Grigori Rasputin gained immense political power in the Russian Empire by convincing Tsar Nicholas II and Tsarina Alexandra that his mystical prayers could cure their son's hemophilia.

Why a reprieve could look like a cure

Hemophilia prevents blood from clotting normally, so an injury can lead to prolonged bleeding. In the early 20th century, doctors had few ways to control the condition. Aspirin, sometimes given for pain or fever, could make bleeding more likely because it interferes with platelets—the blood components that help form clots.

That created a troubling possibility in the care of Tsarevich Alexei: if aspirin was worsening a bleeding episode, stopping it might help the boy improve. Some medical historians suspect Rasputin urged the doctors to withhold the drug. The precise advice is uncertain, but a change in treatment followed by a lull in symptoms could readily be understood by the family as evidence that Rasputin’s prayers had worked.

From a family’s trust to political influence

For Nicholas II and Alexandra, Alexei’s illness was not an abstract medical problem. The heir’s safety carried the future of the dynasty, and each crisis brought fear and a search for help. Rasputin’s apparent ability to offer reassurance—and, at times, to coincide with the boy’s improvement—made him unusually valuable to Alexandra.

That private trust acquired public consequences. As Nicholas spent increasing time away from the capital during World War I, Alexandra relied on Rasputin’s counsel in political matters. His influence did not come from a formal office or proven medical expertise; it grew from access to the imperial family and the belief that he could protect its most vulnerable member.

A possible practical effect—removing a drug that aggravated bleeding—could therefore reinforce a mystical explanation and help turn a child’s medical crises into a source of power at court.