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Sir Frederick Treves
English surgeon, born February 15, 1853, Dorchester;
died December 7, 1923, Lausanne, Switzerland.
Associated eponyms:
Elephant man's syndrome
See Recklinghausen's disease.
Treves' bloodless fold
Bloodless fold of Treves. An ileocecal fold of peritoneum associated with the appendix.
Biography:
Frederick Treves was a famous pioneer in abdominal surgery. In 1902 he performed an appendicectomy on King Edward VII. Today he is mostly remembered as the physician to the Elephant Man.
Frederick Treves was born at 8 Cornhill Street in Dorchester, Dorset. He received his medical education at the London School of Medicine, and in 1879 he became surgical registrar and assistant surgeon at London Hospital. For a period of time worked as a lecturer of practical anatomy and demonstrator in anatomy at that hospital, in 1883 becoming surgeon as well as head of the school of anatomy. In 1885 Treves was Hunterian professor of anatomy at the Royal College of Surgeons.
Treves fought in the Transvaal in the Bower War of 1899-1902.
Treves was a brilliant lecturer and a very able surgeon who made original contributions to surgical anatomy, peritonitis, intestinal obstruction and appendicitis. He was an ardent supporter of aseptic as opposed to antiseptic surgery.
On May 4, 1901, Treves was knighted by King Edward VII, on whom he performed an appendectomy in June 1902. The king desperately needed an appendicitis operation but strongly opposed going into hospital. 'I have a coronation on hand,' he protested. But Treves was adamant: 'It will be a funeral, if you don't have the operation.' Treves won, and the king lived. He did not remove the appendix but carried out an appendicectomy to drain an abscess. He was later to write a manuscript on events surrounding the operation on Edward VII but it was suppressed.
In 1902 Treves retired from medical practice to become an author. In 1918 he moved to Lake Geneva, Switzerland with his family. He died from peritonitis in December 1922, and was cremated in Lausanne. His funeral took place at St. Peter's church, Dorchester, on January 2, 1924 and the king and queen were represented by Lord Dawson. The famous poet and novelist Thomas Hardy (1840-1928) attended and chose the hymns. Hardy also wrote a poem for the occasion and had it published in The Times. It stated with the words: 'In the evening, when the world knew he was dead.' His ashes were buried in Dorchester
Besides his medical works, Treves wrote several travel books, and a highly popular guide to his native county of Dorset, his first love. He was also a keen photographer. As president and founder of the Society of Dorset Men in London he encouraged other exiles to study their native county. As a very small boy he attended the school run by Dorset's greatest dialect poet, William Barnes (1801-1886).
Quotations
The symptoms of disease are marked by purpose, and the purpose is beneficent.
The processes of disease aim not at the destruction of life, but at the saving of it.
Address to the Edinburgh Philosophical Institution, October 31, 1905.
In the fact of misfortune it is merciless to blot out hope.
Physician to the Elephant Man
Sir Frederick Treves’ fame today rests upon his association with Joseph Carey Merrick (1862-1890), whom he helped. Merrick is better known as the Elephant Man. Joseph Carey Merrick was a disfigured person who, after a brief career as a professional "freak," became the best-known resident patient of London Hospital from 1886 until his death. He is sometimes erroneously referred to as John Merrick. Joseph Carey Merrick was born at 50, Lee Street, Leicester, the son of Joseph Rockley Merrick and his wife Mary Jane, née Potterton. Merrick's mother was a slightly crippled, frail and religious woman, but otherwise his parents and his brother William Arthur (1865-1870) and his sister Marion Eliza (born 1867) appeared normal. His brother died from scarlet fever, his mother from bronchial pneumonia in 1873, when Joseph was eight years old.
He was apparently normal until about the age of five, when he began showing signs of a strange disorder that caused overgrowths over much of the skin and bone surfaces. A preliminary diagnosis of elephantiasis was given, but this was dismissed as the disease progressed.
His head became enormous, the 3 feet circumference was that of a man’s waist, with large bags of brownish spongy skin hanging from the back of his head and across his face. Subject to papiloma, the skin had many folds of excess tissue, and an odious smell came from the cauliflower-looking sac, which hung down.
Deformation of the jaws rendered him incapable of showing facial expression or speaking in more than a splutter that was difficult to understand. His left arm was normal and delicate to look at. His right arm, however, was discoloured and grotesque, ending in a 12-inch wrist and a finlike hand. The legs imitated the deformed arm, and a defective hip caused such lameness that Merrick could walk only with the aid of a stick.
In 1875 Joseph Merrick found work at MM Freeman Cigar Factory, 9, Lower Hill Street. Two years later, in 1877, he made the most unlikely choice of work, as he began a short-lived career as a door-to-door salesman. Later that year he moved in with his Uncle Charles and aunt Sarah over their barbershop at 144 Churchgate.
In December 1879 Joseph Merrick met William Cartwright, administrator of the Leicester Workhouse, to which Joseph was admitted on the 29th of that month. He left the workhouse on March 22, 1880, after a six-week stay, only to return two or three days later, destitute.
In mid 1882 Joseph Merrick underwent surgery at Leicester Hospital to remove fleshy (trunk-like) protuberance from the upper lip. Dr. Charles Marriott and Dr. Thomas Warburton Benfield are presumed to have attended.
On Sunday, August 29, 1884, Joseph Merrick ate his final meal at the workhouse, starting a career as a sideshow freak with the back-street entrepreneur Tom Norman acting as his manager/agent. Norman was showing the Elephant man at the rear of vacant waxworks (which contained gruesome model’s of Jack the Ripper’s victims) opposite the London Hospital in Whitechapel Road. A placard outside an exhibition – exhibit 123 - in one of the shops displayed a man with animal features. Dr. Treves, who had learned about Merrick from his house surgeon, Reginald Tuckett, was determined to see this phenomenon. The great pathologist John Bland-Sutton had already seen Merrick.
In November 1884, when he was 21, Joseph Merrick met Dr. Frederick Treves. Seated in the dim light, among old cans and furniture grey with dust, Treves saw a bent figure. It was the Elephant Man whose disfigured frame was open to view. Dr. Treves was appalled. When Joseph rose, on the dictates of the showman, the doctor saw a downcast and degraded figure. A sign in front of Merrick read ”The Deadly Fruit of Original Sin.” This disturbed Treves greatly; and he decided to move Merrick to London Hospital.
Joseph, however, could not show himself in public. A crowd would gather and he would be mobbed. So a disguise of a long coat and facial mask was arranged. The examination began. Joseph was frightened - no one had ever shown him kindness. When his study was finished, the doctor handed him over his professional card.
On December 2, 1884, Frederick Treves presented Merrick before the London Pathological Society, at 53 Berners Street, Bloomsbury.
When the police closed down Norman’s freak show, Norman decided that Merrick was more trouble than he was worth. He cut his losses and sold Merrick to an Austrian who took him to Brussels, where he was robbed and abandoned by Austrian showmen in early June 1886.
Merrick made his way to Ostend where he was befriended by Mr. Wardell Cardew. He then travelled back up the coast to Antwerp where he took a steamer to Harwich. It is difficult to imagine the horror of Merrick's predicament. Apart from the obvious impediments of appearance and speech, he had no language other than English, and no experience of fending for himself. Somehow he managed the crossing and arrived eventually at London's Liverpool Street Station where he nearly caused a riot.
In June 1886, Merrick arrived at Liverpool Street railway station - he limped along the quay as children ran ahead. An eager mob jostled to peep beneath his cloak and mock his physical looks. He had not eaten, drunk little and received neither sympathy nor understanding. He wanted to hide from these tormentors. Penniless and alone, he had no home or lodgings. Mercifully, the intervention of the police prevented further ridicule and it was a lone constable who noticed the card. Dr. Treves wasted no time!
Penniless
A vacant room used for emergencies - delirium tremens or the insane - was made available in Bedstead Square at the rear of The London Hospital. Joseph lived in security under the wing of medicine, being treated for exhaustion, malnutrition and bronchitis.
On December 4, 1886, Richard Carr Gomm, director of the London Hospital, wrote to The Times, outlining Merrick’s case and appealing for financial support. The response was immediate and he was overwhelmed with donations. But money was not all. The case was so peculiar that an attendant nurse was needed. Many women replied to the advertisement but not all were suitable - one unfortunate ran screaming from the room.
Volunteers
Most carers were volunteers. They performed their daily functions well enough, but avoided direct contact and did not treat Joseph as an equal. This he accepted, understanding their anxiety. But, nevertheless, he needed the warmth of human contact.
To alleviate the difficulty, Dr. Treves asked a friend to help. A widow, she entered the room with a smile and shook his hand, sat on the stool and chatted for several minutes. Joseph was overcome, for the doctor learned this was the first woman to treat him with kindness.
The doctor found Joseph Merrick intelligent. He could read and his speech was progressing. The Bible and Book of Common Prayer were his favourites and far different from the newsprint or odd novel he picked up.
Dr. Treves knew little of Joseph's past but one thing was clear: Joseph loved his mother and would often say: "It is strange. You see, my mother was so beautiful". For several weeks, all went well, though events set in a period of depression. "When I am next moved, can I go to a blind asylum or to a lighthouse? Joseph was haunted by the past - from the ill treatment and the degradation he had suffered.
Dr. Treves realised this and tried to eliminate these thoughts. Walks in the hospital ground were allowed and Joseph ventured to the hospital gates. In disguise, he was but a cripple.
The case attracted much newspaper attention. Many wanted to come and see for themselves, and especially female members of the nobility showed great interest, and Joseph had a constant succession of visitors. Joseph looked forward to each new arrival and longed to hear of outside news.
Women were especially fascinated. Many came and wished him well, smiled and talked of local events. Visiting the Elephant man was in high vogue among the elegant London Ladies. On May 21, 1887, Alexandra (1844-1902), the Princess of Wales, later Queen Alexandra – and the Duke of Cambridge (1819-1904) - stayed a few moments and promised to return. Regular communication was established with the exchange of Christmas cards. He idolised her autographed photograph.
One season, the gift of a dressing bag brought him great pleasure and he often dressed in the style of a toff. The bag was of theatrical origin, so a visit to live drama was arranged. Seated in a special box, Joseph was enthralled by ”Puss In Boots” at Drury Lane Theatre, and later questioned a Mrs. Kendall of the outcome. She had organised the visit with the authorities and answered the inquiries confidently as she was a member of the Drury Lane cast. "I wonder what happened to the Prince - is he still in the dungeon?" asked Joseph.
Spirit of Adventure
Adventure stirred inside him; he longed to step from his immediate environs into the outside world. In the summer of 1889, after new photos had been taken to document the rapid progress of the disease, Merrick spent six weeks vacationing in a gamekeeper's lodge in Fawsley Park, Northampton. Here, at last he was free to roam at nature's will, untroubled by following eyes.
Joseph returned to the security of Bedstead Square but six months later, on Friday, April 11, 1890, Joseph Carey Merrick he was found dead in his bed. Treves wrote of Merrick's death: "He was lying on his back as if asleep and had evidently died without a struggle, since not even the coverlet of the bed was disturbed." The cause of Merrick's death is not known, but it is thought that he tried to lay down to sleep in a normal manner and died of asphyxiation. He longed to sleep as others did but, because of the size of his head, had to rest crouched upon pillows.
Had it not been for Dr. Treves, he certainly would have died on the railway platform or alone in a lunatic asylum.
On Tuesday, April 15, 1890, Mr. Wynne Baxter (coroner) led the judicial inquiry into Merrick’s death. In a letter dated the 16th, Richard Carr Gomm wrote a letter to the London Times detailing Merrick’s life and death.
Joseph Carey Merrick’s remains were cast in plaster, specimens were taken, and the body was dissected by Frederick Treves. The skeleton remains on display at the London Hospital.
But what did he suffer from?
The disorder from which Merrick suffered was long thought to be an extremely severe case of neurofibromatosis, but in the late 20th century researchers concluded that probably Merrick's remarkable deformities had been the result of an extremely rare disease known as the Proteus syndrome.
A successful play about Merrick, The Elephant Man, by Bernard Pomerance, opened on Broadway in 1978. An unrelated motion picture by filmmaker David Lynch was released in 1980. The film is based on Sir Frederick Treves’ The Elephant Man, and Other Reminiscences and Ashley Montagus’s (born 1905) The Elephant Man, A Study in Human Dignity.
Michael Jackson, the American black-and-white singer, wanted to buy Merrick’s bones from London Hospital.
"Women and nervous persons fly in terror from the sight of him,
and that he is debarred from seeking to earn a 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."
From a letter to The Times written by Mr Carr Gomm, December 1886.
Bibliography:
- Scrofula and Glandular Disease. London, 1882.
- Surgical Applied Anatomy.
London, 1883; 7th edition, 1918; translated into French.
- Intestinal Obstructions.
London, Cassell & Co, 1884. Jacksonian prize essay.
translated into German.
- A Manual of Surgery. With several collaborators.
3 volumes; London, 1886.
- A case of haemophilia: pedigree through five generations.
Lancet, London, 1886, 2: 533-534.
True haemophilia in female. The family was the subject of several later investigations, the last being reported in Lancet, 1973, 2: 734.
- A German-English Dictionary of Medical Terms.
With H. Lang. London, 1890.
- A Manual of Operative Surgery. 2 volumes; London, 1891.
- Highways and Byways in Dorset. 1906.
This was immediately the most popular book ever written on the county. It is still one of the most sought-after Dorset titles.
- The Student’s Handbook of Surgical Operations.
London, 1892; 5th edition, 1930.
- The Elephant Man, and Other Reminiscences. London, 1923.
- Stephen Trombley:
Sir Frederick Treves : The Extra-Ordinary Edwardian.
- Ashley Montagu (born 1905:
The Elephant Man, A Study in Human Dignity. 1971, 1979, 1996.
- Christine Sparks:
The Elephant Man.A novel.
Paperback edition, Ballantine Books, 1995.
- Robert Bogdan:
Freak Show : Presenting Human Oddities for Amusement and Profit.
Reprint edition, University of Chicago Press, June 1990.
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