Twelve Diseases that Changed Our World. Irwin W. Sherman

men. After the Tsar took over as Commander-in-Chief in 1916, the results were even more disastrous, and Nicholas was seen as personally responsible. Nicholas' position as Commander-in-Chief took him away from St. Petersburg, and Alexandra was left to govern in his absence. While she ruled the country, Rasputin ruled her. He prevailed upon her to make several government appointments, and the positions were filled by individuals who turned out to be unfit for their duties. The turnover rate among these officials was high, adding instability to incompetence. Both Rasputin and Alexandra were hated by the Russian people, not least because of Alexandra's German origins, which led to accusations that she was a traitor. An increasingly high mortality rate among the soldiers at the front, as well as Alexandra's urging that liberal reforms be abandoned and the Tsar become more autocratic, led to even further hatred of the Tsar by the Russian people. In December 1916, in an attempt to free the Tsar and Tsarina from Rasputin's influence, Prince Youssoupov and Grand Duke Pavlovitch, the Tsar's nephew, assassinated Rasputin. They were punished by being exiled, an action that drove a wedge between Nicholas and the rest of the Romanov family.

      Early in 1917, conditions in St. Petersburg deteriorated even further: food and fuel were scarce, people had to queue for hours in the bitter cold to buy bread, and revolution began to brew in the streets. Nicholas ordered, “I command that the disorders in the capital shall be stopped tomorrow as they are inadvisable at the heavy time of war with Germany and Austria.” The troops were no longer on his side and did not respond; the soldiers who were garrisoned in St. Petersburg were of no help since they were already consorting with the revolutionaries. The rebellious crowds took over the city, and a provisional government was established. The provisional government attempted to maintain the Romanov dynasty as a constitutional as opposed to an autocratic monarchy by demanding that Nicholas abdicate in favor of the Tsarevich Alexis, with Grand Duke Michael (the Tsar's brother) as Regent; the Army commanders also urged Nicholas to abdicate. Because of his unpopularity and recent ill health, he eventually agreed. However, instead of abdicating in favor of his son, he assigned the throne to his brother Grand Duke Michael and excluded the frail Tsarevich from the succession. The new government, which had been prepared to accept Alexis as a constitutional monarch, feared that Grand Duke Michael might prove to be as autocratic as Tsar Nicholas. Sensing this, Michael abdicated a day after being named Tsar. Anarchy resulted, and the Bolshevik Party, which promised bread, land, and peace, rose to power. As the various political parties struggled for power, the country descended into civil war, and the provisional government feared for the safety of the imperial family. In the spring of 1917, the government approached Great Britain with a request to grant asylum to Nicholas and his family, but the Tsar's cousin, George V, declined. The Tsar and his family were then sent to Tobolsk in Siberia, and in April 1918, after the Bolsheviks had seized power, they were transferred to Yekaterinburg in the Urals. They remained confined at Ipatiev House in Yekaterinburg until the summer of 1918. On 16 July 1918, Nicholas, Alexandra, their five children, their physician, and three servants were taken to the basement, where they were assassinated in a hail of bullets by a Bolshevik firing squad. The Romanov dynasty, which had lasted for over 300 years, had come to an end. It is possible that had the Tsarevich been healthy enough to be named as constitutional monarch after the abdication of his father, the political system might have stabilized and the Bolshevik revolution might have been avoided.

      The Spanish royal family bleeds out

      The youngest of Queen Victoria's nine children, Beatrice, was born in 1857. She was a hemophilia carrier. She married Henry of Battenberg and transmitted the gene to three of her four children; the eldest son was unaffected. The second son, Leopold, was a hemophiliac. He joined the King's Royal Rifle Corps, but because he was physically delicate and lame, he never saw active service; he died in 1922 following a hip operation. The third son, Maurice, also probably a hemophiliac (although this has been disputed), joined the King's Royal Fusiliers and died of wounds received at the battle of Ypres. The only daughter, Victoria Eugenie (known as Ena), who was a carrier for hemophilia, married Alphonso XIII, the King of Spain; her condition had a significant impact on the political stability of Spain.

      The shortage of healthy heirs from the marriage of Eugenie and Alphonso contributed to anti-British feeling in Spain since it was believed that the British had defiled the royal blood of Spain by imposing a genetically defective wife on the Spanish monarch. Unfortunately for Ena, her status as the origin of this disease in the Spanish royal family led to tension in her marriage and its eventual breakdown. Although technically Spain was a constitutional monarchy, in actuality the political parties were weak and so the Spanish King was responsible for appointing his governments. At the end of World War I, the position of the monarchy was further weakened by strikes, assassinations, and a military disaster in Morocco. In 1923, General Miguel Primo de Rivera orchestrated a coup and seized dictatorial power. The King named him Prime Minister, thus appearing to support him. The dictatorship was initially successful and popular, but the people eventually tired of living under a dictator, and Primo de Rivera was unable to sustain his position in the face of economic instability in the late 1920s. The last straw came when the military withdrew support after he imposed some unpopular reforms. He resigned in 1930. The King also lost popular support, and he and his family went into voluntary exile in 1931. Spain became a republic. During the next 5 years, various political groups struggled for power: in 1933 the moderate conservatives were elected, but by 1935 they were replaced by the leftists; military leaders then plotted to overthrow the leftist government. In 1936, Generalissimo Francisco Franco, who had built his reputation in the Moroccan wars of the 1920s, led a Nationalist revolt against the leftists. Franco's justification for his revolt was the defense of Catholic values against all enemies including communism, liberalism, and separatism. The political situation, however, continued to deteriorate, with revolts and murders and finally the Civil War (1936 to 1939). Franco's regime did not tolerate insubordination or political opposition, and those who were opposed to the militaristic society were purged, executed, or imprisoned.

      The monarchists in Spain pressed Franco to restore the monarchy. Indeed, monarchism was strong among the generals who had backed him. However, Franco feared that restoration of a liberal constitutional monarchy would be both anti-Catholic and anti-Nationalist. Further, the possible royal heirs were now living in exile. Alphonso, the eldest son, who inherited the hemophilia gene from his great grandmother Queen Victoria, renounced his claim to the throne in order to marry a commoner, although his removal from the succession as a result of his hemophilia was already being considered. He died at age 31 from a hemorrhage after a car crash. Gonzalo, the youngest son and another hemophiliac, died at the age of 19, also from an uncontrollable hemorrhage after a car accident. Jaime, the second son, who had been deaf since a childhood operation for mastoiditis, renounced his claim to the throne on the grounds of his disability. The remaining son, Juan (the father of the present king of Spain, Juan Carlos), was the only healthy son who survived to adulthood. The number of potential heirs was therefore very limited. The Nationalists, under Franco, received strong support from Italy and Germany, and by April 1939 they were victorious. From the 1940s onward, Spain was under the influence of what Franco liked to call “national Catholicism.” During World War II, Spain, although in sympathy with Hitler and Germany, remained neutral. For not taking sides and for Franco's pro-Fascist policies, Spain was ostracized by the Allies after the war, and this continued to adversely affect the Spanish economy. However, by the 1950s, Spain's economy improved as it opened its markets, and it became strategically important to Britain and the United States in the Cold War. Franco permitted the United States to build air and naval bases in Spain in exchange for economic and military aid. This helped in industrial expansion and improved the economy further. In 1955, Spain was admitted to the United Nations. From 1969 to 1973 there was an unresolved power struggle between the reformists and the conservatives. Miners and other workers went on strike, Basque terrorism increased, and Franco was aging and unwell. The situation was resolved in 1975: General Franco died on 20 November, and Juan Carlos (the son of Don Juan) was crowned King on 22 November. In the end, Franco's 30-year dictatorial regime was replaced by the liberal constitutionalism he had fought so hard against.

      The influence of hemophilia during World War II

      Leopold, the eighth child of Queen Victoria, was born on 7 April 1853. He was the only son to be affected by hemophilia. He bruised easily