The abdominal swelling is called splenomegaly, a severe swelling of the spleen that is a major clue to the real cause of the episode. In ninety percent of cases the onset of aplastic crisis takes place before the age of fifteen. Alexei's episode occurred seven weeks after his eighth birthday. The median age of onset is seven. The most important evidence to support a diagnosis of aplastic crisis in the Spala episode is the spontaneous remission.
Aplastic crisis is a self-limiting disorder.
It will last six, and possibly as many as ten days, and then subside all on its own. Rasputin was quite right when he advised the Empress that her son would get better if the doctors were not allowed to bother him too much. The recommended treatment is to give the patient only comfort and supportive measures until the bone marrow's ability to produce healthy red blood cells is able to recover. There is nothing mysterious about how Alexei's health had improved after the arrival of Rasputin's telegram. The haemorrhaging that was the result of aplastic crisis had simply run its course.