The history of haemophilia in the royal families of Europe.

On 17 July 1998 a historic ceremony of mourning and commemoration took place in the ancestral church of the Peter and Paul Fortress in St Petersburg. President Boris Yeltsin, in a dramatic eleventh-hour change of heart, decided to represent his country when the bones of the last emperor, Tsar Nicholas II, and his family were laid to rest 80 years to the day after their assassination in Yekaterinberg (Binyon, 1998). Prince Michael of Kent expressed his sadness over the controversy surrounding the burial which he described as ‘a great opportunity to heal divisions in Russian society’. He described it as ‘ironic that the Orthodox Church, for so long the bedrock of the people’s faith, should find it difficult to give this blessing the country had expected’. ‘I have studied the results of DNA testing carried out in England and abroad and am convinced that the remains are those of the Tsar and his family’ (The Times, 1998a). Unfortunately, politicians and the hierarchy of the Russian Orthodox Church had argued about what to do with the bones previously stored in plastic bags in a provincial city mortuary. Politics, ecclesiastical intrigue, secular ambition, and emotions had fuelled the debate. Yeltsin and the Church wanted to honour a man many consider to be a saint, but many of the older generation are opposed to the rehabilitation of a family which symbolizes the old autocracy. Yeltsin’s sudden decision to attend the funeral sets him at odds with the Russian Church, which remains sceptical about the authenticity of the bones and insists that the recent DNA tests are fallible. The scientific evidence regarding the remains seems overwhelming, but the historical drama continues. What has this got to do with haematology and haemophilia in particular? Most of us are aware that Tsar Nicholas II’s son, Alexei, had haemophilia. What is not always appreciated is the impact that haemophilia has had on the Royal Houses of Europe for over 100 years. The interest has only been heightened by the unknown whereabouts of Alexei and one of his sisters. As we shall see, there is even now a possibility that the mystery may be solved.