Editor—Russia's tsars were despots.1 Their lineage lost ground in the late 19th century and some time later ended in bloody murder. Tsars were not appointed: they inherited power and abused it. Sometimes their power was usurped by those with the ear of the throne.
Figure 1.

Credit: BAL
Peter the Great sought favour with the French court and played at boats with William of Orange. There was only one tsar at a time.
How can a title so suffused in historical imperfection ever be taken seriously? Or was that the intention?
Competing interests: JNH has strong republican tendencies.
References
- 1.Burns H. Health tsars. BMJ 2004;328: 117-8. (17 January.) [DOI] [PMC free article] [PubMed] [Google Scholar]
