freaks, real and false, was himself only nineteen. However, Chang and Eng, the first genuine xiphopagic twins (as doctors called them) ever seen here, required no genius as showmen to attract great popular and medical interest.

They were already accustomed to the latter. Back in Siam some native doctors had proposed plans for separating the boys. One suggested “hanging them across a fine cat-gut cord, like a pair of saddle-bags, estimating that this would, in time, work its way entirely through the connecting ligature, by degrees, allowing the several parts to heal as it progressed.” Another advised cutting them apart with a red-hot wire. But in the United States, eminent doctors were less inclined to advise such measures.

John Collins Warren, then professor of anatomy and surgery in the Harvard Medical School, made careful studies of the twins. He concluded that the band between them was largely cartilage with an insignificant number of connecting blood vessels, lymphatics, and small nerves. He felt, however, that there was probably a continuous peritoneal cavity within the band which would make attempts at surgical separation hazardous and unwarranted. Other leading American physicians concurred. For Chang and Eng it was probably just as well; if they had been separated, they would have gained comfort and independence, but they would have been reduced to two lonely and insignificant Siamese boys, stranded far from home.

So, still joined, they sailed from the United States to England, where they were enthusiastically welcomed in October of 1829. Crowds poured out to see them, and once again the doctors examined them. Sir Astley Paston Cooper, president of the Royal College of Surgeons, also held back from the suggestion that the twins be separated.

Other medical reports were made. Sir James Y. Simpson, then only beginning his great career as a Scottish physician, found that when potassium iodide was given to one twin no iodide reaction was found in the urine of his partner. Jn a study more comprehensible to the layman, Professor G. B. Bolton fed asparagus to Chang and found its characteristic odor in his urine, but none in Eng’s. The doctors considered it significant that though Chang began to drink heavily as time went on, Eng was never affected even when his brother was drunk.

If the pushing, shoving, and curious stares of the crowds and the thumping and probing of the doctors disturbed the brothers, they certainly were not displeased by the money which poured in. All of it belonged to them once they had reached the age of twenty-one and had dispensed with the services of their “owner,” Hunter. By 1833, they had amassed a fortune of some $60,000, and they decided to retire. After a little more than four years as famous freaks, they were world-renowned. They had not only advertised Siam, but they also constituted about all the civilized world knew of their homeland.

They returned to the United States, cut off the queues they had earlier

worn, and became both naturali/ed American citizens and Baptists. They assumed the surname of Bunker. According to one story, they took it from a bystander at the immigration office when they were told they must have a family name. Another version is that they adopted the name Bunker (North Carolina corruption of Bon Coeur) from a friend in that state. At any event, when they settled there, the legislature allowed them to take the name.

They made their home near the town of Mt. Airy in Surry County, in the northwestern part of the state, and soon established themselves as prosperous and competent farmers. They were welcomed there. Tired of travel, they found the forested hill country appealing. It was no tidewater area of settled gentility but more like the frontier, a place in which men noted that with their four arms the twins made “excellent hands to carry up the corner of a loghouse” (as their authorized literary promoter put it). Each of them could use an axe at the same time without interfering with the other. Sometimes they swung one axe with all arms. With two axes they could cut from the opposite sides of a tree, bringing it down in short order.

Because they were “sensitive” men “disposed to shun observation,” they “selected so retired a portion of the country for their residence.” But they were hardly recluses. They had learned to speak English well by the time they arrived in North Carolina—perhaps from answering the questions of the curious who examined them. They had also learned the value of the dollar. With their savings they acquired a plantation with slaves and livestock. Later, after their marriages, they built a house in Mt. Airy itself so that their children might be near a school. Their back-country neighbors regarded them as “remarkable for their energy and industry” and their frugal manner of living. Those neighbors learned, too, that “in point of shrewdness in a trade” the twins were a match for anyone. In business deals, they were always partners and “in signing papers, one always signed for both.”

Though retired, the twins did not relish a life of inactivity. Excellent judges of horseflesh, they could tame the wildest colts. They could do more actual labor than any four slaves. Still, despite their disposition to shun the vulgar curiosity of crowds, both Chang and Eng were friendly, even gregarious, neighbors in the back country. Familiarity made them seem less freakish there. Respect for them grew after they killed a marauding wolf, known far and wide as “Bobtail,” which had terrorized the region by carrying off not only sheep, calves, and swine but, it was said, Negro babies as well.

The brothers became, like their neighbors, inveterate smokers and chewers of tobacco. They were regular attendants at church and other religious meetings. They joined their neighbors in fishing, hunting, and games—and while they played chess and draughts “tolerably well,” they got

no enjoyment from playing each other. They joined in the lively interest of Carolinians in politics and took part in all elections in their district; it is not in the record as to whether they agreed or disagreed on political matters. Yet the Siamese strangers in Carolina sometimes quarreled with each other so violently that once they begged their family physician, Dr. Joseph Hollingsworth, to cut them apart, even if it killed them. As time went on, Chang grew more irritable and more attached to the bottle.

In 1853, after nearly twenty years of busy retirement, the twins took to the road again, announcing “their intention of exhibiting themselves once more, during a very brief period, after which it is their firm determination to take their final retirement from public life.” Possibly a little traveling circus which passed by their property—the sight of an elephant trudging through back-country Carolina set all the dogs howling—made them long for the excitements of the tent and the museum.

More probably marriage and growing families made it necessary. Ultimately Chang had ten children by his Adelaide. Eng had twelve by his Sarah Ann. As family men, they were much respected in the Carolina hills. Their descendants are today wellregarded citizens of North Carolina; one great-greatgrandson, a banker, still carries the friendly nickname “Chink.” (The roster of their scions has also included a president of the Union Pacific Railroad and a major general in the U.S. Air Force.)

There are no records upon which to base speculation about the conjugal relations of Chang, Eng, Adelaide, and Sarah Ann. Obviously their relationship was always a triangle if not a foursome. Under such circumstances it is not too hard to understand the early report that “their collateral domestic life was unhappy.” The sister-wives quarreled, so that the brother-husbands were forced to maintain separate establishments. They made a firm pact that they would spend three days in one house and three days in the other. Perhaps on the seventh day they rested.

That brief “last” period of exhibition in 1853 did not suffice. Chang and Eng suffered financially after the Civil War, particularly from the loss of their slaves. A shy but enterprising young Confederate veteran, Major Henry A. London, on returning home after Lee’s surrender, became interested in helping the twins as a means of helping himself in desperate times. Recently his daughter recalled : After the War Between the States my father, who was 18 years old, and his brother-inlaw, Mr. Zimmerman, went to the Siamese twins in Mt. Airy to see if they would be interested in making some money (as everyone in the South was broke) and be exhibited again in the North. They were delighted over the idea, so Father and Mr. Zimmerman became the advance press agents, going to various organizations and displaying the pictures of the Siamese twins, etc. When they came to Baltimore and the fashionable resort of Cape May, Mr.

Zimmerman would stay in his room as he was so afraid he would be seen by some of his friends. They did this for a season and all made some much needed money.

Not satisfied with the proceeds of Major London’s efforts, Chang and Eng set out for Europe again, this time under the more expert direction of P. T. Barnum. While returning from Liverpool to America in 1870, Chang had a paralytic stroke during one of his increasingly frequent alcoholic debauches. As this involved his left arm and leg, Eng henceforth carried much of Chang’s weight.

Back on their plantations in North Carolina, on Monday, January 12, 1874, Chang developed a “dry cough with scanty, frothy sputum.” He complained, too, of a pain in his chest. Dr. Hollingsworth directed that he not venture out. Nevertheless, on Thursday, the usual day to move to Eng’s house, he honored the agreement, and they made the trip in an open buggy in very cold weather. Eng remained in excellent health throughout Chang’s illness. On Friday Chang felt better but that night he “had such severe pain in the chest, and so much distress he thought he would die.”

The twins were alone in a room with a young son of Eng’s. Sometime in the course of the night they got up and sat by the fire. Eng wanted to retire but Chang insisted upon sitting up, as his “breathing was so bad that it would kill me to lie down.” Finally about one o’clock they went to bed; after an hour or so the family heard someone call but no one went to them.

Later Eng awakened and asked his son, “How is your Uncle Chang?”

The boy said, “Uncle Chang is cold-Uncle Chang is dead.”

When Eng’s wife entered the room, he began crying out to her: “My last hour is come … I am dying.”

He did not speak of his brother’s death.

“He rubbed his upper extremities,” the old medical records say, “and raised them restlessly, and complained of a choking sensation. The only notice he took of Chang was to move nearer to him. Eng’s last words were, ‘May the Lord have mercy upon my soul.’ ”

Dr. Hollingsworth did not reach the house until both twins were dead. Though the family were averse to an autopsy, he obtained consent to put the bodies in a position to be preserved until he could obtain an expert to perform one. The bodies were cooled and placed in a coffin that was put in a wooden box enclosed in tin; this was imbedded in charcoal in the dry cellar of Eng’s home. William Augustus Reich, the local tinsmith, in a letter (probably to his sister) written from Mt. Airy on January 19, 1874, told about the unusual coffin: Dear Darling J

I write you a few lines this morning. I expect you heard the Siamese twins are

dead. I got an order late Saturday evening for a large tin coffin. I made it. I worked nearly all night, finished it about noon yesterday. Cut out yesterday afternoon and soldered them up. It was a sight the people that was there. It was a long time before I could get my foot in at the door, so crowded. It was like a camp meeting so many people horses and carriages. It was most night before I got through soldering them up. They are not going to bury them but keep them in the house. I expect they are afraid somebody would steal them. The Siamese twins is the greatest human curiosity in the world and who ever thought I would be the man to solder them up. I had to cut into 34 big sheets of tin to make the coffin. I have a notion to charge $20 do you think that would be about right? Their death was sudden and unexpected on Friday night late. … All the doctors went out Saturday morning prepared to cut them apart, but they were both dead when they got there. I heard somebody say that Chang had always been accustomed to liquor, but had not used any for a few days and perhaps caused a reaction. … They were both real business men and have large families. … The Siamese twins were nicely dressed in black with slippers on. I helped lift them in their coffin it was a strange sight. I must close with our best love I remain

Affectionately Augustus It was a sight to see the people that came to my house to see me make this coffin. It was the greatest job I ever done. I send you a drop of solder that dropped on the coffin as I was soldering them up yesterday.

Shortly after the death of the twins, Dr. William Pancoast, of a family of famous Philadelphia physicians, requested the mayor of Philadelphia to telegraph the mayor of Greensboro, North Carolina, seeking permission for an autopsy. The mayor of Greensboro replied that he had no knowledge or power in the matter. A week after the death, Dr. Hollingsworth met in Philadelphia with Dr. Pancoast and Professor Samuel D. Gross, of Jefferson Medical College, and a letter was dispatched to the widows of Chang and Eng proposing that Dr. Pancoast come to embalm and examine the bodies. A commission consisting of Dr. Pancoast and Dr. Harrison Alien, famous anatomist of the University of Pennsylvania, with a Dr. Andrews as companion and aide, arrived in Mt. Airy on January 31, two weeks after the twins’ death.

At a conference with the widows, it was agreed that, as a consideration for embalming the bodies, permission would be granted to exhume and to examine the structure between them, provided that no incision be made that would impair the external surface of the band. Later a written agreement allowed the bodies to be

taken to Philadelphia, if kept safe in a fireproof building.

Great and curious crowds of Carolinians gathered to help the commission exhume the bodies, which were carried to a large chamber for photographs and autopsy. The room was then cleared of all except the commission. The bodies were found well preserved, and embalming was begun. It was found that the aortas of both twins were marked by fatty degeneration—Chang’s so much so that the chloride of zinc used as an embalming agent had to be injected in the lower part of the abdomen rather than downward through the aorta. It was soon decided that a better autopsy could be done in Philadelphia. Back the bodies went into the coffin and into Gus Reich’s tin masterpiece and into an express car, and thence to the College of Physicians and Surgeons in Philadelphia. There they were placed under the care of the commission in the Mutter Museum and were closely locked and guarded.

At well-attended meeting of the College on February 18, the commission exhibited the bodies and demonstrated the findings. These indicated that the band of union connected the twins at the abdominal segment of the breastbone. It contained peritoneal pouches and an extension of liver substance from each abdomen. Vascular connections were sparse but colored plaster material injected into the portal circulation of Chang was found to flow into Eng’s portal vessels as far down as the lower abdominal cavity. The limitations imposed by the widows on the extent of the autopsy left certain anatomical features unclear. It was found that the lower pointed ends of the hearts “present toward each other.” The bladder of Chang, who died first, was found contracted and empty, while Eng’s was markedly distended with urine.

In discussions of his findings before the College, Dr. Pancoast made no statement as to the cause of Chang’s death but speculated about Eng’s: “Probably the valves of his heart were in a disorganized condition, and probably also the shock [of Chang’s death] upon that weakened organ caused death.”

Dr. Harrison Alien said, In my opinion, Chang died of a cerebral clot. From inquiry at his home, I was led to believe that the lung symptoms were not due to pneumonia; indeed, were not severe enough to have been so caused. The suddenness of the death, the general atheroma [fatty inner degeneration] of the arteries, and the fact that there has been previously an attack of cerebral paralysis, all indicated that the death was of cerebral origin. Eng probably died of fright as the distended bladder seemed to point to a profound emotional disturbance of the nervous system, the mind remaining clear until stupor came on,—a stupor which was probably syncopal [ i.e. , due to cerebral anemia]!

A modern medical man, Dr. Worth B. Daniels of Washington, D.C., has also speculated upon the cause of death. In a paper delivered before the American Clinical and Climatological Association, of which

he is president, Dr. Daniels began by reviewing the known facts. Chang had severe atherosclerosis and had suffered a cerebral thrombosis. Five days before his death he developed a cough productive of frothy sputum and some chest pain. Chang’s death was so quiet it did not awaken Eng. This would indicate, Dr. Daniels thought, that Chang’s death was not due purely to the pulmonary edema.

“It was,” he said, using a succession of medical terms, “probably sudden as might occur with an abnormal rhythm. It appears to me that the diagnoses in Chang’s case were: (i) Xiphopagic twin. (2) Generalized atherosclerosis. (3) Coronary atherosclerosis. (4) Myocardial infarction. (5) Congestive heart failure with pulmonary edema. (6) Arrhythmia, probably ventricular fibrillation.”

Then he added: “In Eng’s case, I fully agree with Dr. Harrison Allen. Eng died of fright. If you doubt this try being joined to a dead, xiphopagic twinl”

Could the twins have been separated safely? Considering the medical conditions of the time, probably not. Efforts at separation prior to the introduction of anaesthesia and aseptic surgical techniques were fraught with great danger. Most such attempts resulted in the deaths of both twins. Frequently, even now, the connecting structures are so vital to the survival of both individuals that separation is still hazardous. This is particularly true when the union involves the heads and brain or brain coatings and the spine or the covering of the spinal cords.

But it seems probable that Chang and Eng—or other twins joined in the same way—could be readily separated by a skilled surgeon today. The only vital structure observed in their case, the extension of the liver, could be divided and sutured and the operative wound closed, as is done with an abdominal hernia. But during the lifetime of the brothers from Siam, entry into the abdominal cavity frequently produced peritonitis and death.

Following the autopsy in Philadelphia, the twins were repacked in their tin container and shipped back to North Carolina. Soon they would be forgotten as men who had inescapably lived and loved and died together. They had become just two southerners who, leaving behind them numerous American progeny, were sleeping in their tin coffin in the graveyard of a country Baptist church in North Carolina. But the name by which they were called, in screaming banners above the gates of museums of marvels in America and Europe, may remain forever as the description of all xiphopagic twins, those whom God hath, quite literally, joined together. Chang and Eng, who were inseparable when they lived, remain inseparable in recollection forever.