In Episode 5 of Under The Knife, I discuss the dark history behind anthropodermic bibliopegy, or binding books with human skin. Why was it done? And how exactly did tanners use human skin to create covers in the past?
I often write about rare medical disorders, but there is one extraordinary case which is so strange, that there is only one documented instance of it in medical history. It involves a man who was both a dwarf as well as a giant over the course of his lifetime.
Adam Rainer was born in Graz, Austria to average-sized parents in 1899. When WW1 broke out, Rainer tried to enlist in the army, but at 4’6.3’’ inches tall, he was deemed too short and weak. A year later, Rainer tried again, and although he had grown a full 2 inches, the army rejected him once more on the basis of his height. Standing 4’8.3’’ inches tall at the age of 19, Rainer was considered a dwarf, being nearly 2 inches below the cut-off (4’10’’).
Although he was short, medical reports from the period state that Rainer had abnormally large hands and feet for his height. When he first tried to enlist in the army, he wore shoes sized US 10 (EU 43). Three years later, his feet had doubled to a size US 20 (EU 53), though his height remained relatively static. To put this in perspective: US basketball player, Shaquille O’Neal, wears shoes sized US 23.
At the age of 21, all this changed.
Rainer (pictured right) suddenly began growing at an alarming pace. Over the next decade, he grew from just under 4’10’’ to a shocking 7’1’’. During this period, Rainer also began developing a severe spinal curvature.
What exactly was the cause behind this growth spurt?
Between 1930 and 1931, Rainer was examined by Drs A. Mandl and F. Windholz, during which time they discovered he was suffering from a condition known as acromegaly. In Rainer’s case, this was caused by a tumour on his pituitary gland which led to an overproduction of growth hormones in his body. This was the reason behind his strange appearance, for Rainer didn’t just have abnormally large hands and feet. He also had a protruding forehead and jaw, as well as thick lips set over widely-spaced teeth. Below are images of man with acromegaly – you can see the effects of this syndrome on his facial features as he ages:
The two doctors decided to operate despite believing the chances for success were small given the fact that the tumour had been growing for over a decade. A few months after surgery, Rainer was measured again. His standing height had remained the same, though his spinal curvature was more severe, indicating that he was still growing, albeit at a much slower rate.
Rainer’s health continued to deteriorate. He went blind in his right eye, and began suffering hearing loss in his left ear. Over time, his spinal deformity became so pronounced, Rainer was confined to bed.
He died, aged 51, measuring 7’8’’ – though some newspapers reported his height as 7’10”. He is the only man in history to be classified as both a dwarf as well a giant; and for me, he is a testament to the marvels of the human body.
After failing to turn on the microphone during a daytime shoot, I jump a wall to film a video in Ecton Graveyard in the middle of the night… all in an attempt to win your support for Under The Knife! If you’d like to make a donation to our project, please click here.
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In this special, festive episode of Under The Knife, we take on a Christmas classic and give it a morbid twist. Using the talents of Adrian Teal (artwork), Joel Mishon (animator), and the vocal stylings of Alex Anstey, this video is the first of its kind in our series. So sit back, relax and enjoy my rendition of `Twas the Night Before Christmas as you’ve never heard it before! Featuring myself as the dissected criminal (Thanks, Adrian!).
A boy, who looked ‘about Fourteen Years old’, had come into the hospital to ask ‘what should be done to cure him of many large Swellings on his back’. These growths—some of which had started to develop three years prior—were now as large as a ‘penny loaf’. Freke continued with his description of this horrifying condition:
They arise from all the Vertebrae of the Neck, and reach down to the Os Sacrum; they likewise arise from every Rib of his Body, and joining together in all Parts of his Back, as the Ramifications of Coral do, they make as it were, a fixed bony Pair of Bodice.
Freke ended the letter by adding that the boy ‘had no other Symptom of Rickets on any Joint of his Limbs’. 
What Freke was describing is a rare condition now known as fibrodysplasia ossificans progressiva (FOP). A mutation of the body’s repair mechanism causes fibrous tissue—muscle, tendon and ligament—to ossify when damaged (pictured right: torso of man suffering from FOP). Although FOP is not fatal, most die young, starving to death after their jaws freeze shut or suffocating when new bone develops, making it impossible to breathe.
Freke was the first to describe the condition in detail. However, a French physician by the name of Gui Patin may have come across FOP in the 17th century when he wrote to a colleague that he ‘saw a woman today who finally became hard as wood all over’. 
Today, FOP affects approximately 3,300 people worldwide, or 1 in 2 million. A more recent example showing the effects of the disease can be found in the Mütter Museum in Philadelphia. In 1938, a 5-year-old boy named Harry Raymond Eastlack broke his leg while playing with his sister. Shortly afterwards, bone growths began to develop on the muscles of the boy’s thigh. Within years, the condition began to spread throughout Harry’s body so that by his mid-20s, his entire vertebrae had fused together. In 1973, Harry died of pneumonia, just four days before his 40th birthday. By that time, his body had completely ossified. Even his jaw locked up, leaving only his lips to move. Before he died, Harry had agreed to donate his body (pictured above, both alive and after death) to the museum for further scientific research, where it continues to be studied today.
Given the rarity of the condition, I was surprised to find an 18th-century skeleton showing the tell-tale signs of FOP in the Hunterian Collection at the Royal College of Surgeons in London. And yet there it was, catalogued simply as RCSH/P 804.
I wondered: whose bones were these? And how did they end up in the hands of the anatomist, John Hunter (below), for whom the collection is named after?
It turns out that when the surgeon, George Hawkins, died suddenly in 1783, he left behind a collection of anatomical specimens that were then auctioned off. Amongst them was the skeleton of an adult male with an excessive number of bony outgrowths on his rather twisted frame. Hunter—always on the lookout for rare and unusual specimens—purchased the skeleton for the extraordinary sum of 85 guineas. 
Records at the Royal College of Surgeons describe the skeleton as belonging to a 39-year-old man named Mr Jeffs. Hunter’s assistant, William Clift, later reported that he had been told that the skeleton had been buried for seven years before it was procured, presumably by Hawkins. According to Hunter, this was ‘evident from the state of the softer parts of most of the bones’. 
Was this the body of the young boy whom had sought Freke’s help in 1736? If the boy was indeed 14-years-old, as Freke had guessed, that would put his death sometime around 1761. Add to that 7 years before his skeleton was recovered, and it is very possible the specimen now residing in the Hunterian Collection once belonged to the boy described in the letter.
Of course, like so many of the specimens residing in medical collections today, we will never be able to confirm the skeleton’s former identity. What I can say with some degree of certainty is that he must have suffered greatly in the 18th century. With no real way to manage his pain, everyday life would have been excruciating. It is also likely that he would have been unable to work at the end of his life. Depending on his financial circumstances, this could have been just as crippling as his debilitating condition.
Today, Mr Jeffs ‘stands’ next to Charles Bryne, the famous Irish Giant (right). Visitors to the Hunterian are often mesmerised by Byrne’s 7’7’’ frame, and rarely cast more than a fleeting glance at the twisted skeletal remains next to him.
Hidden in the shadows of something much bigger than himself, Mr Jeffs is to visitors what he likely was to surgeons in his day: a passing curiosity. His story, however, warrants further attention, for FOP remains incurable. There is still much to be learned from Mr Jeffs and his skeletal remains.
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1. Philosophical Transactions of the Royal Society 41 (January, 1753): pp. 369 – 370.
2. Qtd in Thomas Maeder, ‘A Few Hundred People Turned to Stone,’ The Atlantic (Feb., 1998). I cannot track down the original source for this quote; although I do know that most people incorrectly date this letter to 1692. Gui Patin died in 1672, and his letters were posthumously published in 1692.
3. L. W. Proger & J. Dobson, comps., Descriptive Catalogue of the Pathological Series in the Hunterian Museum of The Royal College of Surgeons of England, vol. 2 (1972), pp. 68-70.
We’re excited to release the trailer for a new mini-series on Under The Knife! In Relic Face-Off, contestants will be invited onto the show and asked to bring with them an object related to a chosen theme. I will then try to ‘one-up’ them with an object of my own, and the audience will be asked to vote in the comment section on which oddity they think is more fascinating. Click here to view.
In the first challenge, Chris Skaife–Yeoman Warder and Ravenmaster at the Tower of London–will face-off with me on TORTURE DEVICES. Please subscribe to our YouTube Channel for updates. We hope you enjoy the trailer (and the concept)!
In the 3rd Episode of Under The Knife, I discuss the medical thinking behind Victorian anti-masturbation devices, and the surprising history of one of the world’s most beloved breakfast cereals. Alex Anstey, Adrian Teal and I have worked hard on this video – we hope you like it!
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