On September 27, 1849, Poe left Richmond, Virginia, on his way home to New York. No reliable evidence exists about Poe's whereabouts until a week later on October 3, when he was found delirious on the streets of Baltimore, outside Ryan's Tavern (sometimes referred to as Gunner's Hall). A printer named Joseph W. Walker sent a letter requesting help from an acquaintance of Poe, Dr. Joseph E. Snodgrass. His letter reads:
“Dear Sir—There is a gentleman, rather the worse for wear, at Ryan's 4th ward polls, who goes under the cognomen of Edgar A. Poe, and who appears in great distress, and he says he is acquainted with you, and I assure you, he is in need of immediate assistance.
Yours, in haste, Jos. W. Walker”
Snodgrass later claimed the note said that Poe was "in a state of beastly intoxication," but the original letter proves otherwise.
Snodgrass's first-hand account describes Poe's appearance as "repulsive," with unkempt hair, a haggard, unwashed face and "lusterless and vacant" eyes. His clothing, Snodgrass said, which included a dirty shirt but no vest and unpolished shoes, was worn and did not fit well. Dr. John Joseph Moran, who was Poe's attending physician, gives his own detailed account of Poe's appearance that day: "a stained faded, old bombazine coat, pantaloons of a similar character, a pair of worn-out shoes run down at the heels, and an old straw hat." Poe was never coherent long enough to explain how he came to be in this condition, and it is believed the clothes he was wearing were not his own, not least because wearing shabby clothes was out of character for Poe.
Moran cared for Poe at the for-profit Washington College Hospital on Broadway and Fayette Street. He was denied any visitors and was confined in a prison-like room with barred windows in a section of the building reserved for drunk people. Poe is said to have repeatedly called out the name "Reynolds" on the night before his death, though no one has ever been able to identify the person to whom he referred. One possibility is that he was recalling an encounter with Jeremiah N. Reynolds, a newspaper editor and explorer who may have inspired the novel The Narrative of Arthur Gordon Pym of Nantucket. Another possibility is Henry R. Reynolds, one of the judges overseeing the Fourth Ward Polls at Ryan's Tavern, who may have met Poe on Election Day. Poe may have instead been calling for "Herring," as the author had an uncle-in-law in Baltimore named Henry Herring. In fact, in later testimonies Moran avoided reference to Reynolds but mentioned a visit by a "Misses Herring." He also claimed he attempted to cheer Poe up during one of the few times Poe was awake. When Moran told his patient that he would soon be enjoying the company of friends, Poe allegedly replied that "the best thing his friend could do would be to blow out his brains with a pistol."
In Poe's distressed state, he made reference to a wife in Richmond. He may have been hallucinating, thinking that his wife, Virginia, was still alive, or he may have been referring to Sarah Elmira Royster, to whom he had recently proposed. He did not know what had happened to his trunk of belongings which, it transpired, had been left behind at the Swan Tavern in Richmond. Moran reported that Poe's final words were "Lord, help my poor soul" before dying on October 7, 1849.
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