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The Salvation Army reported in 1890 that out of a population of approximately 5.6 million in the Great Metropolis, 30,000 were prostitutes, and 32,000 men, women, and juveniles were in prison. A year earlier, in 1889,160,000 people were convicted of drunkenness, 2,297 committed suicide, and 2,157 were found dead on streets, in parks, and in hovels. In the Great Metropolis, slightly less than one-fifth of the population was homeless, in workhouses or asylums, in hospitals, or ravaged by poverty and near starvation. Most of the "raging sea" of misery, to the founder of the Salvation Army, General William Booth, was located in London's East End, where a cunning predator like Jack the Ripper could easily butcher drunken, homeless prostitutes.

When the Ripper was terrorizing the East End, the population of his hunting ground was estimated at a million. If one includes the overcrowded nearby hamlets, the population doubles. East London, which included the London docks and run-down areas of Whitechapel, Spitalfields, and Bethnal Green, was bordered on the south by the River Thames, to the west by the City of London, to the north by Hackney and Shoreditch, with the River Lea to the east. The growth of the East End had been heavy because the road that led from Aldgate to Whitechapel to Mile End was a major artery for leaving the city, and the earth was level and easy to build upon.

The anchor of the East End was the London Hospital for the poor, which is still located on Whitechapel Road but is now called the Royal London Hospital. When Scotland Yard's John Grieve took me on one of several retrospective visits to what is left of the Ripper crime scenes, our meeting place was the Royal London Hospital, a grim Victorian brick building that doesn't seem to have been modernized much. The depressiveness of the place is but a faint imprint of what a pitiful pit it must have been in the late 1800s, when Joseph Carey Merrick - mistakenly called John Merrick by the showman who "owned" him last - was granted shelter in two of the hospital's first-floor back rooms.

Merrick - doomed to be known as the "Elephant Man" - was rescued from torment and certain death by Sir Frederick Treves, a courageous, kind physician. Dr. Treves was on the London Hospital's staff in November 1884 when Merrick was a slave to the carnival trade across the street inside a deserted greengrocer's shop. In front was a huge canvas advertising a life-size "frightful creature that could only have been possible in a nightmare," as Dr. Treves described it years later when he was Sergeant-Surgeon to King Edward VII.

For two pence, one could gain admittance to this barbaric spectacle. Children and adults would file inside the cold, vacant building and crowd around a red tablecloth hanging from the ceiling. The showman would yank back the curtain to "ooh!"s and "aah!"s and cries of shock as the hunched figure of Merrick cowered on his stool, dressed in nothing but an oversized pair of filthy, threadbare trousers. Dr. Treves lectured on anatomy and had seen just about every conceivable form of disfigurement and filth, but he had never encountered or smelled any creature quite so disgusting.

Merrick suffered from von Recklinghausen disease, caused by mutations in genes that promote and inhibit cell growth. His physical aberrations included bony deformations so grotesque that his head was almost three feet in circumference with a mass that projected from his brow like a "loaf" and occluded one eye. The upper jaw was similar to a tusk, with the upper lip curled inside out, making it very difficult for Merrick to speak. "Sack-like masses of flesh covered by… loathsome cauliflower skin" draped from his back, his right arm, and other parts of his body, his face frozen in an inhuman mask incapable of expression. Until Dr. Treves intervened it was believed that Merrick was obtuse and mentally impaired. In fact, he was an extremely intelligent, imaginative, and loving human being.

Dr. Treves noted that one would have expected Merrick to be a bitter, hateful man because of the abominable way he had been treated all of his life. How could he be kind and sensitive when he had known nothing but mockery and cruel abuse? How could anyone be born with more against him? As Dr. Treves pointed out, Merrick would have been better off insensible and unaware of his hideous appearance. In a world that worships beauty, what greater anguish can there be than to suffer from such revolting ugliness? I don't think anyone would argue with the notion that Merrick's deformity was more tragic than Walter Sickert's.

It is quite possible that at some point Sickert paid his twopence and took a peek at Merrick. Sickert was living in London in 1884 and engaged to be married. He was an apprentice to Whistler, who knew the East End rag-shop scenes in the slums of Shoreditch and Petticoat Lane and would etch them in 1887. Sickert went where the Master went. They wandered together. Sometimes Sickert wandered about the sordid squalor on his own. The "Elephant Man" was just the sort of cruel, degrading exhibition that Sickert would have found amusing, and perhaps, for an instant, Merrick and Sickert were eye to eye. It would have been a scene replete with symbolism, for each was the other inside out.

In 1888, Joseph Merrick and Walter Sickert were simultaneously living secret lives in the East End. Merrick was a voracious reader and keenly curious. He would have been all too aware of the horrible murders beyond his hospital walls. A rumor began to circulate that it was Merrick who went out in his black cloak and hood at night and slaughtered Unfortunates. It was the monster Merrick who butchered women because they would not have him. To be deprived of sex would drive any man mad, especially such a beast as that carnival freak who ventured out into the hospital garden only after dark. Fortunately, no rational person took such nonsense seriously.

Merrick's head was so heavy he could scarcely move it, and the stalk of his neck would snap if his head ever fell back. He did not know what it was like to settle into a pillow at night, and in his fantasies he lay himself down to sleep and prayed the Lord would one day bless him with the sweet caresses and kisses of a woman - best of all, a blind one. Dr. Treves thought it a tragic irony that Merrick's organs of generation were nothing like the rest of him, but unfortunately, he was perfectly capable of the sexual love he would never have. Merrick slept sitting up with his huge head hung low, and he could not walk without a cane.

It is not known whether the baseless rumors that he was the Whitechapel killer ever reached his safe little rooms crammed with signed photographs of celebrities and royalty, some of whom had come to see him. What a great act of benevolence and tolerance to visit the likes of him and not outwardly register horror. What a story to relate to one's friends, to dukes and duchesses, to lords and ladies, or to Queen Victoria herself. Her Majesty was fascinated by life's mysteries and curiosities and had been quite fond of Tom Thumb, an American midget named Charles Sherwood Stratton who was only forty inches tall. It was easier to enter the cloistered world of harmless and amusing mutants than to wade through the "bottomless pit of decaying life," as Beatrice Webb described the East End, where rents were steep because overcrowding gave slumlords the upper hand.

The equivalent of a dollar to a dollar-fifty a week in rent was sometimes a fifth of a worker's salary, and when one of these Ebenezer Scrooge slumlords decided to raise the rent, sometimes a large family found itself homeless with nothing but a handbarrow to tote away all its worldly goods. A decade later Jack London went undercover in the East End to see for himself what it was like, and he related terrible stories of poverty and filth. He described an elderly woman found dead inside a room so infested with vermin that her clothing was "gray with insects." She was skin and bones, covered with sores, her hair matted with "filth" and a "nest of vermin," London wrote. In the East End, he reported, an attempt at cleanliness was a "howling farce," and when rain fell it was "more like grease than water."