideration.  

It would not be unreasonable to suggest that the reason there have been no rebuttals to date is based on the fact that very few would have bothered to read that section. Curiosities have minimum priority over the extensive weekly publications researchers are compelled to sift through.

Mr Kendrick while you construct quaint definitions for those who choose not to follow your string of innovative presumptions, it does not serve your argumentation very well.