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Dmitry Ivanovich, known as Dmitry of Uglich or Tsarevich Dmitry, was the youngest son of Tsar Ivan IV Vasilyevich, called Ivan the Terrible, and of Maria Fyodorovna Nagaya, Ivan's last wife. He was born in Moscow in 1582. Because Ivan's later marriages exceeded the number recognized as canonical by the Russian Orthodox Church, Dmitry's legitimacy as a dynastic heir was open to challenge. After Ivan died in 1584, the throne passed to Dmitry's half-brother Feodor I. Real authority was exercised by a circle of boyars in which Boris Godunov, Feodor's brother-in-law, became the leading figure. Dmitry and his mother were sent from court to Uglich, a town on the Volga that was given to the child as an appanage.

On 15 May 1591 the eight-year-old tsarevich died in the palace compound at Uglich. The official investigation reported that Dmitry suffered from epilepsy and that he had accidentally cut his own throat with a knife during a seizure while playing a throwing game with other children. A widespread contemporary belief, later adopted by many historians, held that he had been assassinated so that Boris Godunov would face no rival from Ivan's line. The death triggered a riot in Uglich in which several representatives of Moscow were killed. Maria Nagaya and her kinsmen were accused of fomenting disorder and were confined or forced into monastic life.

When Feodor I died childless in 1598, the Rurikid dynasty in the male line came to an end and Boris Godunov was elected tsar. Uncertainty about Dmitry's fate contributed to the Time of Troubles. Pretenders known as False Dmitrys claimed to be the tsarevich who had escaped death; the first False Dmitry took Moscow in 1605. After his overthrow in 1606, Tsar Vasily IV Shuisky had the body of the child buried at Uglich exhumed and brought to Moscow. The remains were enshrined in the Archangel Cathedral of the Kremlin, and Dmitry was canonized by the Russian Orthodox Church as a passion-bearer, a saint who endured an unjust death without resistance.

The Church of St. Demetrius on the Blood was later built in Uglich on the site associated with his death. In Russian Orthodox tradition he is commemorated on days marking his death, the translation of his relics, and his birth, and he is venerated as a wonderworking saint and as the heavenly patron of Uglich. Scholarly opinion remains divided on whether the events of 1591 were accident, murder, or a more complex combination of illness and politics, but the cult of Tsarevich Dmitry has been an established part of Russian Orthodox piety since the early seventeenth century.

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