As indicated by the title of the story, when the narrator finds him, Rodrick Usher is in a state of decline to say the least. He seems to have developed multiple neuroses and psychological disorders, including a hypersensitivity to sensory stimuli and a severe anxiety. His sister, Madeline, is the only other remaining member of the Usher family and also seems to be in no state to improve the fortunes of the family. Furthermore, Usher seems to be in a delusional state, believing his house to be alive and intertwined with his own personal fate. The home is in an incredible state of disrepair, and Usher seems to associate his theory with the vegetation growing around the home. Though he is is an obviously demented state, he still acts very cordially to his old friend.
When his boyhood friend catches up with him, Roderick Usher's in a terrible state. Physically and mentally, he's an absolute wreck. This is perfectly consistent with the picture that Roderick gave the narrator in the letter he wrote to him. But even so, nothing can prepare the narrator for the shock he receives on seeing his childhood friend after all these years.
Though Roderick acts in a friendly, cordial manner, his physical appearance is completely different from how the narrator remembers it. There's a cadaverousness about his complexion (this is a polite way of saying he looks like a corpse). In addition to Usher's ghostly pallor, his lips are somewhat thin and pale. And to top it off, he has large, gleaming eyes as well as matted hair grown long and wild. His whole appearance mirrors the state of decay and disorder into which the House of Usher has fallen.
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