He has jumped from a wealthy but obscure pillar of old-money Palm Beach society to a central figure in the Jeffrey Epstein scandal in two days flat.

Now the question is how much did Joel Pashcow, who contributed some of the most salacious pages to the 'birthday book' that Epstein received from friends and colleagues when he turned 50, know of the disgraced financier's mistreatment of young girls.

'Joel knew more about Jeffrey's perversions than anyone,' one source told Daily Mail. 'That much is clear from his entry in the birthday book.

'Unfortunately he is now seriously ill and is not in a place where he could give any helpful assistance to investigators.'

Among the pages Pashcow was responsible for is one showing Epstein handing balloons and candy to young girls – and then 20 years later receiving a naked massage from topless blondes in the grounds of Donald Trump's club Mar-a-Lago.