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IntroiuctionThe writing of this book is the result, like most things in life, of a circumstance of Fate. Since the day, now over ten years ago, that my wife and I discovered that our son had hemophilia, I have tried to learn how other families dealt with the problems raised by this unique disease. In time, this led to curiosity about the response of the parents of the boy who was the most famous hemophiliac of all, the Tsarevich Alexis, the only son and heir of Nicholas II, last Tsar of all the Russias.What I discovered was both fascinating and frustrating. There was general agreement that the child's hemophilia had been a significant factor in the lives of the parents, Tsar Nicholas and Empress Alexandra, and thereby in the fall of Imperial Russia. Thus, in the most comprehensive political study of the period, The Fall of the Russian Monarchy, Sir Bernard Pares declares categorically: "On August 12, 1904 . . . took place the event which more than anything else determined the whole later course of Russian history. On that day was at last bom the heir to the throne, long expected and fervently prayed for." What Pares is saying, and what is scarcely disputed by anyone, is that in an effort to deal with the agonies hemophilia inflicted on her son, the distraught mother turned to Gregory Rasputin, the remarkable Siberian mystagogue. Thereafter, Rasputin's presence near the throne his influence on the Empress and, through her, on the government of Russiabrought about or at least helped to speed the fall of the dynasty.This was fascinating. But it was frustrating to discover that even those who attached the greatest significance to the effect of the disease on events did not explain, either in human or in medical terms,