…that women and nervous persons fly in terror from the sight of him,
and that he is debarred from seeking to earn his livelihood in any ordinary way, yet he is superior in intelligence, can read and write, is quiet, gentle, not to say even refined in his mind.
He occupies his time in the hospital by making with his own available hand little cardboard models, which he sends to the matron, doctor, and those who have been kind to him.
Through all the miserable vicissitudes of his life he has carried about a painting of his mother to show that she was a decent and presentable person, and as a memorial of the only one who was kind to him in life until he came under the care of the nursing staff of the London Hospital and the surgeon who has befriended him.
It is a case of singular affliction brought about through no fault of himself; he can but hope for quiet and privacy during a life that Mr. Treves assures me is not likely to be long. –Carr Gomm, Chairman of the Management Committee of the London Hospital
Frederick Treves, [the] tall young surgeon, had never come across anything quite like the Elephant Man before. …They stood facing each other in Treve’s room in the Anatomical Department of the Medical School of the London Hospital. The emphasis of the examination was on the physical aspects: to pass a tape measure round the head and limbs, finger the skin, assess the movement of the joints, hold back the shapeless blubber of the lips with a spatula to examine the inside of the mouth. There were massive abnormalities of the skin and flesh as well as some obvious and extraordinary distortions in bone structure. Meticulously Treves charted every feature, recorded each peculiarity that he could discover on the appalling map of Merrick’s body, but seemed to have hardly begun to approach any closer to an explanation in this chaotic anatomical wilderness.
The proportions were grotesque: a measurement of 36 inches was recorded for the head’s circumference, another of 12 inches for that of the right wrist and one of 5 inches for the most swollen finger of the right hand. Yet Merrick was a short man, scarcely more than 5 feet 2 inches in height. In the skin Treves felt he could recognize two distinct abnormalities. First there was an abnormality of the soft, subcutaneous tissue that lay immediately beneath the skin. It seemed in places to have greatly increased in quantity so that in these regions the skin was raised up above the surrounding tissue. Where this happened, the skin was so loose on the body that it could be slipped about quite easily, or grasped and drawn away from the deeper tissue in folds.
In three areas these changes were so marked that the weight of the skin drew the tissues down into pendulous folds that hung almost like curtains of flesh from the body. One of these folds, about six inches square, hung in front of the right armpit, taking its root from the surface of the right breast and shoulder. A similar but less conspicuous fold hung down behind the armpit. It was in the buttocks, however, that the process was most marked. Here the skin flap was so thick and extensive that at first sight it looked as though the buttocks themselves descended in a great fold reaching almost to the level of the mid-thigh. So heavy and awkward was this fold of flesh that it tended to interfere with the functioning of the bowel and the action of defecation.
The second abnormality Treves recognized in the skin was the presence of numerous warty growths or papillomata. These varied in size from small pimple-like roughenings of the skin to huge cauliflower-textured masses. Their size and number varied between different areas of the body. In fact, the skin of the left arm was free from blemish, and parts of the face, and the eyelids and ears, seemed unaffected; the penis and scrotum were perfectly normal. Over the chest and abdomen the warts were small and sparse, but over the back of the head, and from between the shoulder blades down to the lower back and buttocks, they spread out as exuberant growths of dusky purplish skin, deeply cleft and fissured. From the largest of these warty growths there rose the exceedingly foul odour that Treves first noticed in the exhibition shop.
If the skin changes made Joseph hideous, however, it was the skeletal changes which made him misshapen; but again, not all of the body was affected. Metamorphoses in the bones seemed to be confined to the skull, the bones of the right arm and hand and those of each leg below the knee.
The skull was enormous. It was completely irregular in shape, in surface being covered by huge rounded bosses of bone, some of them larger than tangerines. The most conspicuous bony lump stood out on the brow, but there were others to the side and back of the head. The whole left side of the head actually seemed to bulge out immediately above the ear, so that the ear was itself folded downwards almost at a right angle. It was extremely difficult to trace the complete surface of the skull with any precision, for over most of the scalp the skin had produced cauliflower-like masses and folds of loose skin in abundance.
The bones of the face were similarly distorted. The forehead was unduly large, uneven and rather protuberant, making the eyes appear small and set back deeply in the head. The bones of the right cheek were also much enlarged, so that the cheek was hard and prominent. The swelling here had pushed the hard palate forward and down and forced the nose and mouth somewhat to the left. When the mouth was open it was possible to see a scar where a piece of tissue had evidently been removed at some time by an operation*(see below); the lower jaw seemed quite normal.
The right arm was greatly inflated, being two or three times the size of its fellow. Treves gained the impression that every bone in the limb, apart from the shoulder blade and collar bone, was uniformly enlarged, but there were none of the knobbly swellings upon the bones that were so prominent in the skull. The fantastic distortions of the bones had almost crippled the arm, for when Treves tried to manipulate it he found that , while it could be moved fairly freely at the shoulder and elbow, the wrist and fingers were so stiff as to make the hand almost useless. Merrick could not, for example, turn this particular hand over and back again. The hand meanwhile was weirdly deformed, its huge misshapen fingers crowding one another into deformity and even partial dislocation of the joints. Strangely enough, though, the finger nails on the hand were perfect. As if in mocking contrast, the left arm was completely unaffected, having a delicacy and neatness of proportion that made Treves think of the arm of a young girl.
Both feet were distorted in a manner similar to the right arm, the bones being uniformly enlarged and the toes malformed and enormous. Merrick’s posture illustrated the presence of the old disease of his left hip that Treves had already diagnosed, for he stood with his left leg held stiffly forward and away from the body. Apart from the tell-tale sign of a former hip disease and the various changes to the skin and bones, however, Treves could find little else amiss. The irony was that the Elephant Man apparently enjoyed good health in all other respects, suffering from no serious illness apart from his mysterious condition and even possessing an appreciable muscular strength.
As a specimen of humanity, Merrick was ignoble and repulsive; but the spirit of Merrick, if it could be seen in the form of the living, would assume the figure of an upstanding and heroic man, smooth browed and clean of limb, and with eyes that flashed undaunted courage.
Frederick Treves –excerpted from The True History of the Elephant Man by Michael Howell & Peter Ford
* At approximately age 20, a few years prior to Joseph’s admission into London Hospital, he’d had surgery performed at Leicester Infirmary. His disease having advanced and ever growing worse, he’d had a pink lump growing from his upper jaw—his “elephant’s trunk”—and it had been getting longer every month. In only two years time since the first appearance of the pink lump, this tumour grew to project inches out of his mouth. It had become impossible for him to make himself understood. He couldn’t chew solid food, and what he was eating often fell out of his mouth. –from The Elephant Man by Frederick Drimmer
