Nicholas II’s battle with typhoid in 1900

PHOTO: Emperor Nicholas II recovering from typhoid at Livadia, December 1900

During Tsarist times, typhoid, or “spotted fever”, affected every one from paupers to emperors—the often fatal illness did not discriminate. This intestinal infection caused by a specific type of Salmonella bacterium was a frequent guest in the imperial residences. And all because of poor sanitation. For example, the kitchen of the Winter Palace in St. Petersburg, only stopped taking water directly from the Neva River in 1868, while mineral filters and urns for boiling water were only installed in the palace in the 1920s! And we are talking here only of the water used by the Imperial Family: servants, valets, stokers and porters lived in, and bustled in and out of, the Winter Palace. The common folk and acquaintances that came to visit the Imperial Family in their tiny rooms had a very careless attitude to personal hygiene and as a result, the palace was teeming with lice, bedbugs, cockroaches and, of course, mice.

It is not surprising then that under these conditions that Empress Maria Alexandrovna, the spouse of Emperor Alexander II, their son Alexander Alexandrovich (future Alexander II) and the latter’s daughter Xenia Alexandrovna all caught typhoid fever.

During his stay in Livadia[1] in the autumn of 1900, Nicholas II became gravely ill with typhoid. Initially, doctors were afraid to diagnose the disease for a long time and then they argued about what medication to prescribe.

The Emperor fell ill with what proved to be a rather serious from of typhoid. The Empress had a great horror of the illness, but a crisis always found her self-possessed and resourceful. She nursed the Emperor herself, even doing the night nursing, and acted as his private secretary when he was able to attend to papers, transmitting his decisions to his Ministers. The Empress wrote to her sister, Princess Louis [aka Victoria of Battenberg], at the time:

“Nicky really was an angel of patience during his wearisome illness, never complaining, always ready to do all one bid him. His old valet and I nursed him. The shock of his illness and feeling myself necessary gave me new strength, as I had been very wretched before. I rebelled at a nurse being taken and we managed perfectly ourselves.”

Orchie [Alexandra’s old nurse] would wash his face and hands in the morning. She would bring the Empress her meals, where she would take them while resting on the sofa in her husband’s room. She suffered from head and heartache, the latter from nerves and many sleepless nights. When Nicholas began getting better, she read to him.

He first had a digestive upset on 22nd October 1900, and almost immediately the Emperor’s temperature rose to 39-40 degrees Celsius (102-104 degrees Fahrenheit). The high temperature and severe headache, coupled with food poisoning, continued until 12th November.

PHOTO: Alexandra Feodorovna standing behind her husband, who is seated in a wheelchair while recovering from typhoid. Nicholas II is seated in front of a table, wearing a dressing gown, and a rug placed over his legs. Livadia, Crimea. December 1900

The Emperor actually received no treatment. Despite being pregnant for the fourth time and in a lot of pain, Alexandra nursed him back to health, rarely leaving his side. While Alexandra Feodorovna was the one who looked after him, his sister Grand Duchess Xenia Alexandrovna, recorded her brother’s illness and recovery:

“Poor Nicky is lying in bed, he didn’t sleep at all at night because of terrible pains in his back. In the morning his temperature was 38.2 – during the day 38.7. His eyes are tired and pale! [Dr.] Girsh says that it’s influenza! Thank God there’s nothing in the lungs, or in general anywhere else. Poor Alix [Alexandra Feodorovna] – she looks very tired.” – Xenia’s diary, 27th October 1900

“Later on I drove to Livadia and looked in on Nicky for a minute. The back of his neck hurts terribly, and he doesn’t know where to turn his head. All the pain from his back and legs has gone upwards, and he is suffering terribly. Poor Alix has forgotten about her own sickness and is moving around more. Girsh is adamant, that it isn’t typhoid (we asked him). Girsh asked Nicky to call someone else, to put everyone’s mind at rest – it was decided to call for [Dr.] Tikhonov.” – Xenia’s diary, 29th October 1900

“We met Tikhonov, who told us that several symptoms of typhoid had developed, and that they were almost sure that it was typhoid! At Livadia we immediately questioned Girsh. It’s astounding that influenza should suddenly turn into typhoid!

“At Livadia we immediately questioned Girsh. It’s astounding that influenza should suddenly turn into typhoid! With Alix’s permission Professor Popov was sent for; we had lunch alone together downstairs; a little later [Count] Fredericks arrived, tearing his hair and saying he was in a terrible position, that everyone wanted news, while he was not allowed to tell anyone anything. He wanted us to persuade Alix to allow a bulletin to be published, which we were able to do. She agreed that there is nothing worse than trying to conceal things! We telegraphed poor Mama. Thank God Alix is so calm.” – Xenia’s diary, 31st October 1900

“Thank the Lord, Nicky had an excellent night – he slept until morning, his temperature was 38.7 and he felt well. Alix called me to see Nicky – he was in remarkably good spirits, and chatted and joked. Alix was also in a good mood, having slept well. They didn’t want to let me go, but in the end I left of my own accord, as he needs complete rest and had been talking to much.

“All the unnecessary furniture has been removed from the bedroom, and will be taken into Alix’s drawing room this afternoon. Alix is now sleeping in another bed, at least the doctors have achieved that much.” – Xenia’s diary, 1st November 1900

“They are not happy that Nicky’s temperature is so low 36°, but the pulse is good at 66. They are afraid of a haemorrhage, God preserve us! It’s so terrifying, help us God, save our Nicky!” – 13th November 1900

PHOTO: Nicholas II recovering from typhoid fever, with his sister Grand Duchess Xenia Alexandrovna. Livadia, Crimea. December 1900.

Against this background, discussions about who should succeed Nicholas II, in the event that he should die. The Empress attempted to persuade her husband to change the Laws of Succession to allow females to inherit the throne in the absence of any male heirs in order for their four-year-old daughter Grand Duchess Olga Nikolaevna [2] to inherit the empire, as opposed to her uncle, Grand Duke Michael Alexandrovich. Ultimately, these changes did not take place.

After 13th November, the Tsar’s temperature started coming down and on 30th November, for the first time, Nicholas spent half an hour on his balcony. “It was sunny, warm and still… Thank God my typhoid was mild and I didn’t suffer at all during the whole time. I had a strong appetite and now my weight is increasing noticeably every day…”

Nicholas recovered six months later, in May-June 1901, however, little Olga came down with typhoid. Alexandra would nurse their eldest daughter through her illness.

On the 24th November 1900 Nicholas wrote to his mother:

“About my little wife I can only say that she was my guardian angel, looked after me better than any sister of mercy!”


[1] Up until 1911, Nicholas II and his family stayed in the Small Livadia Palace during their visits to Crimea, after which they lived in the iconic white stone palace, which was constructed on the site of the Large Livadia Palace. The Small Palace survived until the Great Patriotic War (1941-45).

[2] The Succession Prospects of Grand Duchess Olga Nikolaevna (1895-1918) by Carolyn Harris, published in Canadian Slavic Papers, Volume 54, 2012 – Issue 1-2

© Paul Gilbert. 6 February 2021