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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/75869-0.txt b/75869-0.txt new file mode 100644 index 0000000..4c99a06 --- /dev/null +++ b/75869-0.txt @@ -0,0 +1,4412 @@ + +*** START OF THE PROJECT GUTENBERG EBOOK 75869 *** + + + + + A + DOCTOR + ENJOYS + SHERLOCK + HOLMES + + + “Nor must you find fault with me if I often give you what I have + borrowed from my various reading, in the very words of the authors + themselves” (Macrobius--trans. by Boswell). + + Boswell: _The Hypochondriack_, No. XXI + + + + + A + DOCTOR + ENJOYS + SHERLOCK + HOLMES + + + Edward J. Van Liere + + + + + VANTAGE PRESS NEW YORK WASHINGTON HOLLYWOOD + + + + + FIRST EDITION + + + _All rights reserved, including the right of + reproduction in whole or in part in any form._ + + + Copyright, 1959, by Edward J. Van Liere, M.D. + + + Published by Vantage Press, Inc. + 120 West 31st Street, New York 1, N. Y. + + + Manufactured in the United States of America + + + Library of Congress Catalog Card Number: 59-14293 + + + + + To my grandsons: + Edward Van Liere Batchelder and Terry Lewis Batchelder. + + + + + ACKNOWLEDGMENTS + + +I am indebted to several people for helpful criticism in the writing of +these essays. My medical colleagues, Dr. Gordon R. McKinney, and Dr. +David W. Northup, read a number of the essays and made many helpful +suggestions. Professor Armand E. Singer of the Romance Language +Department of West Virginia University critically reviewed all the +manuscripts, and his scholarly erudition is indeed appreciated. The +sympathetic assistance of my wife is also gratefully acknowledged. On +occasion, she took me gently by the hand, and led me away from many a +pitfall. The kind people who aided me must not be taken to task for +errors of commission. I alone am responsible for these. + + +It is a pleasure to thank my capable and efficient secretaries, Mrs. +Mildred Fisher and Mrs. Ann Beavers, for typing the manuscripts. + + +Several of these essays have appeared in the following journals: + + _The West Virginia Medical Journal_ + _Harvard Medical Alumni Journal_ + _The Physiologist_ + _The Baker Street Journal_ + _The Quarterly of the Phi Beta Pi Medical Fraternity_ + _The Student Journal of the American Medical Association_ + + +Permission has been kindly granted to reproduce these essays here. + + + + + CONTENTS + + + Doctor Watson and the Weather 11 + The Anatomical Sherlock Holmes 19 + “Brain Fever” and Sherlock Holmes 25 + Curare and Sherlock Holmes 31 + Sherlock Holmes and the Portuguese Man-of-War 35 + Doctor Watson and Nervous Maladies 41 + Dogs and Sherlock Holmes 48 + The Botanical Doctor Watson 54 + The Surgical Doctor Watson 62 + Sherlock Holmes, the Chemist 69 + Doctor Watson’s Universal Specific 77 + Doctor Watson, Endocrinologist 83 + Genetics and Sherlock Holmes 88 + The Zoological Doctor Watson 96 + Doctor Watson, Cardiologist 102 + The Physiologic Doctor Watson 108 + Sherlock Holmes and Doctor Watson, Perennial Athletes 117 + The Therapeutic Doctor Watson 127 + Doctor Watson, General Practitioner 135 + + + + +To undertake the writing of a large book is like entering on a long and +difficult journey, in the course of which much fatigue and uneasiness +must be undergone, while at the same time one is uncertain of reaching +the end of it: whereas writing a short essay is like taking a pleasant +airing that enlivens and invigorates by the exercise which it yields, +while the design is gratified in its completion. + + Boswell: _The Hypochondriack_, No. I + + + + + DOCTOR WATSON AND THE WEATHER + + “It had been a close and rainy day in October.” + + _The Resident Patient_ + + +To me one of the most delightful touches in the tales of Sherlock +Holmes is the frequent mention of the state of the weather. As far as I +know, no one has emphasized the numerous references to the weather by +Dr. Watson. Especially in the opening of the short stories can these +be found, but they are not confined there, for they appear throughout +the longer tales as well. Many instances can be cited to illustrate +Dr. Watson’s allusions to the state of the weather. Let us freshen our +memory by reviewing some of these. + +Numerous references to the rains and winds of autumn may be found, such +as, “... the weather had taken a sudden turn to rain, with autumnal +winds” (_The Adventure of the Noble Bachelor_). And, in a similar vein, +“Outside the wind still screamed and the rain splashed and pattered +against the windows. This strange, wild story seemed to have come to us +from amid the mad elements--blown in upon us like a sheet of seaweed in +a gale” (_The Five Orange Pips_). And in _The Problem of Thor Bridge_, +we find that, as Dr. Watson was dressing one morning, he observed how +the leaves were being whisked away from the plane tree (we would call +it a sycamore) which graced their back yard. + +The events related in _The Hound of the Baskervilles_ took place +in the autumn of the year, and several interesting allusions to this +season may be found: “I walked over to the black window, and I looked +through a blurred pane at the driving clouds and at the tossing +outline of the wind-swept trees. It was a wild night....” Another +reference, “A dull and foggy day with a drizzle of rain. The house +is banked in with rolling clouds....” Also, “All day today the rain +poured down, rustling on the ivy and dripping from the eaves....” +And in another instance, “Rain squalls drifted across ... and the +heavy, slate-coloured clouds hung low over the landscape, trailing in +gray wreaths down the sides of the fantastic hills.” And lastly, an +especially interesting allusion may be cited: + + We hurried through the dark shrubbery, amid the dull moaning of the + autumn wind and the rustle of the falling leaves. The night air was + heavy with the smell of damp and decay. Now and again the moon peeped + out for an instant, but clouds were driving over the face of the sky, + and just as we came out on the moor a thin rain began to fall. + +The paragraph just quoted pictures a rather wet autumn night, but not +an especially bad one. In _The Adventure of the Golden Pince-Nez_, +an extremely wild and stormy night toward the end of November is +depicted. Dr. Watson describes vividly how the wind howled down Baker +Street, and how the rain beat vigorously against the windows. Another +reference may be cited which depicts gloomy autumn days: “It had been a +close and rainy day in October....” (_The Resident Patient_). + +It would appear, then, that many of Sherlock Holmes’ adventures took +place during the fall of the year. It must be inferred that the dark +and stormy days of autumn depressed the great detective, for we find +him saying to Dr. Watson, “Draw your chair up and hand me my violin, +for the only problem we still have to solve is how to while away these +bleak autumnal evenings” (_The Adventure of the Noble Bachelor_). + +From the instances just enumerated, it would seem that Dr. Watson was +fond of picturing a background of wind, rain, and storm for many of his +stories. He also described the well-known fogs of London with telling +effect. In _The Adventure of the Copper Beeches_, Dr. Watson writes, +“A thick fog rolled down the lines of dun-coloured houses, and the +opposing windows loomed like dark, shapeless blurs through the heavy +yellow wreaths.” And again, “It was a September evening and not yet 7 +o’clock, but the day had been a dreary one, and a dense drizzly fog +lay low upon the great city” (_The Sign of the Four_). In the same +story, we find Holmes saying, “See how the yellow fog swirls down the +street and drifts across the dun-coloured houses.” _In The Adventure +of the Bruce-Partington Plans_, Dr. Watson tells how, during the month +of November of 1895, such a heavy fog descended on London that it was +impossible to see the houses on the opposite side of Baker Street. + +In addition to wind, rain, storm, and fog, Dr. Watson makes reference +as well to sharp winter weather. In _The Adventure of the Blue +Carbuncle_, it will be remembered that Dr. Watson visited Sherlock +Holmes two days following Christmas to give his friend the season’s +greetings. Watson writes, “I seated myself in his arm chair and warmed +my hands before his crackling fire, for a sharp frost had set in, and +the windows were thick with ice crystals.” When he and Holmes set out +to obtain information about the goose which had swallowed the blue +carbuncle, Watson tells us: “It was a bitter night, so we drew on our +ulsters and wrapped cravats about our throats. Outside, the stars +were shining coldly in a cloudless sky, and breath of the passers-by +blew out into smoke like so many pistol shots. Our footfalls rang out +crisply and loudly....” + +In _The Adventure of the Abbey Grange_, Watson describes an adventure +which took place on a bitterly cold morning during the winter of ’97. +On another occasion, Watson tells how he and Holmes went for a walk on +a cold and frosty winter evening (_The Adventure of Charles Augustus +Milverton_). A description of a beautiful winter day may be found in +_The Adventure of the Beryl Coronet_: “It was a bright, crisp February +morning, and the snow of the day before still lay deep upon the ground, +shimmering brightly in the wintry sun.” + +Mention is made too of the weather in the spring. On several occasions, +references are made to the cold and stormy weather of the early part +of this season: “It was a cold morning of the early spring, and we +sat after breakfast on either side of a cheery fire in the old room +at Baker Street” (_The Adventure of the Copper Beeches_). _The +Adventure of the Speckled Band_ took place in the spring of ’83. +Watson writes: “It was a wild night. The wind was howling outside, +and the rain was beating and splashing against the window.” In _The +Adventure of the Wisteria Lodge_, the good doctor writes that it was +a cold, dark, windy March evening, and a fine rain was falling. And in +_His Last Bow_, Watson writes that he had recorded in his notebook +that, in the latter part of March in the year 1892, it was a bleak and +windy day. + +Milder spring weather also claimed Dr. Watson’s attention: “It was an +ideal spring day, a light blue sky, flecked with little fleecy clouds +drifting across from west to east. The sun was shining very brightly, +and yet there was an exhilarating nip in the air, which set an edge +to a man’s energy” (_The Adventure of the Copper Beeches_). In a +similar vein, “It was a perfect day, with a bright sun and a few fleecy +clouds in the heavens” (_The Adventure of the Speckled Band_). In +_The Adventure of the Three Garridebs_, a lovely spring evening is +mentioned, and Watson writes that the slanting rays of the setting sun +made even a little prosaic street look golden. + +For some reason or other, less frequent mention is made of summer +weather. There are, however, several interesting references to this +enjoyable season. In the story of _The Greek Interpreter_, Dr. Watson +writes, “It was after tea on a summer evening....” And similarly, in +_The Adventure of the Mazarin Stone_, our attention is called to the +fact that it was the evening of a lovely summer’s day. It would be +expected that somewhere in the stories an allusion would be made to +the torrid days of August: “It was a blazing hot day in August. Baker +Street was like an oven, and the glare of the sunlight upon the yellow +brickwork of the house across the street was painful to the eye” (_The +Adventure of the Cardboard Box_). An especially poignant reference to a +hot summer night may be found in the story _His Last Bow_. Dr. Watson +gives a vivid description of a hot night on the second of August. He +mentions that there was an awesome hush and a feeling of expectancy in +the sultry and stagnant air. The August to which reference is made was +that of 1914--the beginning of World War I. In that holocaust, Great +Britain lost the flower of her youth. She has not yet recovered from +that mortal blow. + +People living in the Victorian era, just like many of us today, were +interested in barometric pressure. In _The Boscombe Valley Mystery_, +an interesting reference to barometric readings may be found. Sherlock +Holmes remarks to Lestrade of Scotland Yard: “How is the glass? +Twenty-nine, I see. No wind, and not a cloud in the sky.” Somewhat +later in the day, he mentions to Dr. Watson: “The glass still keeps +very high.... It is of importance that it should not rain before we +are able to go over the ground.” Fortunately, in this instance good +weather prevailed, for Watson writes, “There was no rain, as Holmes had +foretold, and the morning broke bright and cloudless.” + +One might well ask why Dr. Watson emphasizes the state of the weather +so often? Several reasons come to mind: To make the setting of his +stories more realistic; to take up space in the manuscript; to use the +subject of the weather as an excuse for some fine writing; to reveal +Watson’s little-suspected love of nature; or perhaps still other +reasons. Let us examine some of these. + +It is well known that writers often have dirty weather prevailing when +foul deeds are to be committed. Dr. Watson, however, does not abuse +this privilege in his writings, although he does occasionally take +advantage of unusual atmospheric conditions to make the story more +exciting. A good example of this is to be found in the novel _The +Hound of the Baskervilles_. + +One recalls that Sherlock Holmes laid a trap to catch the villain, +Stapleton. A part of the plan made it necessary for the hero, Sir +Henry, to walk across the dismal moor alone after dark. Holmes had +calculated that Stapleton would let loose his spectral hound that +particular night. It was carefully arranged, of course, so that +Sherlock Holmes, Dr. Watson, and Lestrade would kill the hound before +any harm befell Sir Henry, and then catch Stapleton redhanded. All went +according to plan until a dense fog started to rise from the adjacent +Grimpen Mire. The low visibility produced by the unexpected fog almost +upset Holmes’ well-laid plans and nearly caused the death of Sir Henry, +because his friends could not see the hound until it was dangerously +close to him. + +Can the good doctor be accused of writing about the weather simply to +make the manuscripts longer? I think not. In the first place, there +is no evidence (certainly not in his early career) that the money he +received for his stories bore any relation to their length. Further, +and more important, a man with Watson’s imagination did not have to +rely upon such a mundane topic as the weather to lengthen his stories. +We can dismiss this argument promptly by stating that he was not guilty +of padding his manuscripts in this manner. + +Did he use the weather as an occasional excuse for fine writing? +Probably not, although some of the paragraphs in which he describes +the state of the weather, if examples of fine writing, are certainly +examples of vivid writing as well. Several instances could be given, +but one will suffice: + + It was in the latter days of September, and the equinoctial gales had + set in with exceptional violence. All day the wind had screamed and + the rain had beaten against the windows, so that even here in the + heart of great, handmade London we were forced to raise our minds for + the instant from the routine of life, and to recognize the presence of + those great elemental forces which shriek at mankind through the bars + of civilization, like untamed beasts in a cage. As evening drew in, + the storm grew higher and louder, and the wind cried and sobbed like a + child in the chimney. + + _The Five Orange Pips_ + +What other reasons could be given for Watson’s frequent allusions +to the weather? There are, of course, the dapper gentleman and the +Scotchman, who are conscious of the state of the weather since they +deplore--for different reasons, to be sure--losing the press in their +trousers by being caught in the rain. To the Londoner, however, who +seems obliviously unaware of the somewhat disheveled state of his +attire, such an explanation could scarcely apply. On the other hand, +one cogent reason does come to mind. It must always be remembered that +Watson was both a physician _and_ an author. Now the state of the +weather is of perpetual interest to a general practitioner of medicine, +and this is what Dr. Watson pretended to be. It is true that the +physician who practices in the city probably is not as weather-minded +as his colleague in the country. Dr. Watson lived in the great city of +London, but often made his professional calls on foot and doubtless +trudged through storm and rain: “When your round is a short one you +walk, and when it is a long one you use a hansom” (_The Crooked +Man_). He mentions that after his marriage he dropped in at 221B +Baker Street from time to time when walking in that vicinity. + +In point of fact, the kind of weather is of no little importance to a +person who is called out at any time of day or night, as almost any +physician will testify. This may be one of the important reasons why +Watson makes such frequent mention of the weather in his stories. + +All may not agree with me that such descriptions of the state of the +weather add greatly to the interest of Watson’s writings. This is a +matter of opinion; for doubtless there are many men who have little +interest in the weather under any circumstances. Earl Derr Biggers, the +creator of Charlie Chan, had one of his less liked characters remark +that he was not interested in the weather, since he was not a cabbage. +Be that as it may, I have always pitied those individuals who pay +absolutely no attention to the weather; they are missing a great deal +in life. + +There are people who see beauty and interest only in a beautiful day. +The poet probably was right when he sang, “What is so rare as a day +in June?” But would anyone deny that there is beauty in a snowstorm +or a sleetstorm, and is not a cloudburst or a thunderstorm an awesome +spectacle, and can not even a duststorm be a striking phenomenon? Now +nature, I grant, can overdo this matter of storms, and too much dust +in the atmosphere or a week of rainy, sullen weather leave much to be +desired. + +To those of us who have been thrilled by the saga of Sherlock Holmes +and Dr. Watson, and who have found enjoyment and relaxation in reading +about these famous characters, I would like to make one further +suggestion: Let us think of Dr. Watson not only as a practitioner +of medicine, or only just as an amateur detective and confidant of +Sherlock Holmes, but also as a man interested in many things--a lover +of nature and one who could see charm in all her moods. + + + + + THE ANATOMICAL SHERLOCK HOLMES + + “I believe he is well up in anatomy....” + + _A Study in Scarlet_ + + +A number of references to the anatomy laboratory and to portions of the +cadaver may be found in the tales. Shortly after Watson’s return from +India, he met his old friend Stamford at the Criterion bar in London. +This was a memorable occasion, for it was Stamford who introduced +Watson to Sherlock Holmes. When Stamford was telling Watson something +about Holmes, he said, “I believe he is well up in anatomy....” +Stamford made it clear, however, that Holmes was not a medical student, +but did have pronounced scientific interests. He emphasized the fact +that Holmes had a cold scientific approach to problems which deeply +interested him and that he had been seen “beating the subjects in the +dissecting room with a stick....” When Watson evinced some surprise at +this unbecoming behavior, Stamford explained, “to verify how bruises +may be produced after death” (_A Study in Scarlet_). + +At first glance, Holmes’ activity seems to be inexcusable and betokens +a deplorable disrespect for the dead. His researches must not be +regarded in this light, however, for it may be of distinct medicolegal +interest to ascertain whether the bruises on a body were produced +before or after death. This problem has been studied extensively, +and information concerning it may be found in books dealing with +medicolegal matters. Holmes’ early interest and study in this field are +quite understandable, for at that time he was laying the foundation +for his brilliant career as a specialist in the study of crime. + +When Watson first started rooming with Holmes he found that the latter +“Sometimes ... spent his day ... in the dissecting rooms....” (_A Study +in Scarlet_). In one instance, reference is made to the preservation +of bodies in the anatomy laboratory: “Bodies in the dissecting rooms +are injected with preservative fluids.” The agents employed in the +embalming fluid are given: “carbolic, or rectified spirits would be the +preservative....” (_The Adventure of the Cardboard Box_). + +Osteology must have appealed to Holmes, since bones are frequently +mentioned. Once when Holmes was trying to analyze a difficult case, +he made allusion to Cuvier, the famous anatomist and anthropologist: +“Cuvier could correctly describe a whole animal by the contemplation +of a single bone....” (_The Five Orange Pips_). In _A Study in +Scarlet_, a description of the alkali plains of our great West is +given; these pointed but gruesome sentences may be found: + + Here and there are scattered white objects which glisten in the sun + and stand out against the dull deposit of alkali. Approach and examine + them. They are bones: some large and coarse, others smaller and more + delicate. The former have belonged to oxen and the latter to men. + +In another instance, Holmes was consulted about a “charred fragment +of bone” which had been recovered from a heating furnace in a private +dwelling. He showed it to Watson, who without hesitation stated that it +was the upper condyle of a human femur (_The Adventure of Shoscombe +Old Place_). + +One early spring afternoon, Holmes and Watson upon returning from +a walk found that a visitor had left his pipe on the table. Holmes +picked it up and examined it carefully. Watson writes, “He held it up +and tapped on it with his long, thin forefinger, as a professor might +who was lecturing on a bone” (_The Yellow Face_). This is an apt +allusion, for many medical students will remember the occasion when +an instructor in anatomy held a bone in his hand, pointed out areas +where muscles had been attached, and commented on other characteristic +features. One is reminded of the story of the poet-physician Oliver +Wendell Holmes, who was professor of anatomy at Harvard for many years. +Once when lecturing on the sphenoid bone (a bone of the skull having +an exceedingly complicated architecture), he is reputed to have said +something like this: “Gentlemen, I have in my hand the sphenoid bone. +Gentlemen, I say d---- the sphenoid bone!” Any medical student who has +studied this bone will wholeheartedly agree with the remark. + +Mention is made also of fossil bones. When Holmes and Watson visited +the house of Nathan Garrideb, they noticed a large cupboard full +of them. Holmes was invited to take a seat, but his host found it +necessary to clear the chair of bones. Obviously, Garrideb was a most +enthusiastic collector (_The Adventure of the Three Garridebs_). + +Sherlock Holmes presumably enjoyed anthropology, for several references +to this science may be found in the tales. In _The Hound of the +Baskervilles_, when Dr. Mortimer first met Sherlock Holmes, the +doctor rather facetiously said to him: + + “I hardly expected so dolichocephalic a skull or such well-marked + supra-orbital development. Would you have any objection to my + running my finger along your parietal fissure? A cast of your skull, + sir, until the original is available, would be an ornament to any + anthropological museum. It is not my intention to be fulsome, but I + confess that I covet your skull.” + +Holmes apparently was slightly annoyed at this frank but somewhat +insensate disquisition, and remarked, “You are an enthusiast in your +line of thought, I perceive, sir, as I am in mine.” + +On another occasion when Dr. Mortimer was speaking of Sir Henry +Baskerville, he stated: “A glance at our friend here reveals the +rounded head of the Celt, which carries inside it the Celtic enthusiasm +and power of attachment. Poor Charles’ head was of a very rare type, +half-Gaelic, half-Ivernian in its characteristics.” + +Dr. Mortimer obviously was a keen observer, a person of scholarly +tastes and “a most learned man in his own line.” When he was telling +Sherlock Holmes and Dr. Watson of his friendship with Sir Charles +Baskerville, he remarked, “... and many a charming evening we have +spent together discussing the comparative anatomy of the Bushman and +the Hottentot.” + +Interest in anthropology is evinced further by mention of prehistoric +man. One day, while Dr. Watson was walking on the moor, he met the +naturalist Stapleton, the villain in _The Hound of the Baskervilles_. +Watson’s attention was attracted to the circular rings of stone on a +hillside. He asked his companion whether they were the ruins of ancient +sheep pens. Stapleton replied, “Prehistoric man lived thickly on the +moor....” When Watson questioned him as to when the moor was inhabited; +the answer was, “Neolithic man--no date.” + +Another allusion to ancient man may be cited. In the house of Garrideb, +as mentioned, Holmes and Watson noticed above a cupboard a series of +plaster skulls; the names “Neanderthal,” “Heidelberg,” and “Cromagnon” +were printed underneath them (_The Adventure of the Three Garridebs_). +Not only the anthropologist but the trained biologist as well is, of +course, quite familiar with the names of our early ancestors. + +Once Holmes’ knowledge of anthropology helped him solve an important +case. A maiden lady had received in the mail a small cardboard box +containing two human ears--one that of a woman. Holmes was called in, +and during the course of his investigations visited the receiver of +the gruesome package. He noted the resemblance of one of the severed +ears to those of the lady upon whom he was calling. Because of the +striking likeness, he felt certain that the person whose ear had been +dismembered was a close relative of the lady he had come to interview. + +Somewhat later, he gave a lecture--a thing he was prone to do--to Dr. +Watson on the surface anatomy of the ear: + + ... there is no part of the body which varies so much as the human + ear. Each ear is as a rule quite distinctive and differs from all + others.... I ... examined the ears in the box with the eyes of an + expert and had carefully noted their anatomical peculiarities.... I + perceived that her [Miss Cushing’s] ear corresponded exactly with + the female ear I had just inspected. The matter was entirely beyond + coincidence. There was the same shortening of the pinna, the same + broad curve of the upper lobe, the same convolution of the inner + cartilage. In all essentials it was the same ear. + + Of course, I at once saw the enormous importance of the observation. + It was evident that the victim was a blood relative, and probably a + very close one. + + _The Adventure of the Cardboard Box_ + +This was an exceedingly astute observation on Holmes’ part. He was +right when he remarked that as a rule each ear is quite distinctive, +and cleverly pointed out the important anatomical features. In any +event, the study he made of Miss Cushing’s ear aided him greatly in +solving the mystery of the cardboard box, and we know that the murderer +was promptly apprehended. + +In the story just related, a newspaper of the day was supposed to have +suggested that the preserved ears had been sent by medical students as +a joke. It appears that the maiden lady at one time had had unpleasant +dealings with medical students: “... she let her apartments in her +house to three young medical students, whom she was obliged to get rid +of on account of their noisy and irregular habits.... [The ears were +sent] by those students who owed her a grudge and who hoped to frighten +her by sending her those relics of the dissecting rooms.” + +Although this theory was later proved to be false, it was not too +farfetched. Indeed, many, many stories can be told about the behavior +of medical students in the anatomy laboratory. A favorite minor prank, +for example, is to cut off a finger or an ear and slip it into the +pocket of an unsuspecting visitor. This bit of horseplay probably +discourages future visits to the anatomical laboratory. Although +anatomy instructors deplore such practices, they are likely to overlook +them, because laymen are not encouraged to visit dissecting rooms. + +In the opening of one of the stories, we find Holmes stooping over +a low-power microscope (_The Adventure of Shoscombe Old Place_). He +explained to Watson that there were epithelial cells in the microscopic +field. As far as I am aware, this is the only reference to individual +body cells to be found in the tales. It appears, then, that Holmes +was much more interested in gross structures of the body, especially +osteology, than in microscopic structures. + +We have seen that many pertinent allusions to anatomical science may +be found in the tales. In one instance, at least, Holmes’ intimate +knowledge of surface anatomy--that is, the configuration of the +external ear--enabled him to solve handily a perplexing mystery. The +allusions made to anatomical matters are of especial delight to those +of us in the field of biology. + + + + + “BRAIN FEVER” AND SHERLOCK HOLMES + + “I have only just recovered from nine weeks of brain fever and am + still exceedingly weak.” + + _The Naval Treaty_ + + +Several years ago, there appeared in the _Journal of the American +Medical Association_ a provocative article with the arresting +title, “Brain Fever,” written by Louis Cassamajor.[1] The author is +to be commended for his courage in choosing this unusual title, and +the _Journal_ to be congratulated for publishing it. Although +I welcome the term “brain fever,” I did rub my eyes, because I had +not seen it employed for a long time. In my youth the term was used +commonly, but was dismissed from my mind when I commenced the study +of medicine. It was relegated to the same limbo as the old expression +“typhoid malaria.” + +In order that I may develop my thesis, a brief review of Cassamajor’s +article is in order. The author points out that, in the early part of +the past century, considerable literature appeared describing a disease +known as “brain fever” (called also “hydrocephalic fever” and sometimes +“encephalitis”). For the main part, it occurred in children. The +illness subsided after a few days to a couple of weeks, and the patient +usually recovered. + +The author brings out further that, although the disease was apparently +accompanied by fever, there are no recorded temperatures, for the +modern clinical thermometer was not invented until 1868. It is +emphasized, also, that no neurological signs appeared in the case +reports. It was only after the writings of Erb and of Westphal in 1875 +that neurological examination, as we now know it, began to develop. +For some unknown reason, about 1850 mention of the disease disappeared +from medical literature. The author, however, makes the statement: +“Undoubtedly the condition does exist today.” + +Following a brief historical introduction, the author gives in some +detail the case histories of four children, the youngest six and +one-half and the oldest eleven years of age, whom he had rather +recently diagnosed as suffering from “brain fever.” It is highly +gratifying that they all made a complete recovery. The disease is +characterized by signs and symptoms indicating a considerable brain +involvement, “including convulsions, comas, paralyses, cerebellar +asynergy and a sort of bulbar palsy.” The onset is irregular, except +when head trauma has been previously sustained, when it may be sudden. + +One reason, among others, why this stimulating article especially +interested me was that the term “brain fever” called to my mind the +immortal stories of Sherlock Holmes. In them several individuals are +described as suffering from this condition. It is of nostalgic interest +to examine the circumstances which surrounded these victims when they +were stricken. + +We find in one of the stories that a housemaid, with an unstable +Celtic temperament, “had a sharp touch of brain fever.” She had had +a violent love affair with a handsome but perfidious butler, who had +thrown her over for another girl. Following her partial recovery, she +had taken a terrible vengeance and was directly responsible for her +faithless lover’s death. When questioned about him by the master of the +household, she became hysterical and unmanageable: “For two days [she] +had been so ill, sometimes delirious, sometimes hysterical...” (_The +Musgrave Ritual_). She evidently made a rapid recovery, for on the +third night she disappeared and her whereabouts were never discovered. + +In another story, a young girl whose mother had died was treated +cruelly by her father, who had remarried. She had an income of her +own which she generously allowed her father to use. When she fell in +love with a young man, her father tried desperately to make her sign +a contract providing that, in the event of marriage, he could still +use her money. This she refused to do. He placed her in solitary +confinement so that she could not see her lover, and treated her +inhumanly in other ways: “... he kept on worrying her until she got +brain fever, and for several weeks was at death’s door” (_The +Adventure of the Copper Beeches_). It is pleasant to relate that she +recovered and succeeded in eloping with her lover and presumably lived +happily ever after. + +In still another story, in which Sherlock Holmes attempted to gain an +audience with a middle-aged spinster, he was informed that she was +too ill to be interviewed. Her doctor said: “She has been suffering +since yesterday from brain symptoms of great severity. As her medical +adviser, I cannot possibly take the responsibility of allowing anyone +to see her. I should recommend you to call again in ten days” (_The +Adventure of the Cardboard Box_). This illness, somewhat later in +the story, is referred to specifically as “brain fever.” + +The illness had developed when this spinster heard that conscientious +diplomat. Through his own carelessness, how-her younger sister had been +foully murdered by her husband. It was the spinster who, by wicked +machinations, had been largely responsible for her sister’s death. It +is noteworthy that Holmes was advised to come back ten days later. This +indicates that the disease was not of long duration. + +One of Dr. Watson’s former schoolfellows, Percy Phelps, wrote him, “I +have only just recovered from nine weeks of brain fever and am still +exceedingly weak.” In his letter, he further informed Dr. Watson that +he wished to consult with Sherlock Holmes, and asked his friend to +bring him, since he was in deep trouble. This able young man was an +earnest and ever, he had lost an important state document. In +narrating his story to Sherlock Holmes and Dr. Watson, the patient gave +a vivid description of his distressing illness: “Here I have lain, Mr. +Holmes, for over nine weeks, unconscious, and raving with brain fever +... in my mad fits I was capable of anything. Slowly my reason has +cleared, but it is only during the last three days that my memory has +quite returned” (_The Naval Treaty_). + +This poor fellow had an illness of long duration and, according to the +story, his strength came back but slowly. It will be recalled that +Sherlock Holmes solved the mystery and was able to place the important +state document again in the patient’s hands. As far as we know, he +eventually made a complete recovery in spite of the severity of the +attack. + +In _The Hound of the Baskervilles_, it will be remembered that the +heir, Sir Henry Baskerville, narrowly escaped death on the moor. The +shock of the adventure with the hound, coupled with the fact that +the woman with whom the heir was in love was actually the wife of +the villainous Stapleton, his would-be murderer, was too much for +our hero. Watson writes: “But the shock of the night’s adventure had +shattered his nerves, and before morning he lay delirious in a high +fever under the care of Dr. Mortimer. The two of them were destined to +travel together round the world before Sir Henry had become once more +the hale, hearty man that he had been before he became master of that +ill-omened estate.” + +In this last instance, Watson does not specifically state that the +patient was afflicted with “brain fever,” but the implication is +plainly there. It is, moreover, worthy of note that it took the victim +a long time to regain his health. + +The individuals whom Dr. Watson described as suffering from “brain +fever” obviously had all passed through a terrific mental storm--in +modern parlance, they had sustained “severe psychic traumata.” Whether +this alone could cause “brain fever” is a moot question. The condition +presumably is caused by a virus. That a severe brain storm could cause +the lurking virus to become active seems unlikely. + +Previously it has been mentioned that a head injury apparently is +capable of hastening the onset of brain fever in children. (We will +waive the fact that the cases Dr. Watson described are adults.) A +physical injury presumably produces certain organic changes in the +brain or in its meninges, which perhaps could precipitate an attack +of encephalitis, assuming that the virus was present. There is no +particular evidence that the patients mentioned in the tales had +suffered a head injury. + +It is true, of course, that great emotional upsets are often +accompanied by marked vascular disturbances. These may manifest +themselves in the brain as well as in other parts of the body. It is +not conceivable that encephalitis would follow an emotional storm. +Be that as it may, this can be said: It is generally agreed that +anything which lowers the resistance of an individual may make him more +susceptible to disease. In the cases described by Dr. Watson, the virus +may have been present, and the shock produced by the emotional storm, +which all these people experienced, might have precipitated an attack +of encephalitis (brain fever). + +If this seems too farfetched, and the reader cannot go along with me, +I can say only that I am sorry. I will have to use the argument that +one should allow a talented and imaginative writer like Dr. Watson a +liberal degree of poetic license. + +Dr. Watson may have used the term “brain fever” loosely, and perhaps as +synonymous with extreme nervous exhaustion. He does, however, mention +that some of the sufferers became delirious. This symptom is suggestive +of encephalitis. Also, in one or two instances the victim recovered +rather quickly, which points to an acute condition such as encephalitis +rather than nervous exhaustion. I am cognizant that some may regard +this as a specious argument. + +The question could be raised whether the patients described by Dr. +Watson suffered from hysteria. This condition cannot entirely be ruled +out. Hysteria has protean manifestations, and may even be accompanied +by fever. The great mental storms through which these patients passed +are conducive to hysterical attacks. The fact, however, that these +individuals ran a high fever and were dangerously ill would militate +against a diagnosis of hysteria. It seems fairly safe to assume that +the disease from which they suffered probably had an organic basis. + +The reader should be reminded that Dr. Watson began the study of +medicine only a short time after the researches of Erb and of Westphal +on the nervous system had been published. Neurology had not yet come +into its own, and it is likely that the medical profession did not +make fine distinctions when dealing with diseases of the brain or its +meninges. It probably is not charitable for me to suggest that the +professors who taught the young Watson about nervous diseases in the +year 1876 or thereabouts had not kept up with the literature in their +field--a fault of which we are all more or less guilty. + +Dr. Watson has been taken to task by some critics in the medical +profession for using the term “brain fever,” and the implication has +been made that his employment of a meaningless term was unworthy +of a medically trained man. Now it appears that this criticism is +unjustified. We might quarrel with Dr. Watson as to what brought on +the attacks of “brain fever,” or whether the victims actually had the +disease in the cases he so vividly described, but the term itself is +acceptable. + +The Holmesian enthusiast will rejoice that the term “brain fever” +is again in good repute and is accepted by the medical fraternity. +The very fact that the staid _Journal of the American Medical +Association_ has published an article bearing the title “Brain +Fever” has stripped criticism of all weapons. The loyal Holmesian no +longer needs to feel apologetic for the nomenclature Dr. Watson used to +describe a rather unusual and fortunately rare clinical entity. + + + + + CURARE AND SHERLOCK HOLMES + + “... for the action of the alkaloid is rapid.” + + _A Study in Scarlet_ + + +Curare is used as a lethal agent in two of the Sherlock Holmes stories. +In the novel _A Study in Scarlet_, liberties are taken with the +pharmacologic properties of curare, for actions are ascribed to this +agent which it could not possibly have had. But in _The Adventure +of the Sussex Vampire_, curare is employed scientifically and with +telling effect; and indeed, an interesting plot is built around this +agent. + +Let us first examine the role curare played in _A Study in Scarlet_. +Holmes, it will be remembered, wished to determine the toxicity of +certain pills and instructed Dr. Watson to fetch a little dog, which +already was _in extremis_: “... that poor little devil of a terrier +which has been bad so long, and which the landlady wanted you to put +out of its pain yesterday.” Watson commented on the state of the +animal: “Its laboured breathing and glazing eye showed that it was not +far from its end. Indeed, its snow-white muzzle proclaimed that it had +already exceeded the usual term of its existence.” Then, according to +Dr. Watson, some of the pills which were thought to contain curare +were dissolved in milk and offered to the sick dog: “The unfortunate +creature’s tongue seemed hardly to have been moistened in it before it +gave a convulsive shiver in every limb and lay as rigid and lifeless as +if it had been struck by lightning.” + +Before we comment on the sudden death of the terrier, let us see what +befell Enoch Drebber, who was forced by Jefferson Hope to swallow +a pill containing curare. The wretched Drebber met the same fate as +the aged terrier, for we find Watson writing: “... the action of the +alkaloid is rapid. A spasm of pain contorted his features; he threw his +hands out in front of him, staggered, and then with a hoarse cry, fell +heavily upon the floor. I turned him over with my foot, and placed my +hand upon his heart. There was no movement. He was dead.” + +The deaths of Drebber and the terrier were dramatically portrayed, and +Dr. Watson is to be congratulated on the vivid picture he presented. +The trained scientist however, could not entirely accept the events +as he outlined them. The difficulty lies in the fact that curare is +relatively harmless if taken by mouth. If extremely large doses are +administered on an empty stomach, sufficient curare may be absorbed +to cause grave symptoms, but death would not be instantaneous, for +absorption is slow from mucous surfaces. If, on the other hand, there +were an open lesion in the stomach or the upper part of the small +intestine, such as an ulcer, then rapid absorption could take place, +and death would ensue in a relatively short time, although not as +rapidly as portrayed in the story. The action of curare is rapidly +lethal only if injected directly into the blood stream. It would +stretch our credulity too far to assume that both the dog and the man +had either a gastric or a duodenal ulcer. + +Let us now consider how curare was employed in the story _The Adventure +of the Sussex Vampire_. It will be recalled that Sherlock Holmes was +asked by Mr. Robert Ferguson to investigate certain irregularities in +his household. Ferguson, a fine gentleman, was very much in love with +his beautiful Peruvian wife; but one day, to his infinite horror, he +had actually seen her sucking blood from a wound on the neck of their +year-old baby. She refused to make any explanation, and the husband +and wife became estranged. There was another child in the family, an +invalid boy of fifteen, Ferguson’s son by a previous marriage. + +Dr. Watson accompanied Sherlock Holmes to Ferguson’s country home on a +dreary autumn day. One of the rooms of the old house contained a fine +collection of South American utensils and weapons which presumably had +been brought from Peru by the mistress of the house. As Holmes was +examining this interesting collection, the movements of a dog attracted +his attention. Holmes noted that the dog experienced difficulty in +walking. The astute detective asked Ferguson what ailed the dog. His +host replied that the thing had also puzzled the veterinarian. The +latter had thought it might be spinal meningitis. Holmes asked a few +more questions about the dog, and finally remarked that the picture the +dog presented was very suggestive. + +The frantic husband insisted that Holmes tell all he knew or suspected. +Holmes then gently explained to the indulgent father that his +fifteen-year-old invalid boy was so insanely jealous of his healthy +baby half-brother that he had tried to do away with him by wounding +him with an arrow treated with curare. The boy had first tried out the +poison on the dog. Ferguson’s wife, in an heroic effort to save her +baby, had sucked the site of the arrow wound. The mystery was solved, +and Holmes and Watson had the keen satisfaction of clearing up the +grave misunderstanding between Ferguson and his lovely Peruvian wife. + +In this story, curare was handled in an expert manner. It is known, of +course, that the South American Indians dipped their arrowheads into a +curare solution before using them to kill birds. The curare was rapidly +absorbed from the wound made by the arrow; the wing muscles became +paralyzed; and the bird plummeted to earth--an airplane without wings. + +_The Adventure of the Sussex Vampire_ was written many years ago. What +is the status of curare today? This interesting compound has actually +insinuated itself from the jungle not only into the experimental +laboratory but into the surgical amphitheater as well. This is not +the place to take up in detail the clinical use of curare, but a few +remarks are in order. + +Relaxation of the muscles is often highly desirable in surgical +procedures; it is not surprising, therefore, that the anesthetists have +added curare to their armamentarium. Although curare has no anesthetic +action _per se_, it has been found to serve as a useful adjuvant to +certain anesthetic agents. It has been used also for the convulsions +of strychnine poisoning, tetanus, and hydrophobia, as well as certain +spastic contractures. It could furthermore be of help in the management +of dislocations, especially in heavily muscled individuals. + +Curare should be employed only by experienced workers, for the muscles +of respiration may become paralyzed, and unless mechanical respiration +is given immediately, the patient will die of asphyxia. Fortunately, +curare is quickly excreted by the body, and the patient will soon start +voluntary breathing movements. + +In conclusion, let us turn to the tales. _The Adventure of the Sussex +Vampire_ could have been written only by an individual quite familiar +with the action of curare, and with a good understanding of clinical +medicine. This story is of especial interest to physicians. Not only +is curare used in the plot in an interesting and unusual manner, but +certain psychosomatic problems are presented: The estrangement of the +husband and wife; and a clear portrayal of how the mind of a physically +handicapped youngster may become warped, even though reared in an +excellent environment. + + + + + SHERLOCK HOLMES AND THE PORTUGUESE MAN-OF-WAR + + “I did what I could to relieve his pain.” + + _The Adventure of the Copper Beeches_ + + +_The Adventure of the Lion’s Mane_ has always appealed to me, although +I am mindful that this story is not universally popular with Holmesian +enthusiasts. The story was written by Sherlock Holmes himself. The +title alone arrests one’s attention. Immediately, one thinks of a +magnificently maned lion at bay, or, as one artist pictures him, +standing in the moonlight on the shore of the ocean, roaring defiantly +at the incoming waves. + +As the adventure unfolds, however, we learn that while the story +does deal with the ocean, a lion is not mentioned, but rather a huge +jellyfish, _Cyanea capillata_. It is also called the “Lion’s Mane,” for +as Holmes wrote, the jellyfish resembled a mass of tangled hair which +looked as if it might have been procured from a lion’s mane. + +Let us recall that in this story the death of a person, as well as that +of a dog, was produced by the poisonous sting of the Lion’s Mane. The +victim of this catastrophe was Fitzroy McPherson, a young scientist who +had suffered from rheumatic fever, and whose heart had been damaged. In +spite of his cardiac ailment, he was portrayed as a fine athlete and an +expert swimmer. It was his custom to take a daily dip in the ocean in +and out of season. + +At the time of which we write, Sherlock Holmes was living in retirement +on the Sussex Downs, not far from the place where McPherson often +swam. One fine morning in July, following a severe storm, Holmes and +his neighbor Stackhurst, who kept a preparatory school, were taking a +bracing walk. To their intense surprise and dismay, they discovered the +figure of McPherson, a science master of Stackhurst’s establishment, +coming up the path staggering as if drunk. As they came nearer, he +uttered a terrible cry and fell upon his face. They rushed to his +side and turned him on his back. He was _in extremis_. Just before he +expired, he indistinctly uttered words that sounded like “lion’s mane.” +The cause of his death was a mystery even to Holmes. + +A few days later, Ian Murdoch, a colleague and close friend of the late +McPherson, went swimming in the exact spot where the latter had met his +untimely death. Holmes dramatically describes how Ian Murdoch lurched +in the room, extremely pale, and with his clothes all rumpled. It was +an effort for him to stand; finally, he staggered to the sofa and +collapsed from the excruciating pain. He experienced great difficulty +in getting his breath, his face appeared livid, and beads of cold sweat +stood on his brow. It appeared that he was also _in extremis_. + +It is not necessary to relate here the steps which Holmes took in +solving this baffling mystery. Suffice it to say that he came to the +conclusion that both McPherson and Murdoch had come into contact with +a huge jellyfish. He became absolutely convinced of this when he +discovered in the attic of his home a book by J. G. Wood entitled, _Out +of Doors_. Holmes found in this book a description of a patient who +had been in contact with a jellyfish. The victim complained that while +the local pain was severe, it was nothing compared to the pangs which +surged through his chest. It was impossible for him to stand up. The +cardiac beat became quite irregular; the heart would virtually stop, +and then several violent pulsations would occur. + +Admittedly, Holmes’ story is a thrilling one. The criticism to be made, +however, is that although _Cyanea capillata_ can produce a nasty sting, +it probably could not produce death, especially in a healthy person. +There is no question but that it would be an unpleasant experience for +a swimmer to come into contact with _Cyanea_. In a standard textbook +of biology, _Cyanea arctica_, another species of the same genus, is +described as a creature which may measure six feet in diameter and bear +tentacles reaching the astonishing length of one hundred and thirty +feet! It can readily be seen that a swimmer could easily be stung by +such a jellyfish before recognizing the danger. + +Since it is generally believed that _Cyanea capillata_ cannot cause +the death of an individual, and since the symptoms described in _The +Adventure of the Lion’s Mane_ were so grave, the coelenterate which +Holmes had in mind probably was no other than _Physalia_, commonly +known as the Portuguese man-of-war. Exposure to the tentacles of this +creature is apt to produce a chain of alarming symptoms. + +Owing to my warm interest in Holmes’ story I read with profit and +keen enjoyment a case history reported by Klein and Bradshaw.[2] A +twenty-year-old man, while swimming about twenty feet off North Miami +Beach, Florida, came into contact with a Portuguese man-of-war. His +attention was drawn to a purple object floating near him, which he +thought to be a balloon. He swam up and touched it. Immediately, he +became aware of a sharp stinging sensation on his arm and shoulder. +Noting several strands which he could not brush off, he left the +water at once, and a companion removed them with a towel. Underneath +each strand could be seen a “painful fiery red welt.” Soon he found +it difficult to breathe, and shortly suffered from severe abdominal +cramps. A little later, he showed signs of shock and mental confusion. + +A swimmer exposed to the tentacles of these large jellyfish may, +according to Klein and Bradshaw, suffer pain, swelling, and redness +in the affected part. In a few minutes to an hour following exposure, +systemic effects may appear, such as anxiety, muscular pains and +cramps, dyspnea, constriction of the throat, cardiac symptoms, and +prostration. The authors stress that the alarming symptoms which often +follow stings from coelenterates suggest the action of a powerful +neurotoxin. + +Waite,[3] writing in the same year, stresses the fact that contact with +a Portuguese man-of-war produces symptoms indicative of anaphylactic +shock, such as pallor, sweating, faintness, fall in blood pressure, and +the like. He mentions that although there have been no authenticated +medical reports of death as a result of the sting of a Portuguese +man-of-war, it could happen if complicated by anaphylactic shock. + +One wonders, of course, what would have happened if the patient +described by Klein and Bradshaw had been some distance from shore. +If anaphylactic shock had occurred within a few minutes, the patient +no doubt would have drowned if no one had been in the vicinity to +help him. A swimmer who experiences difficulty in breathing, who is +afflicted with severe abdominal cramps, who shows signs of shock, and +who is mentally confused, will certainly drown. Indeed, any one of +these four symptoms could provoke disaster in deep water. + +The treatment instituted by Klein and Bradshaw is worthy of our +attention. The patient was hospitalized and given calcium gluconate +and benadryl intravenously. Epinephrine and atropine were administered +intramuscularly, and ammonia applied locally. I might add that a purist +could raise the question whether all this medication was necessary. The +next day, the itching areas were treated with tetracaine. The patient +made an uneventful recovery, although it took about three weeks before +the lesions were healed. Waite emphasizes that, in case of anaphylactic +shock, epinephrine or benadryl should be given immediately. He warns +further that if angioneurotic edema appears, the air passageways +should be cleared, oxygen supplied, and, if necessary, a tracheotomy +performed. The latter constitutes heroic treatment, but may, of course, +save a person’s life. + +Let us return to _The Adventure of the Lion’s Mane_, in an attempt +to ascertain what medical agents were used fifty years ago to treat the +sting of coelenterates. As previously mentioned, Sherlock Holmes was in +retirement and living alone, so unfortunately he could not call upon +his friend Dr. Watson to prescribe for Ian Murdoch. + +Holmes, however, rose to the occasion and made an earnest attempt to +help the patient, for he writes that he soaked cotton in salad oil and +applied it to the wounds. He felt that this greatly alleviated the +pain. The famous detective showed real ingenuity in making use of such +a homely remedy. He also gave the suffering man liberal quantities of +brandy, which doubtless had a narcotizing effect. There is considerable +evidence that brandy was widely used for medicinal purposes at the turn +of the century, when this adventure is supposed to have occurred. + +It is of interest to speculate upon what medication Dr. Watson would +have administered to Ian Murdoch had he been in attendance. At that +time, neither benadryl nor calcium gluconate nor, for that matter, +tetracaine was available. On the other hand, epinephrine, atropine, +and ammonia were even then widely used. Dr. Watson presumably would +have given a hypodermic injection of morphine and offered the patient +brandy, as did Sherlock Holmes. He, too, doubtless would have applied +some soothing ointment to the painful lesions, or, like Klein and +Bradshaw, might have used ammonia. It is even possible that he would +have employed epinephrine. The latter certainly was indicated, for +the symptoms described by Holmes were those of anaphylactic shock. +This syndrome (anaphylactic shock) was not well understood fifty years +ago. In point of fact, the word “anaphylaxis” was coined in 1907 by +Richet. This, as mentioned earlier, was the year when the adventure was +supposed to have taken place. Holmes, however, wrote _The Adventure +of the Lion’s Mane_ probably in 1925, since it was first published +in 1926. At that time, the significance of anaphylactic shock in man +was pretty well understood, and it is possible that he was familiar +with this condition. + +It is a pity that we have to resort to speculation, and that Dr. Watson +was not in attendance instead of Holmes, a nonmedical man. If such +had been the case, Watson probably would have mentioned the agents +medical men used at that time. This would not only have satisfied our +sympathetic curiosity but, what is more important, these facts would +have been of historical interest. We then could actually have compared +the medical agents which were prescribed fifty years ago with those +currently employed for the grave symptoms of shock produced by the +excruciatingly painful stings of coelenterates. + + + + + DOCTOR WATSON AND NERVOUS MALADIES + + “... the shock of the night’s adventures had shattered his nerves.” + + _The Hound of the Baskervilles_ + + +The harrowing adventures experienced by some of the characters in the +stories of Sherlock Holmes, and the great shocks they sustained, often +induced in them a state of high nervous tension. References to such +individuals are numerous. + +Sherlock Holmes himself possessed an iron constitution, and was favored +with an especially well-balanced mind. His biographer, John H. Watson, +M.D., writes, “All emotions ... were abhorrent to his cold, precise but +admirably balanced mind” (_A Scandal in Bohemia_). But even Holmes, +on one occasion at least, was on the verge of a serious nervous +breakdown. In the spring of 1897, Dr. Watson became concerned about +the health of his distinguished friend: “... I found him a prey to the +blackest depression ... [even his realization of his worldly fame] was +insufficient to rouse him from his nervous prostration” (_The Reigate +Puzzle_). + +Watson felt that Holmes needed a complete rest in a quiet and soothing +atmosphere, and finally persuaded the great detective to take a holiday +in the country. Arrangements were made to stay at the home of one of +Dr. Watson’s old friends. On the evening of their arrival, their host, +Colonel Hayter, in the course of a conversation following dinner, told +them of an unusual burglary which had occurred a few nights before +in the neighborhood. When Holmes manifested too warm an interest in +this event, Watson became alarmed and cautioned him: “You are here +for a rest, my dear fellow. For Heaven’s sake don’t get started on +a new problem when your nerves are all in shreds” (_The Reigate +Puzzle_). Watson’s admonition proved of no avail. The next morning, +while at breakfast, they were informed that a dastardly murder had +been committed at the home of a nearby neighbor. Inspector Forrester, +knowing that Sherlock Holmes was in the vicinity, asked for his help. +Holmes answered the call, and after a rather painful experience, solved +the mystery brilliantly in the course of a few hours. + +The neat solution of this case, together with the concomitant +excitement which it afforded, apparently caused Holmes to recover +quickly from his “blackest depression,” for that afternoon he remarked +to his faithful friend, “Watson, I think our quiet rest in the country +has been a distinct success, and I shall certainly return much +invigorated to Baker Street tomorrow” (_The Reigate Puzzle_). This +episode demonstrates the man’s superb constitution. Most people would +have required several weeks, or even months, to recover their normal +health following a severe nervous breakdown. But not Holmes. + +In several instances, the characters described by Dr. Watson showed +clear-cut signs of hysteria. When the well-known banker Alexander +Holden found that the “Beryl Coronet,” which had been intrusted to his +care, had been mutilated and three of its jewels stolen, he became +greatly agitated and called on Sherlock Holmes: + + For a while he could not get his words out, but swayed his body and + plucked at his hair like one who has been driven to the extreme limits + of his reason. Then suddenly springing to his feet, he beat his head + against the wall with such force that we both rushed upon him and tore + him away to the centre of the room. + + _The Adventure of the Beryl Coronet_ + +This highly respected citizen must have been an emotionally unstable +person. One wonders how he could have been a successful banker, with +such a sensitive nervous system. The poor man must have lain awake +many a weary night worrying about his investments. We do not know +his subsequent history, but I suspect that he eventually developed +hypertension or suffered from gastric ulcers. + +When Rachel Howells was questioned by the master of the house about the +disappearance of her perfidious lover Brunton, she showed pronounced +signs of hysteria: + + She looked at me with so strange an expression that I began to suspect + that her brain was affected.... She fell back against the wall with + shriek after shriek of laughter, while I, horrified at this sudden + hysterical attack, rushed to the bell to summon help. The girl was + taken to her room still screaming and sobbing.... + + _The Musgrave Ritual_ + +There was a real reason for the girl’s behavior; she had been directly +responsible for her lover’s horrible death. It is small wonder that she +suffered a violent hysterical attack. + +Once Dr. Watson was asked to see the wife of his boyhood friend Robert +Ferguson. It was a tragic situation. She had been observed on several +occasions sucking blood from her infant son. The sympathetic doctor +stated that she appeared only half conscious, and had a frightened +expression. Her pulse and temperature were both high, but he felt +that this was due to her highly emotional state (_The Adventure of +the Sussex Vampire_). Mrs. Ferguson was probably suffering from +hysteria. The attack cleared up promptly when Sherlock Holmes sat down +at the patient’s bedside and, in the presence of her husband, analyzed +the situation, explaining why it was necessary for Mrs. Ferguson to +suck the baby’s wounds. They had been made by arrows dipped in curare. +The baby’s insanely jealous half-brother had committed this atrocious +deed. Truly, a shocking episode! + +In _The Greek Interpreter_, reference is made to a man who showed +symptoms of St. Vitus’ dance. Mr. Melas described his unpleasant +companion: “... his lips and eyelids were continually twitching like a +man with St. Vitus’ dance. I could not help thinking that his strange, +catchy little laugh was also a symptom of some nervous malady.” + +The term “St. Vitus’ dance” is seldom used nowadays; it is presently +called “acute chorea.” This condition is characterized by irregular +involuntary contractions of the muscles and is associated with a +variable amount of psychic disturbance. The name (St. Vitus’ dance) +has been handed down from the Middle Ages. Epidemics characterized +by excitement, gesticulations, and dancing brought about mainly by +religious fervor were in those days not uncommon. Whenever these +symptoms became excessive, the people in the Rhenish province +frequently made pilgrimages to the Chapel of St. Vitus in Zebern. + +Another reference to twitching muscles may be cited. Sherlock Holmes +called on Mr. Sidney Johnson, senior clerk and draughtsman, in an +office from which extremely important secret papers had disappeared. +Watson writes that the clerk had haggard cheeks, and that his hands +were twitching from the nervous strain he had undergone (_The Adventure +of the Bruce-Partington Plans_). + +In the tales, other references may be found to shattered nerves and +states of nervous exhaustion. In describing the condition of her +father, Alice Turner tells Sherlock Holmes: “... Dr. Willow says +that he is a wreck and that his nervous system is shattered” (_The +Boscombe Valley Mystery_). The real reason for his pitiful state, +which his daughter did not know, was that he had recently murdered an +old acquaintance. + +When Don Murillo, Tiger of San Pedro, tried to kidnap Miss Burnett, she +broke away from him, and with the help of a friend got into a cab. Here +Holmes saw her, and observed that she was in a state of collapse from +nervous exhaustion (_The Adventure of Wisteria Lodge_). This brave +lady had been locked in a room for a number of days with insufficient +food, and had undergone other traumatic experiences. It is no wonder +that Holmes found her in such a pitiful state. + +After Sir Henry Baskerville had narrowly escaped death on the moor from +the savage hound, he suffered a nervous collapse, “... the shock of +the night’s adventure had shattered his nerves.” Sir Henry assuredly +was not a weak man, but the victim of a concatenation of unfortunate +circumstances. The family history of the hound, Sir Henry’s love for a +married woman, his isolation and loneliness, and the somber landscape +of the bleak moor doubtless all preyed on his mind. When the hound +actually sprang upon him, his nervous system finally reached the +breaking point. Stronger men than he would have quailed. + +Mr. Marlow Bates, the manager of the estates of the wealthy “Gold King” +Mr. Gibson (whose wife had been found dead), called on Sherlock Holmes. +Watson describes him as a small, thin, fidgety man, who appeared to be +on the brink of a serious nervous breakdown. Although in great fear of +his vicious employer, Bates detested him so heartily that he hurried +to Baker Street and told Holmes that Gibson was an “infernal villain.” +In view of the circumstances, this was indeed a grave accusation. The +reader will recall that the “Gold King” had not murdered his wife; she +had died by her own hand (_The Problem of Thor Bridge_). + +The eyes often show a characteristic expression under emotional strain. +Referring to Colonel Valentine Walther, whose brother had suddenly +died, Watson observes that he had wild eyes and presented a worried +and disheveled appearance (_The Adventure of the Bruce-Partington +Plans_). It was discovered that it was the colonel who had stolen +an extremely important state document. His older brother, Sir James, +suspected Valentine’s guilt. The shock was too much for the older +man and caused his death; there was a question as to whether he took +his own life. Be that as it may, his younger brother was responsible +for the tragedy. We are not surprised to learn that the eyes of the +colonel had a wild expression. + +People under great emotional strain often break out in a cold sweat. +Nearly everyone has, at one time or another, experienced this +phenomenon. It is caused by violent stimulation of the sympathetic +nervous system. When John Openshaw’s uncle Elias received a letter +containing five orange pips, a great change came over him. At times he +acted like a madman. His nephew told Holmes, “At such times I have seen +his face, even on a cold day, glisten with moisture, as though it were +new raised from a basin” (_The Five Orange Pips_). + +A cold sweat is more apt to manifest itself on the forehead, but it +is not necessarily limited to the face, for any portion, or all, +of the body may be involved. The cold, clammy sweat produced under +conditions of intense mental stress is different, of course, from the +normal healthy sweat brought about by a warm environment or by physical +exertion, or by both. The physiologic explanation of a cold sweat is +that it is a condition brought about by pain or fear as a reaction +anticipatory of the strenuous muscle movements that may ensue. + +Victor Trevor’s father was also the recipient of a letter which led to +tragedy: + + My father read it, clapped both hands to his head and began running + round the room in little circles like a man who has been driven out of + his senses.... I saw that he had a stroke. + + _The “Gloria Scott”_ + +Apparently, this individual became so agitated, and his blood pressure +rose so high, that he was stricken with a fatal cerebral hemorrhage. +It is well known that emotions may produce a pronounced rise in blood +pressure even in healthy people. + +Most of the nervous maladies described by Dr. Watson were in the +nature of acute episodes, and more or less transient in character. The +individuals he depicted were high-strung, nervous people, overwhelmed +by the traumatic experiences to which they had been subjected. Some +of these were unable to suppress their emotions and either became +hysterical or suffered a nervous collapse. + +As a rule, we do not think of the English people as giving way to +their feelings, but as governing them strictly. It is the Latins who +are supposed to manifest hysterical reactions. However, it would +take extraordinarily strong men, regardless of their nationality, +to maintain normal mental equilibrium under some of the situations +described in the spine-tingling tales; even the stolid Britishers +cracked under the mental strain. The nervous system of man can +withstand just so much and no more. It is given to but few to possess +nerves of steel, and even such rare individuals finally reach a +breaking point. Man is not a machine, but a human being. + +If Dr. Watson were writing his adventurous stories today, he probably +would stress the fact that long-continued nervous strain is likely +to produce ulcers of the stomach or of the duodenum. The modern view +is that mental worry may lead to hypertension and to diseases of the +arteries, especially those which supply the heart muscles, namely, the +coronaries--although it is true, as previously mentioned, that most +of the characters depicted in the tales suffered mental strain for a +substantial length of time. + +It is noteworthy that both Sherlock Holmes and Dr. Watson maintained a +nice mental balance even during periods of tremendous excitement and +danger. A striking characteristic about both was their extraordinary +fearlessness and mental poise. Although people around them often +manifested signs of abject fear, or were given to hysterical outbursts, +our heroes never faltered, but maintained a calm demeanor and +dispatched neatly and efficiently the task before them. + + + + + DOGS AND SHERLOCK HOLMES + + “It was a giant dog, as large as a calf, tawny tinted, with hanging + jowl, black muzzle, and huge projecting bones.” + + _The Adventure of the Copper Beeches_ + + +To those interested in animals, it is gratifying to know that two of +the most popular heroes of detective fiction--Sherlock Holmes and +Dr. Watson--both loved dogs. They did not like them in a sickly, +sentimental sense, but rather with a genuine, masculine affection. +They regarded them as dogs, not as human beings, and emphasized and +respected their canine personalities. I am sure every self-respecting +dog would want to be so regarded. + +Frequent mention of dogs is found in the tales. In point of fact, the +grisly, spectral hound portrayed in _The Hound of the Baskervilles_ +has become a byword not only among readers of detective fiction but +also with people in general. Various kinds of dogs are portrayed: large +dogs, small dogs, good ones and bad ones. In one instance, a lovable, +curly-haired spaniel is depicted; in another, a plodding bloodhound; +and in still another, a fiendish dog. + +One Sunday evening, in early September, in the year 1903, Sherlock +Holmes summarily sent for Dr. Watson. The friendly doctor, not wishing +to disappoint his friend, set out for Baker Street, and entered the +old apartment, which for a number of years had also been his home. +Holmes waved him to a chair, and after a considerable period of silence +remarked that he was seriously considering writing a monograph on +the use of dogs in the work of a detective (_The Adventure of the +Creeping Man_). + +Dr. Watson did not think much of the idea, and pointed out that this +field had been pretty thoroughly explored. Holmes would not agree. +He explained that he wished to approach the subject from a somewhat +different angle than had previously been done. He argued that a dog +reflected a family’s life. If the household were a happy one, the dog +would be friendly and frisky; conversely, if the family were gloomy, +the dog would appear sad. He insisted further that dangerous and +unpleasant dogs are owned by dangerous and unpleasant people. + +Holmes bolstered his argument by giving as an illustration the case on +which he was presently working. He believed that the changed behavior +of a wolfhound toward his master might turn out to be an important clue +in solving the mystery. This eventually proved to be true, as will +be described later. Although we may congratulate Holmes on his keen +analysis, and on his pungent manner of presenting the argument, there +surely must be many exceptions which come to the minds of us all. We +have witnessed nice people who harbor vicious dogs, and the opposite as +well. We will not quibble, but agree for the main part that Holmes was +probably right. + +Hounds are frequently mentioned. In _The Sign of the Four_, Watson, +describing Holmes in action, writes: “So swift, silent, and furtive +were his movements, like those of a trained bloodhound picking out a +scent.” Again, in _A Study in Scarlet_, we see: “As I watched him I +was irresistibly reminded of a pure-blooded, well-trained foxhound, +as it dashes backward and forward through the covert, whining in its +eagerness, until it comes across the lost scent.” In _The Red-Haired +League_, Jones of Scotland Yard, speaking to his colleague Wilson, +comments: “Our friend Holmes here is a wonderful man for starting a +chase. All he wants is an old dog to help him in the running down.” +Other habits of hounds may be found in _The Adventure of the Devil’s +Foot_ and _The Adventure of the Bruce-Partington Plans_. Numerically, +hounds are mentioned more frequently in the tales than any other +kind of dog, and in several instances hounds actually track down the +criminal. + +It will be recalled that in _The Sign of the Four_ the dependable old +hound Tobey follows a creosote scent. In _The Adventure of the Missing +Three-Quarter_, faithful old Pompey follows a carriage which had had +aniseed squirted upon the wheel by Holmes. On this occasion, Holmes +remarks to Watson that a draghound would follow aniseed indefinitely. +Holmes takes almost a human interest in Pompey. The detective formally +introduces the dog to Dr. Watson and speaks highly of the draghound’s +tracking ability. However, he did not trust all dogs, for we find him +saying to Watson that some dogs bite the hand that feeds them (_The +Adventure of the Three Gables_). + +Two especially fiendish dogs are portrayed in the tales: Carlo the +mastiff, in _The Adventure of the Copper Beeches_; and the spectral +hound, in _The Hound of the Baskervilles_. In the former, the +despicable Rucastle, the master of Carlo, said: “We feed him once a +day, and not too much then, so that he is always as keen as mustard.... +God help the trespasser whom he lays his fangs upon!” Miss Violet +Hunter, the heroine of the story, saw this beast one night: “It was a +giant dog, as large as a calf, tawny tinted, with hanging jowl, black +muzzle, and huge projecting bones.” Watson vividly describes the attack +Carlo finally made on his master: + + There was the huge famished brute, its black muzzle buried in + Rucastle’s throat, while he writhed and screamed upon the ground. + Running up, I blew its brains out, and it fell over with its keen + white teeth still meeting in the creases of his neck. + +In _The Hound of the Baskervilles_, we find a hound which would +frighten the Evil One himself. Evidently, this huge beast was a +mongrel: “It was not a pure bloodhound and it was not a pure mastiff; +but it appeared to be a combination of the two--gaunt, savage, and as +large as a small lioness.” Watson paints this animated picture: + + A hound it was, an enormous coal-black hound, but not such a hound as + mortal eyes have ever seen. Fire burst from its open mouth, its eyes + glowed with a smouldering glare, its muzzle and hackles and dewlap + were outlined in flickering flame. + +While this hound was worrying the throat of Sir Henry Baskerville, +Holmes emptied five barrels of his revolver into the creature’s flank. +“With a last howl of agony and a vicious snap in the air, it rolled +upon its back, four feet pawing furiously, and then fell limp upon its +side.” + +Other breeds are not ignored. Holmes, who had considerable +professional jealousy, would not admit that Jones of Scotland Yard +had the imagination a detective should have, or that he had a keen +intellect, but does pay him this fine compliment: “He is as brave as +a bulldog....” (_The Red-Haired League_.) A reference is made to rat +terriers in _The Adventure of the Crooked Man_. Spaniels also are +mentioned on at least two occasions. Dr. Mortimer, in the story of _The +Hound of the Baskervilles_, owns a curly-haired spaniel of which he +is extremely fond. Unfortunately, this lovable dog comes to grief on +the moor. In _The Adventure of Shoscombe Old Place_, a spaniel plays +an important part in solving the mystery. The so-called “Shoscombe +spaniels” were famous throughout England, and, according to Holmes, +were frequently mentioned at dog shows. He successfully uses one of +these, a pet spaniel, to establish the fact that the person in the +carriage is not the dog’s mistress. Holmes was satisfied that the +spaniel was right, and insisted that dogs do not make mistakes in such +cases. + +Another instance can be cited where the behavior of a dog helped +Sherlock Holmes solve a perplexing problem. In talking to Watson, he +laid great stress on the fact that Professor Presbury’s heretofore +friendly wolfhound Roy had turned on his master and tried to attack +him. This extraordinary episode played an important part in the final +solution of the mystery (_The Adventure of the Creeping Man_). +The facts in the case were these: Professor Presbury, a distinguished +physiologist, had fallen madly in love with a very young girl, and, +in an effort to regain his lost youth, had periodically been taking +hypodermic injections of serum obtained from langurs. According to +the story, the monkey serum produced apelike qualities in Professor +Presbury. Following the injections, the professor would deliberately +and maliciously tease his wolfhound until one night the hound slipped +his collar and viciously attacked his master. He buried his muzzle in +his master’s throat; and if timely aid had not come, Presbury would +have been killed. As Holmes remarked to Watson, the hound thought he +was attacking the monkey and not the professor. + +Since Holmes was a detective, and not a professional biologist, he +seldom found it necessary to use dogs for experimental purposes. Once, +however, he did not hesitate to try out the effects of a poison drug, +curare, on an old dog which was _in extremis_. It will be recalled +that this poison caused instant death (_A Study in Scarlet_). While +not a biological scientist--as we understand the word today--Holmes +nevertheless was scientifically minded, and it is certain that had the +need arisen to obtain evidence which would have helped mankind he would +not have hesitated to experiment on a normal, healthy dog. He was a +practical man, in the fullest sense of the word, and had, as Watson +said, “... an admirably balanced mind” (_A Scandal in Bohemia_). + +It is true that both Sherlock Holmes and Dr. Watson grieved when Dr. +Mortimer’s pet curly-haired spaniel met its fate on the moor, and they +both loved Tobey, the faithful old bloodhound who had aided them in +_The Sign of the Four_. However, they did not hesitate to shoot +five bullets into the flank of the hound of the Baskervilles when he +was at the throat of Sir Henry, or to blow out the brains of Carlo the +mastiff when he sank his teeth into the fat neck of the villainous +Rucastle. Holmes and Watson were not sentimentalists, but virile, +vigorous men of action--the type of men dogs like. + +Finally, Dr. Watson pays a tribute to dogs in general in _The +Adventure of the Lion’s Mane_. In this story, after McPherson died +from his encounter with the Lion’s Mane (_Cyanea capillata_), +his pet Airedale eventually met a similar fate. According to Sherlock +Holmes himself, the terrier did not eat for a week following his +master’s death, and finally followed the trail of his dead master. He +was found dead on the edge of the same pool where his master had lost +his life. It is true that the terrier did not have the opportunity +of saving his master’s life--but no doubt he would have, had it been +possible. The story portrays vividly the bond of companionship between +a man and his dog, for in this instance the dog apparently gave his +life searching for his master. Dr. Watson pays tribute to such devotion +in the words of Sherlock Holmes: “That the dog should die was after +the beautiful, faithful nature of dogs.” This is a tribute that can +be endorsed by all, but especially by biologists, who are so deeply +indebted to the dog for the aid it has given in the search for means to +alleviate the pain and suffering of mankind. I am certain that every +biologist who professes to be a Christian gentleman would say “Amen” +to Dr. Watson’s beautiful tribute to an animal which would die so that +mankind might live. + + + + + THE BOTANICAL DOCTOR WATSON + + “... there stood a patriarch among oaks, one of the most magnificent + trees that I have ever seen.” + + _The Musgrave Ritual_ + + +Many delightful references to plant life may be found in the tales. +These allusions enrich the stories and add greatly to their charm and +interest. Love for inviting landscapes, for trees, for flowers, and +for shrubs appears to be innate in human beings. This would be a drab +world indeed without a variegated and a beautiful plant life. One need +not be a botanist to appreciate the beauty and fragrance of a rose or +a violet. They are different in design, but lovely in their own ways. +It is not meet that we attempt to analyze their beauty; let us merely +enjoy it. If an extravagant phrase be permitted, let us not subject the +beauty of the orchid to the flame of the analytic blowpipe or attempt +to measure the fragrance of the June rose with an olfactometer. + +After Dr. Watson had lived with Sherlock Holmes a few weeks, he became +intensely interested in this quiet but unusual man. One day he sat +down and made an attempt to analyze and evaluate Holmes’ conversance +in several fields. While Dr. Watson felt that Holmes’ understanding of +anatomy was good, his knowledge of botany was “variable.” The worthy +doctor writes: “Knowledge of Botany--Variable. Well up in belladonna, +opium, and poisons generally. Knows nothing of practical gardening” (_A +Study in Scarlet_). Thus, it appears that Holmes was more interested +in medicinal plants, and especially those from which poisons could be +extracted. This does not surprise us, because of his interest in crime +detection; we know, too, of his researches in the chemistry of the +alkaloids. + +We must keep in mind that Watson wrote of Sherlock Holmes: +“Appreciation of nature found no place among his many gifts” (_The +Adventure of the Cardboard Box_). A man uninterested in nature is +not apt to take especial notice or appreciate the beauty of flowers or +vegetation. We are indebted, therefore, largely to Dr. Watson for the +many pleasing references to plant life and landscapes. + +We find allusions to a botanist and to the study of botany in _The +Valley of Fear_ and in _The Adventure of Wisteria Lodge_. In the first +story, Watson likens Holmes to a botanist rapt in his admiration for +a beautiful flower; and in the latter story, Watson points out that +many instructive days can be spent in the study of botany and suggests +the use of an elementary text on the subject, a spud, and a proper box +to hold the specimens. The amateur botanist will surely appreciate +these suggestions. Such a person will find pleasure no matter where he +strays--in the forest, the plains, the mountains, or the desert. He +will never be bored. + +Dr. Watson obviously loved the vegetation of early spring, for he +writes: “... the first faint shoots of green were breaking out upon the +elm, and the sticky spearheads of the chestnuts were just beginning to +burst into their fivefold leaves” (_The Adventure of the Yellow Face_). +Also, we read, “The trees and wayside hedges were just throwing out +their first green shoots.” (_The Adventure of the Speckled Band_). + +The observant doctor was not unmindful of the autumn foliage. In _The +Hound of the Baskervilles_, he calls our attention to the melancholy +aspect of the countryside in the fall of the year, and speaks of the +yellow leaves lying on the ground, some still fluttering down from the +trees. In _The Problem of Thor Bridge_, he notes that the plane tree +in the backyard was losing its remaining leaves on a stormy October +morning. (We would call a plane tree a sycamore.) Some people claim +they become somewhat melancholic in the autumn and dislike to see the +leaves falling, the grass turning brown, and other signs associated +with the fall of the year. I am not one of these. There is much to be +said for distinct changes in seasons. The changes occurring in the +autumn are necessary so that the wonderful season of spring may be +thoroughly appreciated and enjoyed. + +Several types of landscapes are pictured. In _A Study in Scarlet_, +the arid land in our great West is described: + + As far as the eye can reach stretches the great flat plainland, all + dusted over with patches of alkali, and intersected by clumps of the + dwarfish chaparral bushes. + +The purist might object to the term “chaparral bushes,” because +chaparral, being a nonspecific term, refers to any stunted type of +vegetation found growing on dry soil in our West. It might have been +more proper simply to have said “clumps of chaparral.” In the same +story, a prosperous, peaceful countryside landscape is depicted: +“All looked so peaceful and happy, the rustling trees and the broad +silent stretch of grainland....” In _The Adventure of the Solitary +Cyclist_, a landscape of flowering gorse is described, and attention +is called to its golden color on the heather-covered fields. + +Dr. Watson obviously was impressed with landscapes of gold and bronze, +especially those which contained faded ferns, for we find him using the +description several times, for example: + + The sun was beginning to sink ... and the long, sloping plain in front + of us was tinged with gold, deepening into rich, ruddy browns where + the faded ferns and brambles caught the evening light. + + _Silver Blaze_ + +Similarly, in the same story: “... the low curves of the moor, +bronze-coloured from the fading ferns, stretched away to the sky +line....” Besides these landscapes, several references to some of +the famous forests of England are made in _The Adventure of Black +Peter_ and _The Naval Treaty_. + +As might be anticipated, numerous allusions are made to trees. Dr. +Watson presents a pleasing picture: “Just beyond it is a nice little +grove of Scotch firs, and I used to be very fond of strolling down +there, for trees are always a neighborly kind of thing” (_The Yellow +Face_). The word “neighborly” strikes a sympathetic note. All of +us have experienced this feeling at one time or another. Walking in a +pleasant woodland, one can quietly commune with nature. The singular +thing is that on such occasions the creative mind is often stimulated. +New ideas and new concepts apparently rise from the subconscious to the +higher brain centers. Numerous examples could be given of this truly +remarkable phenomenon. + +Dr. Watson must have had a lively interest in oak trees, for he alludes +to them on several occasions. He speaks of “ancient” oaks and “mighty” +oaks, terms surely applicable to the famous English oak trees (_The +Valley of Fear_ and _The Adventure of the Solitary Cyclist_). + +The prize oak, presumably, is the one described in _The Musgrave +Ritual_. Sherlock Holmes related the story to Dr. Watson one winter +night: “... there stood a patriarch among oaks, one of the most +magnificent trees that I have ever seen.” He went on to quote his +host, Reginald Musgrave: “It was there at the Norman Conquest in all +probability.... It has a girth of twenty-three feet.” Truly, it was a +mighty oak and worthy of comment. If its girth was twenty-three feet, +it had a diameter of approximately seven and one-third feet. The events +described in the story occurred in the last quarter of the nineteenth +century, so the tree must have been over nine hundred years old if it +dated from the Norman Conquest of 1066. + +Probably few people appreciate the longevity of oak trees. I recall, +as a child, an oak that stood not far from my home. I have seen it +periodically for over a half-century. It still looks about the same +as when I first saw it, but presumably it has had a slow but steady +growth throughout the years. Assuming that such a tree is not ravaged +by wind and storm or struck by lightning, it probably will stand for +several centuries. This is a fascinating thought, because it staggers +the imagination to think what historical events could occur during such +a span of years. + +Dr. Watson describes trees in various settings, such as parks (_The +Adventure of the Solitary Cyclist_ and _The Adventure of the Abbey +Grange_), and in several instances as borders for avenues or lanes. A +number of examples might be cited, but one will suffice: “The house ... +with a fine lime-lined avenue leading to it” (_The “Gloria Scott”_). + +In _The Hound of the Baskervilles_, the Yew Alley of Baskerville Hall +played an extremely important part in the story. It will be recalled +that Sir Charles, before going to bed at night, was wont to take a walk +down the Yew Alley. One night he saw the huge hound which the evil +Stapleton had purposely let loose on the moor. Sir Charles became so +frightened that he ran headlong and dropped dead from a heart attack. + +In this story, too, mention is made of trees which have been subjected +to adverse growing conditions. Dr. Watson speaks of trees which have +been stunted and nipped on the moor, and emphasizes how the oaks and +firs are bent and twisted by the furious storms throughout the years. +The bizarre shapes which such trees assume are truly fascinating. Their +irregular outlines appear ghostlike by night and weird by day. They are +the joy of the amateur photographer and the professional artist. + +Various types of trees are used to create a proper setting for the +mystery stories. In _The Adventure of the Mazarin Stone_, a melancholy +grove of half-grown pines is described; and in _The Adventure of +Wisteria Lodge_, a row of chestnuts is depicted as giving the avenue a +gloomy appearance. + +The fact that pine trees are used to set the note for a gloomy +landscape calls for comment. I have always felt that a clump of +evergreen trees around a house creates a distinctly depressing +atmosphere; this is especially true if the house is isolated in the +country. To me these somber trees give a sense of loneliness and gloom, +and bring to mind Anna Katherine Green’s mystery story, _The House of +Whispering Pines_. It may be that this story, which I read in my youth, +is the reason for my feeling. I am sure, in any event, that many people +enjoy evergreen trees around their home, especially in winter, as a +welcome relief from the drab, slate-gray landscape. + +Besides those trees already enumerated, several other species are +mentioned throughout the tales: namely, the larch, the beech, and +the copper beech. In _The Adventure of the Copper Beeches_, this +description occurs: “The group of trees with their dark leaves shining +like burnished metal in the light of the setting sun....” + +Flower beds and borders are described in several of the tales. In _The +Sign of the Four_, we find that: “... just under the window a single +foot-mark was visible in the flower bed.” Also, in _The Adventure of +the Devil’s Foot_, a flower border lying underneath the window is +noted, but it contained no trace of a footprint. Obviously, footprints +are a necessary component of mystery stories; and what better place to +look for them than in the soft earth of a flower bed under a window? + +In all the stories, only a few flowers are specifically named: +crocuses, orchids, roses, and violets. In _The Hound of the +Baskervilles_, when Dr. Watson met the wife of the naturalist Stapleton +on the moor, she asked him to pick an orchid for her, and explained +that the moor was rich in them. This is supposed to have occurred in +the fall of the year. It seems singular that orchids would be in bloom +at that time. + +The amateur gardener will be sympathetically interested to read of +gardens and lawns which did not live up to expectations: “A small +garden sprinkled over with a scattered eruption of sickly plants +separated each of these houses” (_A Study in Scarlet_). In _The +Adventure of the Retired Colourman_, a sorry-looking garden is +depicted. It is pictured as going to seed and bearing every evidence +of gross neglect. In _The Red-Haired League_, an ill-kept lawn is +described: “... where a lawn of weedy grass and a few clumps of faded +laurel bushes made a hard fight against a smoke-laden and uncongenial +atmosphere.” + +Several welcome allusions are made to the odors of flowers or of +vegetation. The scent of flowers, gardens, greenhouses, trees, meadows, +swamps, and the decay of autumn leaves often bring back memories of +other times and places. In _The Naval Treaty_, we find “... the rich +scent of the garden ...”; and in _A Study in Scarlet_, we read of “... +the balsamic odours of the pine trees....” All of us have experienced +the refreshing and delightful odors of a flower garden, and those who +have been in the north, or in the mountains in almost any latitude, +remember with pleasure the clean smell of the evergreen trees. In _The +Adventure of the Lion’s Mane_, our attention is called to the scent of +thyme on the downs. I am sure that to many people the faintly exotic +aroma of thyme (which belongs to the mint family) is enjoyable. + +Some plants have a distinctly heavy, cloying odor--for example, certain +lilies. The effect produced may actually be unpleasant. Dr. Watson, in +describing a greenhouse, brings this out (_The Adventure of Charles +Augustus Milverton_). He speaks of the heavy fragrance of certain +plants which actually causes a choking sensation. The odor of decayed +plants arising from the treacherous Grimpen Mire is emphasized in _The +Hound of the Baskervilles_. Most of us are familiar with the miasmic +vapors which often arise from swampland. Presumably, everyone has his +own favorite odor. Some people enjoy the exquisite fragrance of the +rose, some that of the carnation, and others the faint and delicate +odor of the sweet pea. The city dweller who was raised in the country +may yearn for the sweet smell of newly mown hay, and, strangely enough, +may even long for the pungent ammoniacal smell of the barnyard. + +Throughout the tales, we find mention of bracken, bramble, bushes, +ferns, gorse, heather, hedges, laurel, lichens, rhododendron, shrubs, +and vines. We have already alluded to many of these. To my knowledge, +in only one instance is there a reference to blood-stained vegetation +indicating that a murder might have been committed. We find, in +_The Adventure of the Priory School_, that Holmes, to the horror of +Watson, held up some flowering gorse which was blood-stained. The +surrounding heather, too, showed evidence of old blood stains. It will +be remembered that these were found on the spot where the unfortunate +German master of the Priory School had met his death. + +Everyone interested in Sherlock Holmes will vividly recall the meeting +between Holmes and Professor Moriarty on the brink of the falls of the +Reichenbach. Dr. Watson inspected the spot shortly after the meeting: + + A few yards from the end the soil was all ploughed up into a patch of + mud, and the brambles and ferns which fringed the chasm were torn and + bedraggled. + + _The Final Problem_ + +The patches of mud and torn vegetation gave clear evidence of what had +taken place on the edge of the falls. We learn later, of course--much +to our surprise and satisfaction--that Holmes had, by his superior +skill, triumphed over his arch enemy. The meeting marked the end of +Professor Moriarty, the Napoleon of crime. + +Dr. Watson’s many allusions to botany give added charm to the tales, +and indicate not only his love for the flora of England but also his +zest for nature. + + + + + THE SURGICAL DOCTOR WATSON + +“... the thin white hand he laid on the mantelpiece ... was that of an + artist rather than of a surgeon.” + + _The Resident Patient_ + + +Dr. Watson professed to be a general practitioner of medicine. Such a +person is called upon from time to time to do minor, but under ordinary +conditions he does not attempt to do major, surgery. To my knowledge, +there is no particular reference to major surgery in any of the tales, +although one or two famous surgeons are mentioned. On the other hand, +numerous allusions are made to minor surgery. I am cognizant of the +fact that there is often but a thin line between major and minor +surgery. + +Dr. Watson evidently felt that a good surgeon must have large and +supple hands, for he writes: “... the thin white hand he laid on the +mantelpiece ... was that of an artist rather than a surgeon” (_The +Resident Patient_). The size of the hand probably is not of major +importance. It is the ability to use the hands that counts. Several +eminent surgeons, to my own knowledge, are men of large physical +stature, and I am sure have correspondingly large hands. But I have +seen some equally capable men, hardly of average height, who had small +hands. Harvey Cushing, the brilliant Harvard brain surgeon, was a man +of medium size, and, if I recall correctly, had rather small hands. Let +us not labor this point further, for this is not an essay on surgeons’ +hands, but turn to the tales of Sherlock Holmes. + +It is axiomatic that every man who practices medicine, regardless of +his specialty, must be familiar with the current literature in his +field. It is gratifying that Dr. Watson appreciated this. In _The +Adventure of the Golden Pince-Nez_, Watson observes that one stormy +night he and Holmes sat together in silence; the latter was working on +a palimpsest, while Watson was reading a treatise on surgery. + +Holmes appreciated that a correct diagnosis is of paramount importance +to a conscientious surgeon. In _The Problem of Thor Bridge_, we +find Mr. Neil Gibson, the “Gold King,” telling Holmes that he was +like a surgeon, because Holmes wanted to know every symptom before +he ventured a diagnosis. Holmes quickly retorted that this was quite +true, and strongly implied that his client was withholding important +information which Holmes needed before the mystery about which he was +being consulted could be solved. + +There are a number of references to scalp wounds or injuries to the +skull, or both. In the rough-and-tumble life a detective leads, it +might be expected that he would often see such injuries. Let us examine +some of them. + +Once Sherlock Holmes himself came under a surgeon’s care. The great +detective had been attacked on the street by two ruffians and had +been pretty roughly handled (_The Adventure of the Illustrious +Client_). Sir Leslie Oakshot, the eminent London surgeon who had +been called in, stated that Holmes had suffered lacerations of the +scalp and that several stitches were necessary. Holmes fortunately made +an uneventful recovery, and we learn that the stitches were taken out +on the seventh day. + +Dr. Watson describes a man in _The Adventure of the Solitary Cyclist_ +who had suffered a severe scalp wound. He had been found unconscious, +although the bones of the skull had not been penetrated. Another case +is mentioned which surely must puzzle the layman (_The Adventure +of the Dancing Men_). A bullet passed through the frontal portion +of the brain. The reader is assured that, although the patient was +unconscious, she would live. The medically trained person would think +immediately of an accidental lobotomy. + +One is reminded in this connection of the skull of a workman exhibited +in the museum of the Harvard Medical School. This rare specimen shows +an enormous hole made by a tamping bar. The bar passed through the +skull, and a considerable amount of brain substance was destroyed. +Remarkably enough, the patient did not die from this terrific injury, +but lived for a long time afterward--surely a most unusual case. +It should be added that he suffered an unfortunate change in his +personality following the accident. + +In several instances, the head injuries mentioned were immediately +fatal. For example, in _The Adventure of the Empty House_, an +expanding revolver bullet was fired into the victim’s head. In _The +Boscombe Valley Mystery_, we find that: “The head had been beaten +in by repeated blows of some heavy and blunt weapon.” In this last +story, Dr. Watson gets technical: “In the surgeon’s deposition it was +stated that the posterior third of the left parietal bone and the left +half of the occipital bone had been shattered by a heavy blow from a +blunt weapon.” But contrast the following nontechnical description: +“The injury from which the unfortunate veteran was suffering was found +to be a jagged cut some two inches long at the back part of his head, +which had evidently been caused by a violent blow from a blunt weapon” +(_The Crooked Man_). This is a good example of a wound so simply +described that anyone could easily understand and appreciate it. With +few exceptions, Watson never forgot that he was writing for laymen. + +Scalp wounds and injuries to the head are often used to dramatize +detective stories. The average layman instinctively feels that such +wounds are extraordinarily dangerous, and that people experiencing such +accidents are nearly always in a critical state. This, of course, may +or may not be true, because nature has provided a strong bony cage to +protect the brain. + +In _The Adventure of the Sussex Vampire_, there occurs a reference +concerning an orthopedic problem. Dr. Watson writes that the gait of +a fifteen-year-old boy suggested plainly that he had a weak spine. We +are further informed that a fall in childhood had brought about this +condition. The devoted father spoke of the lad as being an unfortunate +cripple and quite inoffensive. He was quite mistaken, for this +so-called inoffensive lad became so insanely jealous of his normal, +healthy baby half-brother that he tried to do away with him by use of +curare, the South American Indian arrow poison. When Holmes unearthed +this diabolic scheme, he reluctantly informed the boy’s unsuspecting +father. Holmes prefaced his remarks by stating that he was a busy man +and would come to the point quickly; and he used the simile that, the +swifter surgery is done, the less painful it is. + +The idea Holmes expressed in regard to swift surgery holds our +interest. In the early days, before the discovery of ether, surgeons +for obvious reasons attempted to perform operations in the shortest +possible time. Indeed, the skill of a surgeon was largely gauged by the +speed with which he could perform an operation. + +In at least two of the tales, the carotid artery was the focal point +of interest. In _The Adventure of the Creeping Man_, we find that +when Professor Presbury was viciously attacked by his wolfhound, the +teeth of the dog narrowly missed the carotid artery. In spite of the +rather severe hemorrhage which followed, it will be recalled that the +professor recovered. In _The Adventure of the Golden Pince-Nez_, +the victim was not as lucky. His carotid had been severed by an +old-fashioned sealing-wax knife, and death ensued in a short time. +Watson emphasized that the wound was small but deep. He was aware that +a large blunt instrument might have pushed the elastic artery aside +rather than piercing it. + +We find one reference to an amputation, although it was not performed +by a surgeon. Early one morning, there appeared in Dr. Watson’s +consultation room a young engineer who, during the preceding night, had +undergone a harrowing experience in which his thumb had been hacked off +by a vicious counterfeiter. The doctor was astounded when he saw the +wound: “It gave even my hardened nerves a shudder to look at it. There +were four protruding fingers and a horrid, red, spongy surface where +the thumb should have been. It had been hacked or torn right from the +roots” (_The Adventure of the Engineer’s Thumb_). + +When Dr. Watson asked the victim whether the wound had bled a +great deal, the answer was: “Yes, it did.... I tied one end of my +handkerchief very tightly around the wrist and braced it up with a +twig.” Watson’s succinct reply was: “Excellent. You should have been +a surgeon.” To satisfy the reader’s sympathetic curiosity, it should +be mentioned that Dr. Watson gave the patient a drink of brandy, and +cleansed and bandaged the wound. Since the thumb had been “torn right +out from the roots,” it seems that Dr. Watson should have taken a few +stitches to bring the cut tissues together. No such mention is made, +and it is to be hoped that the wound healed satisfactorily. + +It is noteworthy that this engineer must have had a rugged +constitution. Dr. Watson, after caring for the wound, took him to 221B +Baker Street, where he joined Holmes and Watson in eating a substantial +breakfast. Then, for the benefit of the consulting detective, he +related the night’s terrible adventure at some length. He next +accompanied Holmes and his companions on a train journey to Eyeford, a +little Berkshire village. This was a strenuous program. The question +arises, why did the kind Watson allow his patient to do all these +things? This young man should have received a narcotic to deaden the +pain, which must have been severe, and then should have gone to bed. If +the patient experienced difficulty in going to sleep, a hypnotic should +have been administered. In this instance, Dr. Watson placed himself in +an indefensible position. + +Let us now turn from injuries of the human flesh and consider something +relatively less gruesome. A surgical instrument is described and, +interestingly enough, the name of the manufacturer is given. Holmes +himself calls our attention to it: “... an ivory-handled knife with a +very delicate, inflexible blade marked Weiss & Co., London” (_Silver +Blaze_). Parenthetically, it should be stated that Weiss & Co., +are still famous makers of knives. Indeed, there are several in my +laboratory at the present time. + +When Holmes speaks of the singularity of this knife, and suggests to +Dr. Watson that surely this was in his line, the latter states, “It is +what we call a cataract knife.” Holmes replies, “A very delicate blade +devised for very delicate work.” The reader should be reminded that +the knife in question was not employed to murder a human being, but a +villainous horse trainer had intended to use it to cut the tendon of a +famous race horse. It will be remembered that the nefarious scheme was +never carried out, for the highly nervous thoroughbred animal killed +his trainer by kicking him on the head before the operation could be +performed. + +As far as I am aware, Watson did not make any specific mention of any +other surgical instruments in the tales. He does, however, on one +occasion make an allusion to a surgeon’s choice of his instrument +during an operation. He is commenting on Holmes’ selection of tools +when attempting to open the safe of the notorious blackmailer, +Charles Augustus Milverton, and points out that Holmes chose his +instruments with the same scientific precision as a surgeon about to +perform an important operation (_The Adventure of Charles Augustus +Milverton_). + +In the present essay, we have discussed only those cases which are +concerned with surgery. But in England the medical man is often +spoken of as a “surgeon,” rather than a physician or a doctor or a +general practitioner. We find such expressions in the Sherlock Holmes +stories: “And here comes the country surgeon ...” (_The Adventure +of the Copper Beeches_). Numerous other references could be cited, +but this one will suffice. Furthermore, a doctor’s treatment room is +spoken of as his “surgery.” This latter expression is often found, +especially in English novels. The villain Stapleton, in _The Hound of +the Baskervilles_, tells Dr. Watson that he had been visiting with +Dr. Mortimer, and that while they were in his “surgery,” Dr. Mortimer +had pointed out Dr. Watson through the window. In another instance, +we find, “The surgery, where I used to make up my drugs ...” (_The +Sign of the Four_). In this country, we would simply call it “the +doctor’s office,” or if we wanted to be more specific, his “treatment” +or “examining room.” These are minor differences, it is true, but they +are of passing interest. + +Some of the wounds so dramatically described by Dr. Watson surely +became severely infected, and the patient’s suffering must have been +considerable. Pasteur and Lister had already published the results of +their brilliant researches, and the medical profession was well aware +of the dangers of infections at the time. In spite of this, not much +could be done once the wounds began to suppurate, for the antibiotics +had as yet not been discovered. We may rest assured, however, that Dr. +Watson did all he could to alleviate the patient’s pain and to promote +healing of the wound. + + + + + SHERLOCK HOLMES, THE CHEMIST + + “A formidable array of bottles and test tubes, with the pungent + cleanly smell of hydrochloric acid, told me that he had spent his day + in the chemical work which was so dear to him.” + + _The Red-Haired League_ + + +Mention is made from time to time in the tales of certain chemical +problems which occupy the attention of the great detective. Moreover, +the chemical desk and chemical paraphernalia in the rooms at 221B +Baker Street are referred to frequently. Indeed, the reader would be +disappointed if they were not mentioned, for he has come to accept them +as he has the Persian slipper and the gasogene. Since we are living +in an age of chemistry, it is pertinent and timely to review Sherlock +Holmes’ interest in this important field. It is, moreover, of certain +intellectual and historical interest to examine--even though rather +superficially--the status of any phase of chemistry during the last +quarter of the past century, or, for that matter, of any period. At the +time of which we write, biological chemistry was still in its infancy, +but organic chemistry was already an important subject. + +In _A Study in Scarlet_, it will be remembered that when +Stamford took Dr. Watson to the laboratory of the medical school to +meet Sherlock Holmes, they found him working on a chemical problem. +So enthusiastic was Holmes that, even before Stamford had had an +opportunity to present Watson, Holmes sprang to his feet and cried: +“I’ve found it! I’ve found it!... I have found a reagent which is +precipitated by hemoglobin, and by nothing else.” He then acknowledged +the introduction, and made the famous remark, “You have been in +Afghanistan, I perceive.” + +Holmes proceeded next to give a demonstration of his new test: + + “Now, I add this small quantity of blood to a litre of water. You + perceive that the resulting mixture has the appearance of water. The + proportion of blood cannot be more than one in a million. I have no + doubt, however, that we shall be able to obtain the characteristic + reaction.” + + As he spoke, he threw into the vessel a few white crystals, and then + added some drops of a transparent fluid. In an instant, the contents + assumed a dull mahogany color, and a brownish dust was precipitated to + the bottom of the glass jar. + +Holmes was so well pleased that he added, “Now we have the Sherlock +Holmes’ test....” + +At this point a sour note can be injected. Assuming that Holmes did +discover a sensitive test for hemoglobin, it was nevertheless not +a specific one for human blood. The blood of many animals contains +hemoglobin. In a case of murder, for example, if blood were found on a +cudgel, a knife, or on the clothing of a suspect, it would still have +to be proved that it was human blood. This, incidentally, can now be +scientifically shown, but it is a long, delicate procedure. + +After Holmes had demonstrated his brilliant experiment, the trio sat +down, and Holmes and Watson discussed the possibility of sharing rooms. +Holmes volunteered, “I generally have chemicals about, and occasionally +do experiments.” Parenthetically, it may be stated that Watson on later +occasions complained about the odors produced by these experiments. As +we know, however, an agreement was reached, and perhaps the two most +famous characters in fiction decided to cast their lot together and +locate on 221B Baker Street. + +The staid Dr. Watson, after living with Holmes several weeks, took +it upon himself to make an appraisal of his unusual roommate. His +conclusions were that Holmes’ knowledge in certain areas, such as +literature, philosophy, and astronomy, was “nil,” but in the field of +chemistry, “profound.” + +Holmes as a college student had evinced a marked interest in chemistry. +When telling Dr. Watson the story of _The “Gloria Scott,”_ his +first case, he said: “All this occurred during the first month of the +long vacation. I went up to my London rooms, where I spent seven weeks +working out a few experiments in organic chemistry.” + +Holmes maintained his interest in chemistry throughout the years. +In _The Red-Haired League_, Watson describes how he called on +Holmes one day: “A formidable array of bottles and test-tubes, with +the pungent cleanly smell of hydrochloric acid, told me that he had +spent his day in the chemical work which was so dear to him.” When +Watson asked him whether he had reached a solution, Holmes answered in +the affirmative, and stated it was the bisulphate of baryta. Watson, +evidently disgusted said, “No, no, the mystery.” Holmes’ reply was: +“Oh, that! I thought of the salt that I have been working upon.” Today +one seldom hears the word “baryta” in this country; we speak of it as +“barium.” The bisulphate of baryta, therefore, which Holmes mentioned, +becomes barium sulphate. + +The hobby of the great detective, it appears, afforded him relaxation, +for we find: + + “Well, I gave my mind a thorough treat by plunging into a chemical + analysis. One of our greatest statesman has said that a change of work + is the best rest. So it is. When I had succeeded in dissolving the + hydrocarbon which I was at work at, I came back to our problem of the + Sholtos, and thought the whole matter out again.” + + _The Sign of the Four_ + +In his later years, Holmes must have missed his chemical experiments; +for once, when he was away from home, we find Watson writing that +his friend’s temper was on edge because he especially yearned for +his chemistry bench and his scrapbook (_The Adventure of the Three +Students_). + +Holmes was wont at times to announce the results of his chemical +researches in a dramatic manner. According to Watson, his hero was +not averse to seeking the limelight. We already have seen how Holmes +acted when he discovered an agent precipitated only by hemoglobin. He +insisted upon telling of his important discovery before giving Stamford +an opportunity of presenting Watson. We find another typical example in +_The Naval Treaty_: + + Holmes was seated at his side-table clad in his dressing-gown, and + working hard over a chemical investigation. A large curved retort was + boiling furiously in the bluish flame of a Bunsen burner, and the + distilled drops were condensing into a two-litre measure. My friend + hardly glanced up as I entered, and I, seeing that his investigation + must be of importance, seated myself in an armchair and waited. He + dipped into this bottle ... and finally brought a test-tube containing + a solution over to the table. In his right hand he held a slip of + litmus paper. + + “You come at a crisis, Watson,” said he. “If this paper remains blue, + all is well. If it turns red, it means a man’s life.” He dipped it + into the test-tube and it flushed at once into a dull, dirty crimson. + “Hum, I thought as much!” + +It is hardly necessary to point out that such dramatic chemical +discoveries so glibly announced by Holmes are rare, and it is not given +to any one individual to find many of them in a lifetime. + +Reference already has been made to the fact that the reader rather +expects Dr. Watson to make mention of the chemical bench when he +describes the rooms at 221B Baker Street. One imagines Dr. Watson of a +winter evening sitting in his rocking chair before the fire, absorbed +in a treatise on surgery while Sherlock Holmes is busily engaged with +some chemical problem. In _The Adventure of the Mazarin Stone_, we +find Watson writing that it was pleasant to find himself again at 221B +Baker Street, and that he felt at home when he saw the old chemical +bench, the chemicals, and the other paraphernalia in the living room. +Watson again mentions this in _The Adventure of the Empty House_, +where he speaks of the old landmarks, and especially of the chemical +corner. + +On one occasion, Watson described a small chemical laboratory in a +dwelling place. + + It appeared to have been fitted up as a chemical laboratory. A + double line of glass-stoppered bottles was drawn up upon the wall + opposite the door and the table was littered over with Bunsen burners, + test-tubes and retorts. In the corner stood carboys of acid in wicker + baskets. One of these appeared to leak, or to have been broken, for a + stream of dark-coloured liquid had trickled out from it, and the air + was heavy with a peculiarly pungent, tarlike odor. + + _The Sign of the Four_ + +This passage shows clearly that Dr. Watson was quite familiar with the +arrangement in chemical laboratories. + +Previously, it was mentioned that at their first meeting Holmes had +warned Watson that he preferred to do chemical experiments in his +rooms. The good doctor probably did not think much about it at that +time, but later he had occasion to get firsthand information. In _The +Musgrave Ritual_, Watson, telling how untidy Holmes was, states, +“Our chambers were always full of chemicals....” We find further, in +_The Sign of the Four_: + + He [Holmes] would hardly reply to my questions and busied himself all + the evening in an abstruse chemical analysis, which involved much + heating of retorts and distilling of vapors, ending at last in a smell + which fairly drove me out of the apartment. Up to the small hours of + the morning I could hear the clinking of his test-tubes which told me + that he was still engaged in his malodorous experiments. + +And again, in _The Adventure of the Dancing Men_, we find Watson +writing that Holmes was fouling the air with some malodorous chemical +experiment. And finally, in _The Adventure of the Dying Detective_, +Watson relates that the long-suffering Mrs. Hudson, too, often had to +put up with noxious odors emanating from Holmes’ chemical experiments. + +One wonders whether on occasion Watson regretted the day he agreed to +share an apartment with his famous friend. It may be that Watson, who +also had had considerable chemistry in his medical student days, did +not mind too much the ill smells which from time to time polluted their +living quarters; at any rate, there is no indication that Watson ever +thought of seeking other quarters on this account. + +Not only did Holmes’ chemical experiments fill the apartment with +unpleasant odors, but he also kept ungodly hours. In _The Adventure +of the Copper Beeches_, we find: + + The telegram ... came late one night, just as I was thinking of + turning in, and Holmes was settling down to one of those all-night + chemical researches which he frequently indulged in, when I would + leave him stooping over a retort and a test-tube at night and find him + in the same position when I came down to breakfast in the morning. + +This instance, as well as others just mentioned, clearly show that +Holmes was apt to devote long hours to his experiments. Evidently, he +thought nothing of sitting up until the small hours of the morning, or, +for that matter, all night, pursuing his researches. If young college +instructors in departments of chemistry showed such zeal, they surely +would soon gain recognition in their fields. Working all day and most +of the night, however, probably is too much to expect of the average +human frame. + +The casual reader naturally takes it for granted that Holmes’ love +for chemistry was due to his interest in crime detection; that is, +he intended to use the knowledge he gained from his experiments for +practical purposes. We recognize this today as applied research. I +would like to emphasize that Holmes was interested in pure or basic +research, too--in other words, research which has no immediate +practical value. Instances may be found in the tales to support this +view. I will mention only two: “That will do very nicely. Then perhaps +I had better postpone my analysis of the acetones, as we may need +to be at our best in the morning” (_The Adventure of the Copper +Beeches_). And, in _The Final Problem_, Holmes remarks rather +plaintively to Watson: “Between ourselves, the recent cases in which I +have been of assistance to the royal family of Scandinavia, and to the +French Republic have left me in such a position that I could continue +to live in the quiet fashion which is most congenial to me, and to +concentrate my attention upon my chemical researches.” + +His interest in basic research is rather remarkable, for in that day +there were comparatively few persons engaged in any type of chemical +research. Today, of course, there are thousands of chemists working in +institutions of higher learning and also in many industries. Indeed, +some of the chemists in large industrial plants are not only allowed +but encouraged to do basic research. + +We can conceive of Holmes as a famous professor of chemistry in a great +university. In _The Adventure of the Dancing Men_, Watson writes +that Holmes had propped his test tubes in a rack, and that he then +began to lecture like a professor addressing his class. As a teacher, +he might at times have been somewhat curt with his students and +probably impatient with the stupid ones, but at all times he would have +been fair. He had the energy, stamina, and enthusiasm not only to be a +stimulating teacher but a productive scholar as well. He would not have +been an armchair professor, but rather a leader in his chosen field. We +are thankful that he did not choose an academic career, for then the +delightful Sherlock Holmes stories never would have been written, and +the world would be a less interesting place in which to live. + +In closing, we can paint a pleasant picture of Sherlock Holmes in his +retirement in his comfortable home on the Sussex Downs. We can imagine +him in the long English twilight working at his chemical bench before +a large window overlooking the beautiful countryside. His fingers +are stained with acids, alkalies, silver nitrate, and other potent +chemicals. His pipe is going full blast, and his brow is probably +perplexed as he scans a recent learned treatise on the chemistry of the +aldehydes or the alkaloids. + +While his researches may be profound and manifold, it is more than +likely that he devotes his best efforts toward the detection of some +obscure poisons, with the hope that some scheming sinister criminal +may be brought to justice. Time does not hang heavily on his hands +in his retirement, for there is no end to chemical researches; +infinite problems present themselves to the prepared mind. With his +keen intellect, his wide knowledge, and his rich imagination, he has +doubtless outlined investigative work which will keep him happy and +busy for years to come. + + + + + DOCTOR WATSON’S UNIVERSAL SPECIFIC + + “... with the aid of ammonia and brandy, I had the satisfaction of + seeing him open his eyes.” + + _The Greek Interpreter_ + + +The therapeutic agent most frequently used by Dr. Watson was brandy. +Mention is made of this stimulant in a number of the tales. Let us +examine the conditions in which Dr. Watson’s favorite remedy was used. + +In _The Adventure of the Blue Carbuncle_, Sherlock Holmes had +accused the pathetic Ryder of stealing the valuable carbuncle. The poor +wretch turned pale, and Holmes remarked to Watson, “Give him a drink +of brandy.” In describing this incident, Watson writes, “For a moment +he had staggered and nearly fallen, but the brandy brought a tinge of +colour into his cheeks....” + +We find, in _The Adventure of Wisteria Lodge_, that when the +eminently respectable Mr. Scott Eccles was relating his strange +experience to Sherlock Holmes and Dr. Watson, Inspector Gregson of +Scotland Yard came in unannounced and informed Eccles that Mr. Garcia, +his host of the preceding night, had been found murdered. Dr. Watson +writes that their client turned deathly pale. Holmes quickly suggested +to Watson that he give Eccles a brandy and soda. This evidently helped +the poor fellow; he gulped it down, and his face soon resumed its +normal color. + +Dr. Watson, in the story of _The Greek Interpreter_, took credit for +saving the life of Mr. Melas, who was found locked in a room filled +with a poisonous gas. Holmes and Watson rushed into the room and +dragged out the victim. Dr. Watson writes that, “... with the aid of +ammonia and brandy, I had the satisfaction of seeing him open his eyes.” + +In _The Naval Treaty_, Holmes found the highly important document +which his client Mr. Percy Phelps thought had been lost through his own +negligence. The great detective invited him to have breakfast with him +and Watson; and when Phelps took the lid off the dish which was served +him, and saw the precious papers lying there, he became hysterical with +joy: “Then he fell back into an armchair so limp and exhausted with his +own emotions that we had to pour brandy down his throat to keep him +from fainting.” + +We learn, in _The Adventure of the Priory School_, that when Thorney +Huxtable, M.A., Ph.D., made his dramatic entrance and collapsed upon +Holmes’ bearskin hearthrug, both the detective and the medical man +extended helping hands. Holmes hurriedly placed a cushion under his +head, and Watson got ready to give him a drink of brandy. However, +the pompous fellow fell to the floor in a faint. When he regained +consciousness, he asked for some milk and a biscuit. This revived him, +and he then told his story. We do not know whether he was an abstainer +or not. + +Brandy evidently enjoyed a reputation as an effective stimulant even +among laymen. In perusing the tales, we find in one instance that it +was given by a tutor to his servant who had suffered a mental shock; +and in another, a constable intended to give it to a beautiful young +woman who, he thought, had fainted. Dr. Watson relates, in _The +Adventure of the Three Students_, how Mr. Soames, tutor and lecturer +at one of the great British universities, administered brandy to his +servant, Bannister. The highly nervous tutor thought his man had +disturbed the examination papers on his desk; and when Bannister saw +that the papers had been disturbed, he appeared as if he were about to +faint. Soames immediately gave him a drink of brandy; but, in spite +of the stimulant, Bannister appeared to be in a state of collapse, and +threw himself into a nearby chair. We shall never know whether or not +it was an actual collapse, the brandy failing to help, for later it +came out that the servant was desirous of concealing something on the +seat of the chair. We may safely assume, however, that in any event +Bannister welcomed the proffered drink. + +We learn from the pen of Dr. Watson, also, how Lady Hilda duped +Constable McPherson and obtained the precious blue envelope which +contained high state secrets (_The Adventure of the Second Stain_). The +crestfallen constable told Holmes that, when Lady Hilda had seen the +stain on the carpet, she apparently fell down in a faint. The constable +rushed outside to a nearby corner to procure some brandy, but when +he returned, the noble lady had disappeared. We wonder whether the +constable treated himself to the drink which he had procured for her. + +In two other instances--one related by Sherlock Holmes and the other +by Dr. Watson--brandy was administered with a lavish hand indeed, and +the inference may be drawn that the subjects probably drank about +all they could decently manage. In _The Adventure of the Lion’s +Mane_, Ian Murdock, who had come into contact with the jellyfish +_Cyanea capillata_, staggered into the room, on the verge of a +collapse, crying for brandy. Holmes, in writing this tale, tells how +he administered a half-tumbler of the stuff. The treatment appeared +to be of some help, but the patient was still in great pain. Holmes +gave him several more large drinks. Finally, Murdock’s head fell upon +the cushion in a state of unconsciousness. It was well that he did not +attempt to get up and walk. I doubt whether he could have stood up. + +In the second example, Victor Hatherly, a hydraulic engineer, had +suffered a terrifying experience (_The Adventure of the Engineer’s +Thumb_). In his effort to escape being crushed to death by the +powerful hydraulic press, he had torn off his thumb. When he presented +himself in Dr. Watson’s surgery and began to tell of his ghastly +experience, he became hysterical. Dr. Watson, who had given him a drink +of water previously, rose to the occasion: “I dashed some brandy into +the water, and the colour began to come back to his bloodless cheeks.” +He then proceeded to bandage the area where the thumb had been. This +must have been a most painful operation indeed, and it is hoped that +Dr. Watson did not spare the brandy. There is reason to believe that +he did not. Since the engineer wished to report the incident, Watson +took him to consult with Sherlock Holmes. The latter listened to the +engineer’s story, “... placed a pillow beneath his head, and laid +a glass of brandy and water within his reach.” Dr. Watson did not +indicate whether the patient was able to go home under his own power. + +Let us turn now to the longer tales of Sherlock Holmes. In _The Sign +of the Four_, when Jonathan Small was telling his story to Holmes +and his colleagues, the astute detective remarked to him: “... you had +best take a pull out of my flask, for you are very wet.” And a little +later: “He stopped and held out his manacled hands for the whiskey and +water which Holmes had brewed for him.” + +In _The Hound of the Baskervilles_, the reader will recall that the +Baronet, Sir Henry, was attacked by the spectral hound and miraculously +escaped death. Dr. Watson writes: “Lestrade thrust his brandy flask +between the Baronet’s teeth, and two frightened eyes were looking up at +us.” And, when Holmes asked him whether he was strong enough to stand, +the Baronet replied: “Give me another mouthful of that brandy and I +shall be ready for anything.” Brandy was given also to the beautiful +Mrs. Stapleton, the villain’s wife, when she was found in her house in +a pitifully exhausted state. + +Dr. Watson himself had need of brandy as a stimulant at least once in +his lifetime. He, like everyone else, believed that Sherlock Holmes had +died with Professor Moriarty at the Reichenbach Falls. We cannot blame +the doctor for fainting when, three years later, he saw Holmes in the +flesh standing on the opposite side of the study table. Watson claims +that this was the only time in his life he had ever fainted. When he +regained consciousness, he found that Holmes had undone his collar +and had administered brandy to him (_The Adventure of the Empty +House_). + +Brandy and whiskey are, of course, used medicinally today, but probably +not as frequently as several decades ago. Some scientists argue +that alcohol does not cause a physiologic stimulation but rather a +depression. Pharmacologically, this is true, for it is now accepted +that the talkativeness and hilarity so often produced by alcohol do not +indicate a true stimulation of the nervous system but a removal of the +inhibition which the higher centers normally exert. + +On the other hand, it is still held by many physicians, and some +pharmacologists as well, that brandy and whiskey are useful therapeutic +agents in emergencies. Dr. Torald Sollman, dean of American +pharmacologists, feels that alcohol is a quick-acting stimulant, and +has a definite place in treating conditions such as syncope, exhaustion +and certain forms of shock. He attributes its effect to reflex +stimulation, which accounts for its brief action.[4] He suggests that +a dose of 25 cc. (somewhat less than an ounce) of whiskey or brandy be +given, and that it be repeated every ten or fifteen minutes. + +Dr. Watson, throughout his stirring adventures with Sherlock Holmes, +was called upon to meet many emergencies. He was presumably justified +in resorting to frequent administrations of brandy. He had ample +opportunity for observing the effects of his medication, and apparently +was well satisfied with his results, for he continued to employ brandy +as a stimulant throughout the years. One practical justification for +doing so was that it seemingly always was available. There is every +reason to believe that Dr. Watson carried a flask of brandy, as did +Sherlock Holmes. Even Lestrade, the dependable Scotland Yard detective, +was not found wanting when the occasion demanded, as we have seen in +the story of _The Hound of the Baskervilles_. Apparently, it was +the practice of the day. + +In conclusion, we may rest assured that Dr. Watson was firmly convinced +that his favorite remedy, brandy, as he employed it, helped alleviate +the suffering of his unfortunate fellow men. We may accept, also, +that he administered it only in an emergency, and when he was morally +certain that there was a real indication for its use--in short, he +observed faithfully the ethics of his noble profession. + + + + + DOCTOR WATSON, ENDOCRINOLOGIST + + “The emotional qualities are antagonistic to clear reasoning.” + + _The Sign of the Four_ + + +The colorful story of _The Adventure of the Creeping Man_ has +always especially interested me, for the theme embraces the fascinating +field of endocrinology. The plot revolves around Professor Presbury, +the Camford physiologist, who is portrayed as a biological scientist of +international renown. It is in order to review briefly the setting of +the story. + +Professor Presbury, a widower in his early sixties, had fallen madly +in love with a very young girl, the daughter of one of his colleagues. +During the course of the love affair, he began to show pronounced +changes in personality; he became secretive, highly irritable at +intervals, and on occasion even savage. When this portly and dignified +physiologist began to do such astounding things as walking on all fours +and swinging on the ivy-covered walls with the abandon and agility +of an ape, he naturally caused grave concern to his only daughter +Edith and to his associate Mr. Bennett, Edith’s fiancé. Furthermore, +the professor’s heretofore faithful wolfhound Roy had tried to +attack his master on several occasions. Events came to such a pass +that Mr. Bennett and Miss Presbury asked Sherlock Holmes to make an +investigation. + +Holmes summoned Dr. Watson to 221B Baker Street one night in September, +and casually announced that he was seriously considering writing a +monograph on the uses of dogs in detective work. He observed that +the action of a dog often reflects family life, and gave as an +illustration the case on which he was presently working. He believed +that the changed behavior of the wolfhound toward his master might +prove to be an important clue in solving the mystery. In point of fact, +this eventually proved to be true. + +During this discussion, Mr. Bennett called on Sherlock Holmes and, +in the presence of Dr. Watson, reviewed the strange actions of the +professor and the dog’s attitude toward his master. He brought out the +important information that it was every ninth day when Presbury acted +so abnormally. With this latter fact in mind, it was not difficult for +Sherlock Holmes to arrange to be on hand at a time when the professor +would probably perform again his astonishing antics. + +Accordingly, one night Holmes and Watson secreted themselves in the +shrubbery in the professor’s extensive yard and awaited events. Holmes +had previously instructed Mr. Bennett to follow secretly his future +father-in-law should he venture out on this particular night. Their +vigil was rewarded, for about midnight the famous physiologist emerged +from his house clad in his dressing gown. To the astonishment of his +onlookers, he began walking on all fours. Dr. Watson describes his +further antics. The professor, with surprising agility, began to ascend +the ivy-colored walls, springing aimlessly from branch to branch, but +apparently hugely enjoying his singular powers. He finally tired of +thus disporting himself, came down to the ground, and moving along on +his hands and feet, made his way to the barn where Roy was tethered. +Remaining at a safe distance, he deliberately teased the dog until the +infuriated beast, having managed to slip his collar, sank his teeth +into the neck of the unfortunate professor. The two onlookers, with the +help of Bennett, rushed to the rescue; without their intervention, the +dog doubtless would have killed his master. + +Holmes had been working quietly on the case and had discovered that +Presbury, in his desire to regain the vigor of his youth, had connived +with an obscure Prague scientist who was attempting to unravel the +secret of rejuvenescence. Holmes found that this individual was +attacking the problem by studying the physiologic effects on man of the +administration of serum obtained from certain apes. The serum he had +prescribed for Professor Presbury had been prepared from the langur, a +large black-faced monkey which lives on the slopes of the Himalayas. +Holmes emphasized that the langur was both a climber and a crawler. +The implication is obvious; it accounts for the professor’s mode of +progression and his agility as a climber. + +Holmes, discussing the case later with Watson, remarked that it was the +untimely love affair with the young girl which had given the professor +the idea of trying to turn himself into a younger man. Holmes also +commented on the strange behavior of the wolfhound; he felt the dog +had turned on his master because he thought it was a monkey he was +attacking. + +The theme of this story is of interest particularly to biologically +trained men. About the time it was written, there was a great deal of +interest in the possibility of rejuvenation by the transplantation of +testicular glands or by an injection of their extract. The work of +Steinach and of Voronoff, the European physiologists, had received +immoderate publicity. + +The real pioneer in the study of rejuvenation was, of course, +Charles-Edouard Brown-Séquard (1818-94), who reported the results of +his experiments in June 1889 before the _Société de Biologie_. +This brilliant French psychologist during the course of the preceding +fortnight had administered to himself six subcutaneous injections of +the water extract of ground-up testicles of dogs or of guinea pigs. He +was then seventy-two years old. He enthusiastically reported that the +effects had been astonishingly beneficial, and firmly believed that +both his physical forces and his mental activities were enormously +improved. He claimed that he felt less fatigued at the end of the day, +which was quite important to him, since he spent long hours in his +laboratory. + +Brown-Séquard had such an enviable reputation as a scientist that +testicular extracts at once became widely and indiscriminately used. +The idea spread like wildfire. More than twelve thousand physicians +were administering testicular extracts to their patients before the end +of the year. Some of the more conservative physicians in England and +in the United States, however, were highly critical of Brown-Séquard’s +recent researches. They spoke derisively of the extract as “senile +folly,” “elixir of youth,” and made other uncomplimentary remarks. In +fairness to Brown-Séquard, it should be stated that he realized the +extract was not a panacea for all illnesses. But he did feel, up to the +time of his death, which occurred four years later, that testicular +extracts built up what he termed “nervous force.” + +It is now recognized by modern endocrinologists that the distinguished +Brown-Séquard had not controlled his experiments well. The testicular +extracts he used were probably inactive. If I may be technical about +it, he had made an aqueous extract which would leave behind the +hormones, which are fat soluble. It is known also that some of the +claims made by Steinach and by Voronoff were grossly exaggerated. + +It is possible that people who are not familiar with the science of +endocrinology might gain the impression that the administration of +ape serum could produce the effects so vividly described in _The +Adventure of the Creeping Man_. The concept that such a serum exists +is, of course, rank nonsense. Even though the tale is incredible, I +confess that I have always enjoyed reading it. This may be because it +is a story about a physiologist--and an unusual physiologist, for he +was also extremely wealthy. Parenthetically, mention should be made +that the story actually touches on science-fiction, which is at present +so much in vogue. + +The theme of rejuvenation has been used by numerous authors. One +story which comes to mind is the novel _Black Oxen_, written by +the late Gertrude Atherton, and published many years ago. This book +was widely read. The story, of course, was actually in the nature of +science-fiction. + +The subject of the renewal of youth is not as popular as it was some +years ago. There are still a few charlatans in the medical profession +who take advantage of the public and prescribe gonadal therapy +irrationally and even indiscriminately. These misguided medical men +make wild promises as to the permanent benefits to be derived from +administration of gonadal extracts. Indeed, there have been a few such +doctors in the United States, and one, at least, is reported to have +amassed a fortune. A few of these men have acted in good faith, and we +may charitably assume they believed that the administration of gonadal +extracts stimulated the libido of their patients or enabled them to +lead a more strenuous life. Be that as it may, many such practitioners +have acted on slender evidence, and they surely have, in a large +measure, the will to believe. + +Since the time Dr. Watson wrote _The Adventure of the Creeping +Man_, there have been highly important developments in gonadal +therapy. Testosterone, for example, a preparation from the male gonads, +is presently widely used and has a definite place in the therapeutic +armamentarium of any reputable physician. There are other preparations, +such as the estrogenic substances and progesterone, which have +therapeutic uses. These latter substances are extracted from the female +gonads. It would take us too far afield to elaborate on these or to +give the indication for their uses. There is good reason to believe +that there will be many new developments in this particular field, for +the science of endocrinology is still in its infancy. + + + + + GENETICS AND SHERLOCK HOLMES + + “The point under discussion was how far any singular gift in an +individual was due to his ancestry and how far to his early training.” + + _The Greek Interpreter_ + + +Allusions are made in several of the tales to the subject of +genetics--that is, the science of heredity. Many of the observations +set forth, although perhaps not entirely acceptable today, are +nevertheless intellectually stimulating. + +Nearly all human beings--some much more than others--are interested +in matters pertaining to heredity. Most of us like to hear about our +grandparents and even about our great-grandparents, despite the fact +that the deeds of some of our ancestors, and the lives they lived, may +cause us some embarrassment. + +In this connection, I am reminded of a statement made to me one evening +(a long time ago) by a distinguished Southerner of the old school, a +Kentucky gentleman, during a discussion of our ancestors. In effect, +he suggested that perhaps we should not examine the lives of our early +kinfolk too closely, because one of them might have been hanged as a +horse thief. + +When we uncover some irregularity in the behavior of our ancestors, we +often toss it aside by pointing out that after all they were products +of their times, which indicates, in part at least, that environment +was highly important. There is doubtless considerable truth in this +statement, but an honorable man in the eighteenth century probably had +(or anyway, _should_ have had) the same high standard of conduct +as an honorable man in the twentieth century. Rather than sermonize +further, let us turn to the tales of Sherlock Holmes. + +We find Doctor Watson and Sherlock Holmes talking together on a +beautiful summer evening. Doctor Watson writes: + + ... the conversation ... came round to the question of atavism and + hereditary aptitudes. The point under discussion was how far any + singular gift in an individual was due to his ancestry and how far to + his early training. + + _The Greek Interpreter_ + +Watson expressed the thought that Holmes’ faculty of observation and +his peculiar facility for deduction were due to his own systematic +training. Holmes ventured this was true only to some extent. When +Watson asked him why he thought it hereditary, Holmes replied, “Because +my brother Mycroft possesses it in a larger degree than I do.” + +Doctor Watson was amazed at this answer, and expressed the sentiment +that if any other man in England possessed greater keenness in +observation and deductive powers than did Sherlock Holmes, the public +would surely know of him. Watson hinted it was Holmes’ modesty which +caused him to extoll his brother’s powers. Holmes quickly made this +rejoinder: “I cannot agree with those who rank modesty among the +virtues. To the logician all things should be seen exactly as they are, +and to underestimate one’s self is as much a departure from truth as to +exaggerate one’s own powers. When I say, therefore, that Mycroft has +better powers of observation than I, you may take it that I am speaking +the exact and literal truth.” + +There are doubtless many people who would take issue with the thoughts +Holmes expressed. But they do contain more than a modicum of truth. +Is there not an expression to the effect that false modesty is not a +virtue? Does not the matter of intellectual honesty also enter into +this picture? We will not at this time pursue the matter further, +although it is tempting. + +Sherlock Holmes suggested to Dr. Watson that, since he had never +met Mycroft, it would be fitting for him to make his acquaintance. +Accordingly, they set out for the Diogenes Club, where Holmes assured +Watson that Mycroft, on account of his routine life, would be found +this very hour of the day. + +Watson was presented to this extraordinary person: + + ... his face ... had preserved something of the sharpness of + expression which was so remarkable in that of his brother. His eyes, + which were of a peculiarly light, watery gray, seemed to always + retain that far-away introspective look which I had only observed in + Sherlock’s when he was exerting his full powers. + +Watson has skillfully depicted the family likeness--that is, the highly +intelligent face and the dreamy and introspective look. Obviously, +Mycroft and Sherlock were both remarkably keen, alert men. + +At the Diogenes Club, Mycroft and Sherlock seated themselves before a +window which gave them a clear view of the street. As they sat there +conversing, two strangers were approaching along the sidewalk. Mycroft +called attention to them, and the following brilliant dialogue ensued: + + “Look at these two men ... coming toward us....” + + “The billiard-marker and the other?” + + “Precisely. What do you make of the other?” + +(Dr. Watson then explained that he noted some chalk marks on the +waistcoat of one of the men which was the only evidence of billiards +he could see, and that the other one was carrying several packages.) + + “An old soldier, I perceive,” said Sherlock. + + “And very recently discharged,” remarked the brother. + + “Served in India, I see.” + + “And a non-commissioned officer.” + + “Royal Artillery, I fancy,” said Sherlock. + + “And a widower.” + + “But with a child.” + + “Children, my dear boy, children.” + +Watson laughingly remarked that this was too much. Sherlock and Mycroft +assured him it was not. They pointed out some of the salient points +which had enabled them to make their astute conclusions. Among those +mentioned were that the man in question had the bearing of a soldier, +wore the expression of authority, and had a deeply tanned skin (which +suggested he had served in India). The fact that he was wearing deep +mourning indicated he was probably a widower. + +The dialogue actually was a contest of wits between Sherlock and +Mycroft. The latter obviously won when he said, “Children, my dear boy, +children.” This winning stroke Mycroft explained in this way: “He has +been buying things for his children.... There was a rattle which shows +one of them is young ... a picture book under his arm shows that there +is another child to be thought of.” + +When Mycroft had finished, Holmes merely turned to Watson and smiled, +not only to acknowledge his brother’s genius but also his superiority +in observation and deduction. + +Sherlock Holmes apparently believed firmly that heredity played an +extremely important part in the life of an individual. There is no end +to the argument among biologists whether heredity or environment plays +the more significant role in the development of an individual. It is +especially so with a person’s mental capacity. One who unfortunately +has inherited a mediocre mind will always be handicapped, to a degree, +regardless of his environment or training. The mental powers will +remain ordinary. Conversely, the individual who is endowed with a +keener intellect will always be potentially the intellectual superior +of his less fortunate brother. There is no doubt that training and +environment in general will aid both types of individuals, but even +the most ideal developmental conditions can not completely overcome a +deficient genetic constitution. + +In the story of _The Yellow Face_, it will be recalled that a +white woman had married a Negro. The child, according to the story, +had even a darker skin than her father: “It was our misfortune that +our only child took after his people rather than mine. It is often so +in such matches, and little Lucy is darker than her father was.” This +statement must be challenged. It appears incredible that a child born +of a white mother could be darker than her Negro father. If the mother +had had some Negro blood, then by certain arrangements of genes this +could have happened, but not otherwise. Dr. Watson doubtless is in +error in this instance. + +A hereditary likeness once enabled Holmes to solve a mystery (_The +Adventure of the Cardboard Box_). A maiden lady (Miss Cushing) +had received in the mail a small cardboard box containing two human +ears--one that of a woman. Holmes was called in, and during the course +of the investigation visited the receiver of this gruesome package. +He noted the resemblance of one of the severed ears to the ears of +the lady upon whom he was calling. Because of the striking likeness, +he felt certain that the person whose ear had been dismembered was a +close relative of the Miss Cushing whom he had come to interrogate. +Holmes remarks to Dr. Watson: “I perceived that her ear corresponded +exactly with the female ear I had just inspected.... There was the same +shortening of the pinna, the same broad curve of the upper lobe, the +same convolution of the inner cartilage.... It was evident that the +victim was a blood relation, and probably a very close one.” It will be +recalled that the dismembered ear proved to be that of Miss Cushing’s +sister. + +Holmes propounds an interesting theory of the development of the +individual, in _The Adventure of the Empty House_. Speaking of +the terrible Colonel Moran, he expressed the idea that the individual +represents the whole procession of his ancestors in his development, +and that the person becomes the epitome of the history of his own +family. Doctor Watson thought this rather fanciful, and Holmes’ +rejoinder was that he would not insist upon it. + +In _The Hound of the Baskervilles_, Holmes successfully demonstrates +by means of a family portrait that the villain Stapleton is actually +a Baskerville. It will be remembered that Holmes stands upon a chair +and uses his arm to cover the broad hat and the long ringlets depicted +in the portrait. Now that only the features are visible, the portrait +of old Hugo Baskerville boldly stands out. Watson is astounded when he +beholds the results. Holmes remarks that it was an interesting instance +of a throwback, apparently both physical and spiritual. + +The discovery that Stapleton markedly resembles one of his early +ancestors is not too surprising, for this surely could happen in any +family. The remarkable thing is that Holmes had had the acumen to cover +up certain portions of the old family portrait to make the face of +old Hugo Baskerville stand out. This clever demonstration would not +have occurred to many people. The extraordinary family resemblance +portrayed is a splendid example of atavism--that is, a reappearance of +the characteristics of a remote ancestor which presumably had been more +or less absent in intervening generations. The matter of atavism would +make a most interesting study. Therein lies the value and interest of +the old family album which used to grace the center table in the parlor. + +In _The Adventure of the Copper Beeches_, Holmes makes a neat +point in regard to the subject of heredity: “My dear Watson, you as a +medical man are continually gaining light as to the tendencies of a +child by the study of the parents. Don’t you see that the converse is +equally valid. I have frequently gained my first real insight into the +character of parents by studying their children.” + +This is an interesting analysis. Let us pursue the thought further. The +expression is often heard that a child’s behavior resembles that of one +of his parents. A popular way of putting it is that he is “a chip off +the old block.” This makes it appear that the pattern of behavior is +set up early in life. An old maxim has it: “As the twig is bent, so the +tree will incline.” + +The problem is not always as simple as Holmes suggests. It is true that +we all have seen fine and lovable children whose parents have similar +qualities. But we also have seen ill-mannered, nasty-tempered children +whose parents have fine characters and possess charming manners. One +is reminded of a statement attributed to the gentle and amiable Robert +Louis Stevenson: “It has been a source of perpetual mystification to +me where all the disagreeable medical students go to, and all the +admirable doctors come from.” + +I think the same may be said about some of the spoiled, unlovable +children. Many of them develop into sterling young men and women who +later in life carry on with noble purpose and high resolve. These +individuals often form the backbone of their community. + +The entire matter of heredity is a complicated one, and much is still +to be learned about the subject. It is extremely important in the +study and practice of medicine. There are some common diseases which +certainly run in families, such as migraine, high blood pressure +(hypertension), and diseases of the coronary arteries. And it is +definitely known that diabetes may be inherited. In my own experience, +I have known a father with diabetes whose three daughters had all +developed this condition early in life. There are other diseases just +as formidable: for example, certain neurological and mental diseases. +Any researches which may throw any light on the subject of heredity +should be encouraged. + +As we have seen, there are not many allusions in the Sherlock Holmes +stories to genetics. It is a pity that the topic of crime and heredity +was not touched upon. As far as I know, no specific reference is made +to it. I am not sufficiently acquainted with crime statistics to know +how commonly one would find several criminals in one family--that is, +in a single generation. However, one does think of those Missouri +bandits: the James brothers, the Younger brothers, and the Daltons. +Perhaps there are others. In any case, one would like to know whether +their parents or grandparents had criminal records. I submit, however, +that these last-named cases are rather special ones, for the James +brothers and their colleagues were products of an unusual period. +Doubtless, a black sheep may be found in an otherwise respectable +family. As Sherlock Holmes stated to Dr. Watson, once in a while a +carrion crow appears among the eagles (_The Adventure of Shoscombe +Old Place_). + + + + + THE ZOOLOGICAL DOCTOR WATSON + + “The coyote skulks among the scrub, the buzzard flaps heavily through + the air, and the grizzly bear lumbers through the dark ravines....” + + _A Study in Scarlet_ + + +Dr. Watson was a man of catholic tastes and diversified interests. Not +only was he a capable and experienced physician, but he was a man of +letters, an amateur detective, and an athlete of considerable ability. +No one, as far as I know, has emphasized his interest in zoology. +This trait is more apparent to those acquainted with the biological +sciences, but even the most casual reader cannot but notice the +frequent references to animal life. + +The plots in a number of the tales depend entirely upon a zoologic +background. In _The Adventure of the Lion’s Mane_, for example, the +death of a person as well as that of a dog are attributed to the +poisonous sting of _Cyanea capillata_, a huge jellyfish. A swamp adder, +which Watson describes as “the deadliest snake in India,” is used to +kill two people in _The Adventure of the Speckled Band_. In another +tale, the plot hinges upon the fact that a goose has swallowed a rare +jewel, which is eventually recovered from its crop (_The Adventure of +the Blue Carbuncle_). A race horse is answerable for the mysterious +death of his trainer (_Silver Blaze_). In _The Adventure of the Veiled +Lodger_, a lion is responsible for the dilemma of the unfortunate +lodger. The central theme in _The Adventure of the Creeping Man_ has to +do with the antics of a scientist who at times shows apelike qualities. +Finally, in _The Hound of the Baskervilles_, the grisly spectral hound +plays the title role. + +Let us consider first some references to the lower forms of life, +such as insects. The naturalist Stapleton, in _The Hound of the +Baskervilles_, was supposed to be an authority on butterflies and +moths, that is, lepidoptera. When he and Watson met one day on the +moor, the naturalist invited him to see his collection, which he +described as the most complete in the southwest of England. Later in +the story, when searching the house for the fiendish Stapleton, Dr. +Watson describes a room fitted up as a small museum with glass-topped +cases filled with butterflies and moths. + +The scholarly recluse Nathan Garrideb evidently was another such +collector, for when Holmes and Watson visited his house they found +cases of butterflies and moths on each side of the entrance (_The +Adventure of the Three Garridebs_). One must remind the reader +that butterflies are distinguished from moths by the shape of their +antennae, the former having clubbed antennae, the latter not. + +Two allusions are made to the antennae of insects. In _The Adventure +of the Illustrious Client_, the waxed tips of the Baron’s mustache +are likened to an insect’s antennae. The other is found in _The +Hound of the Baskervilles_. Dr. Watson, observing Dr. Mortimer, the +country practitioner, rolling a cigarette, remarks that his long and +quivering fingers remind one of the agility and restlessness of the +antennae of an insect. These descriptions are extremely apt, since the +antennae of insects are nearly always in motion. + +In _The Adventure of Black Peter_, Captain Peter Carey was found +one morning harpooned to death in a small shed near his house. Holmes +remarks that the captain had been pinned to the wall like a beetle on a +card. + +Let us go higher in the zoological scale. It is evident that Holmes +despised snakes, for he refers to them as extremely repugnant +creatures and remarks to Watson that watching them in a zoo gives him +a most unpleasant sensation (_The Adventure of Charles Augustus +Milverton_). A number of animals which live in the water are +mentioned: namely, fish, jellyfish, sharks, seals, and crocodiles. +For instance, when Holmes introduces his brother Mycroft to Watson, +the latter writes that Mycroft put “... out a broad fat hand like the +flipper of a seal” (_The Greek Interpreter_). And in _The Sign +of the Four_, Jonathan Small had the extreme misfortune of having +his leg bitten off by a crocodile. + +Birds are not neglected. In _The Adventure of the Solitary Cyclist_, +Watson tells how he and Holmes on one of their walks enjoyed the music +of the birds. On another occasion, he likens Holmes to a lank bird +(_The Adventure of the Dancing Men_). Watson, in _The Adventure of the +Priory School_, speaks of the plover and the curlew; and in _The Hound +of the Baskervilles_, the raven and bittern are used effectively to +accentuate the utter loneliness of the moor. The ravens croak loudly +behind the tor, and this is the only life stirring over the vast +landscape. When Watson one day asks the naturalist Stapleton what had +caused the bloodcurdling sound on the moor, the latter’s shifty reply +is that they had heard the cry of the last of the bitterns. In _A Study +in Scarlet_ occurs the felicitous expression: “... the buzzard flaps +heavily through the [desert] air....” In _The Adventure of Shoscombe +Old Place_, Holmes makes the pertinent statement, when speaking of +the weakness of Lord Robertson, that even among eagles one may find a +carrion crow. + +An occasional reference to the eggs of birds also occurs. Watson +writes, “... a young lady entered the room with a bright quick face, +freckled like a plover’s egg ...” (_The Adventure of the Copper +Beeches_). The cipher Holmes employed in _The “Gloria Scott”_ +contained the words, “pheasant hen eggs.” + +So much for the lower forms of life; let us move on to the mammals. +Attention is called to several small mammals--in _The Adventure of +the Crooked Man_, a mongoose; and in _The Sign of the Four_, a +stoat and a mole as well as a weasel. The reader may recall that other +names for a stoat are “ermine” or “ferret.” + +Large mammals are referred to more often. Dr. Watson writes, in _A +Study in Scarlet_, “The coyote skulks among the scrub ... and the +grizzly bear lumbers along the dark ravines....” Big-horn sheep also +appear: “... there stood a creature somewhat resembling a sheep in +appearance, but armed with a pair of gigantic horns. The big-horn--for +so it was called....” In this same story, bison are also to be found. +Holmes, exasperated when looking for footprints, says, “If a herd of +buffaloes happened along, there could not be a greater mess.” In still +another instance, Watson writes, “... the observer would have come to +the conclusion that one of those great herds of bisons which graze upon +the prairie land was approaching him.” A herd of bison is referred to +again in _The Boscombe Valley Mystery_. Holmes feelingly remarks, +“Oh, how simple it would all have been had I been there before they +came like a herd of buffalo and wallowed over it!” It is obvious that +Holmes was impressed with the immense herds of buffalo which once +roamed over the great plains of our romantic West. + +In _The Valley of Fear_, we come across an interesting analogy. +Holmes remarks to Watson that Porlock, although unimportant in his own +right, nevertheless takes on importance through his close touch with +the master criminal Professor Moriarty. He spoke of the relationship of +the two men as that of the pilot fish to the shark, or of the jackal +to the lion; that is, one was insignificant and the other formidable. +In this same story, our attention is called to two other mammals--the +wolf and the caribou. In _The Adventure of the Speckled Band_, we +are introduced to two African animals, the cheetah (reputed to be the +fastest animal on earth) and the baboon. And in _The Adventure of +the Creeping Man_, reference is made to one of the higher apes, the +langur, which is described as a large animal with a black face living +on the slopes of the Himalayas. + +When we read about large mammals, big-game hunting comes to mind, +at least to the sportsman. Several allusions to this exciting and +dangerous sport are found in the tales. In _The Naval Treaty_, we +read, “... it has the sort of excitement about it that the sportsman +feels when he lies beside the water course and waits for the big game.” +In _The Adventure of Black Peter_, we read again of the hunter’s +thrill while lying in wait for some unknown large beast to approach the +water hole. + +When Sherlock Holmes ironically introduces the terrible Colonel Moran +to Dr. Watson and Lestrade, he says, among other things, that the +Colonel is an outstanding big-game hunter, practically without peer, +and that his bag of tigers remains unrivaled (_The Adventure of +the Empty House_). In _The Adventure of the Bruce-Partington +Plans_, Holmes notes that it was such a foggy day in London that a +thief or murderer could roam the streets and pounce on his prey like +a tiger in the jungle. In another instance, Holmes tells Watson about +Count Sylvius, the famous big-game hunter who had stolen the Crown +diamond. The nonchalant detective facetiously remarks that if the +Count could add him (Holmes) to his bag of big game, it would be an +outstanding triumph (_The Adventure of the Mazarin Stone_). + +The numerous allusions to animal life in the tales show clearly that +Dr. Watson was keenly interested in zoology. This is not unexpected, +since he was a physician, and, as everyone knows, a student of medicine +has a broad training in the biological sciences. It is doubtful whether +a man untrained in biologic science could have used the references to +animals as accurately and as effectively as did Dr. Watson. + +Where did he obtain his love for zoology? Solely from his preparatory +studies in medicine? Probably not. Dr. Watson was an athlete and an +outdoor man. Such men frequently take a pronounced interest in plant +and animal life, since it is before their eyes a good part of the time. + +We may conclude, then, that Dr. Watson was not only a physician, an +amateur detective, an athlete, and a man of letters, but a zoologist as +well. In this age of specialization, it is refreshing to reflect that +Dr. Watson had such a wide range of interests. + + + + + DOCTOR WATSON, CARDIOLOGIST + + “Marsten had sprung out of his chair in a paroxysm of anger, when he + suddenly pressed his hand to his side, his face turned a dusky hue, + and he fell backward....” + + _The Sign of the Four_ + + +Dr. Watson did not profess to be a cardiologist, but rather a general +practitioner of medicine. There are more allusions to minor surgery +and to nervous disorders in the tales than there are to diseases of +the heart or circulation. There are, however, several references to +the latter which are of historical interest to medical students and +practicing physicians. + +Let us examine some of the references to cardiovascular conditions. In +_The Sign of the Four_, a sudden cardiac death already cited above +is described: + + Marsten had sprung out of his chair in a paroxysm of anger, when he + suddenly pressed his hand to his side, his face turned a dusky hue, + and he fell backward, cutting his head against the corner of the + treasure-chest. When I stooped over him, I found to my horror that he + was dead. + +The cause of death in this instance, so dramatically described, +presumably was produced by a coronary occlusion. It is noteworthy that +the patient was “in a paroxysm of anger” at the time he was stricken. +One is reminded of John Hunter, the famous English anatomist, who in +later life suffered from severe angina pectoris. He is reputed to have +said that he was at the mercy of any rascal who saw fit to make him +angry. Any intense emotion, of course, is capable of producing profound +effects on the cardiovascular system. + +It will be remembered in the novel, _The Hound of the Baskervilles_, +that Sir Charles Baskerville had a cardiac disorder. His friend and +physician, Dr. James Mortimer, had concurred that “Sir Charles’ +health has for some time been impaired, and points especially to +some affection of the heart manifesting itself in changes in colour, +breathlessness, and acute attacks of nervous depression.” One evening, +when Sir Charles was taking his customary walk between the rows of +yew trees, he saw the awesome hound; he became greatly frightened and +ran as fast as he could toward Baskerville Hall. He fell dead before +he reached the house. In this instance, the intense mental excitement +and the tremendous physical effort caused heart failure--perhaps +ventricular failure produced by a diseased myocardium rather than a +coronary occlusion. + +Physical exertion does not necessarily produce a coronary occlusion. It +was once thought that patients suffering from angina pectoris, or who +actually had coronary disease, should not exert themselves physically. +They were warned, for example, not to run to catch a streetcar. A +more liberal view is held today; most patients are urged to exercise +themselves. In point of fact, many coronary occlusions occur when the +patient is at complete rest or performing some slight task. + +An interesting allusion to cardiac neurosis may be found in _The Sign +of the Four_. When Dr. Watson was introduced to Thaddeus Sholto, +the latter became greatly excited and said: “A doctor, eh?... Have +you your stethoscope? Might I ask you--would you have the kindness? +I have grave doubts as to my mitral valve, if you would be so very +good. The aortic I may rely upon, but I would value your opinion upon +the mitral.” After Dr. Watson had listened to Sholto’s heart, and had +assured him that he had no cause for uneasiness, the patient turned to +Miss Morstan and said: “You will excuse my anxiety, Miss Morstan ... I +am a great sufferer, and I have long had suspicions as to that valve. I +am delighted to hear that they are unwarranted.” + +The above clearly depicts a man who is unduly, and probably needlessly, +alarmed about the condition of his heart; the diagnosis of cardiac +neurosis can obviously be made. This could have been brought about by +some physician who, in an ill-advised moment, had hinted to the patient +that he might be suffering from a cardiac disorder. Such a condition +is spoken of as “iatrogenic heart disease.” Unfortunately, a good many +people suffer from cardioneurosis, and the majority probably would be +benefited by consulting a psychiatrist. The doctor might be able to +ascertain the underlying cause for the patient’s fear. + +These passages from _The Sign of the Four_ show that Dr. Watson +was acquainted with valvular heart disease; they are, however, rather +farfetched, if not ludicrous, and probably could not be appreciated +by the nonmedical reader. Watson does not often attempt to show his +erudition or weary his readers by employing technical terms. A good +example of this matter-of-factness may be found in _The Crooked +Man_: “The injury from which this unfortunate veteran was suffering +was found to be a jagged cut some two inches long at the back part +of his head, which had evidently been caused by a violent blow from +a blunt weapon.” The above is written in a language that anyone can +understand. + +In the novel _A Study in Scarlet_, may be found an interesting +reference to an aortic aneurism. Jefferson Hope told Dr. Watson to put +his hand over his heart. Watson writes: + + I did so, and became at once conscious of an extraordinary throbbing + and commotion which was going on inside. The walls of the chest seemed + to thrill and quiver as a frail building would do inside when some + powerful engine was at work. In the silence of the room I could hear + a dull humming and buzzing noise which proceeded from the same source. + +Dr. Watson promptly diagnosed it as an aortic aneurism. Just before +Watson made his examination, Jefferson Hope had put up a terrific +struggle to escape capture, and it had taken four men to subdue him: + + So powerful and fierce was he that the four of us were shaken off + again and again. He appeared to have the convulsive strength of a man + in an epileptic fit. It was not until Lestrade succeeded in getting + his hand inside his neckcloth and half strangling him that we made him + realize that his struggles were of no avail. + +The remarkable thing is that this man was suffering from an aortic +aneurism which was on the point of bursting. Why the aneurism did not +burst during the terrific struggle will always be a mystery. We find +later in the story that it subsequently did burst. + +Several references to the pulse may be found in the tales. When +the pompous if dignified Thorney Huxtable, M.A., Ph.D., collapsed +in Holmes’ living room, Dr. Watson attended him, and described the +condition as one of severe exhaustion; he spoke of the pulse as being +thready in character (_The Adventure of the Priory School_). In +_The Adventure of the Stock Broker’s Clerk_, a man had tried +to hang himself, but Dr. Watson helped rescue him just in time. The +patient was placed on the floor, and the good doctor immediately felt +his pulse; he reported that it was feeble and intermittent. + +At the time Dr. Watson practiced medicine, more attention was probably +paid to the study of the pulse than now obtains. The experienced +physician knows that considerable information can be obtained by +studying the pulse. Not only can the rate be ascertained, but the +character of the beat as well: whether it is full or bounding, or +thready or feeble, and the like. By digital pressure on the radial +artery, a rough idea can be obtained of the systemic blood pressure, +and at the same time some information can be gained as to whether the +artery shows any sclerosis. + +Some physicians of the older school feel that the younger generation +of physicians neglects the pulse, and its study is becoming a lost +art. The more recently trained physicians are more apt to depend upon +certain instruments of precision. Be that as it may, we have already +seen that Dr. Watson attempted to gain as much information as he could +by feeling the pulse. + +On one occasion (_The Adventure of Shoscombe Old Place_), Dr. Watson +speaks of a failing heart; he describes a patient who had a dropsical +condition. When reading about a failing heart in English medical +literature, one cannot but think of William Withering (1741-99), who +was the first physician to employ digitalis therapeutically as a +single pharmacologic agent. He reported his findings many years before +Dr. Watson practiced medicine. It is singular that Dr. Watson never +mentioned any digitalis preparation in the Sherlock Holmes stories. +He does mention amyl nitrite, but not in connection with any heart +condition; he also mentions morphine as a drug to assuage pain, but +again not in connection with the heart. + +Since the time Dr. Watson practiced medicine in London, great strides +have been made in the diagnosis and treatment of cardiovascular +disorders. The electrocardiogram and other instruments have been +developed for diagnosing disorders of the heart and vessels. Methods of +treatment, such as the use of antibiotic drugs, and agents for reducing +high blood pressure, have been of inestimable value. + +In this country during the past few years, the citizens have become +increasingly aware of the value of research in cardiovascular disease. +It is noteworthy that a part of this interest was stimulated by the +fact that President Dwight D. Eisenhower suffered a coronary occlusion +and later a mild cerebral accident. + +In conclusion, when Dr. Watson practiced medicine, he did not have any +effective drugs at his disposal to combat hypertension, or any drugs, +such as dicumarol, to lessen the danger of further coronary occlusions. +We may be assured, however, that those agents he did have were used to +the best of his ability, and he did all he could to restore the patient +to health. No man could do more. + + + + + THE PHYSIOLOGIC DOCTOR WATSON + + “Surely your medical experience will tell you, Watson, that weakness + in one limb is often compensated for by exceptional strength in the + other.” + + _The Man with the Twisted Lip_ + + +Since I am a professional physiologist, references made to physiologic +matters in the tales are of especial interest to me. Physiology, as the +term is now used, may be defined as the science which deals with the +function of an organism and its parts, in contrast with anatomy, which +is concerned only with the structure of an organism. + +Dr. Watson took his work at the University of London Medical School, +and was graduated in 1878--eighty years ago. We may assume that he +received good training in physiology; at any rate, he apparently had +a healthy respect for this important science. Let us examine the +references he makes to physiologic matters in the tales. + + + _Physiologists_ + + +In _The Adventure of the Creeping Man_, a physiologist, Professor +Presbury, is the central figure. Dr. Watson speaks of him as a renowned +“Camford” physiologist. The word “Camford” is a happy choice. It +strikes one that it could be a combination of two words, Cambridge +and Oxford. Whether Dr. Watson had these two famous schools in mind, +I cannot say, but I am inclined to believe he did. It is noteworthy +that he depicts Professor Presbury as a wealthy man. On one occasion, +Sherlock Holmes and Doctor Watson called at Presbury’s home. The good +doctor wrote glowingly about the physiologist’s charming house and +beautiful grounds, and emphasized that the professor was surrounded +with every sign of luxury. + +This is truly an unusual picture, for not many professional +physiologists are wealthy, and they certainly are not surrounded with +luxury. Professor Presbury, fortunately, was an exception. He must have +been a wealthy man in his own right, or have married a woman of means, +for surely he did not become wealthy by teaching physiology. + +Professor Presbury’s assistant, Mr. Trevor Bennett, is interestingly +pictured as a handsome, tall young man, and elegantly dressed. He +was portrayed as having the shyness of the student rather than the +self-possession of a man of the world. We can readily understand his +shyness and his studious manner, but it is more difficult to imagine +his elegant appearance. Bennett, we find later, had a medical degree, +so perhaps he enjoyed a consulting clinical practice, which might +account for his exceptional elegance. + +Mr. Bennett’s careful grooming is in contrast to the usual situation, +because physiologists, I fear, do not have the reputation for being +well-dressed people. They are apt to be somewhat indifferent about +their personal appearance, especially when at work in the laboratory. +This is quite understandable, since they often work with such animals +as cats, dogs, and monkeys, and with even larger animals like sheep, +goats, and pigs. Some of the more fastidious scientists don old clothes +for such occasions, but this is not always convenient. At any rate, the +average physiologist is not known for his elegant appearance--and for +good measure, I will throw in the pharmacologists also! Several living +examples of each could be cited to prove my point, but I must refrain +from embarrassing my distinguished friends and colleagues. At least +Mr. Bennett may be considered an exception. + + + _Endocrinology_ + + +In the story discussed above, the author uses the theme of +endocrinology. Professor Presbury, widower in his early sixties, had +fallen madly in love with a very young girl. In his desire to regain +his lost youth, the professor administered to himself injections of +serum prepared from apes. A conniving Prague scientist had prepared the +material from the langur, which Watson dramatically described as one of +the higher apes, distinguished by a black face, and an inhabitant of +the slopes of the Himalayas. + +According to the story, the serum had a profound effect on the +professor. Following the serum injections, which he took at nine-day +intervals, he acquired the characteristics of an ape, not only by +simulating the mode of locomotion of this animal but by developing, +also, an uncanny ability to climb. + +One night, following a serum injection, the professor got into grave +difficulty when his heretofore faithful wolfhound Roy, which he was +bedeviling, attacked him viciously. As Sherlock Holmes told Dr. Watson, +the wolfhound thought he was attacking the monkey, not his master. +Presbury was saved by the quick action of Holmes and Watson. + +The plot is fantastic, but interestingly told. Today this story would +be regarded as science-fiction. It was written at a time when the +subject of rejuvenescence had been made popular by the endocrine +studies of Steinach and of Voronoff, the European scientists. The +father of endocrinological studies was, of course, Charles-Edouard +Brown-Séquard, who had reported his studies on testicular extracts in +1889. Dr. Watson was undoubtedly familiar with Brown-Séquard’s work. +In _The Adventure of the Creeping Man_, Holmes points out a moral +when he remarks to Watson that, if one leaves the straight road to +destiny, even the highest type man may revert to the animal. + + + _Digestion_ + + +Let us turn to the physiology of digestion. Dr. Watson obviously felt +that one should eat sparingly if brain work is to be done. We find him +saying that his friend Holmes had eaten no breakfast, because in his +more intense moments he allowed himself no food. Holmes contended that +he did not have energy to spare for both nerve force and digestion +(_The Adventure of the Norwood Builder_). On another occasion, +Holmes, when talking to Doctor Watson, emphasized the fact that +starvation refines the faculties. He insisted that during digestion the +brain is robbed of blood, because blood is needed in the splanchnic +area. Holmes insisted that he himself was a brain, and the rest of his +body a mere appendix (_The Adventure of the Mazarin Stone_). + +The ideas expressed in the above paragraph hold our physiologic +interest because, at the time Watson wrote, the concept he expressed +was the accepted one. Later work has shown that this theory is not +tenable. The modern view is that digestion does not influence the +blood supply to the brain. In point of fact, nature has taken careful +precautions to ensure the brain of a rich blood supply at all times +under normal physiologic conditions. + +Although the brain does not suffer in its blood supply during +digestion, it is well known that the body is capable of shunting blood +to those regions which are functioning and are, therefore, in need of +it. If a hearty meal is eaten, a rich supply of blood is required to +digest and absorb it. Athletes know that a large meal should not be +eaten before taking strenuous exercise. Indeed, if a substantial amount +of food be eaten preceding intense physical exertion, the athlete may +become nauseated or even vomit. + +The voluntary muscles need blood when functioning, and the greater the +amount of exercise, the more blood is needed. The circulatory system +cannot supply both the splanchnic region and the skeletal muscles under +these conditions, so some part of the body must suffer. The nausea and +vomiting are, in a measure at least, produced by anemia of the stomach. +In the example just given, there is also a nervous component, which in +some individuals plays an extremely important part. + +Let us return to the blood supply of the brain. There is some evidence +that the brain needs a slightly increased blood supply during lively +mental activity, but not all physiologists will accept these findings. +However, this may safely be stated: the metabolism of the brain is high +at all times and is not affected by mental work. If one indulges in +“heavy thinking,” one simply directs the activities of the nerve cells +in the brain, which already are active. + +If we accept the hypothesis that increased mental activity does call +for slightly more blood to the brain, then the mind actually may be +more keen and alert when the circulatory system does not have to +sustain the burden of digestion and absorption of food. The fact that +there is often a feeling of well-being following a satisfying meal does +not negate this concept. There are those who maintain that the mind +functions best during a state of moderate fasting. Dr. Watson evidently +believed this, as has been previously stated. All physiologists would +not agree with this concept. Undoubtedly, there is a wide individual +variation in this regard, and it would be unwise to make a sweeping +generalization. + + + _A Weaker Sex?_ + + +Dr. Watson implies, in _The Adventure of the Devil’s Foot_, that +physiologically the female has a weaker constitution than the male. +In this story, it will be recalled that two men and one woman were +exposed to the fumes of the powdered devil’s-foot root. Watson stated +that only the woman was killed, presumably because she was the more +sensitive. This is indeed a challenging statement. + +Considerable proof can be adduced to show that the female is hardier +than the male. The old cliché, “the weaker sex,” can be seriously +questioned. It is well known, for example, that women can withstand a +high blood pressure for years. In some instances, although by no means +all, it seems to do them but little harm, since in spite of it they may +live to a ripe old age. Hypertension in the male is generally a serious +condition. Many men die comparatively young from heart failure or from +cerebral hemorrhage due to hypertensive states. + +Recently, it has been shown that female animals, such as rats, can +withstand acute oxygen-want far better than males. I do not wish to +belabor the point that the female may be hardier than the male, but two +more bits of evidence can be presented. Data compiled by life-insurance +companies definitely show that there are more widows in this country +than widowers. Lastly, more boy babies die than girl babies. + +These arguments seem to prove convincingly that the male and not the +female is the weaker sex. The problem, however, is not as simple as +this, but space does not permit further critical treatment of the +subject. In fairness to Dr. Watson, it must be stated that many of the +facts just presented were not known when he wrote his entertaining but +gruesome story about the devil’s-foot root. + + + _Mental Development in the Young_ + + +We find, in _The Adventure of the Sussex Vampire_, an interesting +and significant reference to mental development in the young. Holmes, +speaking of a child, remarked in this story that the child probably had +a very well-developed mind, because his body had been circumscribed in +action. Obviously, a child who has a definite physical handicap cannot +romp and play like other healthy, vigorous children. He is forced to +find other outlets, and as a result probably reads a great deal, and is +likely, moreover, to be thrown in with older people. As a consequence, +his mind presumably is more precociously trained. There are many +physically handicapped children, and this entire matter deserves more +critical psychologic study than it has so far received. + + + _Curare and Physiology_ + + +Dr. Watson was acquainted, at least to a degree, with the action of +curare. Actually, he used it as a lethal agent in two of his tales: in +his novel _A Study in Scarlet_, and in his story, _The Adventure +of the Sussex Vampire_. In the former, he was careless of the way he +handled curare in his plot, for he ascribed actions to this drug which +it simply does not possess. But in the latter instance, he uses curare +in a masterly manner. He points out, for example, that if a child were +pricked with an arrow which had been dipped in a solution of curare, +death might ensue by muscular paralysis if the curare were allowed +to be absorbed. Incidentally, this story can be highly recommended +not only to physiologists and pharmacologists but to all medical and +biological students as well. + +It is likely that Watson became familiar with curare in his work in +the physiology laboratory, for about twenty years before he enrolled +in medical school, Claude Bernard, the famous French physiologist, had +published his studies on curare. + + + _Muscle Physiology_ + + +Let us now consider references to muscle physiology. Both Sherlock +Holmes and Dr. Watson are portrayed as splendid athletes. In _The +Hound of the Baskervilles_, Watson writes about their heroic +efforts to save Sir Henry from the awesome hound. He states that he +had never seen Holmes run as fast as he did that night. He remarks +further that he (Watson) was reckoned fleet of foot, but Holmes easily +outpaced him. In physiologic parlance, the muscles of Holmes and Watson +presumably had short reflex times. Some men are born fast runners. The +exact reason for this is not fully understood. Probably the entire +neuromuscular apparatus, including the higher nervous centers, is +implicated. Another factor is the mechanical advantage involved in the +muscle-bone relationship. All these factors undoubtedly have to do with +heredity. The entire picture is complicated. We do know, however, that +training alone cannot produce champions. + +In another instance, Holmes discusses with Watson the footprints +found in the yew alley, which were presumably made by Sir Charles +Baskerville. It looked as if he had walked on tiptoe for at least a +part of the way. Watson asked why Sir Charles had walked on tiptoe. +Holmes instantly replied: “He was running, Watson--running desperately, +running for his life, running until he burst his heart and fell dead +upon his face.” + +On another occasion, Holmes described the gait of a man: “... he was +running hard with occasional little springs, such as a weary man +gives who is little accustomed to set any tax upon his legs” (_The +Adventure of the Beryl Coronet_). On still another occasion, we find +an interesting reference to muscle physiology--one which only recently +has been scientifically demonstrated. In _The Man with a Twisted +Lip_ Holmes makes this pregnant remark: “He is a cripple in the +sense that he walks with a limp; but in other respects he appears to be +a powerful and well-nurtured man. Surely your medical experience will +tell you, Watson, that weakness in one limb is often compensated for by +exceptional strength in the other.” + +Muscle physiology is a highly specialized field. Considerable +information is known about the chemical changes which take place during +muscular contractions, but much more needs to be learned. One of the +factors of supreme interest is the short period of time required for +these complicated chemical and heat reactions. The problem is of more +than academic interest, for it must be remembered that, in spite of all +the modern machines at man’s disposal, the greater part of the work in +this world is still done by muscular activity. + +Any light thrown on the exact mechanism of muscle contraction +may eventually prove to be of extreme practical benefit. It is +indeed difficult to overemphasize this point. Finally, there are +certain serious disorders of muscular functioning which may not +only incapacitate individuals but actually cause their death. The +distressing condition of patients suffering from muscular dystrophy +is a poignant example. For this reason, if no other, a complete +understanding of muscular contraction is of paramount importance. + +Since the time when Dr. Watson studied physiology--eighty years +ago--there have been vast developments in this field of science. There +is hardly an area of scientific endeavor in which more research has +been done or is in progress. + + + + + SHERLOCK HOLMES AND DOCTOR WATSON, PERENNIAL ATHLETES + + “Sherlock Holmes was a man who seldom took exercise for exercise’s +sake ... he looked upon aimless bodily exertion as a waste of energy.” + + _The Adventure of the Beryl Coronet_ + + +Sherlock Holmes and Dr. Watson were unquestionably men of outstanding +athletic ability. Holmes was a single-stick player, a boxer, and a +swordsman (_A Study in Scarlet_). Watson had played rugby in +college, and probably had engaged in other collegiate sports. They were +strong men, quick of action and fleet of foot. + +Quickness of action surely was needed to save Sir Henry Baskerville +from the hound. It will be recalled that the fog from the Grimpen Mire +that autumn night had spread over the path which Sir Henry was to +follow from Stapleton’s house to Baskerville Hall. As a consequence, +the visibility was so low that Sherlock Holmes and his companions +could not see the hound until it was dangerously close to its intended +victim. Watson describes the episode dramatically: “Never have I seen +a man run as Holmes ran that night. I am reckoned fleet of foot, but +he outpaced me as much as I outpaced the little professional” (_The +Hound of the Baskervilles_). At any rate, we know that these +determined men, led by Holmes, reached Sir Henry just in time and +killed the hound before it could harm him. + +Watson’s statement, “Never have I seen a man run as Holmes ran that +night,” bespeaks high praise of Holmes as an exceptionally fast +man. Watson, when a college student, had doubtless seen first-class +trackmen perform, but nevertheless he distinctly implies that Holmes +as a runner was in a class by himself. Holmes was making an effort to +save a man’s life, but so were Watson and Lestrade, the Scotland Yard +detective. Holmes, it is true, had the build of a trackman, since he +was tall and lithe, whereas Watson had a decidedly burly physique, and +Lestrade is described as rather short in stature. Watson, despite his +stocky build, admits that he himself was a sprinter of parts, but he +was obviously no match for Holmes. + +Not only was Holmes a fast runner, but a skilled boxer as well. Watson +writes: “He was undoubtedly one of the finest boxers of his weight I +have seen ...” (_The Yellow Face_). A real compliment, for Watson +was a keen sportsman who probably had had occasion to attend many +boxing matches. Holmes was six feet tall--at least he so described +himself (_The Adventure of the Three Students_). The suggestion +has been made that he weighed about 11 stone (154 pounds) and had +a physique resembling that of Bob Fitzsimmons,[5] that is, he was +rangy. A boxer with a long reach has, of course, a decided advantage. +Holmes, too, was fast on his feet, as previously mentioned. Added to +these attributes, he had a superior intelligence, which enabled him +to analyze his opponent’s tactics and to outsmart him. He doubtless +was a dangerous man in the ring. There is evidence that this is so. He +gave an extremely good account of himself when he tackled such rough +customers as Roaring Jack Woodley (_The Adventure of the Solitary +Cyclist_), Joseph Harris (_The Naval Treaty_), and an anonymous +ruffian (_The Final Problem_); furthermore, the professional boxer +McMurdo (_The Sign of the Four_) had a high regard for Holmes’ +boxing ability. + +Besides being a runner and a boxer, Holmes was a wrestler of no mean +ability. He tangled with such villains as Colonel Sebastian Moran, +the second most dangerous man in London (_The Adventure of the Empty +House_); Professor Moriarty, the Napoleon of crime (_The Final +Problem_); and the vigorous and powerful German master spy Von Borck +(_The Last Bow_). It has been suggested,[6] and I believe rightly, that +Holmes used “baritsu” when dealing with these dangerous characters. +They were real killers and would have stopped at nothing. Sherlock +Holmes could not afford to take chances when he encountered them. In +many instances, Holmes had the dependable and powerful Watson at his +side; but whether alone or in company, we know he nearly always got his +man. + +We infer, especially from a certain episode, that Holmes possessed +muscles of steel and had an iron grip. It will be remembered that +on one occasion the fierce and gigantic Dr. Grimesby Roylott strode +unannounced into the chambers at 221B Baker Street. In a fit of temper, +he seized a poker, “... and bent it into a curve” (_The Adventure of +the Speckled Band_). After the unpleasant visitor had left, Holmes +without much apparent effort straightened the poker out--a task +requiring more strength than the initial bending. + +I have always felt that, in spite of this startling demonstration on +the part of Holmes, for sheer bull-like strength Dr. Watson undoubtedly +excelled him. It is true that once at least Watson met his match. +He relates that on one occasion he was assaulted by an extremely +powerful and active man who sprang upon him and nearly choked him +to death (_The Disappearance of Lady Frances Carfax_). This is +an unusual incident, and Watson must have been unprepared, for in a +rough-and-tumble fight he could take care of himself in fast company. +He had the courage and tenacity of an English bulldog, and, what is +more important, knew how to use his strength. Watson did not pretend to +be as quick on his feet as Holmes, but he had the other qualities just +mentioned to a superlative degree, and these count for a great deal in +a catch-as-catch-can bout. Holmes was cognizant of Watson’s prowess, +for once the great detective stated that when a man was in a tight +place there was no better man to have on one’s side than Watson. + +An interesting query can be posed: How did these men keep themselves in +reasonably sound physical condition? Watson does not help us to answer +this question satisfactorily, for he has this to say about Holmes: + + Sherlock Holmes was a man who seldom took exercise for exercise’s + sake. Few men were capable of greater muscular effort, and he was + undoubtedly one of the finest boxers of his weight that I have ever + seen; but he looked upon aimless bodily exertion as a waste of + energy, and he seldom bestirred himself save where there was some + professional object to be served. Then he was absolutely untiring and + indefatigable. That he should have kept himself in training under such + circumstances is remarkable, but his diet was usually of the sparest, + and his habits were simple to the verge of austerity. + + _The Adventure of the Beryl Coronet_ + +Watson makes two statements which especially require critical comment: +the first one, “Few men were capable of greater muscular effort ...” +and the second, “Then he was absolutely untiring and indefatigable.” +These statements are not convincing, because they are not consistent. +Watson plainly indicates that Holmes did not believe in training; and +when the record is examined, we discover that actually both Holmes and +Watson led sedentary lives. Neither of them engaged in any sport while +residing at 221B Baker Street. The only exercise they took, when not +working on a case, was walking. + +It might be in order to digress a moment and speak of the physiology +of exercise. As far as physical training is concerned, we know that +there is no substitute for strenuous exercise. The physiology of +training is not yet well understood, and but few objective criteria +are recognized. There is one criterion, however, which is widely +known, and that is the muscular hypertrophy produced by exercise. The +classical example is the tremendously developed muscles of the arm of +the blacksmith. Most of us in childhood learned Longfellow’s apt lines: +“The smith, a mighty man is he, with large and sinewy hands; And the +muscles of his brawny arms are strong as iron bands.” + +Besides muscular development, there are other factors, although +less objective in character and less clearly understood, which are +brought about by training. Among these are adaptive changes in the +cardiovascular and respiratory system, and certain chemical changes in +the blood. + +Several examples can be given to show that Dr. Watson appreciated the +physiologic symptoms brought about by lack of physical training. On +one occasion, he describes the unexpected visit to 221B Baker Street, +upon a winter’s morning, of Mr. Alexander Holder, the financier of +Threadneedle Street. “He was a man of about fifty, tall, portly, and +imposing ... he was running hard, with occasional little springs, such +as a weary man gives who is little accustomed to set any tax upon his +legs.” Watson continues: “... the man, puffing and blowing, rushed at +our door ...” (_The Adventure of the Beryl Coronet_). This excited +and distracted individual finally composed himself and apologetically +explained that, instead of taking a cab (because cabs go slowly through +the snow), he had hurried to Baker Street on foot. Said he: “That +is why I was so out of breath, for I am a man who takes very little +exercise.” In this connection, one is reminded of Lewis Carroll’s lines: + + “But wait a bit,” the Oysters cried, + “Before we have our chat; + For some of us are out of breath, + And all of us are fat.” + +On another occasion, Watson discloses that, because of his sedentary +life, he became “blown” and was forced to slow down, whereas Holmes +never faltered, because he was always in training. Watson admitted +that his sedentary life had begun to tell upon him and he had to +fall behind. Holmes, on the other hand, never slackened his pace, +and apparently had an inexhaustible supply of nervous energy (_The +Adventure of the Solitary Cyclist_). + +Another example is found in _The Hound of the Baskervilles_. It +will be remembered that, on a damp, sullen evening, Dr. Watson and Sir +Henry attempted to catch the escaped criminal Selden, who was hiding +out on the moor. Watson, in his report to Holmes, writes: + + We were both swift runners and in fairly good training, but we soon + found that we had no chance of overtaking him.... We ran and ran until + we were completely blown, but the space between us grew ever wider. + Finally we stopped and sat panting on two rocks.... + +In this instance, Watson mentions that he was in fairly good physical +condition, although he does not tell us how he managed to reach +that state. We must assume that he had been keeping his weight +down by dieting and probably taking long walks on the lonely moor. +These two factors alone, however, are not sufficient to fit a man +for extraordinary and prolonged physical exertion. As pointed out +previously, the only way this can be done is by daily, well-regulated, +arduous exercise. + +In the matter of physical fitness, there is another side of the shield +which we must examine. A few individuals, although not many, in spite +of their sedentary habits, are apparently at all times physically fit. +The muscles of these men seem to keep their firmness and power even +though they are but little used. This is difficult to understand. +Sherlock Holmes probably was one of these unusual people. + +I doubt whether Watson would fit into this category. The good doctor +probably had a tendency to put on weight rather easily, and one gets +the impression from reading the tales that Watson liked his three +square meals each day. He was, to my mind, a typical beefeater. +Furthermore, he smoked a great deal, but for that matter so did Holmes. +Smoking is thought to interfere with physical fitness; it is said to be +“hard on the wind.” Athletes in training are invariably forbidden to +smoke. Just how smoking affects physical fitness is not known. It is +generally conceded, however, that tobacco in any form, especially if +used to excess, reduces both mental and physical efficiency. There is +considerable scientific proof for this statement, although this is not +the place to present it. + + +The beneficial effect of even a moderate amount of exercise has been +questioned by otherwise intelligent men. A brilliant colleague of mine, +for example, contends that the only thing exercise does is to make one +fit for still more exercise _ad infinitum_. Well, in a measure this +is true, for exercise really is the basis of training, as has been +repeatedly emphasized. One famous educator in this country has publicly +stated that, when he feels like exercising, he lies down until the +feeling passes away. Then there is the story of Chauncey Depew, who +lived to the age of ninety-four. When asked what exercise he took to +maintain his health, he replied: “The only exercise I have ever taken +is to serve as pallbearer for my friends who exercised.” I suspect +that these members of the intelligentsia, in their zeal to make their +points, have purposely overstated their case. + +Be that as it may, many people insist that a certain amount of exercise +causes them to feel better. Admittedly, it is difficult for them +to explain just what is meant when they say “feel better”--it is a +subjective rather than an objective matter. Several reasons can be +mentioned, however, why moderate exercise seems beneficial to many +people. + +To those whose work keeps them constantly at a desk, exercise comes as +a welcome relief from monotony. Physiologically, we know that a change +of occupation in many instances is as good as a rest. A brisk walk +through the park--or better still, in the country--brings to the eye a +shifting panorama and relieves boredom and fatigue. Many people enjoy +sports, such as a leisurely swim or a short round of golf. The pursuit +of these not only calls for exercise, but rests the mind from vexing +problems. In fact, there is something intangible about it all; in many +individuals, a pronounced psychic component unquestionably plays an +important part. Keeping fit, for example, often produces a mental lift +and makes some people feel quite content with themselves. This feeling +may assume sizable, if not untoward, proportions. The person who takes +exercise regularly, who keeps his waistline down, and maintains himself +in a fairly good physical state, may feel smug and distinctly superior. +He often looks down with pity at his friends who do not believe “in +exercise for exercise’s sake,” and, we might add, whose figures confirm +and illustrate the fact. + +In discussing the philosophy of exercise, we wish to make clear that +there is no proof that strenuous muscular activity is beneficial to +the body. Indeed, great physical exertion in those past middle age +may be deleterious to the organism. The late distinguished English +physiologist, Professor F. A. Bainbridge, has happily stated: “The +exercise consequent upon the ordinary activities of life is sufficient.” + +Exercise, however, should not be counted upon to bring about +weight reduction. It has been shown, for example, working with +marathon runners at the Harvard Fatigue Laboratories, that it took +two and one-half hours of steady running to burn up two pounds of +carbohydrates. It has been facetiously pointed out that the most +telling exercise leading to a trim figure is the simple procedure of +pushing the chair away from the dining table. + +The current belief is that people who keep reasonably fit appear +healthier than those who do not. Watson caught this thought when he +wrote that Mr. Garrideb had a cadaverous face, his skin was dull, and +it resembled that of a person who never exercised (_The Adventure of +the Three Garridebs_). + +In passing, we find a reference concerning a means of taking exercise +which shows the austere Holmes in a light frame of mind. He twits +Watson about an individual’s using only one dumbbell, and facetiously +states that such a person would not develop his muscles symmetrically, +and as a consequence might suffer from curvature of the spine (_The +Valley of Fear_). Holmes does not tell the whole story. The +single dumbbell which worried him could have been used alternately +by the right and left hand, and thus unilateral development would be +prevented. Watson, as a medical man, knew this; but like a good soldier +he let Holmes have his fun and made no reply. + +In conclusion, we may say that the principal question we have raised +still remains unanswered: that is, how did Holmes and Watson keep +themselves in good physical condition? This will always be a mystery. +Search as we will, we can find no evidence that either Holmes or Watson +kept himself in training. This seems remarkable since there were times +when they needed strength and stamina in order to put their foes out +of commission, and indeed there were occasions when their very lives +depended upon it. + +It is difficult to believe that unless Holmes and Watson kept +themselves in fairly good condition they could have held their own +against strong and desperate men, who presumably were in good fighting +form. When one considers how important it was for our heroes to keep +physically fit, one is drawn to the irresistible conclusion that they +actually took much more exercise and kept themselves in far better +training than appears in the tales. Besides their long walks through +London, they probably took setting-up exercises at 221B Baker Street. +They may even have done some weight lifting or have used dumbbells +(since Holmes was so concerned about finding a single dumbbell); +perhaps they boxed with each other. It is even possible that they did +some swimming. It will be recalled that, after his retirement, Holmes +frequently went swimming (_The Adventure of the Lion’s Mane_). They may +have engaged in still other forms of exercise. I, for one, am ready to +believe that they did not lead such sedentary lives as Dr. Watson would +have us think. + + + + + THE THERAPEUTIC DOCTOR WATSON + + “I had obtained good results in such cases by the inhalation of + nitrite of amyl....” + + _The Resident Patient_ + + +John H. Watson, M.D., practiced medicine in the city of London in the +early eighties of this past century. This was a long time ago--nearly +seventy-five years. At the time of which we write, Roentgen had not +as yet discovered the X-ray, and Ehrlich’s “606” (salvarsan) was not +available for the treatment of syphilis. Banting and Best, the Canadian +physiologists, had not given insulin to the world, nor had Minot and +Murphy of Harvard discovered that liver extract was an efficient +agent in the treatment of pernicious anemia, a heretofore fatal blood +disease. The sulfonamide drugs and the antibiotics, such as penicillin +and streptomycin, presumably were only a dream. + +From what has been related, it appears that Dr. Watson’s therapeutic +armamentarium, insofar as efficacious drugs are concerned, was sadly +limited. But the fact must not be forgotten that he had at his command +a number of powerful medicines: morphine, cocaine, belladonna, and +strychnine, to name a few. + +Let us turn to the stories and see what medicines Dr. Watson used in +his practice and under what conditions they were employed. + +It appears that iodoform and silver nitrate were well known drugs, +for Holmes on one occasion remarked to him: “... if a gentleman walks +into my rooms smelling of iodoform, with a black mark of nitrate of +silver upon his right forefinger.... I would be dull indeed if I do not +pronounce him to be an active member of the medical profession” (_A +Scandal in Bohemia_). + +Iodoform was introduced as an antiseptic about the year 1879. For +many years it was widely employed as a dusting powder, especially +to diminish infection of open wounds and to promote granulation. +Its persistent and penetrating odor, as well as its relative +ineffectiveness, gradually brought it into disfavor. This is probably +just as well, for its use is not entirely without danger, especially +when iodoform is applied over an extensive area where a good deal of it +can be absorbed. + +Silver nitrate still enjoys a wide usage. It is employed to produce +astringent, antiseptic, and caustic effects. Even many laymen know that +silver nitrate will remove “proud flesh.” Unfortunately, it has the +property of staining the skin “with a black mark” (as Holmes remarked), +which incidentally is often difficult to remove. It may persist until +it is virtually worn off, although recent and superficial stains can be +removed by painting the area with a ten per cent solution of potassium +iodide. + +As might be expected, Dr. Watson found it necessary on several +occasions to resort to morphine to alleviate pain. We find, for +example, that when Kitty Winter, the cast-off mistress of the +infamous Baron Gruner, threw vitriol in the Baron’s face, Dr. Watson +administered a hypodermic of morphine to the wretched Baron to ease +the intense suffering (_The Adventure of the Illustrious Client_). On +another occasion, when Professor Presbury was savagely attacked by +his wolfhound, Watson immediately gave morphine to the unfortunate +professor (_The Adventure of the Creeping Man_). In still another +instance, when Carlos, the mastiff, had attacked Rucastle, Watson +probably would have used morphine had he had it in his possession. He +wrote: “I did what I could to relieve the pain” (_The Adventure of the +Copper Beeches_). He did not state, however, what agent he employed. + +On one occasion, at least, it was necessary to administer morphine +to Sherlock Holmes. He had been attacked and beaten severely by two +ruffians. Sir Leslie Oakshott, the eminent London surgeon, had been +called in on the case. He later tersely remarked to Watson that +Holmes suffered from lacerated scalp wounds, and there were also some +bruises. It had been necessary to take several stitches. Morphine had +been administered (_The Adventure of the Illustrious Client_). +Morphine, because it is a dangerous habit-forming drug, should be +used only when absolutely indicated. It is noteworthy that Dr. Watson +administered morphine only when the patient had suffered a grave +physical injury. He is to be commended for his conservative attitude. + +On many occasions, when assisting Sherlock Holmes with his cases, +Dr. Watson found it necessary to administer a stimulant to those +individuals who had suffered a physical injury or had been under great +emotional stress. His favorite remedy for such conditions was brandy. +Numerous instances may be cited when this agent was employed as an +emergency measure. Dr. Watson obviously believed firmly in the efficacy +of brandy as a stimulant, and, indeed, claimed to have saved the life +of an individual by its use: + + Mr. Melas, however, still lived, and in less than an hour, with the + aid of ammonia and brandy I had the satisfaction of seeing him open + his eyes, and of knowing that my hand had drawn him back from that + dark valley in which all paths meet. + + _The Greek Interpreter_ + +Dr. Watson in this beautiful passage expresses the wish of every +physician. + +Brandy and whiskey were not the only stimulants used by Dr. Watson; in +point of fact, he employed several others. We have noted previously +that ammonia was administered along with brandy to Mr. Melas, the +Greek interpreter. Physicians will recall that ammonia is the principal +ingredient in so-called smelling salts. The vapors of ammonia when +inhaled stimulate the medullary centers, causing an increase in +respiration, and by action on the vasomotor center produce a rise in +blood pressure. + +In his heroic efforts to save the life of a woman who had been +chloroformed nearly to death, Dr. Watson gave ether intravenously with +successful results (_The Disappearance of Lady Frances Carfax_). +At any rate, he records that the patient regained consciousness. Ether +is not often given in this manner as a stimulant, and the question +could be raised whether it was indicated under the condition which +faced Dr. Watson. I am afraid that this was an instance in which the +patient lived in spite of the treatment. + +A popular and effective stimulant, namely, caffeine, was used to bring +a young woman out of a stuporous state produced by opium. Dr. Watson +relates that a couple of cups of very strong coffee brought her out of +this state (_The Adventure of Wisteria Lodge_). Dr. Watson used +the classical agent. Strong coffee is still used today in morphine +poisoning, although relatively new preparations, such as metrazol, +nikethamide, and amphetamine are at present the drugs of choice. Coffee +is, of course, easy to obtain, is a relatively harmless stimulant, and +has the pleasing virtue of not producing disagreeable aftereffects. + +On one occasion, the nature of the stimulant administered was not +disclosed. We find the following: “... while his nurse poured him out +a glass of some stimulating medicine” (_The Naval Treaty_). We +can only guess at the contents of the glass, but more than likely it +contained either brandy or whiskey. We have previously pointed out that +these agents were frequently prescribed as stimulants. + +Dr. Watson, strangely enough, administered amyl nitrite to a patient +who presumably was suffering from catalepsy. He writes, “I had +obtained good results in such cases by the inhalation of nitrite of +amyl....” (_The Resident Patient_). It will be recalled that +this rather rare condition is characterized by a rigidity of all the +skeletal muscles; the patient, as a consequence, tends to remain in any +position in which he is placed. The reason Dr. Watson used amyl nitrite +in this instance is not clear. The nitrites are frequently prescribed +to reduce systemic blood pressure or to relieve angina pectoris. Surely +there is no evidence in the literature that the nitrites are of aid in +cataleptic states. We can dismiss the matter by assuming that in this +instance Dr. Watson used amyl nitrite empirically. + +Oil is mentioned as a therapeutic agent in at least two of the +stories. Both Dr. Watson and Sherlock Holmes had occasion for its use. +When Baron Gruner had vitriol thrown in his face, Dr. Watson tried +to alleviate the poor wretch’s pain by bathing his face in oil and +applying cotton to the raw areas (_The Adventure of the Illustrious +Client_). + +On another occasion, Holmes relates how he treated Murdoch, who had +come into contact with the giant jellyfish. He used cotton-wool which +had been soaked in salad oil; and he related that this application +greatly relieved the pain (_The Adventure of the Lion’s Mane_). +This adventure took place in the country, and we may assume that there +was little, if any, medication on hand. The patient was suffering +intensely, and Holmes did what he could to assuage the pain with the +material he had at his disposal. He showed real ingenuity by making use +of a homely preparation. Morphine obviously was badly needed, and it +is a pity that Dr. Watson was not there to administer it. But it must +be remembered that, at the time this happened, Holmes had retired to +the Sussex Downs and Dr. Watson was in London. A perusal of the story +shows, however, that the patient had been given liberal quantities of +brandy, so perhaps he got along fairly well without morphine after all. + +Dr. Watson used carbolized bandages to dress the hand of the +unfortunate hydraulic engineer who had, a few hours previously, +lost his thumb in an adventure which nearly cost him his life. “I +sponged the wound, cleansed it, dressed it, and finally covered it +over with cotton wadding and carbolized bandages” (_The Adventure +of the Engineer’s Thumb_). Carbolized bandages are no longer used +in present-day surgery. Historically, it is of interest to record +that carbolic acid became widely known as an antiseptic through its +introduction by Lister in 1867. + +Dr. Watson does not often mention hypnotics. We find in one of his +stories that it was the custom of an invalid, Mr. Percy Phelps, to take +some sleeping potion: “... you did not take your usual draught that +night” (_The Naval Treaty_). We shall never know what the “usual +draught” contained. The barbiturates which are so widely used today +were unknown when Dr. Watson practiced medicine. Bromides were employed +not only for sedation but for inducing sleep as well. The draught of +which Watson spoke might have contained chloral hydrate, for it once +enjoyed wide usage as a hypnotic. It is a potent and dangerous drug +and, as generally known, is used by gangsters (among others) in what +are inelegantly but expressively referred to as “knockout drops.” + +An interesting reference is found to an alterative in one of the +stories (_The Disappearance of Lady Frances Carfax_). Holmes, +meeting Watson in an establishment which specialized in Turkish baths, +asked his friend why he insisted upon this type of therapy. The latter +replied that a Turkish bath is actually an alterative in medicine. He +explained further that an alterative was a cleanser of the system. +An “alterative” is defined in _Webster’s Unabridged Dictionary_ +as: “A medicine or treatment which gradually induces a change, and +restores healthy functions without sensible evacuations.” A modern +medical dictionary states: “An obsolete term originally used for drugs +said to reestablish healthy functions of the system.” (_Dorland’s +Illustrated Medical Dictionary_. Philadelphia: W. B. Saunders +Company, 1947). + +Present-day medical students probably never heard of alteratives. Many +middle-aged physicians, however, will remember them well, for formerly +alteratives were used extensively in therapeutics, and included the +following preparations: iodine, arsenic, iron, and the compounds of +mercury. Nowadays, a more scientific attitude is taken toward these +agents, and they are prescribed only if there is a specific need for +them: for example, iron for certain anemias, mercury for syphilis, +and so on. If one considers the esteem in which alteratives were held +in the latter part of this past century--and, for that matter, in the +early part of the present one--it is surprising that Dr. Watson did not +mention alteratives more frequently. + +One wishes that Dr. Watson had mentioned other drugs used in his +practice. In the early part of the twentieth century, a survey +in England showed that physicians considered that from thirty to +thirty-five drugs were necessary to practice medicine satisfactorily. +In the stories of Sherlock Holmes, the names of about a dozen occur. +Dr. Watson probably mentioned only those which for the main part are +familiar to the layman. + +Drugs are, of course, an important part of the armamentarium of +doctors, especially those engaged in general practice. From the +evidence at hand, obviously Dr. Watson was not a therapeutic nihilist, +but neither can he be accused of prescribing drugs loosely or in +excessive doses. + +The matter of overdosing with drugs calls for a brief comment. The +famous poet-physician, Oliver Wendell Holmes, wrote: “If the whole +_materia medica_ (excepting opium and ether) as now used, could +be sunk to the bottom of the sea, it would be all the better for +mankind--and all the worse for the fishes.” These were harsh words; +but when written, timely. The indiscriminate use of drugs was directly +responsible for the genesis of the ill-conceived homeopathic system +of medicine founded by Hahnemann. The followers of this school used +drugs in such minute doses that they were virtually ineffectual. It is, +indeed, an ill wind which blows no good, for the rise of homeopathy had +a sobering influence on many physicians of the allopathic school who +were using drugs lavishly, but not well. Let us not forget, however, +that the prescribing of drugs plays only a part--albeit an important +one--in the successful practice of medicine. + +In conclusion, we may think of Dr. Watson briskly setting out to +answer the call, carrying his trusty bag filled with the recognized +and popular drugs of that period. He undoubtedly prescribed these +fairly liberally, and firmly believed in their curative powers. +Most of Dr. Watson’s patients probably got well with the aid of, or +perhaps in spite of, his prescriptions. Those who were not helped by +his medication were undoubtedly benefited by his kindliness and his +sympathetic understanding of their ailments. + + + + + DOCTOR WATSON, GENERAL PRACTITIONER + + One night ... there came a ring to my bell, about the hour when a + man gives his first yawn and glances at the clock. I sat up in my + chair.... I groaned for I was newly back from a weary day. + + _The Man with the Twisted Lip_ + + +John H. Watson, M.D., was born in England in 1852. He was graduated +from the University of London Medical School in 1878 (_A Study in +Scarlet_), and took his internship at St. Bartholomew’s Hospital. + +Since England was then engaged in a war on the Afghan frontier, +Dr. Watson became attached as a military surgeon to the Fifth +Northumberland Fusiliers. The English were badly defeated on July 27, +1880 by a large Afghan force at Maiwand. Dr. Watson received a painful +wound--a Jezail bullet hit him in the shoulder. Later he contracted +typhoid fever in a base hospital at Peshawar. He was eventually +discharged from the army and returned to London with a very modest +disability pension. + +Not long after this, he met Sherlock Holmes through a mutual +acquaintance, and they obtained comfortable living quarters at 221B +Baker Street. While living with Holmes, Dr. Watson, as we know, +assisted him in many of his cases and served as his chronicler. + +After a time, Dr. Watson married and set up as a general practitioner +in London. Doubtless, many of his experiences in his practice are +reflected in his writing. It is in order to consider some of the +references made to the general practice of medicine in the tales. + +In one of Watson’s early stories, _A Scandal in Bohemia_ (written +about seventy years ago), we find Holmes saying to Dr. Watson: + + As to your practice, if a gentleman walks into my rooms smelling + of iodoform, with a black mark of nitrate of silver upon his right + forefinger and a bulge on the side of his top-hat to show where he has + secreted his stethoscope, I must be dull indeed, if I do not pronounce + him to be an active member of the medical profession. + +As Holmes stated, if an individual smelled of iodoform, had silver +nitrate stains on his fingers, and carried his stethoscope in his hat, +it would not be difficult to pronounce him a medical man. Iodoform, +which was once widely used, is employed but little today, and it would +be poor taste for a physician making professional calls to carry its +odor with him. Silver nitrate is still widely used, but most physicians +make an earnest effort to keep their hands looking neat and free of +stains. + +Dr. Watson had an appropriate sense of the fitness of things, +and appreciated the fact that a physician should comport himself +with dignity both in manner and in dress. Dr. Watson writes: “The +rough-and-tumble work in Afghanistan, coming on the top of a natural +Bohemianism of disposition, has made me rather more lax than befits +a medical man” (_The Musgrave Ritual_). In speaking of dress, +Watson states: “His dress was quiet and sober--a black frock coat, dark +trousers, and a touch of color about his necktie” (_The Resident +Patient_). + +It is hardly necessary to say that the modern physician no longer +carries his stethoscope in his hat. An interesting reference is found +in the story just mentioned concerning how the general practitioner +carried his instruments. One evening, Holmes and Watson returned from +a walk and found a brougham waiting at their door. Holmes remarked +that it belonged to a general practitioner. Watson writes: “I was +sufficiently conversant with Holmes’ methods to be able to follow his +reasoning, and to see the nature and state of the various medical +instruments in the wicker basket which hung in the lamplight inside the +brougham....” + +A fact not generally known in this country is that a red lamp was once +the sign of the general practitioner. Reference is made to this in +_The Adventure of the Six Napoleons_. Watson writes that a bust of +Napoleon, owned by a Dr. Barnicott, was found broken near his red lamp. + +A pleasing manner is surely a desirable trait in a physician. There +are doctors whose mere presence in the sickroom makes a patient feel +better. Dr. Watson is depicted as a person not only eager to help his +patients but also as a kind and sympathetic individual--attributes +that are most commendable in all physicians. Once when Dr. Watson was +speaking of a lady who was emotionally upset, he writes: “We soothed +and comforted her by such words as we could find.” Somewhat later, he +states: “I am an old campaigner.... If I can be of any assistance, +either to you or my friend here, I should be indeed happy” (_The Man +with the Twisted Lip_). In _The Adventure of the Sussex Vampire_, +Dr. Watson again states that he would be glad to be of any service. +Later, when he was asked to see a lady who had suffered a great nervous +shock, he explains how he stepped up to the bed on which she was lying +and spoke a few reassuring words to her, while he took her pulse and +temperature. + +Dr. Watson, like many practitioners, presumably had patients whom he +felt he was not helping, and who were taking an inordinate amount of +his time and energy. It is likely that he persuaded them to seek the +aid of some other physician. Holmes probably sensed this, for on one +occasion Dr. Watson asked whether a certain individual was Holmes’ +client. The detective remarked that he supposed so, since Scotland +Yard had sent this individual to him on the same principle that some +doctors refer their incurable patients to quacks, with the idea that +nothing can be done for them anyway, and that whatever happens they are +no worse off than they were formerly. Dr. Watson made no reply. One +does not like to think that an ethical practitioner would knowingly +send any patient to a quack. Holmes probably was in a facetious mood +when he made this remark, and was simply teasing Watson, who was not +known for his sense of humor. + +Dr. Watson clearly recognized a doctor’s responsibility to his patient, +because in _The Sign of the Four_ he writes: “Remember that I speak +not only as one comrade to another but as a medical man to one for +whose constitution he is to some extent answerable.” In _The Dying +Detective_, Holmes twitted Watson by reminding him that he was after +all only a general practitioner with rather mediocre qualifications. +This hurt Dr. Watson, and his comment was that Holmes might be his +master elsewhere, but not in the sickroom. Here undeniably Watson was +his master. + +Like other general practitioners, Dr. Watson undoubtedly had hard days, +but presumably he answered night calls. The following occurs in _The +Man with the Twisted Lip_: + + One night ... there came a ring to my bell, about the hour when a man + gives his first yawn and glances at the clock. I sat up in my chair, + and my wife ... made a little face of disappointment.... I groaned, + for I was newly back from a weary day. + +Obviously, Dr. Watson had never had a lucrative practice, for he +states: “Everyone was out of town, and I yearned for the glades of the +New Forest or the shingle of Southsea. A depleted bank account had +caused me to postpone my holiday....” (_The Resident Patient_). In a +similar vein, “I have nothing to do today. My practice is never very +absorbing” (_The Red-Haired League_). In _A Scandal in Bohemia_ occurs +a reference which further indicates that Dr. Watson was not a busy +practitioner: “At three o’clock precisely I was at Baker Street, but +Holmes had not yet returned.... I sat down beside the fire, however, +with the intention of awaiting him however long he might be.” This +shows that Dr. Watson was not loath to be absent from his practice in +the middle of the day for an indeterminate length of time. Apparently, +he thought nothing of this, but sat down calmly out of reach of his +patients to wait for his friend. + +We must not infer, however, that his practice was always dull, for on +one occasion he explains that he had pressing professional business of +his own, and it was not possible for him to accompany Holmes (_The +Adventure of the Illustrious Client_). And again: “A professional +case of great gravity was engaging my attention at the time, and the +whole of next day I was busy at the bedside of the sufferer” (_The +Red-Haired League_). Also, once when Holmes suggested that he and +Watson go out of town, the latter writes that although it was easy for +Holmes to go almost any time, he (Watson) had to do a certain amount +of planning and hurrying because his practice was not inconsiderable. +Holmes was cognizant of the fact that Watson had definite obligations, +for once Holmes told a client that not only was he a busy man but +that Dr. Watson had his patients to consider (_The Adventure of the +Creeping Man_). + +Apparently, at the time Watson wrote, it was common for physicians +to buy and sell their practice. Several references are made to this +custom. Watson describes how he had purchased his practice: + + I had bought a connection.... Old Mr. ... from whom I purchased it, + had at one time an excellent practice, but his age, and an affliction + ... had very much thinned it.... Until when I purchased it from him + it had sunk from twelve hundred to a little more than three hundred a + year. + + _The Stock Broker’s Clerk_ + +It must be remembered that at that time the English pound was worth +almost five dollars; so the practice described by Dr. Watson had been +bringing in about $6,000 per year, but had sunk to $1,500. In those +days, of course, money went much further than it does now, and $6,000 a +year was a splendid income. + +On another occasion, Watson relates that, at the request of Holmes, who +wanted Watson to come to live with him at Baker Street, he sold his +small Kensington practice at a rather good figure to a young doctor. A +few years later, he found that the purchaser was a distant relative of +Holmes, and it was the latter who actually had put up the money (_The +Adventure of the Norwood Builder_). + +Dr. Watson takes sly digs at specialists. Once he remarks that a +certain individual was an excellent antagonist, and that he was as +cool as ice, silky voiced and soothing as a fashionable consultant +(_The Adventure of the Illustrious Client_). And another time, he +states that he read in his friend’s eye the arrogance which a learned +specialist might experience who had been called to see a case only to +find the patient had measles (_The Adventure of the Abbey Grange_). + +As to the drugs used in Watson’s day, only about a dozen are mentioned. +Among them were ammonia, amyl nitrite, brandy, caffeine, ether, +chloroform, iodoform, carbolic acid, curare, and silver nitrate. A +survey made in England in the early part of this century showed that +physicians considered from twenty to twenty-five drugs necessary to +practice medicine satisfactorily. If a survey were made today, it is +likely that more would be listed, because during the past few years +potent antibiotic agents have been discovered and great strides +have been made in chemotherapy. Oliver Wendell Holmes, the famous +poet-physician, if living today, could not write as he did in the last +century: “If the whole materia medica (excepting opium and ether) as +now used could be sunk to the bottom of the sea it would be all the +better for mankind--and all the worse for the fishes.” + +We may think of the faithful Dr. Watson answering a call, perhaps late +at night, his stethoscope concealed in his hat, and his trusty medical +bag filled with the acceptable drugs. We can picture him further, +riding along in his hansom--the lights of which shine dimly through +the fog--rattling over the cobblestones of the old London streets, +carrying on the tradition of his noble profession. And we pray that +this priceless tradition will continue as long as mankind suffers from +illnesses of the mind or body. + + + + + FOOTNOTES: + + +[Footnote 1: Cassamajor, Louis, “Brain Fever,” _Journal of the +American Medical Association_, CXLIX (1952), 1443-46.] + +[Footnote 2: Klein, W. E., and R. H. Bradshaw, “Portuguese Man-of-War +Sting,” _Armed Forces Medical Journal_, II (March, 1951), 509-512.] + +[Footnote 3: Waite, C. L., “Medical Problems of an Underwater +Demolition Team,” _Armed Forces Medical Journal_, II (Sept., +1951), 1317-26.] + +[Footnote 4: Sollman, T., _A Manual of Pharmacology_ +(Philadelphia, W. B. Saunders Co., 6th ed., 1946), p. 104.] + +[Footnote 5: H. T. Webster, “Observations on Sherlock Holmes as an +Athlete and Sportsman,” _The Baker Street Journal_, III (1948), +No. 1, pp. 24-31.] + +[Footnote 6: H. T. Webster, _op. cit._] + + + + +=TRANSCRIBER’S NOTES= Simple typographical errors have been +silently corrected; unbalanced quotation marks were remedied when the +change was obvious, and otherwise left unbalanced. Punctuation and +spelling were made consistent when a predominant preference was found +in the original book; otherwise they were not changed. Inconsistent +hyphens left as printed. + + + +*** END OF THE PROJECT GUTENBERG EBOOK 75869 *** diff --git a/75869-h/75869-h.htm b/75869-h/75869-h.htm new file mode 100644 index 0000000..7fc504c --- /dev/null +++ b/75869-h/75869-h.htm @@ -0,0 +1,5132 @@ +<!DOCTYPE html> +<html lang="en"> +<head> + <meta charset="UTF-8"> + <title> + A Doctor Enjoys Sherlock Holmes | Project Gutenberg + </title> + <link rel="icon" href="images/cover.jpg" type="image/x-cover"> + <style> + +body { + margin-left: 10%; + margin-right: 10%; +} + +h1 { + text-align: center; + clear: both; +} + +h2, h3 { + text-align: center; + font-weight: bold; + margin-top: 1em; + margin-bottom: 1em; + } + +p { + margin-top: .51em; + text-align: justify; + margin-bottom: .49em; + text-indent: 1.5em; +} + +.nind {text-indent:0;} + +.nindc {text-align:center; text-indent:0;} + +.large {font-size: 125%;} + +.space-above2 { margin-top: 2em; } +.space-below2 { margin-bottom: 2em; } + +.spa1 { + margin-top: 1em + } + + +hr { + width: 33%; + margin-top: 2em; + margin-bottom: 2em; + margin-left: 33.5%; + margin-right: 33.5%; + clear: both; +} + +hr.chap {width: 65%; margin-left: 17.5%; margin-right: 17.5%;} +@media print { hr.chap {display: none; visibility: hidden;} } + +div.chapter {page-break-before: always;} +h2.nobreak {page-break-before: avoid;} + +ul {margin-left: 3em; padding-left: 0;} +li {list-style-type: none; padding-left: 2em; text-indent: -2.5em; text-align: left;} + +table { + margin-left: auto; + margin-right: auto; +} +table.autotable { border-collapse: collapse; } +table.autotable td { padding: 0.25em; } + +.tdl {text-align: left;} +.tdr {text-align: right;} + +.pagenum { /* uncomment the next line for invisible page numbers */ + /* visibility: hidden; */ + position: absolute; + left: 92%; + font-size: small; + text-align: right; + font-style: normal; + font-weight: normal; + font-variant: normal; + text-indent: 0; +} /* page numbers */ + +.blockquot { + margin-left: 5%; + margin-right: 10%; +} + +.right {text-align: right;} + +.allsmcap {font-variant: small-caps; text-transform: lowercase;} + +/* Images */ + +img { + max-width: 100%; + width: 100%; + height: auto + } + +.width500 { + max-width: 500px + } + +.x-ebookmaker img { + width: 80% + } + +.x-ebookmaker .width500 { + width: 100% + } + + +.figcenter { + margin: auto; + text-align: center; + page-break-inside: avoid; + max-width: 100%; +} + +/* Footnotes */ +.footnotes {border: 1px dashed;} + +.footnote {margin-left: 10%; margin-right: 10%; font-size: 0.9em;} + +.footnote .label {position: absolute; right: 84%; text-align: right;} + +.fnanchor { + vertical-align: super; + font-size: .8em; + text-decoration: + none; +} + +/* Poetry */ +/* uncomment the next line for centered poetry */ +.poetry-container {display: flex; justify-content: center;} +.poetry-container {text-align: center;} +.poetry {text-align: left; margin-left: 5%; margin-right: 5%;} +.poetry .stanza {margin: 1em auto;} +.poetry .verse {text-indent: -3em; padding-left: 3em;} + +/* Transcriber's notes */ +.transnote {background-color: #E6E6FA; + color: black; + font-size:small; + padding:0.5em; + margin-bottom:5em; + font-family:sans-serif, serif; +} + +/* Poetry indents */ +.poetry .indent0 {text-indent: -3em;} +.poetry .indent4 {text-indent: -1em;} + + + </style> +</head> +<body> +<div style='text-align:center'>*** START OF THE PROJECT GUTENBERG EBOOK 75869 ***</div> + + +<figure class="figcenter width500" id="cover" style="width: 1719px;"> +<img src="images/cover.jpg" width="1719" height="2560" alt="An eminent physician brings Sherlock Holmes and Doctor Watson +to us in a new, engrossing light, in a series of essays on the medico-biological aspects of the Conan Doyle tales."> +</figure> + + +<hr class="chap x-ebookmaker-drop"> +<div class="chapter"> +<p class="nindc"><span class="large"> +A<br> +DOCTOR<br> +ENJOYS<br> +SHERLOCK<br> +HOLMES</span></p> +</div> + +<hr class="chap x-ebookmaker-drop"> +<div class="chapter"> +<div class="blockquot"> + +<p>“Nor must you find fault with me if I often give you what I have +borrowed from my various reading, in the very words of the authors +themselves” (Macrobius—trans. by Boswell).</p> + +<p class="right"> +Boswell: <i>The Hypochondriack</i>, No. XXI</p> +</div></div> + + + +<hr class="chap x-ebookmaker-drop"> +<div class="chapter"> +<h1>A<br> +DOCTOR<br> +ENJOYS<br> +SHERLOCK<br> +HOLMES</h1> + + +<p class="nindc space-above2 space-below2"> +<span class="large">Edward J. Van Liere</span></p> + + +<figure class="figcenter width500" id="logo" style="width: 200px;"> + <img src="images/logo.jpg" width="200" height="191" alt="decorative"> +</figure> + + +<p class="nindc space-below2"> +VANTAGE PRESS <span class="allsmcap">NEW YORK</span> +<span class="allsmcap">WASHINGTON</span> <span class="allsmcap">HOLLYWOOD</span> +</p> +</div> + +<hr class="chap x-ebookmaker-drop"> + + +<div class="chapter"> +<p class="nindc space-above2 space-below2"> +FIRST EDITION</p> + +<p class="nindc space-above2"> +<i>All rights reserved, including the right of<br> +reproduction in whole or in part in any form.</i></p> + +<p class="nindc space-above2"> +Copyright, 1959, by Edward J. Van Liere, M.D.</p> + +<p class="nindc space-above2"> +Published by Vantage Press, Inc.<br> +120 West 31st Street, New York 1, N. Y.</p> + +<p class="nindc space-above2"> +Manufactured in the United States of America</p> + +<p class="nindc space-above2 space-below2"> +Library of Congress Catalog Card Number: 59-14293</p> +</div> + + +<hr class="chap x-ebookmaker-drop"> + + +<div class="chapter"> +<p class="nindc space-above2"> +To my grandsons:<br> +<br> +Edward Van Liere Batchelder and Terry Lewis Batchelder.</p> +</div> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<h2 class="nobreak" id="ACKNOWLEDGMENTS">ACKNOWLEDGMENTS</h2> +</div> + + +<p>I am indebted to several people for helpful criticism in the writing of +these essays. My medical colleagues, Dr. Gordon R. McKinney, and Dr. +David W. Northup, read a number of the essays and made many helpful +suggestions. Professor Armand E. Singer of the Romance Language +Department of West Virginia University critically reviewed all the +manuscripts, and his scholarly erudition is indeed appreciated. The +sympathetic assistance of my wife is also gratefully acknowledged. On +occasion, she took me gently by the hand, and led me away from many a +pitfall. The kind people who aided me must not be taken to task for +errors of commission. I alone am responsible for these.</p> + +<p class="space-above2"> +It is a pleasure to thank my capable and efficient secretaries, Mrs. +Mildred Fisher and Mrs. Ann Beavers, for typing the manuscripts.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p>Several of these essays have appeared in the following journals:</p> + +<ul><li> <i>The West Virginia Medical Journal</i></li> +<li> <i>Harvard Medical Alumni Journal</i></li> +<li> <i>The Physiologist</i></li> +<li> <i>The Baker Street Journal</i></li> +<li> <i>The Quarterly of the Phi Beta Pi Medical Fraternity</i></li> +<li> <i>The Student Journal of the American Medical Association</i></li> +</ul> + +<p class="nind space-above2"> +Permission has been kindly granted to reproduce these essays here.</p> +</div> + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<h2 class="nobreak" id="CONTENTS">CONTENTS</h2> +</div> + + +<table class="autotable"> +<tbody><tr> +<td class="tdl">Doctor Watson and the Weather</td> +<td class="tdr"><a href="#Page_11">11</a></td> +</tr><tr> +<td class="tdl">The Anatomical Sherlock Holmes</td> +<td class="tdr"><a href="#Page_19">19</a></td> +</tr><tr> +<td class="tdl">“Brain Fever” and Sherlock Holmes</td> +<td class="tdr"><a href="#Page_25">25</a></td> +</tr><tr> +<td class="tdl">Curare and Sherlock Holmes</td> +<td class="tdr"><a href="#Page_31">31</a></td> +</tr><tr> +<td class="tdl">Sherlock Holmes and the Portuguese Man-of-War</td> +<td class="tdr"><a href="#Page_35">35</a></td> +</tr><tr> +<td class="tdl">Doctor Watson and Nervous Maladies</td> +<td class="tdr"><a href="#Page_41">41</a></td> +</tr><tr> +<td class="tdl">Dogs and Sherlock Holmes</td> +<td class="tdr"><a href="#Page_48">48</a></td> +</tr><tr> +<td class="tdl">The Botanical Doctor Watson</td> +<td class="tdr"><a href="#Page_54">54</a></td> +</tr><tr> +<td class="tdl">The Surgical Doctor Watson</td> +<td class="tdr"><a href="#Page_62">62</a></td> +</tr><tr> +<td class="tdl">Sherlock Holmes, the Chemist</td> +<td class="tdr"><a href="#Page_69">69</a></td> +</tr><tr> +<td class="tdl">Doctor Watson’s Universal Specific</td> +<td class="tdr"><a href="#Page_77">77</a></td> +</tr><tr> +<td class="tdl">Doctor Watson, Endocrinologist</td> +<td class="tdr"><a href="#Page_83">83</a></td> +</tr><tr> +<td class="tdl">Genetics and Sherlock Holmes</td> +<td class="tdr"><a href="#Page_88">88</a></td> +</tr><tr> +<td class="tdl">The Zoological Doctor Watson</td> +<td class="tdr"><a href="#Page_96">96</a></td> +</tr><tr> +<td class="tdl">Doctor Watson, Cardiologist</td> +<td class="tdr"><a href="#Page_102">102</a></td> +</tr><tr> +<td class="tdl">The Physiologic Doctor Watson</td> +<td class="tdr"><a href="#Page_108">108</a></td> +</tr><tr> +<td class="tdl">Sherlock Holmes and Doctor Watson, Perennial Athletes</td> +<td class="tdr"><a href="#Page_117">117</a></td> +</tr><tr> +<td class="tdl">The Therapeutic Doctor Watson</td> +<td class="tdr"><a href="#Page_127">127</a></td> +</tr><tr> +<td class="tdl">Doctor Watson, General Practitioner</td> +<td class="tdr"><a href="#Page_135">135</a></td> +</tr> +</tbody> +</table> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<div class="blockquot"> +<p>To undertake the writing of a large book is like entering on a long and +difficult journey, in the course of which much fatigue and uneasiness +must be undergone, while at the same time one is uncertain of reaching +the end of it: whereas writing a short essay is like taking a pleasant +airing that enlivens and invigorates by the exercise which it yields, +while the design is gratified in its completion.</p> + +<p class="right"> +Boswell: <i>The Hypochondriack</i>, No. I</p> +</div></div> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_11">[Pg 11]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSON_AND_THE_WEATHER"> +DOCTOR WATSON AND THE WEATHER</h2> +</div> + +<div class="blockquot"> + +<p class="nindc">“It had been a close and rainy day in October.”</p> + +<p class="right"> +<i>The Resident Patient</i></p> +</div> + + +<p>To me one of the most delightful touches in the tales of Sherlock +Holmes is the frequent mention of the state of the weather. As far as I +know, no one has emphasized the numerous references to the weather by +Dr. Watson. Especially in the opening of the short stories can these +be found, but they are not confined there, for they appear throughout +the longer tales as well. Many instances can be cited to illustrate +Dr. Watson’s allusions to the state of the weather. Let us freshen our +memory by reviewing some of these.</p> + +<p>Numerous references to the rains and winds of autumn may be found, such +as, “... the weather had taken a sudden turn to rain, with autumnal +winds” (<i>The Adventure of the Noble Bachelor</i>). And, in a similar +vein, “Outside the wind still screamed and the rain splashed and +pattered against the windows. This strange, wild story seemed to have +come to us from amid the mad elements—blown in upon us like a sheet of +seaweed in a gale” (<i>The Five Orange Pips</i>). And in <i>The Problem +of Thor Bridge</i>, we find that, as Dr. Watson was dressing one +morning, he observed how the leaves were being whisked away from the +plane tree (we would call it a sycamore) which graced their back yard.</p> + +<p>The events related in <i>The Hound of the Baskervilles</i> took place +in the autumn of the year, and several interesting allusions to this +season may be found: “I walked over to the black window, and I looked +through a blurred pane at the driving clouds and at the tossing +<span class="pagenum" id="Page_12">[Pg 12]</span> +outline of the wind-swept trees. It was a wild night....” Another +reference, “A dull and foggy day with a drizzle of rain. The house +is banked in with rolling clouds....” Also, “All day today the rain +poured down, rustling on the ivy and dripping from the eaves....” +And in another instance, “Rain squalls drifted across ... and the +heavy, slate-coloured clouds hung low over the landscape, trailing in +gray wreaths down the sides of the fantastic hills.” And lastly, an +especially interesting allusion may be cited:</p> + +<div class="blockquot"> + +<p>We hurried through the dark shrubbery, amid the dull moaning of the +autumn wind and the rustle of the falling leaves. The night air was +heavy with the smell of damp and decay. Now and again the moon peeped +out for an instant, but clouds were driving over the face of the sky, +and just as we came out on the moor a thin rain began to fall.</p> +</div> + +<p>The paragraph just quoted pictures a rather wet autumn night, but not +an especially bad one. In <i>The Adventure of the Golden Pince-Nez</i>, +an extremely wild and stormy night toward the end of November is +depicted. Dr. Watson describes vividly how the wind howled down Baker +Street, and how the rain beat vigorously against the windows. Another +reference may be cited which depicts gloomy autumn days: “It had been a +close and rainy day in October....” (<i>The Resident Patient</i>).</p> + +<p>It would appear, then, that many of Sherlock Holmes’ adventures took +place during the fall of the year. It must be inferred that the dark +and stormy days of autumn depressed the great detective, for we find +him saying to Dr. Watson, “Draw your chair up and hand me my violin, +for the only problem we still have to solve is how to while away these +bleak autumnal evenings” (<i>The Adventure of the Noble Bachelor</i>).</p> + +<p>From the instances just enumerated, it would seem that Dr. Watson was +<span class="pagenum" id="Page_13">[Pg 13]</span> +fond of picturing a background of wind, rain, and storm for many of his +stories. He also described the well-known fogs of London with telling +effect. In <i>The Adventure of the Copper Beeches</i>, Dr. Watson +writes, “A thick fog rolled down the lines of dun-coloured houses, and +the opposing windows loomed like dark, shapeless blurs through the +heavy yellow wreaths.” And again, “It was a September evening and not +yet 7 o’clock, but the day had been a dreary one, and a dense drizzly +fog lay low upon the great city” (<i>The Sign of the Four</i>). In +the same story, we find Holmes saying, “See how the yellow fog swirls +down the street and drifts across the dun-coloured houses.” <i>In The +Adventure of the Bruce-Partington Plans</i>, Dr. Watson tells how, +during the month of November of 1895, such a heavy fog descended on +London that it was impossible to see the houses on the opposite side of +Baker Street.</p> + +<p>In addition to wind, rain, storm, and fog, Dr. Watson makes reference +as well to sharp winter weather. In <i>The Adventure of the Blue +Carbuncle</i>, it will be remembered that Dr. Watson visited Sherlock +Holmes two days following Christmas to give his friend the season’s +greetings. Watson writes, “I seated myself in his arm chair and warmed +my hands before his crackling fire, for a sharp frost had set in, and +the windows were thick with ice crystals.” When he and Holmes set out +to obtain information about the goose which had swallowed the blue +carbuncle, Watson tells us: “It was a bitter night, so we drew on our +ulsters and wrapped cravats about our throats. Outside, the stars +were shining coldly in a cloudless sky, and breath of the passers-by +blew out into smoke like so many pistol shots. Our footfalls rang out +crisply and loudly....”</p> + +<p>In <i>The Adventure of the Abbey Grange</i>, Watson describes an +adventure which took place on a bitterly cold morning during the winter +of ’97. On another occasion, Watson tells how he and Holmes went for a +walk on a cold and frosty winter evening (<i>The Adventure of Charles +<span class="pagenum" id="Page_14">[Pg 14]</span> +Augustus Milverton</i>). A description of a beautiful winter day may be +found in <i>The Adventure of the Beryl Coronet</i>: “It was a bright, +crisp February morning, and the snow of the day before still lay deep +upon the ground, shimmering brightly in the wintry sun.”</p> + +<p>Mention is made too of the weather in the spring. On several occasions, +references are made to the cold and stormy weather of the early part +of this season: “It was a cold morning of the early spring, and we +sat after breakfast on either side of a cheery fire in the old room +at Baker Street” (<i>The Adventure of the Copper Beeches</i>). <i>The +Adventure of the Speckled Band</i> took place in the spring of ’83. +Watson writes: “It was a wild night. The wind was howling outside, +and the rain was beating and splashing against the window.” In <i>The +Adventure of the Wisteria Lodge</i>, the good doctor writes that it was +a cold, dark, windy March evening, and a fine rain was falling. And in +<i>His Last Bow</i>, Watson writes that he had recorded in his notebook +that, in the latter part of March in the year 1892, it was a bleak and +windy day.</p> + +<p>Milder spring weather also claimed Dr. Watson’s attention: “It was an +ideal spring day, a light blue sky, flecked with little fleecy clouds +drifting across from west to east. The sun was shining very brightly, +and yet there was an exhilarating nip in the air, which set an edge +to a man’s energy” (<i>The Adventure of the Copper Beeches</i>). In a +similar vein, “It was a perfect day, with a bright sun and a few fleecy +clouds in the heavens” (<i>The Adventure of the Speckled Band</i>). In +<i>The Adventure of the Three Garridebs</i>, a lovely spring evening is +mentioned, and Watson writes that the slanting rays of the setting sun +made even a little prosaic street look golden.</p> + +<p>For some reason or other, less frequent mention is made of summer +weather. There are, however, several interesting references to this +enjoyable season. In the story of <i>The Greek Interpreter</i>, +Dr. Watson writes, “It was after tea on a summer evening....” And +similarly, in <i>The Adventure of the Mazarin Stone</i>, our attention +is called to the fact that it was the evening of a lovely summer’s +<span class="pagenum" id="Page_15">[Pg 15]</span> +day. It would be expected that somewhere in the stories an allusion +would be made to the torrid days of August: “It was a blazing hot day +in August. Baker Street was like an oven, and the glare of the sunlight +upon the yellow brickwork of the house across the street was painful +to the eye” (<i>The Adventure of the Cardboard Box</i>). An especially +poignant reference to a hot summer night may be found in the story +<i>His Last Bow</i>. Dr. Watson gives a vivid description of a hot +night on the second of August. He mentions that there was an awesome +hush and a feeling of expectancy in the sultry and stagnant air. The +August to which reference is made was that of 1914—the beginning of +World War I. In that holocaust, Great Britain lost the flower of her +youth. She has not yet recovered from that mortal blow.</p> + +<p>People living in the Victorian era, just like many of us today, +were interested in barometric pressure. In <i>The Boscombe Valley +Mystery</i>, an interesting reference to barometric readings may be +found. Sherlock Holmes remarks to Lestrade of Scotland Yard: “How is +the glass? Twenty-nine, I see. No wind, and not a cloud in the sky.” +Somewhat later in the day, he mentions to Dr. Watson: “The glass still +keeps very high.... It is of importance that it should not rain before +we are able to go over the ground.” Fortunately, in this instance good +weather prevailed, for Watson writes, “There was no rain, as Holmes had +foretold, and the morning broke bright and cloudless.”</p> + +<p>One might well ask why Dr. Watson emphasizes the state of the weather +so often? Several reasons come to mind: To make the setting of his +stories more realistic; to take up space in the manuscript; to use the +subject of the weather as an excuse for some fine writing; to reveal +Watson’s little-suspected love of nature; or perhaps still other +reasons. Let us examine some of these.</p> + +<p>It is well known that writers often have dirty weather prevailing when +foul deeds are to be committed. Dr. Watson, however, does not abuse +this privilege in his writings, although he does occasionally take +<span class="pagenum" id="Page_16">[Pg 16]</span> +advantage of unusual atmospheric conditions to make the story more +exciting. A good example of this is to be found in the novel <i>The +Hound of the Baskervilles</i>.</p> + +<p>One recalls that Sherlock Holmes laid a trap to catch the villain, +Stapleton. A part of the plan made it necessary for the hero, Sir +Henry, to walk across the dismal moor alone after dark. Holmes had +calculated that Stapleton would let loose his spectral hound that +particular night. It was carefully arranged, of course, so that +Sherlock Holmes, Dr. Watson, and Lestrade would kill the hound before +any harm befell Sir Henry, and then catch Stapleton redhanded. All went +according to plan until a dense fog started to rise from the adjacent +Grimpen Mire. The low visibility produced by the unexpected fog almost +upset Holmes’ well-laid plans and nearly caused the death of Sir Henry, +because his friends could not see the hound until it was dangerously +close to him.</p> + +<p>Can the good doctor be accused of writing about the weather simply to +make the manuscripts longer? I think not. In the first place, there +is no evidence (certainly not in his early career) that the money he +received for his stories bore any relation to their length. Further, +and more important, a man with Watson’s imagination did not have to +rely upon such a mundane topic as the weather to lengthen his stories. +We can dismiss this argument promptly by stating that he was not guilty +of padding his manuscripts in this manner.</p> + +<p>Did he use the weather as an occasional excuse for fine writing? +Probably not, although some of the paragraphs in which he describes +the state of the weather, if examples of fine writing, are certainly +examples of vivid writing as well. Several instances could be given, +but one will suffice:</p> + +<div class="blockquot"> + +<p>It was in the latter days of September, and the equinoctial gales had +set in with exceptional violence. All day the wind had screamed and +the rain had beaten against the windows, so that even here in the +heart of great, handmade London we were forced to raise our minds for +<span class="pagenum" id="Page_17">[Pg 17]</span> +the instant from the routine of life, and to recognize the presence of +those great elemental forces which shriek at mankind through the bars +of civilization, like untamed beasts in a cage. As evening drew in, +the storm grew higher and louder, and the wind cried and sobbed like a +child in the chimney.</p> + +<p class="right"> +<i>The Five Orange Pips</i></p> +</div> + +<p>What other reasons could be given for Watson’s frequent allusions +to the weather? There are, of course, the dapper gentleman and the +Scotchman, who are conscious of the state of the weather since they +deplore—for different reasons, to be sure—losing the press in their +trousers by being caught in the rain. To the Londoner, however, who +seems obliviously unaware of the somewhat disheveled state of his +attire, such an explanation could scarcely apply. On the other hand, +one cogent reason does come to mind. It must always be remembered that +Watson was both a physician <i>and</i> an author. Now the state of the +weather is of perpetual interest to a general practitioner of medicine, +and this is what Dr. Watson pretended to be. It is true that the +physician who practices in the city probably is not as weather-minded +as his colleague in the country. Dr. Watson lived in the great city of +London, but often made his professional calls on foot and doubtless +trudged through storm and rain: “When your round is a short one you +walk, and when it is a long one you use a hansom” (<i>The Crooked +Man</i>). He mentions that after his marriage he dropped in at 221B +Baker Street from time to time when walking in that vicinity.</p> + +<p>In point of fact, the kind of weather is of no little importance to a +person who is called out at any time of day or night, as almost any +physician will testify. This may be one of the important reasons why +Watson makes such frequent mention of the weather in his stories.</p> + +<p>All may not agree with me that such descriptions of the state of the +<span class="pagenum" id="Page_18">[Pg 18]</span> +weather add greatly to the interest of Watson’s writings. This is a +matter of opinion; for doubtless there are many men who have little +interest in the weather under any circumstances. Earl Derr Biggers, the +creator of Charlie Chan, had one of his less liked characters remark +that he was not interested in the weather, since he was not a cabbage. +Be that as it may, I have always pitied those individuals who pay +absolutely no attention to the weather; they are missing a great deal +in life.</p> + +<p>There are people who see beauty and interest only in a beautiful day. +The poet probably was right when he sang, “What is so rare as a day +in June?” But would anyone deny that there is beauty in a snowstorm +or a sleetstorm, and is not a cloudburst or a thunderstorm an awesome +spectacle, and can not even a duststorm be a striking phenomenon? Now +nature, I grant, can overdo this matter of storms, and too much dust +in the atmosphere or a week of rainy, sullen weather leave much to be +desired.</p> + +<p>To those of us who have been thrilled by the saga of Sherlock Holmes +and Dr. Watson, and who have found enjoyment and relaxation in reading +about these famous characters, I would like to make one further +suggestion: Let us think of Dr. Watson not only as a practitioner +of medicine, or only just as an amateur detective and confidant of +Sherlock Holmes, but also as a man interested in many things—a lover +of nature and one who could see charm in all her moods.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_19">[Pg 19]</span></p> +<h2 class="nobreak" id="THE_ANATOMICAL_SHERLOCK_HOLMES"> +THE ANATOMICAL SHERLOCK HOLMES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc">“I believe he is well up in anatomy....”</p> + +<p class="right"> +<i>A Study in Scarlet</i></p> +</div> + + +<p>A number of references to the anatomy laboratory and to portions of the +cadaver may be found in the tales. Shortly after Watson’s return from +India, he met his old friend Stamford at the Criterion bar in London. +This was a memorable occasion, for it was Stamford who introduced +Watson to Sherlock Holmes. When Stamford was telling Watson something +about Holmes, he said, “I believe he is well up in anatomy....” +Stamford made it clear, however, that Holmes was not a medical student, +but did have pronounced scientific interests. He emphasized the fact +that Holmes had a cold scientific approach to problems which deeply +interested him and that he had been seen “beating the subjects in the +dissecting room with a stick....” When Watson evinced some surprise at +this unbecoming behavior, Stamford explained, “to verify how bruises +may be produced after death” (<i>A Study in Scarlet</i>).</p> + +<p>At first glance, Holmes’ activity seems to be inexcusable and betokens +a deplorable disrespect for the dead. His researches must not be +regarded in this light, however, for it may be of distinct medicolegal +interest to ascertain whether the bruises on a body were produced +before or after death. This problem has been studied extensively, +and information concerning it may be found in books dealing with +medicolegal matters. Holmes’ early interest and study in this field are +quite understandable, for at that time he was laying the foundation +<span class="pagenum" id="Page_20">[Pg 20]</span> +for his brilliant career as a specialist in the study of crime.</p> + +<p>When Watson first started rooming with Holmes he found that the +latter “Sometimes ... spent his day ... in the dissecting rooms....” +(<i>A Study in Scarlet</i>). In one instance, reference is made to +the preservation of bodies in the anatomy laboratory: “Bodies in the +dissecting rooms are injected with preservative fluids.” The agents +employed in the embalming fluid are given: “carbolic, or rectified +spirits would be the preservative....” (<i>The Adventure of the +Cardboard Box</i>).</p> + +<p>Osteology must have appealed to Holmes, since bones are frequently +mentioned. Once when Holmes was trying to analyze a difficult case, +he made allusion to Cuvier, the famous anatomist and anthropologist: +“Cuvier could correctly describe a whole animal by the contemplation +of a single bone....” (<i>The Five Orange Pips</i>). In <i>A Study in +Scarlet</i>, a description of the alkali plains of our great West is +given; these pointed but gruesome sentences may be found:</p> + +<div class="blockquot"> + +<p>Here and there are scattered white objects which glisten in the sun +and stand out against the dull deposit of alkali. Approach and examine +them. They are bones: some large and coarse, others smaller and more +delicate. The former have belonged to oxen and the latter to men.</p> +</div> + +<p>In another instance, Holmes was consulted about a “charred fragment +of bone” which had been recovered from a heating furnace in a private +dwelling. He showed it to Watson, who without hesitation stated that it +was the upper condyle of a human femur (<i>The Adventure of Shoscombe +Old Place</i>).</p> + +<p>One early spring afternoon, Holmes and Watson upon returning from +a walk found that a visitor had left his pipe on the table. Holmes +picked it up and examined it carefully. Watson writes, “He held it up +and tapped on it with his long, thin forefinger, as a professor might +who was lecturing on a bone” (<i>The Yellow Face</i>). This is an apt +allusion, for many medical students will remember the occasion when +<span class="pagenum" id="Page_21">[Pg 21]</span> +an instructor in anatomy held a bone in his hand, pointed out areas +where muscles had been attached, and commented on other characteristic +features. One is reminded of the story of the poet-physician Oliver +Wendell Holmes, who was professor of anatomy at Harvard for many years. +Once when lecturing on the sphenoid bone (a bone of the skull having +an exceedingly complicated architecture), he is reputed to have said +something like this: “Gentlemen, I have in my hand the sphenoid bone. +Gentlemen, I say d—— the sphenoid bone!” Any medical student who has +studied this bone will wholeheartedly agree with the remark.</p> + +<p>Mention is made also of fossil bones. When Holmes and Watson visited +the house of Nathan Garrideb, they noticed a large cupboard full +of them. Holmes was invited to take a seat, but his host found it +necessary to clear the chair of bones. Obviously, Garrideb was a most +enthusiastic collector (<i>The Adventure of the Three Garridebs</i>).</p> + +<p>Sherlock Holmes presumably enjoyed anthropology, for several references +to this science may be found in the tales. In <i>The Hound of the +Baskervilles</i>, when Dr. Mortimer first met Sherlock Holmes, the +doctor rather facetiously said to him:</p> + +<div class="blockquot"> + +<p>“I hardly expected so dolichocephalic a skull or such well-marked +supra-orbital development. Would you have any objection to my +running my finger along your parietal fissure? A cast of your skull, +sir, until the original is available, would be an ornament to any +anthropological museum. It is not my intention to be fulsome, but I +confess that I covet your skull.”</p> +</div> + +<p>Holmes apparently was slightly annoyed at this frank but somewhat +insensate disquisition, and remarked, “You are an enthusiast in your +line of thought, I perceive, sir, as I am in mine.”</p> + +<p><span class="pagenum" id="Page_22">[Pg 22]</span></p> + +<p>On another occasion when Dr. Mortimer was speaking of Sir Henry +Baskerville, he stated: “A glance at our friend here reveals the +rounded head of the Celt, which carries inside it the Celtic enthusiasm +and power of attachment. Poor Charles’ head was of a very rare type, +half-Gaelic, half-Ivernian in its characteristics.”</p> + +<p>Dr. Mortimer obviously was a keen observer, a person of scholarly +tastes and “a most learned man in his own line.” When he was telling +Sherlock Holmes and Dr. Watson of his friendship with Sir Charles +Baskerville, he remarked, “... and many a charming evening we have +spent together discussing the comparative anatomy of the Bushman and +the Hottentot.”</p> + +<p>Interest in anthropology is evinced further by mention of prehistoric +man. One day, while Dr. Watson was walking on the moor, he met +the naturalist Stapleton, the villain in <i>The Hound of the +Baskervilles</i>. Watson’s attention was attracted to the circular +rings of stone on a hillside. He asked his companion whether they were +the ruins of ancient sheep pens. Stapleton replied, “Prehistoric man +lived thickly on the moor....” When Watson questioned him as to when +the moor was inhabited; the answer was, “Neolithic man—no date.”</p> + +<p>Another allusion to ancient man may be cited. In the house of +Garrideb, as mentioned, Holmes and Watson noticed above a cupboard a +series of plaster skulls; the names “Neanderthal,” “Heidelberg,” and +“Cromagnon” were printed underneath them (<i>The Adventure of the Three +Garridebs</i>). Not only the anthropologist but the trained biologist +as well is, of course, quite familiar with the names of our early +ancestors.</p> + +<p>Once Holmes’ knowledge of anthropology helped him solve an important +case. A maiden lady had received in the mail a small cardboard box +containing two human ears—one that of a woman. Holmes was called in, +and during the course of his investigations visited the receiver of +the gruesome package. He noted the resemblance of one of the severed +ears to those of the lady upon whom he was calling. Because of the +striking likeness, he felt certain that the person whose ear had been +<span class="pagenum" id="Page_23">[Pg 23]</span> +dismembered was a close relative of the lady he had come to interview.</p> + +<p>Somewhat later, he gave a lecture—a thing he was prone to do—to Dr. +Watson on the surface anatomy of the ear:</p> + +<div class="blockquot"> + +<p>... there is no part of the body which varies so much as the human +ear. Each ear is as a rule quite distinctive and differs from all +others.... I ... examined the ears in the box with the eyes of an +expert and had carefully noted their anatomical peculiarities.... I +perceived that her [Miss Cushing’s] ear corresponded exactly with +the female ear I had just inspected. The matter was entirely beyond +coincidence. There was the same shortening of the pinna, the same +broad curve of the upper lobe, the same convolution of the inner +cartilage. In all essentials it was the same ear.</p> + +<p>Of course, I at once saw the enormous importance of the observation. +It was evident that the victim was a blood relative, and probably a +very close one.</p> + +<p class="right"> +<i>The Adventure of the Cardboard Box</i></p> +</div> + +<p>This was an exceedingly astute observation on Holmes’ part. He was +right when he remarked that as a rule each ear is quite distinctive, +and cleverly pointed out the important anatomical features. In any +event, the study he made of Miss Cushing’s ear aided him greatly in +solving the mystery of the cardboard box, and we know that the murderer +was promptly apprehended.</p> + +<p>In the story just related, a newspaper of the day was supposed to have +suggested that the preserved ears had been sent by medical students as +a joke. It appears that the maiden lady at one time had had unpleasant +dealings with medical students: “... she let her apartments in her +house to three young medical students, whom she was obliged to get rid +of on account of their noisy and irregular habits.... [The ears were +<span class="pagenum" id="Page_24">[Pg 24]</span> +sent] by those students who owed her a grudge and who hoped to frighten +her by sending her those relics of the dissecting rooms.”</p> + +<p>Although this theory was later proved to be false, it was not too +farfetched. Indeed, many, many stories can be told about the behavior +of medical students in the anatomy laboratory. A favorite minor prank, +for example, is to cut off a finger or an ear and slip it into the +pocket of an unsuspecting visitor. This bit of horseplay probably +discourages future visits to the anatomical laboratory. Although +anatomy instructors deplore such practices, they are likely to overlook +them, because laymen are not encouraged to visit dissecting rooms.</p> + +<p>In the opening of one of the stories, we find Holmes stooping over a +low-power microscope (<i>The Adventure of Shoscombe Old Place</i>). +He explained to Watson that there were epithelial cells in the +microscopic field. As far as I am aware, this is the only reference +to individual body cells to be found in the tales. It appears, then, +that Holmes was much more interested in gross structures of the body, +especially osteology, than in microscopic structures.</p> + +<p>We have seen that many pertinent allusions to anatomical science may +be found in the tales. In one instance, at least, Holmes’ intimate +knowledge of surface anatomy—that is, the configuration of the +external ear—enabled him to solve handily a perplexing mystery. The +allusions made to anatomical matters are of especial delight to those +of us in the field of biology.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_25">[Pg 25]</span></p> +<h2 class="nobreak" id="BRAIN_FEVER_AND_SHERLOCK_HOLMES"> +“BRAIN FEVER” AND SHERLOCK HOLMES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc">“I have only just recovered from nine weeks of brain fever and am +still exceedingly weak.”</p> + +<p class="right"> +<i>The Naval Treaty</i></p> +</div> + + +<p>Several years ago, there appeared in the <i>Journal of the American +Medical Association</i> a provocative article with the arresting +title, “Brain Fever,” written by Louis Cassamajor.<a id="FNanchor_1" href="#Footnote_1" class="fnanchor">[1]</a> The author is +to be commended for his courage in choosing this unusual title, and +the <i>Journal</i> to be congratulated for publishing it. Although +I welcome the term “brain fever,” I did rub my eyes, because I had +not seen it employed for a long time. In my youth the term was used +commonly, but was dismissed from my mind when I commenced the study +of medicine. It was relegated to the same limbo as the old expression +“typhoid malaria.”</p> + +<p>In order that I may develop my thesis, a brief review of Cassamajor’s +article is in order. The author points out that, in the early part of +the past century, considerable literature appeared describing a disease +known as “brain fever” (called also “hydrocephalic fever” and sometimes +“encephalitis”). For the main part, it occurred in children. The +illness subsided after a few days to a couple of weeks, and the patient +usually recovered.</p> + +<p>The author brings out further that, although the disease was apparently +accompanied by fever, there are no recorded temperatures, for the +modern clinical thermometer was not invented until 1868. It is +<span class="pagenum" id="Page_26">[Pg 26]</span> +emphasized, also, that no neurological signs appeared in the case +reports. It was only after the writings of Erb and of Westphal in 1875 +that neurological examination, as we now know it, began to develop. +For some unknown reason, about 1850 mention of the disease disappeared +from medical literature. The author, however, makes the statement: +“Undoubtedly the condition does exist today.”</p> + +<p>Following a brief historical introduction, the author gives in some +detail the case histories of four children, the youngest six and +one-half and the oldest eleven years of age, whom he had rather +recently diagnosed as suffering from “brain fever.” It is highly +gratifying that they all made a complete recovery. The disease is +characterized by signs and symptoms indicating a considerable brain +involvement, “including convulsions, comas, paralyses, cerebellar +asynergy and a sort of bulbar palsy.” The onset is irregular, except +when head trauma has been previously sustained, when it may be sudden.</p> + +<p>One reason, among others, why this stimulating article especially +interested me was that the term “brain fever” called to my mind the +immortal stories of Sherlock Holmes. In them several individuals are +described as suffering from this condition. It is of nostalgic interest +to examine the circumstances which surrounded these victims when they +were stricken.</p> + +<p>We find in one of the stories that a housemaid, with an unstable +Celtic temperament, “had a sharp touch of brain fever.” She had had +a violent love affair with a handsome but perfidious butler, who had +thrown her over for another girl. Following her partial recovery, she +had taken a terrible vengeance and was directly responsible for her +faithless lover’s death. When questioned about him by the master of the +household, she became hysterical and unmanageable: “For two days [she] +had been so ill, sometimes delirious, sometimes hysterical...” (<i>The +Musgrave Ritual</i>). She evidently made a rapid recovery, for on the +third night she disappeared and her whereabouts were never discovered.</p> + +<p><span class="pagenum" id="Page_27">[Pg 27]</span></p> + +<p>In another story, a young girl whose mother had died was treated +cruelly by her father, who had remarried. She had an income of her +own which she generously allowed her father to use. When she fell in +love with a young man, her father tried desperately to make her sign +a contract providing that, in the event of marriage, he could still +use her money. This she refused to do. He placed her in solitary +confinement so that she could not see her lover, and treated her +inhumanly in other ways: “... he kept on worrying her until she got +brain fever, and for several weeks was at death’s door” (<i>The +Adventure of the Copper Beeches</i>). It is pleasant to relate that she +recovered and succeeded in eloping with her lover and presumably lived +happily ever after.</p> + +<p>In still another story, in which Sherlock Holmes attempted to gain an +audience with a middle-aged spinster, he was informed that she was +too ill to be interviewed. Her doctor said: “She has been suffering +since yesterday from brain symptoms of great severity. As her medical +adviser, I cannot possibly take the responsibility of allowing anyone +to see her. I should recommend you to call again in ten days” (<i>The +Adventure of the Cardboard Box</i>). This illness, somewhat later in +the story, is referred to specifically as “brain fever.”</p> + +<p>The illness had developed when this spinster heard that conscientious +diplomat. Through his own carelessness, how-her younger sister had been +foully murdered by her husband. It was the spinster who, by wicked +machinations, had been largely responsible for her sister’s death. It +is noteworthy that Holmes was advised to come back ten days later. This +indicates that the disease was not of long duration.</p> + +<p>One of Dr. Watson’s former schoolfellows, Percy Phelps, wrote him, “I +have only just recovered from nine weeks of brain fever and am still +exceedingly weak.” In his letter, he further informed Dr. Watson that +he wished to consult with Sherlock Holmes, and asked his friend to +bring him, since he was in deep trouble. This able young man was an +earnest and ever, he had lost an important state document. In +<span class="pagenum" id="Page_28">[Pg 28]</span> +narrating his story to Sherlock Holmes and Dr. Watson, the patient gave +a vivid description of his distressing illness: “Here I have lain, Mr. +Holmes, for over nine weeks, unconscious, and raving with brain fever +... in my mad fits I was capable of anything. Slowly my reason has +cleared, but it is only during the last three days that my memory has +quite returned” (<i>The Naval Treaty</i>).</p> + +<p>This poor fellow had an illness of long duration and, according to the +story, his strength came back but slowly. It will be recalled that +Sherlock Holmes solved the mystery and was able to place the important +state document again in the patient’s hands. As far as we know, he +eventually made a complete recovery in spite of the severity of the +attack.</p> + +<p>In <i>The Hound of the Baskervilles</i>, it will be remembered that +the heir, Sir Henry Baskerville, narrowly escaped death on the moor. +The shock of the adventure with the hound, coupled with the fact +that the woman with whom the heir was in love was actually the wife +of the villainous Stapleton, his would-be murderer, was too much for +our hero. Watson writes: “But the shock of the night’s adventure had +shattered his nerves, and before morning he lay delirious in a high +fever under the care of Dr. Mortimer. The two of them were destined to +travel together round the world before Sir Henry had become once more +the hale, hearty man that he had been before he became master of that +ill-omened estate.”</p> + +<p>In this last instance, Watson does not specifically state that the +patient was afflicted with “brain fever,” but the implication is +plainly there. It is, moreover, worthy of note that it took the victim +a long time to regain his health.</p> + +<p>The individuals whom Dr. Watson described as suffering from “brain +fever” obviously had all passed through a terrific mental storm—in +modern parlance, they had sustained “severe psychic traumata.” Whether +this alone could cause “brain fever” is a moot question. The condition +presumably is caused by a virus. That a severe brain storm could cause +<span class="pagenum" id="Page_29">[Pg 29]</span> +the lurking virus to become active seems unlikely.</p> + +<p>Previously it has been mentioned that a head injury apparently is +capable of hastening the onset of brain fever in children. (We will +waive the fact that the cases Dr. Watson described are adults.) A +physical injury presumably produces certain organic changes in the +brain or in its meninges, which perhaps could precipitate an attack +of encephalitis, assuming that the virus was present. There is no +particular evidence that the patients mentioned in the tales had +suffered a head injury.</p> + +<p>It is true, of course, that great emotional upsets are often +accompanied by marked vascular disturbances. These may manifest +themselves in the brain as well as in other parts of the body. It is +not conceivable that encephalitis would follow an emotional storm. +Be that as it may, this can be said: It is generally agreed that +anything which lowers the resistance of an individual may make him more +susceptible to disease. In the cases described by Dr. Watson, the virus +may have been present, and the shock produced by the emotional storm, +which all these people experienced, might have precipitated an attack +of encephalitis (brain fever).</p> + +<p>If this seems too farfetched, and the reader cannot go along with me, +I can say only that I am sorry. I will have to use the argument that +one should allow a talented and imaginative writer like Dr. Watson a +liberal degree of poetic license.</p> + +<p>Dr. Watson may have used the term “brain fever” loosely, and perhaps as +synonymous with extreme nervous exhaustion. He does, however, mention +that some of the sufferers became delirious. This symptom is suggestive +of encephalitis. Also, in one or two instances the victim recovered +rather quickly, which points to an acute condition such as encephalitis +rather than nervous exhaustion. I am cognizant that some may regard +this as a specious argument.</p> + +<p>The question could be raised whether the patients described by Dr. +Watson suffered from hysteria. This condition cannot entirely be ruled +<span class="pagenum" id="Page_30">[Pg 30]</span> +out. Hysteria has protean manifestations, and may even be accompanied +by fever. The great mental storms through which these patients passed +are conducive to hysterical attacks. The fact, however, that these +individuals ran a high fever and were dangerously ill would militate +against a diagnosis of hysteria. It seems fairly safe to assume that +the disease from which they suffered probably had an organic basis.</p> + +<p>The reader should be reminded that Dr. Watson began the study of +medicine only a short time after the researches of Erb and of Westphal +on the nervous system had been published. Neurology had not yet come +into its own, and it is likely that the medical profession did not +make fine distinctions when dealing with diseases of the brain or its +meninges. It probably is not charitable for me to suggest that the +professors who taught the young Watson about nervous diseases in the +year 1876 or thereabouts had not kept up with the literature in their +field—a fault of which we are all more or less guilty.</p> + +<p>Dr. Watson has been taken to task by some critics in the medical +profession for using the term “brain fever,” and the implication has +been made that his employment of a meaningless term was unworthy +of a medically trained man. Now it appears that this criticism is +unjustified. We might quarrel with Dr. Watson as to what brought on +the attacks of “brain fever,” or whether the victims actually had the +disease in the cases he so vividly described, but the term itself is +acceptable.</p> + +<p>The Holmesian enthusiast will rejoice that the term “brain fever” +is again in good repute and is accepted by the medical fraternity. +The very fact that the staid <i>Journal of the American Medical +Association</i> has published an article bearing the title “Brain +Fever” has stripped criticism of all weapons. The loyal Holmesian no +longer needs to feel apologetic for the nomenclature Dr. Watson used to +describe a rather unusual and fortunately rare clinical entity.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_31">[Pg 31]</span></p> +<h2 class="nobreak" id="CURARE_AND_SHERLOCK_HOLMES"> +CURARE AND SHERLOCK HOLMES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc">“... for the action of the alkaloid is rapid.”</p> + +<p class="right"> +<i>A Study in Scarlet</i></p> +</div> + + +<p>Curare is used as a lethal agent in two of the Sherlock Holmes stories. +In the novel <i>A Study in Scarlet</i>, liberties are taken with the +pharmacologic properties of curare, for actions are ascribed to this +agent which it could not possibly have had. But in <i>The Adventure +of the Sussex Vampire</i>, curare is employed scientifically and with +telling effect; and indeed, an interesting plot is built around this +agent.</p> + +<p>Let us first examine the role curare played in <i>A Study in +Scarlet</i>. Holmes, it will be remembered, wished to determine the +toxicity of certain pills and instructed Dr. Watson to fetch a little +dog, which already was <i>in extremis</i>: “... that poor little devil +of a terrier which has been bad so long, and which the landlady wanted +you to put out of its pain yesterday.” Watson commented on the state of +the animal: “Its laboured breathing and glazing eye showed that it was +not far from its end. Indeed, its snow-white muzzle proclaimed that it +had already exceeded the usual term of its existence.” Then, according +to Dr. Watson, some of the pills which were thought to contain curare +were dissolved in milk and offered to the sick dog: “The unfortunate +creature’s tongue seemed hardly to have been moistened in it before it +gave a convulsive shiver in every limb and lay as rigid and lifeless as +if it had been struck by lightning.”</p> + +<p>Before we comment on the sudden death of the terrier, let us see what +befell Enoch Drebber, who was forced by Jefferson Hope to swallow +<span class="pagenum" id="Page_32">[Pg 32]</span> +a pill containing curare. The wretched Drebber met the same fate as +the aged terrier, for we find Watson writing: “... the action of the +alkaloid is rapid. A spasm of pain contorted his features; he threw his +hands out in front of him, staggered, and then with a hoarse cry, fell +heavily upon the floor. I turned him over with my foot, and placed my +hand upon his heart. There was no movement. He was dead.”</p> + +<p>The deaths of Drebber and the terrier were dramatically portrayed, and +Dr. Watson is to be congratulated on the vivid picture he presented. +The trained scientist however, could not entirely accept the events +as he outlined them. The difficulty lies in the fact that curare is +relatively harmless if taken by mouth. If extremely large doses are +administered on an empty stomach, sufficient curare may be absorbed +to cause grave symptoms, but death would not be instantaneous, for +absorption is slow from mucous surfaces. If, on the other hand, there +were an open lesion in the stomach or the upper part of the small +intestine, such as an ulcer, then rapid absorption could take place, +and death would ensue in a relatively short time, although not as +rapidly as portrayed in the story. The action of curare is rapidly +lethal only if injected directly into the blood stream. It would +stretch our credulity too far to assume that both the dog and the man +had either a gastric or a duodenal ulcer.</p> + +<p>Let us now consider how curare was employed in the story <i>The +Adventure of the Sussex Vampire</i>. It will be recalled that Sherlock +Holmes was asked by Mr. Robert Ferguson to investigate certain +irregularities in his household. Ferguson, a fine gentleman, was very +much in love with his beautiful Peruvian wife; but one day, to his +infinite horror, he had actually seen her sucking blood from a wound on +the neck of their year-old baby. She refused to make any explanation, +and the husband and wife became estranged. There was another child in +the family, an invalid boy of fifteen, Ferguson’s son by a previous +marriage.</p> + +<p><span class="pagenum" id="Page_33">[Pg 33]</span></p> + +<p>Dr. Watson accompanied Sherlock Holmes to Ferguson’s country home on a +dreary autumn day. One of the rooms of the old house contained a fine +collection of South American utensils and weapons which presumably had +been brought from Peru by the mistress of the house. As Holmes was +examining this interesting collection, the movements of a dog attracted +his attention. Holmes noted that the dog experienced difficulty in +walking. The astute detective asked Ferguson what ailed the dog. His +host replied that the thing had also puzzled the veterinarian. The +latter had thought it might be spinal meningitis. Holmes asked a few +more questions about the dog, and finally remarked that the picture the +dog presented was very suggestive.</p> + +<p>The frantic husband insisted that Holmes tell all he knew or suspected. +Holmes then gently explained to the indulgent father that his +fifteen-year-old invalid boy was so insanely jealous of his healthy +baby half-brother that he had tried to do away with him by wounding +him with an arrow treated with curare. The boy had first tried out the +poison on the dog. Ferguson’s wife, in an heroic effort to save her +baby, had sucked the site of the arrow wound. The mystery was solved, +and Holmes and Watson had the keen satisfaction of clearing up the +grave misunderstanding between Ferguson and his lovely Peruvian wife.</p> + +<p>In this story, curare was handled in an expert manner. It is known, of +course, that the South American Indians dipped their arrowheads into a +curare solution before using them to kill birds. The curare was rapidly +absorbed from the wound made by the arrow; the wing muscles became +paralyzed; and the bird plummeted to earth—an airplane without wings.</p> + +<p><i>The Adventure of the Sussex Vampire</i> was written many years +ago. What is the status of curare today? This interesting compound +has actually insinuated itself from the jungle not only into the +experimental laboratory but into the surgical amphitheater as well. +This is not the place to take up in detail the clinical use of curare, +but a few remarks are in order.</p> + +<p><span class="pagenum" id="Page_34">[Pg 34]</span></p> + +<p>Relaxation of the muscles is often highly desirable in surgical +procedures; it is not surprising, therefore, that the anesthetists have +added curare to their armamentarium. Although curare has no anesthetic +action <i>per se</i>, it has been found to serve as a useful adjuvant +to certain anesthetic agents. It has been used also for the convulsions +of strychnine poisoning, tetanus, and hydrophobia, as well as certain +spastic contractures. It could furthermore be of help in the management +of dislocations, especially in heavily muscled individuals.</p> + +<p>Curare should be employed only by experienced workers, for the muscles +of respiration may become paralyzed, and unless mechanical respiration +is given immediately, the patient will die of asphyxia. Fortunately, +curare is quickly excreted by the body, and the patient will soon start +voluntary breathing movements.</p> + +<p>In conclusion, let us turn to the tales. <i>The Adventure of the +Sussex Vampire</i> could have been written only by an individual quite +familiar with the action of curare, and with a good understanding of +clinical medicine. This story is of especial interest to physicians. +Not only is curare used in the plot in an interesting and unusual +manner, but certain psychosomatic problems are presented: The +estrangement of the husband and wife; and a clear portrayal of how the +mind of a physically handicapped youngster may become warped, even +though reared in an excellent environment.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_35">[Pg 35]</span></p> +<h2 class="nobreak" id="SHERLOCK_HOLMES_AND_THE_PORTUGUESE_MAN-OF-WAR"> +SHERLOCK HOLMES AND THE PORTUGUESE MAN-OF-WAR</h2> +</div> + +<div class="blockquot"> + +<p class="nindc">“I did what I could to relieve his pain.”</p> + +<p class="right"> +<i>The Adventure of the Copper Beeches</i></p> +</div> + + +<p><i>The Adventure of the Lion’s Mane</i> has always appealed to me, +although I am mindful that this story is not universally popular +with Holmesian enthusiasts. The story was written by Sherlock Holmes +himself. The title alone arrests one’s attention. Immediately, one +thinks of a magnificently maned lion at bay, or, as one artist pictures +him, standing in the moonlight on the shore of the ocean, roaring +defiantly at the incoming waves.</p> + +<p>As the adventure unfolds, however, we learn that while the story +does deal with the ocean, a lion is not mentioned, but rather a huge +jellyfish, <i>Cyanea capillata</i>. It is also called the “Lion’s +Mane,” for as Holmes wrote, the jellyfish resembled a mass of tangled +hair which looked as if it might have been procured from a lion’s mane.</p> + +<p>Let us recall that in this story the death of a person, as well as that +of a dog, was produced by the poisonous sting of the Lion’s Mane. The +victim of this catastrophe was Fitzroy McPherson, a young scientist who +had suffered from rheumatic fever, and whose heart had been damaged. In +spite of his cardiac ailment, he was portrayed as a fine athlete and an +expert swimmer. It was his custom to take a daily dip in the ocean in +and out of season.</p> + +<p>At the time of which we write, Sherlock Holmes was living in retirement +on the Sussex Downs, not far from the place where McPherson often +<span class="pagenum" id="Page_36">[Pg 36]</span> +swam. One fine morning in July, following a severe storm, Holmes and +his neighbor Stackhurst, who kept a preparatory school, were taking a +bracing walk. To their intense surprise and dismay, they discovered the +figure of McPherson, a science master of Stackhurst’s establishment, +coming up the path staggering as if drunk. As they came nearer, he +uttered a terrible cry and fell upon his face. They rushed to his side +and turned him on his back. He was <i>in extremis</i>. Just before he +expired, he indistinctly uttered words that sounded like “lion’s mane.” +The cause of his death was a mystery even to Holmes.</p> + +<p>A few days later, Ian Murdoch, a colleague and close friend of the late +McPherson, went swimming in the exact spot where the latter had met his +untimely death. Holmes dramatically describes how Ian Murdoch lurched +in the room, extremely pale, and with his clothes all rumpled. It was +an effort for him to stand; finally, he staggered to the sofa and +collapsed from the excruciating pain. He experienced great difficulty +in getting his breath, his face appeared livid, and beads of cold sweat +stood on his brow. It appeared that he was also <i>in extremis</i>.</p> + +<p>It is not necessary to relate here the steps which Holmes took in +solving this baffling mystery. Suffice it to say that he came to the +conclusion that both McPherson and Murdoch had come into contact with +a huge jellyfish. He became absolutely convinced of this when he +discovered in the attic of his home a book by J. G. Wood entitled, +<i>Out of Doors</i>. Holmes found in this book a description of a +patient who had been in contact with a jellyfish. The victim complained +that while the local pain was severe, it was nothing compared to the +pangs which surged through his chest. It was impossible for him to +stand up. The cardiac beat became quite irregular; the heart would +virtually stop, and then several violent pulsations would occur.</p> + +<p>Admittedly, Holmes’ story is a thrilling one. The criticism to be +<span class="pagenum" id="Page_37">[Pg 37]</span> +made, however, is that although <i>Cyanea capillata</i> can produce +a nasty sting, it probably could not produce death, especially in a +healthy person. There is no question but that it would be an unpleasant +experience for a swimmer to come into contact with <i>Cyanea</i>. In a +standard textbook of biology, <i>Cyanea arctica</i>, another species of +the same genus, is described as a creature which may measure six feet +in diameter and bear tentacles reaching the astonishing length of one +hundred and thirty feet! It can readily be seen that a swimmer could +easily be stung by such a jellyfish before recognizing the danger.</p> + +<p>Since it is generally believed that <i>Cyanea capillata</i> cannot +cause the death of an individual, and since the symptoms described in +<i>The Adventure of the Lion’s Mane</i> were so grave, the coelenterate +which Holmes had in mind probably was no other than <i>Physalia</i>, +commonly known as the Portuguese man-of-war. Exposure to the tentacles +of this creature is apt to produce a chain of alarming symptoms.</p> + +<p>Owing to my warm interest in Holmes’ story I read with profit and +keen enjoyment a case history reported by Klein and Bradshaw.<a id="FNanchor_2" href="#Footnote_2" class="fnanchor">[2]</a> A +twenty-year-old man, while swimming about twenty feet off North Miami +Beach, Florida, came into contact with a Portuguese man-of-war. His +attention was drawn to a purple object floating near him, which he +thought to be a balloon. He swam up and touched it. Immediately, he +became aware of a sharp stinging sensation on his arm and shoulder. +Noting several strands which he could not brush off, he left the +water at once, and a companion removed them with a towel. Underneath +each strand could be seen a “painful fiery red welt.” Soon he found +it difficult to breathe, and shortly suffered from severe abdominal +cramps. A little later, he showed signs of shock and mental confusion.</p> + +<p><span class="pagenum" id="Page_38">[Pg 38]</span></p> + +<p>A swimmer exposed to the tentacles of these large jellyfish may, +according to Klein and Bradshaw, suffer pain, swelling, and redness +in the affected part. In a few minutes to an hour following exposure, +systemic effects may appear, such as anxiety, muscular pains and +cramps, dyspnea, constriction of the throat, cardiac symptoms, and +prostration. The authors stress that the alarming symptoms which often +follow stings from coelenterates suggest the action of a powerful +neurotoxin.</p> + +<p>Waite,<a id="FNanchor_3" href="#Footnote_3" class="fnanchor">[3]</a> writing in the same year, stresses the fact that contact with +a Portuguese man-of-war produces symptoms indicative of anaphylactic +shock, such as pallor, sweating, faintness, fall in blood pressure, and +the like. He mentions that although there have been no authenticated +medical reports of death as a result of the sting of a Portuguese +man-of-war, it could happen if complicated by anaphylactic shock.</p> + +<p>One wonders, of course, what would have happened if the patient +described by Klein and Bradshaw had been some distance from shore. +If anaphylactic shock had occurred within a few minutes, the patient +no doubt would have drowned if no one had been in the vicinity to +help him. A swimmer who experiences difficulty in breathing, who is +afflicted with severe abdominal cramps, who shows signs of shock, and +who is mentally confused, will certainly drown. Indeed, any one of +these four symptoms could provoke disaster in deep water.</p> + +<p>The treatment instituted by Klein and Bradshaw is worthy of our +attention. The patient was hospitalized and given calcium gluconate +and benadryl intravenously. Epinephrine and atropine were administered +intramuscularly, and ammonia applied locally. I might add that a purist +could raise the question whether all this medication was necessary. The +next day, the itching areas were treated with tetracaine. The patient +<span class="pagenum" id="Page_39">[Pg 39]</span> +made an uneventful recovery, although it took about three weeks before +the lesions were healed. Waite emphasizes that, in case of anaphylactic +shock, epinephrine or benadryl should be given immediately. He warns +further that if angioneurotic edema appears, the air passageways +should be cleared, oxygen supplied, and, if necessary, a tracheotomy +performed. The latter constitutes heroic treatment, but may, of course, +save a person’s life.</p> + +<p>Let us return to <i>The Adventure of the Lion’s Mane</i>, in an attempt +to ascertain what medical agents were used fifty years ago to treat the +sting of coelenterates. As previously mentioned, Sherlock Holmes was in +retirement and living alone, so unfortunately he could not call upon +his friend Dr. Watson to prescribe for Ian Murdoch.</p> + +<p>Holmes, however, rose to the occasion and made an earnest attempt to +help the patient, for he writes that he soaked cotton in salad oil and +applied it to the wounds. He felt that this greatly alleviated the +pain. The famous detective showed real ingenuity in making use of such +a homely remedy. He also gave the suffering man liberal quantities of +brandy, which doubtless had a narcotizing effect. There is considerable +evidence that brandy was widely used for medicinal purposes at the turn +of the century, when this adventure is supposed to have occurred.</p> + +<p>It is of interest to speculate upon what medication Dr. Watson would +have administered to Ian Murdoch had he been in attendance. At that +time, neither benadryl nor calcium gluconate nor, for that matter, +tetracaine was available. On the other hand, epinephrine, atropine, +and ammonia were even then widely used. Dr. Watson presumably would +have given a hypodermic injection of morphine and offered the patient +brandy, as did Sherlock Holmes. He, too, doubtless would have applied +some soothing ointment to the painful lesions, or, like Klein and +Bradshaw, might have used ammonia. It is even possible that he would +have employed epinephrine. The latter certainly was indicated, for +<span class="pagenum" id="Page_40">[Pg 40]</span> +the symptoms described by Holmes were those of anaphylactic shock. +This syndrome (anaphylactic shock) was not well understood fifty years +ago. In point of fact, the word “anaphylaxis” was coined in 1907 by +Richet. This, as mentioned earlier, was the year when the adventure was +supposed to have taken place. Holmes, however, wrote <i>The Adventure +of the Lion’s Mane</i> probably in 1925, since it was first published +in 1926. At that time, the significance of anaphylactic shock in man +was pretty well understood, and it is possible that he was familiar +with this condition.</p> + +<p>It is a pity that we have to resort to speculation, and that Dr. Watson +was not in attendance instead of Holmes, a nonmedical man. If such +had been the case, Watson probably would have mentioned the agents +medical men used at that time. This would not only have satisfied our +sympathetic curiosity but, what is more important, these facts would +have been of historical interest. We then could actually have compared +the medical agents which were prescribed fifty years ago with those +currently employed for the grave symptoms of shock produced by the +excruciatingly painful stings of coelenterates.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_41">[Pg 41]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSON_AND_NERVOUS_MALADIES"> +DOCTOR WATSON AND NERVOUS MALADIES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“... the shock of the night’s adventures had shattered his nerves.”</p> + +<p class="right"> +<i>The Hound of the Baskervilles</i></p> +</div> + + +<p>The harrowing adventures experienced by some of the characters in the +stories of Sherlock Holmes, and the great shocks they sustained, often +induced in them a state of high nervous tension. References to such +individuals are numerous.</p> + +<p>Sherlock Holmes himself possessed an iron constitution, and was favored +with an especially well-balanced mind. His biographer, John H. Watson, +M.D., writes, “All emotions ... were abhorrent to his cold, precise +but admirably balanced mind” (<i>A Scandal in Bohemia</i>). But even +Holmes, on one occasion at least, was on the verge of a serious nervous +breakdown. In the spring of 1897, Dr. Watson became concerned about +the health of his distinguished friend: “... I found him a prey to the +blackest depression ... [even his realization of his worldly fame] was +insufficient to rouse him from his nervous prostration” (<i>The Reigate +Puzzle</i>).</p> + +<p>Watson felt that Holmes needed a complete rest in a quiet and soothing +atmosphere, and finally persuaded the great detective to take a holiday +in the country. Arrangements were made to stay at the home of one of +Dr. Watson’s old friends. On the evening of their arrival, their host, +Colonel Hayter, in the course of a conversation following dinner, told +them of an unusual burglary which had occurred a few nights before +in the neighborhood. When Holmes manifested too warm an interest in +this event, Watson became alarmed and cautioned him: “You are here +for a rest, my dear fellow. For Heaven’s sake don’t get started on +<span class="pagenum" id="Page_42">[Pg 42]</span> +a new problem when your nerves are all in shreds” (<i>The Reigate +Puzzle</i>). Watson’s admonition proved of no avail. The next morning, +while at breakfast, they were informed that a dastardly murder had +been committed at the home of a nearby neighbor. Inspector Forrester, +knowing that Sherlock Holmes was in the vicinity, asked for his help. +Holmes answered the call, and after a rather painful experience, solved +the mystery brilliantly in the course of a few hours.</p> + +<p>The neat solution of this case, together with the concomitant +excitement which it afforded, apparently caused Holmes to recover +quickly from his “blackest depression,” for that afternoon he remarked +to his faithful friend, “Watson, I think our quiet rest in the country +has been a distinct success, and I shall certainly return much +invigorated to Baker Street tomorrow” (<i>The Reigate Puzzle</i>). This +episode demonstrates the man’s superb constitution. Most people would +have required several weeks, or even months, to recover their normal +health following a severe nervous breakdown. But not Holmes.</p> + +<p>In several instances, the characters described by Dr. Watson showed +clear-cut signs of hysteria. When the well-known banker Alexander +Holden found that the “Beryl Coronet,” which had been intrusted to his +care, had been mutilated and three of its jewels stolen, he became +greatly agitated and called on Sherlock Holmes:</p> + +<div class="blockquot"> + +<p>For a while he could not get his words out, but swayed his body and +plucked at his hair like one who has been driven to the extreme limits +of his reason. Then suddenly springing to his feet, he beat his head +against the wall with such force that we both rushed upon him and tore +him away to the centre of the room.</p> + +<p class="right"> +<i>The Adventure of the Beryl Coronet</i></p> +</div> + +<p>This highly respected citizen must have been an emotionally unstable +person. One wonders how he could have been a successful banker, with +<span class="pagenum" id="Page_43">[Pg 43]</span> +such a sensitive nervous system. The poor man must have lain awake +many a weary night worrying about his investments. We do not know +his subsequent history, but I suspect that he eventually developed +hypertension or suffered from gastric ulcers.</p> + +<p>When Rachel Howells was questioned by the master of the house about the +disappearance of her perfidious lover Brunton, she showed pronounced +signs of hysteria:</p> + +<div class="blockquot"> + +<p>She looked at me with so strange an expression that I began to suspect +that her brain was affected.... She fell back against the wall with +shriek after shriek of laughter, while I, horrified at this sudden +hysterical attack, rushed to the bell to summon help. The girl was +taken to her room still screaming and sobbing....</p> + +<p class="right"> +<i>The Musgrave Ritual</i></p> +</div> + +<p>There was a real reason for the girl’s behavior; she had been directly +responsible for her lover’s horrible death. It is small wonder that she +suffered a violent hysterical attack.</p> + +<p>Once Dr. Watson was asked to see the wife of his boyhood friend Robert +Ferguson. It was a tragic situation. She had been observed on several +occasions sucking blood from her infant son. The sympathetic doctor +stated that she appeared only half conscious, and had a frightened +expression. Her pulse and temperature were both high, but he felt +that this was due to her highly emotional state (<i>The Adventure of +the Sussex Vampire</i>). Mrs. Ferguson was probably suffering from +hysteria. The attack cleared up promptly when Sherlock Holmes sat down +at the patient’s bedside and, in the presence of her husband, analyzed +the situation, explaining why it was necessary for Mrs. Ferguson to +suck the baby’s wounds. They had been made by arrows dipped in curare. +The baby’s insanely jealous half-brother had committed this atrocious +deed. Truly, a shocking episode!</p> + +<p>In <i>The Greek Interpreter</i>, reference is made to a man who showed +<span class="pagenum" id="Page_44">[Pg 44]</span> +symptoms of St. Vitus’ dance. Mr. Melas described his unpleasant +companion: “... his lips and eyelids were continually twitching like a +man with St. Vitus’ dance. I could not help thinking that his strange, +catchy little laugh was also a symptom of some nervous malady.”</p> + +<p>The term “St. Vitus’ dance” is seldom used nowadays; it is presently +called “acute chorea.” This condition is characterized by irregular +involuntary contractions of the muscles and is associated with a +variable amount of psychic disturbance. The name (St. Vitus’ dance) +has been handed down from the Middle Ages. Epidemics characterized +by excitement, gesticulations, and dancing brought about mainly by +religious fervor were in those days not uncommon. Whenever these +symptoms became excessive, the people in the Rhenish province +frequently made pilgrimages to the Chapel of St. Vitus in Zebern.</p> + +<p>Another reference to twitching muscles may be cited. Sherlock Holmes +called on Mr. Sidney Johnson, senior clerk and draughtsman, in an +office from which extremely important secret papers had disappeared. +Watson writes that the clerk had haggard cheeks, and that his hands +were twitching from the nervous strain he had undergone (<i>The +Adventure of the Bruce-Partington Plans</i>).</p> + +<p>In the tales, other references may be found to shattered nerves and +states of nervous exhaustion. In describing the condition of her +father, Alice Turner tells Sherlock Holmes: “... Dr. Willow says +that he is a wreck and that his nervous system is shattered” (<i>The +Boscombe Valley Mystery</i>). The real reason for his pitiful state, +which his daughter did not know, was that he had recently murdered an +old acquaintance.</p> + +<p>When Don Murillo, Tiger of San Pedro, tried to kidnap Miss Burnett, she +broke away from him, and with the help of a friend got into a cab. Here +Holmes saw her, and observed that she was in a state of collapse from +nervous exhaustion (<i>The Adventure of Wisteria Lodge</i>). This brave +lady had been locked in a room for a number of days with insufficient +<span class="pagenum" id="Page_45">[Pg 45]</span> +food, and had undergone other traumatic experiences. It is no wonder +that Holmes found her in such a pitiful state.</p> + +<p>After Sir Henry Baskerville had narrowly escaped death on the moor from +the savage hound, he suffered a nervous collapse, “... the shock of +the night’s adventure had shattered his nerves.” Sir Henry assuredly +was not a weak man, but the victim of a concatenation of unfortunate +circumstances. The family history of the hound, Sir Henry’s love for a +married woman, his isolation and loneliness, and the somber landscape +of the bleak moor doubtless all preyed on his mind. When the hound +actually sprang upon him, his nervous system finally reached the +breaking point. Stronger men than he would have quailed.</p> + +<p>Mr. Marlow Bates, the manager of the estates of the wealthy “Gold King” +Mr. Gibson (whose wife had been found dead), called on Sherlock Holmes. +Watson describes him as a small, thin, fidgety man, who appeared to be +on the brink of a serious nervous breakdown. Although in great fear of +his vicious employer, Bates detested him so heartily that he hurried +to Baker Street and told Holmes that Gibson was an “infernal villain.” +In view of the circumstances, this was indeed a grave accusation. The +reader will recall that the “Gold King” had not murdered his wife; she +had died by her own hand (<i>The Problem of Thor Bridge</i>).</p> + +<p>The eyes often show a characteristic expression under emotional strain. +Referring to Colonel Valentine Walther, whose brother had suddenly +died, Watson observes that he had wild eyes and presented a worried +and disheveled appearance (<i>The Adventure of the Bruce-Partington +Plans</i>). It was discovered that it was the colonel who had stolen +an extremely important state document. His older brother, Sir James, +suspected Valentine’s guilt. The shock was too much for the older +man and caused his death; there was a question as to whether he took +his own life. Be that as it may, his younger brother was responsible +for the tragedy. We are not surprised to learn that the eyes of the +<span class="pagenum" id="Page_46">[Pg 46]</span> +colonel had a wild expression.</p> + +<p>People under great emotional strain often break out in a cold sweat. +Nearly everyone has, at one time or another, experienced this +phenomenon. It is caused by violent stimulation of the sympathetic +nervous system. When John Openshaw’s uncle Elias received a letter +containing five orange pips, a great change came over him. At times he +acted like a madman. His nephew told Holmes, “At such times I have seen +his face, even on a cold day, glisten with moisture, as though it were +new raised from a basin” (<i>The Five Orange Pips</i>).</p> + +<p>A cold sweat is more apt to manifest itself on the forehead, but it +is not necessarily limited to the face, for any portion, or all, +of the body may be involved. The cold, clammy sweat produced under +conditions of intense mental stress is different, of course, from the +normal healthy sweat brought about by a warm environment or by physical +exertion, or by both. The physiologic explanation of a cold sweat is +that it is a condition brought about by pain or fear as a reaction +anticipatory of the strenuous muscle movements that may ensue.</p> + +<p>Victor Trevor’s father was also the recipient of a letter which led to +tragedy:</p> + +<div class="blockquot"> + +<p>My father read it, clapped both hands to his head and began running +round the room in little circles like a man who has been driven out of +his senses.... I saw that he had a stroke.</p> + +<p class="right"> +<i>The “Gloria Scott”</i></p> +</div> + +<p>Apparently, this individual became so agitated, and his blood pressure +rose so high, that he was stricken with a fatal cerebral hemorrhage. +It is well known that emotions may produce a pronounced rise in blood +pressure even in healthy people.</p> + +<p><span class="pagenum" id="Page_47">[Pg 47]</span></p> + +<p>Most of the nervous maladies described by Dr. Watson were in the +nature of acute episodes, and more or less transient in character. The +individuals he depicted were high-strung, nervous people, overwhelmed +by the traumatic experiences to which they had been subjected. Some +of these were unable to suppress their emotions and either became +hysterical or suffered a nervous collapse.</p> + +<p>As a rule, we do not think of the English people as giving way to +their feelings, but as governing them strictly. It is the Latins who +are supposed to manifest hysterical reactions. However, it would +take extraordinarily strong men, regardless of their nationality, +to maintain normal mental equilibrium under some of the situations +described in the spine-tingling tales; even the stolid Britishers +cracked under the mental strain. The nervous system of man can +withstand just so much and no more. It is given to but few to possess +nerves of steel, and even such rare individuals finally reach a +breaking point. Man is not a machine, but a human being.</p> + +<p>If Dr. Watson were writing his adventurous stories today, he probably +would stress the fact that long-continued nervous strain is likely +to produce ulcers of the stomach or of the duodenum. The modern view +is that mental worry may lead to hypertension and to diseases of the +arteries, especially those which supply the heart muscles, namely, the +coronaries—although it is true, as previously mentioned, that most +of the characters depicted in the tales suffered mental strain for a +substantial length of time.</p> + +<p>It is noteworthy that both Sherlock Holmes and Dr. Watson maintained a +nice mental balance even during periods of tremendous excitement and +danger. A striking characteristic about both was their extraordinary +fearlessness and mental poise. Although people around them often +manifested signs of abject fear, or were given to hysterical outbursts, +our heroes never faltered, but maintained a calm demeanor and +dispatched neatly and efficiently the task before them.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_48">[Pg 48]</span></p> +<h2 class="nobreak" id="DOGS_AND_SHERLOCK_HOLMES"> +DOGS AND SHERLOCK HOLMES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“It was a giant dog, as large as a calf, tawny tinted, with hanging +jowl, black muzzle, and huge projecting bones.”</p> + +<p class="right"> +<i>The Adventure of the Copper Beeches</i></p> +</div> + + +<p>To those interested in animals, it is gratifying to know that two of +the most popular heroes of detective fiction—Sherlock Holmes and +Dr. Watson—both loved dogs. They did not like them in a sickly, +sentimental sense, but rather with a genuine, masculine affection. +They regarded them as dogs, not as human beings, and emphasized and +respected their canine personalities. I am sure every self-respecting +dog would want to be so regarded.</p> + +<p>Frequent mention of dogs is found in the tales. In point of fact, +the grisly, spectral hound portrayed in <i>The Hound of the +Baskervilles</i> has become a byword not only among readers of +detective fiction but also with people in general. Various kinds of +dogs are portrayed: large dogs, small dogs, good ones and bad ones. In +one instance, a lovable, curly-haired spaniel is depicted; in another, +a plodding bloodhound; and in still another, a fiendish dog.</p> + +<p>One Sunday evening, in early September, in the year 1903, Sherlock +Holmes summarily sent for Dr. Watson. The friendly doctor, not wishing +to disappoint his friend, set out for Baker Street, and entered the +old apartment, which for a number of years had also been his home. +Holmes waved him to a chair, and after a considerable period of silence +remarked that he was seriously considering writing a monograph on +the use of dogs in the work of a detective (<i>The Adventure of the +<span class="pagenum" id="Page_49">[Pg 49]</span> +Creeping Man</i>).</p> + +<p>Dr. Watson did not think much of the idea, and pointed out that this +field had been pretty thoroughly explored. Holmes would not agree. +He explained that he wished to approach the subject from a somewhat +different angle than had previously been done. He argued that a dog +reflected a family’s life. If the household were a happy one, the dog +would be friendly and frisky; conversely, if the family were gloomy, +the dog would appear sad. He insisted further that dangerous and +unpleasant dogs are owned by dangerous and unpleasant people.</p> + +<p>Holmes bolstered his argument by giving as an illustration the case on +which he was presently working. He believed that the changed behavior +of a wolfhound toward his master might turn out to be an important clue +in solving the mystery. This eventually proved to be true, as will +be described later. Although we may congratulate Holmes on his keen +analysis, and on his pungent manner of presenting the argument, there +surely must be many exceptions which come to the minds of us all. We +have witnessed nice people who harbor vicious dogs, and the opposite as +well. We will not quibble, but agree for the main part that Holmes was +probably right.</p> + +<p>Hounds are frequently mentioned. In <i>The Sign of the Four</i>, +Watson, describing Holmes in action, writes: “So swift, silent, and +furtive were his movements, like those of a trained bloodhound picking +out a scent.” Again, in <i>A Study in Scarlet</i>, we see: “As I +watched him I was irresistibly reminded of a pure-blooded, well-trained +foxhound, as it dashes backward and forward through the covert, +whining in its eagerness, until it comes across the lost scent.” In +<i>The Red-Haired League</i>, Jones of Scotland Yard, speaking to his +colleague Wilson, comments: “Our friend Holmes here is a wonderful man +for starting a chase. All he wants is an old dog to help him in the +running down.” Other habits of hounds may be found in <i>The Adventure +<span class="pagenum" id="Page_50">[Pg 50]</span> +of the Devil’s Foot</i> and <i>The Adventure of the Bruce-Partington +Plans</i>. Numerically, hounds are mentioned more frequently in the +tales than any other kind of dog, and in several instances hounds +actually track down the criminal.</p> + +<p>It will be recalled that in <i>The Sign of the Four</i> the dependable +old hound Tobey follows a creosote scent. In <i>The Adventure of the +Missing Three-Quarter</i>, faithful old Pompey follows a carriage +which had had aniseed squirted upon the wheel by Holmes. On this +occasion, Holmes remarks to Watson that a draghound would follow +aniseed indefinitely. Holmes takes almost a human interest in Pompey. +The detective formally introduces the dog to Dr. Watson and speaks +highly of the draghound’s tracking ability. However, he did not trust +all dogs, for we find him saying to Watson that some dogs bite the hand +that feeds them (<i>The Adventure of the Three Gables</i>).</p> + +<p>Two especially fiendish dogs are portrayed in the tales: Carlo the +mastiff, in <i>The Adventure of the Copper Beeches</i>; and the +spectral hound, in <i>The Hound of the Baskervilles</i>. In the former, +the despicable Rucastle, the master of Carlo, said: “We feed him once a +day, and not too much then, so that he is always as keen as mustard.... +God help the trespasser whom he lays his fangs upon!” Miss Violet +Hunter, the heroine of the story, saw this beast one night: “It was a +giant dog, as large as a calf, tawny tinted, with hanging jowl, black +muzzle, and huge projecting bones.” Watson vividly describes the attack +Carlo finally made on his master:</p> + +<div class="blockquot"> + +<p>There was the huge famished brute, its black muzzle buried in +Rucastle’s throat, while he writhed and screamed upon the ground. +Running up, I blew its brains out, and it fell over with its keen +white teeth still meeting in the creases of his neck.</p> +</div> + +<p>In <i>The Hound of the Baskervilles</i>, we find a hound which would +frighten the Evil One himself. Evidently, this huge beast was a +<span class="pagenum" id="Page_51">[Pg 51]</span> +mongrel: “It was not a pure bloodhound and it was not a pure mastiff; +but it appeared to be a combination of the two—gaunt, savage, and as +large as a small lioness.” Watson paints this animated picture:</p> + +<div class="blockquot"> + +<p>A hound it was, an enormous coal-black hound, but not such a hound as +mortal eyes have ever seen. Fire burst from its open mouth, its eyes +glowed with a smouldering glare, its muzzle and hackles and dewlap +were outlined in flickering flame.</p> +</div> + +<p>While this hound was worrying the throat of Sir Henry Baskerville, +Holmes emptied five barrels of his revolver into the creature’s flank. +“With a last howl of agony and a vicious snap in the air, it rolled +upon its back, four feet pawing furiously, and then fell limp upon its +side.”</p> + +<p>Other breeds are not ignored. Holmes, who had considerable +professional jealousy, would not admit that Jones of Scotland Yard +had the imagination a detective should have, or that he had a keen +intellect, but does pay him this fine compliment: “He is as brave as +a bulldog....” (<i>The Red-Haired League</i>.) A reference is made to +rat terriers in <i>The Adventure of the Crooked Man</i>. Spaniels also +are mentioned on at least two occasions. Dr. Mortimer, in the story of +<i>The Hound of the Baskervilles</i>, owns a curly-haired spaniel of +which he is extremely fond. Unfortunately, this lovable dog comes to +grief on the moor. In <i>The Adventure of Shoscombe Old Place</i>, a +spaniel plays an important part in solving the mystery. The so-called +“Shoscombe spaniels” were famous throughout England, and, according to +Holmes, were frequently mentioned at dog shows. He successfully uses +one of these, a pet spaniel, to establish the fact that the person in +the carriage is not the dog’s mistress. Holmes was satisfied that the +spaniel was right, and insisted that dogs do not make mistakes in such +cases.</p> + +<p>Another instance can be cited where the behavior of a dog helped +<span class="pagenum" id="Page_52">[Pg 52]</span> +Sherlock Holmes solve a perplexing problem. In talking to Watson, he +laid great stress on the fact that Professor Presbury’s heretofore +friendly wolfhound Roy had turned on his master and tried to attack +him. This extraordinary episode played an important part in the final +solution of the mystery (<i>The Adventure of the Creeping Man</i>). +The facts in the case were these: Professor Presbury, a distinguished +physiologist, had fallen madly in love with a very young girl, and, +in an effort to regain his lost youth, had periodically been taking +hypodermic injections of serum obtained from langurs. According to +the story, the monkey serum produced apelike qualities in Professor +Presbury. Following the injections, the professor would deliberately +and maliciously tease his wolfhound until one night the hound slipped +his collar and viciously attacked his master. He buried his muzzle in +his master’s throat; and if timely aid had not come, Presbury would +have been killed. As Holmes remarked to Watson, the hound thought he +was attacking the monkey and not the professor.</p> + +<p>Since Holmes was a detective, and not a professional biologist, he +seldom found it necessary to use dogs for experimental purposes. +Once, however, he did not hesitate to try out the effects of a poison +drug, curare, on an old dog which was <i>in extremis</i>. It will +be recalled that this poison caused instant death (<i>A Study in +Scarlet</i>). While not a biological scientist—as we understand the +word today—Holmes nevertheless was scientifically minded, and it is +certain that had the need arisen to obtain evidence which would have +helped mankind he would not have hesitated to experiment on a normal, +healthy dog. He was a practical man, in the fullest sense of the word, +and had, as Watson said, “... an admirably balanced mind” (<i>A Scandal +in Bohemia</i>).</p> + +<p>It is true that both Sherlock Holmes and Dr. Watson grieved when Dr. +Mortimer’s pet curly-haired spaniel met its fate on the moor, and they +both loved Tobey, the faithful old bloodhound who had aided them in +<i>The Sign of the Four</i>. However, they did not hesitate to shoot +<span class="pagenum" id="Page_53">[Pg 53]</span> +five bullets into the flank of the hound of the Baskervilles when he +was at the throat of Sir Henry, or to blow out the brains of Carlo the +mastiff when he sank his teeth into the fat neck of the villainous +Rucastle. Holmes and Watson were not sentimentalists, but virile, +vigorous men of action—the type of men dogs like.</p> + +<p>Finally, Dr. Watson pays a tribute to dogs in general in <i>The +Adventure of the Lion’s Mane</i>. In this story, after McPherson died +from his encounter with the Lion’s Mane (<i>Cyanea capillata</i>), +his pet Airedale eventually met a similar fate. According to Sherlock +Holmes himself, the terrier did not eat for a week following his +master’s death, and finally followed the trail of his dead master. He +was found dead on the edge of the same pool where his master had lost +his life. It is true that the terrier did not have the opportunity +of saving his master’s life—but no doubt he would have, had it been +possible. The story portrays vividly the bond of companionship between +a man and his dog, for in this instance the dog apparently gave his +life searching for his master. Dr. Watson pays tribute to such devotion +in the words of Sherlock Holmes: “That the dog should die was after +the beautiful, faithful nature of dogs.” This is a tribute that can +be endorsed by all, but especially by biologists, who are so deeply +indebted to the dog for the aid it has given in the search for means to +alleviate the pain and suffering of mankind. I am certain that every +biologist who professes to be a Christian gentleman would say “Amen” +to Dr. Watson’s beautiful tribute to an animal which would die so that +mankind might live.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_54">[Pg 54]</span></p> +<h2 class="nobreak" id="THE_BOTANICAL_DOCTOR_WATSON"> +THE BOTANICAL DOCTOR WATSON</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“... there stood a patriarch among oaks, one of the most magnificent +trees that I have ever seen.”</p> + +<p class="right"> +<i>The Musgrave Ritual</i></p> +</div> + + +<p>Many delightful references to plant life may be found in the tales. +These allusions enrich the stories and add greatly to their charm and +interest. Love for inviting landscapes, for trees, for flowers, and +for shrubs appears to be innate in human beings. This would be a drab +world indeed without a variegated and a beautiful plant life. One need +not be a botanist to appreciate the beauty and fragrance of a rose or +a violet. They are different in design, but lovely in their own ways. +It is not meet that we attempt to analyze their beauty; let us merely +enjoy it. If an extravagant phrase be permitted, let us not subject the +beauty of the orchid to the flame of the analytic blowpipe or attempt +to measure the fragrance of the June rose with an olfactometer.</p> + +<p>After Dr. Watson had lived with Sherlock Holmes a few weeks, he became +intensely interested in this quiet but unusual man. One day he sat +down and made an attempt to analyze and evaluate Holmes’ conversance +in several fields. While Dr. Watson felt that Holmes’ understanding of +anatomy was good, his knowledge of botany was “variable.” The worthy +doctor writes: “Knowledge of Botany—Variable. Well up in belladonna, +opium, and poisons generally. Knows nothing of practical gardening” +(<i>A Study in Scarlet</i>). Thus, it appears that Holmes was more +interested in medicinal plants, and especially those from which poisons +could be extracted. This does not surprise us, because of his interest +in crime detection; we know, too, of his researches in the chemistry +<span class="pagenum" id="Page_55">[Pg 55]</span> +of the alkaloids.</p> + +<p>We must keep in mind that Watson wrote of Sherlock Holmes: +“Appreciation of nature found no place among his many gifts” (<i>The +Adventure of the Cardboard Box</i>). A man uninterested in nature is +not apt to take especial notice or appreciate the beauty of flowers or +vegetation. We are indebted, therefore, largely to Dr. Watson for the +many pleasing references to plant life and landscapes.</p> + +<p>We find allusions to a botanist and to the study of botany in <i>The +Valley of Fear</i> and in <i>The Adventure of Wisteria Lodge</i>. +In the first story, Watson likens Holmes to a botanist rapt in his +admiration for a beautiful flower; and in the latter story, Watson +points out that many instructive days can be spent in the study of +botany and suggests the use of an elementary text on the subject, a +spud, and a proper box to hold the specimens. The amateur botanist will +surely appreciate these suggestions. Such a person will find pleasure +no matter where he strays—in the forest, the plains, the mountains, or +the desert. He will never be bored.</p> + +<p>Dr. Watson obviously loved the vegetation of early spring, for he +writes: “... the first faint shoots of green were breaking out upon the +elm, and the sticky spearheads of the chestnuts were just beginning +to burst into their fivefold leaves” (<i>The Adventure of the Yellow +Face</i>). Also, we read, “The trees and wayside hedges were just +throwing out their first green shoots.” (<i>The Adventure of the +Speckled Band</i>).</p> + +<p>The observant doctor was not unmindful of the autumn foliage. In <i>The +Hound of the Baskervilles</i>, he calls our attention to the melancholy +aspect of the countryside in the fall of the year, and speaks of the +yellow leaves lying on the ground, some still fluttering down from +the trees. In <i>The Problem of Thor Bridge</i>, he notes that the +plane tree in the backyard was losing its remaining leaves on a stormy +October morning. (We would call a plane tree a sycamore.) Some people +claim they become somewhat melancholic in the autumn and dislike +<span class="pagenum" id="Page_56">[Pg 56]</span> +to see the leaves falling, the grass turning brown, and other signs +associated with the fall of the year. I am not one of these. There is +much to be said for distinct changes in seasons. The changes occurring +in the autumn are necessary so that the wonderful season of spring may +be thoroughly appreciated and enjoyed.</p> + +<p>Several types of landscapes are pictured. In <i>A Study in Scarlet</i>, +the arid land in our great West is described:</p> + +<div class="blockquot"> + +<p>As far as the eye can reach stretches the great flat plainland, all +dusted over with patches of alkali, and intersected by clumps of the +dwarfish chaparral bushes.</p> +</div> + +<p>The purist might object to the term “chaparral bushes,” because +chaparral, being a nonspecific term, refers to any stunted type of +vegetation found growing on dry soil in our West. It might have been +more proper simply to have said “clumps of chaparral.” In the same +story, a prosperous, peaceful countryside landscape is depicted: +“All looked so peaceful and happy, the rustling trees and the broad +silent stretch of grainland....” In <i>The Adventure of the Solitary +Cyclist</i>, a landscape of flowering gorse is described, and attention +is called to its golden color on the heather-covered fields.</p> + +<p>Dr. Watson obviously was impressed with landscapes of gold and bronze, +especially those which contained faded ferns, for we find him using the +description several times, for example:</p> + +<div class="blockquot"> + +<p>The sun was beginning to sink ... and the long, sloping plain in front +of us was tinged with gold, deepening into rich, ruddy browns where +the faded ferns and brambles caught the evening light.</p> + +<p class="right"> +<i>Silver Blaze</i></p> +</div> + +<p>Similarly, in the same story: “... the low curves of the moor, +bronze-coloured from the fading ferns, stretched away to the sky +<span class="pagenum" id="Page_57">[Pg 57]</span> +line....” Besides these landscapes, several references to some of +the famous forests of England are made in <i>The Adventure of Black +Peter</i> and <i>The Naval Treaty</i>.</p> + +<p>As might be anticipated, numerous allusions are made to trees. Dr. +Watson presents a pleasing picture: “Just beyond it is a nice little +grove of Scotch firs, and I used to be very fond of strolling down +there, for trees are always a neighborly kind of thing” (<i>The Yellow +Face</i>). The word “neighborly” strikes a sympathetic note. All of +us have experienced this feeling at one time or another. Walking in a +pleasant woodland, one can quietly commune with nature. The singular +thing is that on such occasions the creative mind is often stimulated. +New ideas and new concepts apparently rise from the subconscious to the +higher brain centers. Numerous examples could be given of this truly +remarkable phenomenon.</p> + +<p>Dr. Watson must have had a lively interest in oak trees, for he alludes +to them on several occasions. He speaks of “ancient” oaks and “mighty” +oaks, terms surely applicable to the famous English oak trees (<i>The +Valley of Fear</i> and <i>The Adventure of the Solitary Cyclist</i>).</p> + +<p>The prize oak, presumably, is the one described in <i>The Musgrave +Ritual</i>. Sherlock Holmes related the story to Dr. Watson one winter +night: “... there stood a patriarch among oaks, one of the most +magnificent trees that I have ever seen.” He went on to quote his +host, Reginald Musgrave: “It was there at the Norman Conquest in all +probability.... It has a girth of twenty-three feet.” Truly, it was a +mighty oak and worthy of comment. If its girth was twenty-three feet, +it had a diameter of approximately seven and one-third feet. The events +described in the story occurred in the last quarter of the nineteenth +century, so the tree must have been over nine hundred years old if it +dated from the Norman Conquest of 1066.</p> + +<p>Probably few people appreciate the longevity of oak trees. I recall, +as a child, an oak that stood not far from my home. I have seen it +periodically for over a half-century. It still looks about the same +<span class="pagenum" id="Page_58">[Pg 58]</span> +as when I first saw it, but presumably it has had a slow but steady +growth throughout the years. Assuming that such a tree is not ravaged +by wind and storm or struck by lightning, it probably will stand for +several centuries. This is a fascinating thought, because it staggers +the imagination to think what historical events could occur during such +a span of years.</p> + +<p>Dr. Watson describes trees in various settings, such as parks (<i>The +Adventure of the Solitary Cyclist</i> and <i>The Adventure of the +Abbey Grange</i>), and in several instances as borders for avenues or +lanes. A number of examples might be cited, but one will suffice: “The +house ... with a fine lime-lined avenue leading to it” (<i>The “Gloria +Scott”</i>).</p> + +<p>In <i>The Hound of the Baskervilles</i>, the Yew Alley of Baskerville +Hall played an extremely important part in the story. It will be +recalled that Sir Charles, before going to bed at night, was wont to +take a walk down the Yew Alley. One night he saw the huge hound which +the evil Stapleton had purposely let loose on the moor. Sir Charles +became so frightened that he ran headlong and dropped dead from a heart +attack.</p> + +<p>In this story, too, mention is made of trees which have been subjected +to adverse growing conditions. Dr. Watson speaks of trees which have +been stunted and nipped on the moor, and emphasizes how the oaks and +firs are bent and twisted by the furious storms throughout the years. +The bizarre shapes which such trees assume are truly fascinating. Their +irregular outlines appear ghostlike by night and weird by day. They are +the joy of the amateur photographer and the professional artist.</p> + +<p>Various types of trees are used to create a proper setting for the +mystery stories. In <i>The Adventure of the Mazarin Stone</i>, a +melancholy grove of half-grown pines is described; and in <i>The +Adventure of Wisteria Lodge</i>, a row of chestnuts is depicted as +giving the avenue a gloomy appearance.</p> + +<p><span class="pagenum" id="Page_59">[Pg 59]</span></p> + +<p>The fact that pine trees are used to set the note for a gloomy +landscape calls for comment. I have always felt that a clump of +evergreen trees around a house creates a distinctly depressing +atmosphere; this is especially true if the house is isolated in the +country. To me these somber trees give a sense of loneliness and gloom, +and bring to mind Anna Katherine Green’s mystery story, <i>The House +of Whispering Pines</i>. It may be that this story, which I read in my +youth, is the reason for my feeling. I am sure, in any event, that many +people enjoy evergreen trees around their home, especially in winter, +as a welcome relief from the drab, slate-gray landscape.</p> + +<p>Besides those trees already enumerated, several other species are +mentioned throughout the tales: namely, the larch, the beech, and the +copper beech. In <i>The Adventure of the Copper Beeches</i>, this +description occurs: “The group of trees with their dark leaves shining +like burnished metal in the light of the setting sun....”</p> + +<p>Flower beds and borders are described in several of the tales. In +<i>The Sign of the Four</i>, we find that: “... just under the window +a single foot-mark was visible in the flower bed.” Also, in <i>The +Adventure of the Devil’s Foot</i>, a flower border lying underneath the +window is noted, but it contained no trace of a footprint. Obviously, +footprints are a necessary component of mystery stories; and what +better place to look for them than in the soft earth of a flower bed +under a window?</p> + +<p>In all the stories, only a few flowers are specifically named: +crocuses, orchids, roses, and violets. In <i>The Hound of the +Baskervilles</i>, when Dr. Watson met the wife of the naturalist +Stapleton on the moor, she asked him to pick an orchid for her, and +explained that the moor was rich in them. This is supposed to have +occurred in the fall of the year. It seems singular that orchids would +be in bloom at that time.</p> + +<p>The amateur gardener will be sympathetically interested to read of +<span class="pagenum" id="Page_60">[Pg 60]</span> +gardens and lawns which did not live up to expectations: “A small +garden sprinkled over with a scattered eruption of sickly plants +separated each of these houses” (<i>A Study in Scarlet</i>). In <i>The +Adventure of the Retired Colourman</i>, a sorry-looking garden is +depicted. It is pictured as going to seed and bearing every evidence +of gross neglect. In <i>The Red-Haired League</i>, an ill-kept lawn is +described: “... where a lawn of weedy grass and a few clumps of faded +laurel bushes made a hard fight against a smoke-laden and uncongenial +atmosphere.”</p> + +<p>Several welcome allusions are made to the odors of flowers or of +vegetation. The scent of flowers, gardens, greenhouses, trees, meadows, +swamps, and the decay of autumn leaves often bring back memories of +other times and places. In <i>The Naval Treaty</i>, we find “... the +rich scent of the garden ...”; and in <i>A Study in Scarlet</i>, we +read of “... the balsamic odours of the pine trees....” All of us have +experienced the refreshing and delightful odors of a flower garden, +and those who have been in the north, or in the mountains in almost +any latitude, remember with pleasure the clean smell of the evergreen +trees. In <i>The Adventure of the Lion’s Mane</i>, our attention is +called to the scent of thyme on the downs. I am sure that to many +people the faintly exotic aroma of thyme (which belongs to the mint +family) is enjoyable.</p> + +<p>Some plants have a distinctly heavy, cloying odor—for example, certain +lilies. The effect produced may actually be unpleasant. Dr. Watson, in +describing a greenhouse, brings this out (<i>The Adventure of Charles +Augustus Milverton</i>). He speaks of the heavy fragrance of certain +plants which actually causes a choking sensation. The odor of decayed +plants arising from the treacherous Grimpen Mire is emphasized in +<i>The Hound of the Baskervilles</i>. Most of us are familiar with the +miasmic vapors which often arise from swampland. Presumably, everyone +has his own favorite odor. Some people enjoy the exquisite fragrance of +the rose, some that of the carnation, and others the faint and delicate +odor of the sweet pea. The city dweller who was raised in the country +<span class="pagenum" id="Page_61">[Pg 61]</span> +may yearn for the sweet smell of newly mown hay, and, strangely enough, +may even long for the pungent ammoniacal smell of the barnyard.</p> + +<p>Throughout the tales, we find mention of bracken, bramble, bushes, +ferns, gorse, heather, hedges, laurel, lichens, rhododendron, shrubs, +and vines. We have already alluded to many of these. To my knowledge, +in only one instance is there a reference to blood-stained vegetation +indicating that a murder might have been committed. We find, in <i>The +Adventure of the Priory School</i>, that Holmes, to the horror of +Watson, held up some flowering gorse which was blood-stained. The +surrounding heather, too, showed evidence of old blood stains. It will +be remembered that these were found on the spot where the unfortunate +German master of the Priory School had met his death.</p> + +<p>Everyone interested in Sherlock Holmes will vividly recall the meeting +between Holmes and Professor Moriarty on the brink of the falls of the +Reichenbach. Dr. Watson inspected the spot shortly after the meeting:</p> + +<div class="blockquot"> + +<p>A few yards from the end the soil was all ploughed up into a patch of +mud, and the brambles and ferns which fringed the chasm were torn and +bedraggled.</p> + +<p class="right"> +<i>The Final Problem</i></p> +</div> + +<p>The patches of mud and torn vegetation gave clear evidence of what had +taken place on the edge of the falls. We learn later, of course—much +to our surprise and satisfaction—that Holmes had, by his superior +skill, triumphed over his arch enemy. The meeting marked the end of +Professor Moriarty, the Napoleon of crime.</p> + +<p>Dr. Watson’s many allusions to botany give added charm to the tales, +and indicate not only his love for the flora of England but also his +zest for nature.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_62">[Pg 62]</span></p> +<h2 class="nobreak" id="THE_SURGICAL_DOCTOR_WATSON"> +THE SURGICAL DOCTOR WATSON</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“... the thin white hand he laid on the mantelpiece ... was that of an +artist rather than of a surgeon.”</p> + +<p class="right"> +<i>The Resident Patient</i></p> +</div> + + +<p>Dr. Watson professed to be a general practitioner of medicine. Such a +person is called upon from time to time to do minor, but under ordinary +conditions he does not attempt to do major, surgery. To my knowledge, +there is no particular reference to major surgery in any of the tales, +although one or two famous surgeons are mentioned. On the other hand, +numerous allusions are made to minor surgery. I am cognizant of the +fact that there is often but a thin line between major and minor +surgery.</p> + +<p>Dr. Watson evidently felt that a good surgeon must have large and +supple hands, for he writes: “... the thin white hand he laid on the +mantelpiece ... was that of an artist rather than a surgeon” (<i>The +Resident Patient</i>). The size of the hand probably is not of major +importance. It is the ability to use the hands that counts. Several +eminent surgeons, to my own knowledge, are men of large physical +stature, and I am sure have correspondingly large hands. But I have +seen some equally capable men, hardly of average height, who had small +hands. Harvey Cushing, the brilliant Harvard brain surgeon, was a man +of medium size, and, if I recall correctly, had rather small hands. Let +us not labor this point further, for this is not an essay on surgeons’ +hands, but turn to the tales of Sherlock Holmes.</p> + +<p><span class="pagenum" id="Page_63">[Pg 63]</span></p> + +<p>It is axiomatic that every man who practices medicine, regardless of +his specialty, must be familiar with the current literature in his +field. It is gratifying that Dr. Watson appreciated this. In <i>The +Adventure of the Golden Pince-Nez</i>, Watson observes that one stormy +night he and Holmes sat together in silence; the latter was working on +a palimpsest, while Watson was reading a treatise on surgery.</p> + +<p>Holmes appreciated that a correct diagnosis is of paramount importance +to a conscientious surgeon. In <i>The Problem of Thor Bridge</i>, we +find Mr. Neil Gibson, the “Gold King,” telling Holmes that he was +like a surgeon, because Holmes wanted to know every symptom before +he ventured a diagnosis. Holmes quickly retorted that this was quite +true, and strongly implied that his client was withholding important +information which Holmes needed before the mystery about which he was +being consulted could be solved.</p> + +<p>There are a number of references to scalp wounds or injuries to the +skull, or both. In the rough-and-tumble life a detective leads, it +might be expected that he would often see such injuries. Let us examine +some of them.</p> + +<p>Once Sherlock Holmes himself came under a surgeon’s care. The great +detective had been attacked on the street by two ruffians and had +been pretty roughly handled (<i>The Adventure of the Illustrious +Client</i>). Sir Leslie Oakshot, the eminent London surgeon who had +been called in, stated that Holmes had suffered lacerations of the +scalp and that several stitches were necessary. Holmes fortunately made +an uneventful recovery, and we learn that the stitches were taken out +on the seventh day.</p> + +<p>Dr. Watson describes a man in <i>The Adventure of the Solitary +Cyclist</i> who had suffered a severe scalp wound. He had been found +unconscious, although the bones of the skull had not been penetrated. +Another case is mentioned which surely must puzzle the layman (<i>The +Adventure of the Dancing Men</i>). A bullet passed through the frontal +portion of the brain. The reader is assured that, although the patient +<span class="pagenum" id="Page_64">[Pg 64]</span> +was unconscious, she would live. The medically trained person would +think immediately of an accidental lobotomy.</p> + +<p>One is reminded in this connection of the skull of a workman exhibited +in the museum of the Harvard Medical School. This rare specimen shows +an enormous hole made by a tamping bar. The bar passed through the +skull, and a considerable amount of brain substance was destroyed. +Remarkably enough, the patient did not die from this terrific injury, +but lived for a long time afterward—surely a most unusual case. +It should be added that he suffered an unfortunate change in his +personality following the accident.</p> + +<p>In several instances, the head injuries mentioned were immediately +fatal. For example, in <i>The Adventure of the Empty House</i>, an +expanding revolver bullet was fired into the victim’s head. In <i>The +Boscombe Valley Mystery</i>, we find that: “The head had been beaten +in by repeated blows of some heavy and blunt weapon.” In this last +story, Dr. Watson gets technical: “In the surgeon’s deposition it was +stated that the posterior third of the left parietal bone and the left +half of the occipital bone had been shattered by a heavy blow from a +blunt weapon.” But contrast the following nontechnical description: +“The injury from which the unfortunate veteran was suffering was found +to be a jagged cut some two inches long at the back part of his head, +which had evidently been caused by a violent blow from a blunt weapon” +(<i>The Crooked Man</i>). This is a good example of a wound so simply +described that anyone could easily understand and appreciate it. With +few exceptions, Watson never forgot that he was writing for laymen.</p> + +<p>Scalp wounds and injuries to the head are often used to dramatize +detective stories. The average layman instinctively feels that such +wounds are extraordinarily dangerous, and that people experiencing such +accidents are nearly always in a critical state. This, of course, may +or may not be true, because nature has provided a strong bony cage to +<span class="pagenum" id="Page_65">[Pg 65]</span> +protect the brain.</p> + +<p>In <i>The Adventure of the Sussex Vampire</i>, there occurs a reference +concerning an orthopedic problem. Dr. Watson writes that the gait of +a fifteen-year-old boy suggested plainly that he had a weak spine. We +are further informed that a fall in childhood had brought about this +condition. The devoted father spoke of the lad as being an unfortunate +cripple and quite inoffensive. He was quite mistaken, for this +so-called inoffensive lad became so insanely jealous of his normal, +healthy baby half-brother that he tried to do away with him by use of +curare, the South American Indian arrow poison. When Holmes unearthed +this diabolic scheme, he reluctantly informed the boy’s unsuspecting +father. Holmes prefaced his remarks by stating that he was a busy man +and would come to the point quickly; and he used the simile that, the +swifter surgery is done, the less painful it is.</p> + +<p>The idea Holmes expressed in regard to swift surgery holds our +interest. In the early days, before the discovery of ether, surgeons +for obvious reasons attempted to perform operations in the shortest +possible time. Indeed, the skill of a surgeon was largely gauged by the +speed with which he could perform an operation.</p> + +<p>In at least two of the tales, the carotid artery was the focal point +of interest. In <i>The Adventure of the Creeping Man</i>, we find that +when Professor Presbury was viciously attacked by his wolfhound, the +teeth of the dog narrowly missed the carotid artery. In spite of the +rather severe hemorrhage which followed, it will be recalled that the +professor recovered. In <i>The Adventure of the Golden Pince-Nez</i>, +the victim was not as lucky. His carotid had been severed by an +old-fashioned sealing-wax knife, and death ensued in a short time. +Watson emphasized that the wound was small but deep. He was aware that +a large blunt instrument might have pushed the elastic artery aside +rather than piercing it.</p> + +<p>We find one reference to an amputation, although it was not performed +<span class="pagenum" id="Page_66">[Pg 66]</span> +by a surgeon. Early one morning, there appeared in Dr. Watson’s +consultation room a young engineer who, during the preceding night, had +undergone a harrowing experience in which his thumb had been hacked off +by a vicious counterfeiter. The doctor was astounded when he saw the +wound: “It gave even my hardened nerves a shudder to look at it. There +were four protruding fingers and a horrid, red, spongy surface where +the thumb should have been. It had been hacked or torn right from the +roots” (<i>The Adventure of the Engineer’s Thumb</i>).</p> + +<p>When Dr. Watson asked the victim whether the wound had bled a +great deal, the answer was: “Yes, it did.... I tied one end of my +handkerchief very tightly around the wrist and braced it up with a +twig.” Watson’s succinct reply was: “Excellent. You should have been +a surgeon.” To satisfy the reader’s sympathetic curiosity, it should +be mentioned that Dr. Watson gave the patient a drink of brandy, and +cleansed and bandaged the wound. Since the thumb had been “torn right +out from the roots,” it seems that Dr. Watson should have taken a few +stitches to bring the cut tissues together. No such mention is made, +and it is to be hoped that the wound healed satisfactorily.</p> + +<p>It is noteworthy that this engineer must have had a rugged +constitution. Dr. Watson, after caring for the wound, took him to 221B +Baker Street, where he joined Holmes and Watson in eating a substantial +breakfast. Then, for the benefit of the consulting detective, he +related the night’s terrible adventure at some length. He next +accompanied Holmes and his companions on a train journey to Eyeford, a +little Berkshire village. This was a strenuous program. The question +arises, why did the kind Watson allow his patient to do all these +things? This young man should have received a narcotic to deaden the +pain, which must have been severe, and then should have gone to bed. If +the patient experienced difficulty in going to sleep, a hypnotic should +have been administered. In this instance, Dr. Watson placed himself in +<span class="pagenum" id="Page_67">[Pg 67]</span> +an indefensible position.</p> + +<p>Let us now turn from injuries of the human flesh and consider something +relatively less gruesome. A surgical instrument is described and, +interestingly enough, the name of the manufacturer is given. Holmes +himself calls our attention to it: “... an ivory-handled knife with a +very delicate, inflexible blade marked Weiss & Co., London” (<i>Silver +Blaze</i>). Parenthetically, it should be stated that Weiss & Co., +are still famous makers of knives. Indeed, there are several in my +laboratory at the present time.</p> + +<p>When Holmes speaks of the singularity of this knife, and suggests to +Dr. Watson that surely this was in his line, the latter states, “It is +what we call a cataract knife.” Holmes replies, “A very delicate blade +devised for very delicate work.” The reader should be reminded that +the knife in question was not employed to murder a human being, but a +villainous horse trainer had intended to use it to cut the tendon of a +famous race horse. It will be remembered that the nefarious scheme was +never carried out, for the highly nervous thoroughbred animal killed +his trainer by kicking him on the head before the operation could be +performed.</p> + +<p>As far as I am aware, Watson did not make any specific mention of any +other surgical instruments in the tales. He does, however, on one +occasion make an allusion to a surgeon’s choice of his instrument +during an operation. He is commenting on Holmes’ selection of tools +when attempting to open the safe of the notorious blackmailer, +Charles Augustus Milverton, and points out that Holmes chose his +instruments with the same scientific precision as a surgeon about to +perform an important operation (<i>The Adventure of Charles Augustus +Milverton</i>).</p> + +<p>In the present essay, we have discussed only those cases which are +concerned with surgery. But in England the medical man is often +spoken of as a “surgeon,” rather than a physician or a doctor or a +general practitioner. We find such expressions in the Sherlock Holmes +<span class="pagenum" id="Page_68">[Pg 68]</span> +stories: “And here comes the country surgeon ...” (<i>The Adventure +of the Copper Beeches</i>). Numerous other references could be cited, +but this one will suffice. Furthermore, a doctor’s treatment room is +spoken of as his “surgery.” This latter expression is often found, +especially in English novels. The villain Stapleton, in <i>The Hound of +the Baskervilles</i>, tells Dr. Watson that he had been visiting with +Dr. Mortimer, and that while they were in his “surgery,” Dr. Mortimer +had pointed out Dr. Watson through the window. In another instance, +we find, “The surgery, where I used to make up my drugs ...” (<i>The +Sign of the Four</i>). In this country, we would simply call it “the +doctor’s office,” or if we wanted to be more specific, his “treatment” +or “examining room.” These are minor differences, it is true, but they +are of passing interest.</p> + +<p>Some of the wounds so dramatically described by Dr. Watson surely +became severely infected, and the patient’s suffering must have been +considerable. Pasteur and Lister had already published the results of +their brilliant researches, and the medical profession was well aware +of the dangers of infections at the time. In spite of this, not much +could be done once the wounds began to suppurate, for the antibiotics +had as yet not been discovered. We may rest assured, however, that Dr. +Watson did all he could to alleviate the patient’s pain and to promote +healing of the wound.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_69">[Pg 69]</span></p> +<h2 class="nobreak" id="SHERLOCK_HOLMES_THE_CHEMIST"> +SHERLOCK HOLMES, THE CHEMIST</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“A formidable array of bottles and test tubes, with the pungent +cleanly smell of hydrochloric acid, told me that he had spent his day +in the chemical work which was so dear to him.”</p> + +<p class="right"> +<i>The Red-Haired League</i></p> +</div> + + +<p>Mention is made from time to time in the tales of certain chemical +problems which occupy the attention of the great detective. Moreover, +the chemical desk and chemical paraphernalia in the rooms at 221B +Baker Street are referred to frequently. Indeed, the reader would be +disappointed if they were not mentioned, for he has come to accept them +as he has the Persian slipper and the gasogene. Since we are living +in an age of chemistry, it is pertinent and timely to review Sherlock +Holmes’ interest in this important field. It is, moreover, of certain +intellectual and historical interest to examine—even though rather +superficially—the status of any phase of chemistry during the last +quarter of the past century, or, for that matter, of any period. At the +time of which we write, biological chemistry was still in its infancy, +but organic chemistry was already an important subject.</p> + +<p>In <i>A Study in Scarlet</i>, it will be remembered that when +Stamford took Dr. Watson to the laboratory of the medical school to +meet Sherlock Holmes, they found him working on a chemical problem. +So enthusiastic was Holmes that, even before Stamford had had an +opportunity to present Watson, Holmes sprang to his feet and cried: +“I’ve found it! I’ve found it!... I have found a reagent which is +precipitated by hemoglobin, and by nothing else.” He then acknowledged +the introduction, and made the famous remark, “You have been in +<span class="pagenum" id="Page_70">[Pg 70]</span> +Afghanistan, I perceive.”</p> + +<p>Holmes proceeded next to give a demonstration of his new test:</p> + +<div class="blockquot"> + +<p>“Now, I add this small quantity of blood to a litre of water. You +perceive that the resulting mixture has the appearance of water. The +proportion of blood cannot be more than one in a million. I have no +doubt, however, that we shall be able to obtain the characteristic +reaction.”</p> + +<p>As he spoke, he threw into the vessel a few white crystals, and then +added some drops of a transparent fluid. In an instant, the contents +assumed a dull mahogany color, and a brownish dust was precipitated to +the bottom of the glass jar.</p> +</div> + +<p>Holmes was so well pleased that he added, “Now we have the Sherlock +Holmes’ test....”</p> + +<p>At this point a sour note can be injected. Assuming that Holmes did +discover a sensitive test for hemoglobin, it was nevertheless not +a specific one for human blood. The blood of many animals contains +hemoglobin. In a case of murder, for example, if blood were found on a +cudgel, a knife, or on the clothing of a suspect, it would still have +to be proved that it was human blood. This, incidentally, can now be +scientifically shown, but it is a long, delicate procedure.</p> + +<p>After Holmes had demonstrated his brilliant experiment, the trio sat +down, and Holmes and Watson discussed the possibility of sharing rooms. +Holmes volunteered, “I generally have chemicals about, and occasionally +do experiments.” Parenthetically, it may be stated that Watson on later +occasions complained about the odors produced by these experiments. As +we know, however, an agreement was reached, and perhaps the two most +famous characters in fiction decided to cast their lot together and +locate on 221B Baker Street.</p> + +<p><span class="pagenum" id="Page_71">[Pg 71]</span></p> + +<p>The staid Dr. Watson, after living with Holmes several weeks, took +it upon himself to make an appraisal of his unusual roommate. His +conclusions were that Holmes’ knowledge in certain areas, such as +literature, philosophy, and astronomy, was “nil,” but in the field of +chemistry, “profound.”</p> + +<p>Holmes as a college student had evinced a marked interest in chemistry. +When telling Dr. Watson the story of <i>The “Gloria Scott,”</i> his +first case, he said: “All this occurred during the first month of the +long vacation. I went up to my London rooms, where I spent seven weeks +working out a few experiments in organic chemistry.”</p> + +<p>Holmes maintained his interest in chemistry throughout the years. +In <i>The Red-Haired League</i>, Watson describes how he called on +Holmes one day: “A formidable array of bottles and test-tubes, with +the pungent cleanly smell of hydrochloric acid, told me that he had +spent his day in the chemical work which was so dear to him.” When +Watson asked him whether he had reached a solution, Holmes answered in +the affirmative, and stated it was the bisulphate of baryta. Watson, +evidently disgusted said, “No, no, the mystery.” Holmes’ reply was: +“Oh, that! I thought of the salt that I have been working upon.” Today +one seldom hears the word “baryta” in this country; we speak of it as +“barium.” The bisulphate of baryta, therefore, which Holmes mentioned, +becomes barium sulphate.</p> + +<p>The hobby of the great detective, it appears, afforded him relaxation, +for we find:</p> + +<div class="blockquot"> + +<p>“Well, I gave my mind a thorough treat by plunging into a chemical +analysis. One of our greatest statesman has said that a change of work +is the best rest. So it is. When I had succeeded in dissolving the +hydrocarbon which I was at work at, I came back to our problem of the +Sholtos, and thought the whole matter out again.”</p> + +<p class="right"> +<i>The Sign of the Four</i></p> +</div> + +<p><span class="pagenum" id="Page_72">[Pg 72]</span></p> + +<p>In his later years, Holmes must have missed his chemical experiments; +for once, when he was away from home, we find Watson writing that +his friend’s temper was on edge because he especially yearned for +his chemistry bench and his scrapbook (<i>The Adventure of the Three +Students</i>).</p> + +<p>Holmes was wont at times to announce the results of his chemical +researches in a dramatic manner. According to Watson, his hero was +not averse to seeking the limelight. We already have seen how Holmes +acted when he discovered an agent precipitated only by hemoglobin. He +insisted upon telling of his important discovery before giving Stamford +an opportunity of presenting Watson. We find another typical example in +<i>The Naval Treaty</i>:</p> + +<div class="blockquot"> + +<p>Holmes was seated at his side-table clad in his dressing-gown, and +working hard over a chemical investigation. A large curved retort was +boiling furiously in the bluish flame of a Bunsen burner, and the +distilled drops were condensing into a two-litre measure. My friend +hardly glanced up as I entered, and I, seeing that his investigation +must be of importance, seated myself in an armchair and waited. He +dipped into this bottle ... and finally brought a test-tube containing +a solution over to the table. In his right hand he held a slip of +litmus paper.</p> + +<p>“You come at a crisis, Watson,” said he. “If this paper remains blue, +all is well. If it turns red, it means a man’s life.” He dipped it +into the test-tube and it flushed at once into a dull, dirty crimson. +“Hum, I thought as much!”</p> +</div> + +<p>It is hardly necessary to point out that such dramatic chemical +discoveries so glibly announced by Holmes are rare, and it is not given +to any one individual to find many of them in a lifetime.</p> + +<p>Reference already has been made to the fact that the reader rather +expects Dr. Watson to make mention of the chemical bench when he +<span class="pagenum" id="Page_73">[Pg 73]</span> +describes the rooms at 221B Baker Street. One imagines Dr. Watson of a +winter evening sitting in his rocking chair before the fire, absorbed +in a treatise on surgery while Sherlock Holmes is busily engaged with +some chemical problem. In <i>The Adventure of the Mazarin Stone</i>, we +find Watson writing that it was pleasant to find himself again at 221B +Baker Street, and that he felt at home when he saw the old chemical +bench, the chemicals, and the other paraphernalia in the living room. +Watson again mentions this in <i>The Adventure of the Empty House</i>, +where he speaks of the old landmarks, and especially of the chemical +corner.</p> + +<p>On one occasion, Watson described a small chemical laboratory in a +dwelling place.</p> + +<div class="blockquot"> + +<p>It appeared to have been fitted up as a chemical laboratory. A +double line of glass-stoppered bottles was drawn up upon the wall +opposite the door and the table was littered over with Bunsen burners, +test-tubes and retorts. In the corner stood carboys of acid in wicker +baskets. One of these appeared to leak, or to have been broken, for a +stream of dark-coloured liquid had trickled out from it, and the air +was heavy with a peculiarly pungent, tarlike odor.</p> + +<p class="right"> +<i>The Sign of the Four</i></p> +</div> + +<p>This passage shows clearly that Dr. Watson was quite familiar with the +arrangement in chemical laboratories.</p> + +<p>Previously, it was mentioned that at their first meeting Holmes had +warned Watson that he preferred to do chemical experiments in his +rooms. The good doctor probably did not think much about it at that +time, but later he had occasion to get firsthand information. In <i>The +Musgrave Ritual</i>, Watson, telling how untidy Holmes was, states, +“Our chambers were always full of chemicals....” We find further, in +<i>The Sign of the Four</i>:</p> + +<p><span class="pagenum" id="Page_74">[Pg 74]</span></p> + +<div class="blockquot"> + +<p>He [Holmes] would hardly reply to my questions and busied himself all +the evening in an abstruse chemical analysis, which involved much +heating of retorts and distilling of vapors, ending at last in a smell +which fairly drove me out of the apartment. Up to the small hours of +the morning I could hear the clinking of his test-tubes which told me +that he was still engaged in his malodorous experiments.</p> +</div> + +<p>And again, in <i>The Adventure of the Dancing Men</i>, we find +Watson writing that Holmes was fouling the air with some malodorous +chemical experiment. And finally, in <i>The Adventure of the Dying +Detective</i>, Watson relates that the long-suffering Mrs. Hudson, too, +often had to put up with noxious odors emanating from Holmes’ chemical +experiments.</p> + +<p>One wonders whether on occasion Watson regretted the day he agreed to +share an apartment with his famous friend. It may be that Watson, who +also had had considerable chemistry in his medical student days, did +not mind too much the ill smells which from time to time polluted their +living quarters; at any rate, there is no indication that Watson ever +thought of seeking other quarters on this account.</p> + +<p>Not only did Holmes’ chemical experiments fill the apartment with +unpleasant odors, but he also kept ungodly hours. In <i>The Adventure +of the Copper Beeches</i>, we find:</p> + +<div class="blockquot"> + +<p>The telegram ... came late one night, just as I was thinking of +turning in, and Holmes was settling down to one of those all-night +chemical researches which he frequently indulged in, when I would +leave him stooping over a retort and a test-tube at night and find him +in the same position when I came down to breakfast in the morning.</p> +</div> + +<p>This instance, as well as others just mentioned, clearly show that +Holmes was apt to devote long hours to his experiments. Evidently, he +<span class="pagenum" id="Page_75">[Pg 75]</span> +thought nothing of sitting up until the small hours of the morning, or, +for that matter, all night, pursuing his researches. If young college +instructors in departments of chemistry showed such zeal, they surely +would soon gain recognition in their fields. Working all day and most +of the night, however, probably is too much to expect of the average +human frame.</p> + +<p>The casual reader naturally takes it for granted that Holmes’ love +for chemistry was due to his interest in crime detection; that is, +he intended to use the knowledge he gained from his experiments for +practical purposes. We recognize this today as applied research. I +would like to emphasize that Holmes was interested in pure or basic +research, too—in other words, research which has no immediate +practical value. Instances may be found in the tales to support this +view. I will mention only two: “That will do very nicely. Then perhaps +I had better postpone my analysis of the acetones, as we may need +to be at our best in the morning” (<i>The Adventure of the Copper +Beeches</i>). And, in <i>The Final Problem</i>, Holmes remarks rather +plaintively to Watson: “Between ourselves, the recent cases in which I +have been of assistance to the royal family of Scandinavia, and to the +French Republic have left me in such a position that I could continue +to live in the quiet fashion which is most congenial to me, and to +concentrate my attention upon my chemical researches.”</p> + +<p>His interest in basic research is rather remarkable, for in that day +there were comparatively few persons engaged in any type of chemical +research. Today, of course, there are thousands of chemists working in +institutions of higher learning and also in many industries. Indeed, +some of the chemists in large industrial plants are not only allowed +but encouraged to do basic research.</p> + +<p>We can conceive of Holmes as a famous professor of chemistry in a great +university. In <i>The Adventure of the Dancing Men</i>, Watson writes +that Holmes had propped his test tubes in a rack, and that he then +began to lecture like a professor addressing his class. As a teacher, +<span class="pagenum" id="Page_76">[Pg 76]</span> +he might at times have been somewhat curt with his students and +probably impatient with the stupid ones, but at all times he would have +been fair. He had the energy, stamina, and enthusiasm not only to be a +stimulating teacher but a productive scholar as well. He would not have +been an armchair professor, but rather a leader in his chosen field. We +are thankful that he did not choose an academic career, for then the +delightful Sherlock Holmes stories never would have been written, and +the world would be a less interesting place in which to live.</p> + +<p>In closing, we can paint a pleasant picture of Sherlock Holmes in his +retirement in his comfortable home on the Sussex Downs. We can imagine +him in the long English twilight working at his chemical bench before +a large window overlooking the beautiful countryside. His fingers +are stained with acids, alkalies, silver nitrate, and other potent +chemicals. His pipe is going full blast, and his brow is probably +perplexed as he scans a recent learned treatise on the chemistry of the +aldehydes or the alkaloids.</p> + +<p>While his researches may be profound and manifold, it is more than +likely that he devotes his best efforts toward the detection of some +obscure poisons, with the hope that some scheming sinister criminal +may be brought to justice. Time does not hang heavily on his hands +in his retirement, for there is no end to chemical researches; +infinite problems present themselves to the prepared mind. With his +keen intellect, his wide knowledge, and his rich imagination, he has +doubtless outlined investigative work which will keep him happy and +busy for years to come.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_77">[Pg 77]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSONS_UNIVERSAL_SPECIFIC"> +DOCTOR WATSON’S UNIVERSAL SPECIFIC</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“... with the aid of ammonia and brandy, I had the satisfaction of +seeing him open his eyes.”</p> + +<p class="right"> +<i>The Greek Interpreter</i></p> +</div> + + +<p>The therapeutic agent most frequently used by Dr. Watson was brandy. +Mention is made of this stimulant in a number of the tales. Let us +examine the conditions in which Dr. Watson’s favorite remedy was used.</p> + +<p>In <i>The Adventure of the Blue Carbuncle</i>, Sherlock Holmes had +accused the pathetic Ryder of stealing the valuable carbuncle. The poor +wretch turned pale, and Holmes remarked to Watson, “Give him a drink +of brandy.” In describing this incident, Watson writes, “For a moment +he had staggered and nearly fallen, but the brandy brought a tinge of +colour into his cheeks....”</p> + +<p>We find, in <i>The Adventure of Wisteria Lodge</i>, that when the +eminently respectable Mr. Scott Eccles was relating his strange +experience to Sherlock Holmes and Dr. Watson, Inspector Gregson of +Scotland Yard came in unannounced and informed Eccles that Mr. Garcia, +his host of the preceding night, had been found murdered. Dr. Watson +writes that their client turned deathly pale. Holmes quickly suggested +to Watson that he give Eccles a brandy and soda. This evidently helped +the poor fellow; he gulped it down, and his face soon resumed its +normal color.</p> + +<p>Dr. Watson, in the story of <i>The Greek Interpreter</i>, took credit +for saving the life of Mr. Melas, who was found locked in a room +<span class="pagenum" id="Page_78">[Pg 78]</span> +filled with a poisonous gas. Holmes and Watson rushed into the room and +dragged out the victim. Dr. Watson writes that, “... with the aid of +ammonia and brandy, I had the satisfaction of seeing him open his eyes.”</p> + +<p>In <i>The Naval Treaty</i>, Holmes found the highly important document +which his client Mr. Percy Phelps thought had been lost through his own +negligence. The great detective invited him to have breakfast with him +and Watson; and when Phelps took the lid off the dish which was served +him, and saw the precious papers lying there, he became hysterical with +joy: “Then he fell back into an armchair so limp and exhausted with his +own emotions that we had to pour brandy down his throat to keep him +from fainting.”</p> + +<p>We learn, in <i>The Adventure of the Priory School</i>, that when +Thorney Huxtable, M.A., Ph.D., made his dramatic entrance and collapsed +upon Holmes’ bearskin hearthrug, both the detective and the medical +man extended helping hands. Holmes hurriedly placed a cushion under +his head, and Watson got ready to give him a drink of brandy. However, +the pompous fellow fell to the floor in a faint. When he regained +consciousness, he asked for some milk and a biscuit. This revived him, +and he then told his story. We do not know whether he was an abstainer +or not.</p> + +<p>Brandy evidently enjoyed a reputation as an effective stimulant even +among laymen. In perusing the tales, we find in one instance that it +was given by a tutor to his servant who had suffered a mental shock; +and in another, a constable intended to give it to a beautiful young +woman who, he thought, had fainted. Dr. Watson relates, in <i>The +Adventure of the Three Students</i>, how Mr. Soames, tutor and lecturer +at one of the great British universities, administered brandy to his +servant, Bannister. The highly nervous tutor thought his man had +disturbed the examination papers on his desk; and when Bannister saw +that the papers had been disturbed, he appeared as if he were about to +faint. Soames immediately gave him a drink of brandy; but, in spite +<span class="pagenum" id="Page_79">[Pg 79]</span> +of the stimulant, Bannister appeared to be in a state of collapse, and +threw himself into a nearby chair. We shall never know whether or not +it was an actual collapse, the brandy failing to help, for later it +came out that the servant was desirous of concealing something on the +seat of the chair. We may safely assume, however, that in any event +Bannister welcomed the proffered drink.</p> + +<p>We learn from the pen of Dr. Watson, also, how Lady Hilda duped +Constable McPherson and obtained the precious blue envelope which +contained high state secrets (<i>The Adventure of the Second +Stain</i>). The crestfallen constable told Holmes that, when Lady Hilda +had seen the stain on the carpet, she apparently fell down in a faint. +The constable rushed outside to a nearby corner to procure some brandy, +but when he returned, the noble lady had disappeared. We wonder whether +the constable treated himself to the drink which he had procured for +her.</p> + +<p>In two other instances—one related by Sherlock Holmes and the other +by Dr. Watson—brandy was administered with a lavish hand indeed, and +the inference may be drawn that the subjects probably drank about +all they could decently manage. In <i>The Adventure of the Lion’s +Mane</i>, Ian Murdock, who had come into contact with the jellyfish +<i>Cyanea capillata</i>, staggered into the room, on the verge of a +collapse, crying for brandy. Holmes, in writing this tale, tells how +he administered a half-tumbler of the stuff. The treatment appeared +to be of some help, but the patient was still in great pain. Holmes +gave him several more large drinks. Finally, Murdock’s head fell upon +the cushion in a state of unconsciousness. It was well that he did not +attempt to get up and walk. I doubt whether he could have stood up.</p> + +<p>In the second example, Victor Hatherly, a hydraulic engineer, had +suffered a terrifying experience (<i>The Adventure of the Engineer’s +Thumb</i>). In his effort to escape being crushed to death by the +powerful hydraulic press, he had torn off his thumb. When he presented +<span class="pagenum" id="Page_80">[Pg 80]</span> +himself in Dr. Watson’s surgery and began to tell of his ghastly +experience, he became hysterical. Dr. Watson, who had given him a drink +of water previously, rose to the occasion: “I dashed some brandy into +the water, and the colour began to come back to his bloodless cheeks.” +He then proceeded to bandage the area where the thumb had been. This +must have been a most painful operation indeed, and it is hoped that +Dr. Watson did not spare the brandy. There is reason to believe that +he did not. Since the engineer wished to report the incident, Watson +took him to consult with Sherlock Holmes. The latter listened to the +engineer’s story, “... placed a pillow beneath his head, and laid +a glass of brandy and water within his reach.” Dr. Watson did not +indicate whether the patient was able to go home under his own power.</p> + +<p>Let us turn now to the longer tales of Sherlock Holmes. In <i>The Sign +of the Four</i>, when Jonathan Small was telling his story to Holmes +and his colleagues, the astute detective remarked to him: “... you had +best take a pull out of my flask, for you are very wet.” And a little +later: “He stopped and held out his manacled hands for the whiskey and +water which Holmes had brewed for him.”</p> + +<p>In <i>The Hound of the Baskervilles</i>, the reader will recall +that the Baronet, Sir Henry, was attacked by the spectral hound and +miraculously escaped death. Dr. Watson writes: “Lestrade thrust his +brandy flask between the Baronet’s teeth, and two frightened eyes were +looking up at us.” And, when Holmes asked him whether he was strong +enough to stand, the Baronet replied: “Give me another mouthful of that +brandy and I shall be ready for anything.” Brandy was given also to the +beautiful Mrs. Stapleton, the villain’s wife, when she was found in her +house in a pitifully exhausted state.</p> + +<p>Dr. Watson himself had need of brandy as a stimulant at least once in +his lifetime. He, like everyone else, believed that Sherlock Holmes had +died with Professor Moriarty at the Reichenbach Falls. We cannot blame +<span class="pagenum" id="Page_81">[Pg 81]</span> +the doctor for fainting when, three years later, he saw Holmes in the +flesh standing on the opposite side of the study table. Watson claims +that this was the only time in his life he had ever fainted. When he +regained consciousness, he found that Holmes had undone his collar +and had administered brandy to him (<i>The Adventure of the Empty +House</i>).</p> + +<p>Brandy and whiskey are, of course, used medicinally today, but probably +not as frequently as several decades ago. Some scientists argue +that alcohol does not cause a physiologic stimulation but rather a +depression. Pharmacologically, this is true, for it is now accepted +that the talkativeness and hilarity so often produced by alcohol do not +indicate a true stimulation of the nervous system but a removal of the +inhibition which the higher centers normally exert.</p> + +<p>On the other hand, it is still held by many physicians, and some +pharmacologists as well, that brandy and whiskey are useful therapeutic +agents in emergencies. Dr. Torald Sollman, dean of American +pharmacologists, feels that alcohol is a quick-acting stimulant, and +has a definite place in treating conditions such as syncope, exhaustion +and certain forms of shock. He attributes its effect to reflex +stimulation, which accounts for its brief action.<a id="FNanchor_4" href="#Footnote_4" class="fnanchor">[4]</a> He suggests that +a dose of 25 cc. (somewhat less than an ounce) of whiskey or brandy be +given, and that it be repeated every ten or fifteen minutes.</p> + +<p>Dr. Watson, throughout his stirring adventures with Sherlock Holmes, +was called upon to meet many emergencies. He was presumably justified +in resorting to frequent administrations of brandy. He had ample +opportunity for observing the effects of his medication, and apparently +was well satisfied with his results, for he continued to employ brandy +as a stimulant throughout the years. One practical justification for +<span class="pagenum" id="Page_82">[Pg 82]</span> +doing so was that it seemingly always was available. There is every +reason to believe that Dr. Watson carried a flask of brandy, as did +Sherlock Holmes. Even Lestrade, the dependable Scotland Yard detective, +was not found wanting when the occasion demanded, as we have seen in +the story of <i>The Hound of the Baskervilles</i>. Apparently, it was +the practice of the day.</p> + +<p>In conclusion, we may rest assured that Dr. Watson was firmly convinced +that his favorite remedy, brandy, as he employed it, helped alleviate +the suffering of his unfortunate fellow men. We may accept, also, +that he administered it only in an emergency, and when he was morally +certain that there was a real indication for its use—in short, he +observed faithfully the ethics of his noble profession.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_83">[Pg 83]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSON_ENDOCRINOLOGIST"> +DOCTOR WATSON, ENDOCRINOLOGIST</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“The emotional qualities are antagonistic to clear reasoning.”</p> + +<p class="right"> +<i>The Sign of the Four</i></p> +</div> + + +<p>The colorful story of <i>The Adventure of the Creeping Man</i> has +always especially interested me, for the theme embraces the fascinating +field of endocrinology. The plot revolves around Professor Presbury, +the Camford physiologist, who is portrayed as a biological scientist of +international renown. It is in order to review briefly the setting of +the story.</p> + +<p>Professor Presbury, a widower in his early sixties, had fallen madly +in love with a very young girl, the daughter of one of his colleagues. +During the course of the love affair, he began to show pronounced +changes in personality; he became secretive, highly irritable at +intervals, and on occasion even savage. When this portly and dignified +physiologist began to do such astounding things as walking on all fours +and swinging on the ivy-covered walls with the abandon and agility +of an ape, he naturally caused grave concern to his only daughter +Edith and to his associate Mr. Bennett, Edith’s fiancé. Furthermore, +the professor’s heretofore faithful wolfhound Roy had tried to +attack his master on several occasions. Events came to such a pass +that Mr. Bennett and Miss Presbury asked Sherlock Holmes to make an +investigation.</p> + +<p>Holmes summoned Dr. Watson to 221B Baker Street one night in September, +and casually announced that he was seriously considering writing a +monograph on the uses of dogs in detective work. He observed that +the action of a dog often reflects family life, and gave as an +<span class="pagenum" id="Page_84">[Pg 84]</span> +illustration the case on which he was presently working. He believed +that the changed behavior of the wolfhound toward his master might +prove to be an important clue in solving the mystery. In point of fact, +this eventually proved to be true.</p> + +<p>During this discussion, Mr. Bennett called on Sherlock Holmes and, +in the presence of Dr. Watson, reviewed the strange actions of the +professor and the dog’s attitude toward his master. He brought out the +important information that it was every ninth day when Presbury acted +so abnormally. With this latter fact in mind, it was not difficult for +Sherlock Holmes to arrange to be on hand at a time when the professor +would probably perform again his astonishing antics.</p> + +<p>Accordingly, one night Holmes and Watson secreted themselves in the +shrubbery in the professor’s extensive yard and awaited events. Holmes +had previously instructed Mr. Bennett to follow secretly his future +father-in-law should he venture out on this particular night. Their +vigil was rewarded, for about midnight the famous physiologist emerged +from his house clad in his dressing gown. To the astonishment of his +onlookers, he began walking on all fours. Dr. Watson describes his +further antics. The professor, with surprising agility, began to ascend +the ivy-colored walls, springing aimlessly from branch to branch, but +apparently hugely enjoying his singular powers. He finally tired of +thus disporting himself, came down to the ground, and moving along on +his hands and feet, made his way to the barn where Roy was tethered. +Remaining at a safe distance, he deliberately teased the dog until the +infuriated beast, having managed to slip his collar, sank his teeth +into the neck of the unfortunate professor. The two onlookers, with the +help of Bennett, rushed to the rescue; without their intervention, the +dog doubtless would have killed his master.</p> + +<p>Holmes had been working quietly on the case and had discovered that +Presbury, in his desire to regain the vigor of his youth, had connived +with an obscure Prague scientist who was attempting to unravel the +<span class="pagenum" id="Page_85">[Pg 85]</span> +secret of rejuvenescence. Holmes found that this individual was +attacking the problem by studying the physiologic effects on man of the +administration of serum obtained from certain apes. The serum he had +prescribed for Professor Presbury had been prepared from the langur, a +large black-faced monkey which lives on the slopes of the Himalayas. +Holmes emphasized that the langur was both a climber and a crawler. +The implication is obvious; it accounts for the professor’s mode of +progression and his agility as a climber.</p> + +<p>Holmes, discussing the case later with Watson, remarked that it was the +untimely love affair with the young girl which had given the professor +the idea of trying to turn himself into a younger man. Holmes also +commented on the strange behavior of the wolfhound; he felt the dog +had turned on his master because he thought it was a monkey he was +attacking.</p> + +<p>The theme of this story is of interest particularly to biologically +trained men. About the time it was written, there was a great deal of +interest in the possibility of rejuvenation by the transplantation of +testicular glands or by an injection of their extract. The work of +Steinach and of Voronoff, the European physiologists, had received +immoderate publicity.</p> + +<p>The real pioneer in the study of rejuvenation was, of course, +Charles-Edouard Brown-Séquard (1818-94), who reported the results of +his experiments in June 1889 before the <i>Société de Biologie</i>. +This brilliant French psychologist during the course of the preceding +fortnight had administered to himself six subcutaneous injections of +the water extract of ground-up testicles of dogs or of guinea pigs. He +was then seventy-two years old. He enthusiastically reported that the +effects had been astonishingly beneficial, and firmly believed that +both his physical forces and his mental activities were enormously +improved. He claimed that he felt less fatigued at the end of the day, +which was quite important to him, since he spent long hours in his +laboratory.</p> + +<p>Brown-Séquard had such an enviable reputation as a scientist that +<span class="pagenum" id="Page_86">[Pg 86]</span> +testicular extracts at once became widely and indiscriminately used. +The idea spread like wildfire. More than twelve thousand physicians +were administering testicular extracts to their patients before the end +of the year. Some of the more conservative physicians in England and +in the United States, however, were highly critical of Brown-Séquard’s +recent researches. They spoke derisively of the extract as “senile +folly,” “elixir of youth,” and made other uncomplimentary remarks. In +fairness to Brown-Séquard, it should be stated that he realized the +extract was not a panacea for all illnesses. But he did feel, up to the +time of his death, which occurred four years later, that testicular +extracts built up what he termed “nervous force.”</p> + +<p>It is now recognized by modern endocrinologists that the distinguished +Brown-Séquard had not controlled his experiments well. The testicular +extracts he used were probably inactive. If I may be technical about +it, he had made an aqueous extract which would leave behind the +hormones, which are fat soluble. It is known also that some of the +claims made by Steinach and by Voronoff were grossly exaggerated.</p> + +<p>It is possible that people who are not familiar with the science of +endocrinology might gain the impression that the administration of +ape serum could produce the effects so vividly described in <i>The +Adventure of the Creeping Man</i>. The concept that such a serum exists +is, of course, rank nonsense. Even though the tale is incredible, I +confess that I have always enjoyed reading it. This may be because it +is a story about a physiologist—and an unusual physiologist, for he +was also extremely wealthy. Parenthetically, mention should be made +that the story actually touches on science-fiction, which is at present +so much in vogue.</p> + +<p>The theme of rejuvenation has been used by numerous authors. One +story which comes to mind is the novel <i>Black Oxen</i>, written by +the late Gertrude Atherton, and published many years ago. This book +was widely read. The story, of course, was actually in the nature of +science-fiction.</p> + +<p><span class="pagenum" id="Page_87">[Pg 87]</span></p> + +<p>The subject of the renewal of youth is not as popular as it was some +years ago. There are still a few charlatans in the medical profession +who take advantage of the public and prescribe gonadal therapy +irrationally and even indiscriminately. These misguided medical men +make wild promises as to the permanent benefits to be derived from +administration of gonadal extracts. Indeed, there have been a few such +doctors in the United States, and one, at least, is reported to have +amassed a fortune. A few of these men have acted in good faith, and we +may charitably assume they believed that the administration of gonadal +extracts stimulated the libido of their patients or enabled them to +lead a more strenuous life. Be that as it may, many such practitioners +have acted on slender evidence, and they surely have, in a large +measure, the will to believe.</p> + +<p>Since the time Dr. Watson wrote <i>The Adventure of the Creeping +Man</i>, there have been highly important developments in gonadal +therapy. Testosterone, for example, a preparation from the male gonads, +is presently widely used and has a definite place in the therapeutic +armamentarium of any reputable physician. There are other preparations, +such as the estrogenic substances and progesterone, which have +therapeutic uses. These latter substances are extracted from the female +gonads. It would take us too far afield to elaborate on these or to +give the indication for their uses. There is good reason to believe +that there will be many new developments in this particular field, for +the science of endocrinology is still in its infancy.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_88">[Pg 88]</span></p> +<h2 class="nobreak" id="GENETICS_AND_SHERLOCK_HOLMES"> +GENETICS AND SHERLOCK HOLMES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“The point under discussion was how far any singular gift in an +individual was due to his ancestry and how far to his early training.”</p> + +<p class="right"> +<i>The Greek Interpreter</i></p> +</div> + + +<p>Allusions are made in several of the tales to the subject of +genetics—that is, the science of heredity. Many of the observations +set forth, although perhaps not entirely acceptable today, are +nevertheless intellectually stimulating.</p> + +<p>Nearly all human beings—some much more than others—are interested +in matters pertaining to heredity. Most of us like to hear about our +grandparents and even about our great-grandparents, despite the fact +that the deeds of some of our ancestors, and the lives they lived, may +cause us some embarrassment.</p> + +<p>In this connection, I am reminded of a statement made to me one evening +(a long time ago) by a distinguished Southerner of the old school, a +Kentucky gentleman, during a discussion of our ancestors. In effect, +he suggested that perhaps we should not examine the lives of our early +kinfolk too closely, because one of them might have been hanged as a +horse thief.</p> + +<p>When we uncover some irregularity in the behavior of our ancestors, we +often toss it aside by pointing out that after all they were products +of their times, which indicates, in part at least, that environment +was highly important. There is doubtless considerable truth in this +statement, but an honorable man in the eighteenth century probably had +(or anyway, <i>should</i> have had) the same high standard of conduct +<span class="pagenum" id="Page_89">[Pg 89]</span> +as an honorable man in the twentieth century. Rather than sermonize +further, let us turn to the tales of Sherlock Holmes.</p> + +<p>We find Doctor Watson and Sherlock Holmes talking together on a +beautiful summer evening. Doctor Watson writes:</p> + +<div class="blockquot"> + +<p>... the conversation ... came round to the question of atavism and +hereditary aptitudes. The point under discussion was how far any +singular gift in an individual was due to his ancestry and how far to +his early training.</p> + +<p class="right"> +<i>The Greek Interpreter</i></p> +</div> + +<p>Watson expressed the thought that Holmes’ faculty of observation and +his peculiar facility for deduction were due to his own systematic +training. Holmes ventured this was true only to some extent. When +Watson asked him why he thought it hereditary, Holmes replied, “Because +my brother Mycroft possesses it in a larger degree than I do.”</p> + +<p>Doctor Watson was amazed at this answer, and expressed the sentiment +that if any other man in England possessed greater keenness in +observation and deductive powers than did Sherlock Holmes, the public +would surely know of him. Watson hinted it was Holmes’ modesty which +caused him to extoll his brother’s powers. Holmes quickly made this +rejoinder: “I cannot agree with those who rank modesty among the +virtues. To the logician all things should be seen exactly as they are, +and to underestimate one’s self is as much a departure from truth as to +exaggerate one’s own powers. When I say, therefore, that Mycroft has +better powers of observation than I, you may take it that I am speaking +the exact and literal truth.”</p> + +<p>There are doubtless many people who would take issue with the thoughts +Holmes expressed. But they do contain more than a modicum of truth. +Is there not an expression to the effect that false modesty is not a +<span class="pagenum" id="Page_90">[Pg 90]</span> +virtue? Does not the matter of intellectual honesty also enter into +this picture? We will not at this time pursue the matter further, +although it is tempting.</p> + +<p>Sherlock Holmes suggested to Dr. Watson that, since he had never +met Mycroft, it would be fitting for him to make his acquaintance. +Accordingly, they set out for the Diogenes Club, where Holmes assured +Watson that Mycroft, on account of his routine life, would be found +this very hour of the day.</p> + +<p>Watson was presented to this extraordinary person:</p> + +<div class="blockquot"> + +<p>... his face ... had preserved something of the sharpness of +expression which was so remarkable in that of his brother. His eyes, +which were of a peculiarly light, watery gray, seemed to always +retain that far-away introspective look which I had only observed in +Sherlock’s when he was exerting his full powers.</p> +</div> + +<p>Watson has skillfully depicted the family likeness—that is, the highly +intelligent face and the dreamy and introspective look. Obviously, +Mycroft and Sherlock were both remarkably keen, alert men.</p> + +<p>At the Diogenes Club, Mycroft and Sherlock seated themselves before a +window which gave them a clear view of the street. As they sat there +conversing, two strangers were approaching along the sidewalk. Mycroft +called attention to them, and the following brilliant dialogue ensued:</p> + +<div class="blockquot"> + +<p>“Look at these two men ... coming toward us....”</p> + +<p>“The billiard-marker and the other?”</p> + +<p>“Precisely. What do you make of the other?”</p> +</div> + +<p>(Dr. Watson then explained that he noted some chalk marks on the +waistcoat of one of the men which was the only evidence of billiards +<span class="pagenum" id="Page_91">[Pg 91]</span> +he could see, and that the other one was carrying several packages.)</p> + +<div class="blockquot"> + +<p>“An old soldier, I perceive,” said Sherlock.</p> + +<p>“And very recently discharged,” remarked the brother.</p> + +<p>“Served in India, I see.”</p> + +<p>“And a non-commissioned officer.”</p> + +<p>“Royal Artillery, I fancy,” said Sherlock.</p> + +<p>“And a widower.”</p> + +<p>“But with a child.”</p> + +<p>“Children, my dear boy, children.”</p> +</div> + +<p>Watson laughingly remarked that this was too much. Sherlock and Mycroft +assured him it was not. They pointed out some of the salient points +which had enabled them to make their astute conclusions. Among those +mentioned were that the man in question had the bearing of a soldier, +wore the expression of authority, and had a deeply tanned skin (which +suggested he had served in India). The fact that he was wearing deep +mourning indicated he was probably a widower.</p> + +<p>The dialogue actually was a contest of wits between Sherlock and +Mycroft. The latter obviously won when he said, “Children, my dear boy, +children.” This winning stroke Mycroft explained in this way: “He has +been buying things for his children.... There was a rattle which shows +one of them is young ... a picture book under his arm shows that there +is another child to be thought of.”</p> + +<p>When Mycroft had finished, Holmes merely turned to Watson and smiled, +not only to acknowledge his brother’s genius but also his superiority +in observation and deduction.</p> + +<p>Sherlock Holmes apparently believed firmly that heredity played an +extremely important part in the life of an individual. There is no end +to the argument among biologists whether heredity or environment plays +the more significant role in the development of an individual. It is +<span class="pagenum" id="Page_92">[Pg 92]</span> +especially so with a person’s mental capacity. One who unfortunately +has inherited a mediocre mind will always be handicapped, to a degree, +regardless of his environment or training. The mental powers will +remain ordinary. Conversely, the individual who is endowed with a +keener intellect will always be potentially the intellectual superior +of his less fortunate brother. There is no doubt that training and +environment in general will aid both types of individuals, but even +the most ideal developmental conditions can not completely overcome a +deficient genetic constitution.</p> + +<p>In the story of <i>The Yellow Face</i>, it will be recalled that a +white woman had married a Negro. The child, according to the story, +had even a darker skin than her father: “It was our misfortune that +our only child took after his people rather than mine. It is often so +in such matches, and little Lucy is darker than her father was.” This +statement must be challenged. It appears incredible that a child born +of a white mother could be darker than her Negro father. If the mother +had had some Negro blood, then by certain arrangements of genes this +could have happened, but not otherwise. Dr. Watson doubtless is in +error in this instance.</p> + +<p>A hereditary likeness once enabled Holmes to solve a mystery (<i>The +Adventure of the Cardboard Box</i>). A maiden lady (Miss Cushing) +had received in the mail a small cardboard box containing two human +ears—one that of a woman. Holmes was called in, and during the course +of the investigation visited the receiver of this gruesome package. +He noted the resemblance of one of the severed ears to the ears of +the lady upon whom he was calling. Because of the striking likeness, +he felt certain that the person whose ear had been dismembered was a +close relative of the Miss Cushing whom he had come to interrogate. +Holmes remarks to Dr. Watson: “I perceived that her ear corresponded +exactly with the female ear I had just inspected.... There was the same +shortening of the pinna, the same broad curve of the upper lobe, the +<span class="pagenum" id="Page_93">[Pg 93]</span> +same convolution of the inner cartilage.... It was evident that the +victim was a blood relation, and probably a very close one.” It will be +recalled that the dismembered ear proved to be that of Miss Cushing’s +sister.</p> + +<p>Holmes propounds an interesting theory of the development of the +individual, in <i>The Adventure of the Empty House</i>. Speaking of +the terrible Colonel Moran, he expressed the idea that the individual +represents the whole procession of his ancestors in his development, +and that the person becomes the epitome of the history of his own +family. Doctor Watson thought this rather fanciful, and Holmes’ +rejoinder was that he would not insist upon it.</p> + +<p>In <i>The Hound of the Baskervilles</i>, Holmes successfully +demonstrates by means of a family portrait that the villain Stapleton +is actually a Baskerville. It will be remembered that Holmes stands +upon a chair and uses his arm to cover the broad hat and the long +ringlets depicted in the portrait. Now that only the features are +visible, the portrait of old Hugo Baskerville boldly stands out. Watson +is astounded when he beholds the results. Holmes remarks that it was +an interesting instance of a throwback, apparently both physical and +spiritual.</p> + +<p>The discovery that Stapleton markedly resembles one of his early +ancestors is not too surprising, for this surely could happen in any +family. The remarkable thing is that Holmes had had the acumen to cover +up certain portions of the old family portrait to make the face of +old Hugo Baskerville stand out. This clever demonstration would not +have occurred to many people. The extraordinary family resemblance +portrayed is a splendid example of atavism—that is, a reappearance of +the characteristics of a remote ancestor which presumably had been more +or less absent in intervening generations. The matter of atavism would +make a most interesting study. Therein lies the value and interest of +the old family album which used to grace the center table in the parlor.</p> + +<p>In <i>The Adventure of the Copper Beeches</i>, Holmes makes a neat +<span class="pagenum" id="Page_94">[Pg 94]</span> +point in regard to the subject of heredity: “My dear Watson, you as a +medical man are continually gaining light as to the tendencies of a +child by the study of the parents. Don’t you see that the converse is +equally valid. I have frequently gained my first real insight into the +character of parents by studying their children.”</p> + +<p>This is an interesting analysis. Let us pursue the thought further. The +expression is often heard that a child’s behavior resembles that of one +of his parents. A popular way of putting it is that he is “a chip off +the old block.” This makes it appear that the pattern of behavior is +set up early in life. An old maxim has it: “As the twig is bent, so the +tree will incline.”</p> + +<p>The problem is not always as simple as Holmes suggests. It is true that +we all have seen fine and lovable children whose parents have similar +qualities. But we also have seen ill-mannered, nasty-tempered children +whose parents have fine characters and possess charming manners. One +is reminded of a statement attributed to the gentle and amiable Robert +Louis Stevenson: “It has been a source of perpetual mystification to +me where all the disagreeable medical students go to, and all the +admirable doctors come from.”</p> + +<p>I think the same may be said about some of the spoiled, unlovable +children. Many of them develop into sterling young men and women who +later in life carry on with noble purpose and high resolve. These +individuals often form the backbone of their community.</p> + +<p>The entire matter of heredity is a complicated one, and much is still +to be learned about the subject. It is extremely important in the +study and practice of medicine. There are some common diseases which +certainly run in families, such as migraine, high blood pressure +(hypertension), and diseases of the coronary arteries. And it is +definitely known that diabetes may be inherited. In my own experience, +I have known a father with diabetes whose three daughters had all +<span class="pagenum" id="Page_95">[Pg 95]</span> +developed this condition early in life. There are other diseases just +as formidable: for example, certain neurological and mental diseases. +Any researches which may throw any light on the subject of heredity +should be encouraged.</p> + +<p>As we have seen, there are not many allusions in the Sherlock Holmes +stories to genetics. It is a pity that the topic of crime and heredity +was not touched upon. As far as I know, no specific reference is made +to it. I am not sufficiently acquainted with crime statistics to know +how commonly one would find several criminals in one family—that is, +in a single generation. However, one does think of those Missouri +bandits: the James brothers, the Younger brothers, and the Daltons. +Perhaps there are others. In any case, one would like to know whether +their parents or grandparents had criminal records. I submit, however, +that these last-named cases are rather special ones, for the James +brothers and their colleagues were products of an unusual period. +Doubtless, a black sheep may be found in an otherwise respectable +family. As Sherlock Holmes stated to Dr. Watson, once in a while a +carrion crow appears among the eagles (<i>The Adventure of Shoscombe +Old Place</i>).</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_96">[Pg 96]</span></p> +<h2 class="nobreak" id="THE_ZOOLOGICAL_DOCTOR_WATSON"> +THE ZOOLOGICAL DOCTOR WATSON</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“The coyote skulks among the scrub, the buzzard flaps heavily through +the air, and the grizzly bear lumbers through the dark ravines....”</p> + +<p class="right"> +<i>A Study in Scarlet</i></p> +</div> + + +<p>Dr. Watson was a man of catholic tastes and diversified interests. Not +only was he a capable and experienced physician, but he was a man of +letters, an amateur detective, and an athlete of considerable ability. +No one, as far as I know, has emphasized his interest in zoology. +This trait is more apparent to those acquainted with the biological +sciences, but even the most casual reader cannot but notice the +frequent references to animal life.</p> + +<p>The plots in a number of the tales depend entirely upon a zoologic +background. In <i>The Adventure of the Lion’s Mane</i>, for example, +the death of a person as well as that of a dog are attributed to +the poisonous sting of <i>Cyanea capillata</i>, a huge jellyfish. +A swamp adder, which Watson describes as “the deadliest snake in +India,” is used to kill two people in <i>The Adventure of the Speckled +Band</i>. In another tale, the plot hinges upon the fact that a +goose has swallowed a rare jewel, which is eventually recovered from +its crop (<i>The Adventure of the Blue Carbuncle</i>). A race horse +is answerable for the mysterious death of his trainer (<i>Silver +Blaze</i>). In <i>The Adventure of the Veiled Lodger</i>, a lion is +responsible for the dilemma of the unfortunate lodger. The central +theme in <i>The Adventure of the Creeping Man</i> has to do with the +antics of a scientist who at times shows apelike qualities. Finally, +<span class="pagenum" id="Page_97">[Pg 97]</span> +in <i>The Hound of the Baskervilles</i>, the grisly spectral hound +plays the title role.</p> + +<p>Let us consider first some references to the lower forms of life, +such as insects. The naturalist Stapleton, in <i>The Hound of the +Baskervilles</i>, was supposed to be an authority on butterflies and +moths, that is, lepidoptera. When he and Watson met one day on the +moor, the naturalist invited him to see his collection, which he +described as the most complete in the southwest of England. Later in +the story, when searching the house for the fiendish Stapleton, Dr. +Watson describes a room fitted up as a small museum with glass-topped +cases filled with butterflies and moths.</p> + +<p>The scholarly recluse Nathan Garrideb evidently was another such +collector, for when Holmes and Watson visited his house they found +cases of butterflies and moths on each side of the entrance (<i>The +Adventure of the Three Garridebs</i>). One must remind the reader +that butterflies are distinguished from moths by the shape of their +antennae, the former having clubbed antennae, the latter not.</p> + +<p>Two allusions are made to the antennae of insects. In <i>The Adventure +of the Illustrious Client</i>, the waxed tips of the Baron’s mustache +are likened to an insect’s antennae. The other is found in <i>The +Hound of the Baskervilles</i>. Dr. Watson, observing Dr. Mortimer, the +country practitioner, rolling a cigarette, remarks that his long and +quivering fingers remind one of the agility and restlessness of the +antennae of an insect. These descriptions are extremely apt, since the +antennae of insects are nearly always in motion.</p> + +<p>In <i>The Adventure of Black Peter</i>, Captain Peter Carey was found +one morning harpooned to death in a small shed near his house. Holmes +remarks that the captain had been pinned to the wall like a beetle on a +card.</p> + +<p>Let us go higher in the zoological scale. It is evident that Holmes +despised snakes, for he refers to them as extremely repugnant +<span class="pagenum" id="Page_98">[Pg 98]</span> +creatures and remarks to Watson that watching them in a zoo gives him +a most unpleasant sensation (<i>The Adventure of Charles Augustus +Milverton</i>). A number of animals which live in the water are +mentioned: namely, fish, jellyfish, sharks, seals, and crocodiles. +For instance, when Holmes introduces his brother Mycroft to Watson, +the latter writes that Mycroft put “... out a broad fat hand like the +flipper of a seal” (<i>The Greek Interpreter</i>). And in <i>The Sign +of the Four</i>, Jonathan Small had the extreme misfortune of having +his leg bitten off by a crocodile.</p> + +<p>Birds are not neglected. In <i>The Adventure of the Solitary +Cyclist</i>, Watson tells how he and Holmes on one of their walks +enjoyed the music of the birds. On another occasion, he likens Holmes +to a lank bird (<i>The Adventure of the Dancing Men</i>). Watson, in +<i>The Adventure of the Priory School</i>, speaks of the plover and +the curlew; and in <i>The Hound of the Baskervilles</i>, the raven +and bittern are used effectively to accentuate the utter loneliness +of the moor. The ravens croak loudly behind the tor, and this is the +only life stirring over the vast landscape. When Watson one day asks +the naturalist Stapleton what had caused the bloodcurdling sound on +the moor, the latter’s shifty reply is that they had heard the cry +of the last of the bitterns. In <i>A Study in Scarlet</i> occurs the +felicitous expression: “... the buzzard flaps heavily through the +[desert] air....” In <i>The Adventure of Shoscombe Old Place</i>, +Holmes makes the pertinent statement, when speaking of the weakness of +Lord Robertson, that even among eagles one may find a carrion crow.</p> + +<p>An occasional reference to the eggs of birds also occurs. Watson +writes, “... a young lady entered the room with a bright quick face, +freckled like a plover’s egg ...” (<i>The Adventure of the Copper +Beeches</i>). The cipher Holmes employed in <i>The “Gloria Scott”</i> +contained the words, “pheasant hen eggs.”</p> + +<p>So much for the lower forms of life; let us move on to the mammals. +<span class="pagenum" id="Page_99">[Pg 99]</span> +Attention is called to several small mammals—in <i>The Adventure of +the Crooked Man</i>, a mongoose; and in <i>The Sign of the Four</i>, a +stoat and a mole as well as a weasel. The reader may recall that other +names for a stoat are “ermine” or “ferret.”</p> + +<p>Large mammals are referred to more often. Dr. Watson writes, in <i>A +Study in Scarlet</i>, “The coyote skulks among the scrub ... and the +grizzly bear lumbers along the dark ravines....” Big-horn sheep also +appear: “... there stood a creature somewhat resembling a sheep in +appearance, but armed with a pair of gigantic horns. The big-horn—for +so it was called....” In this same story, bison are also to be found. +Holmes, exasperated when looking for footprints, says, “If a herd of +buffaloes happened along, there could not be a greater mess.” In still +another instance, Watson writes, “... the observer would have come to +the conclusion that one of those great herds of bisons which graze upon +the prairie land was approaching him.” A herd of bison is referred to +again in <i>The Boscombe Valley Mystery</i>. Holmes feelingly remarks, +“Oh, how simple it would all have been had I been there before they +came like a herd of buffalo and wallowed over it!” It is obvious that +Holmes was impressed with the immense herds of buffalo which once +roamed over the great plains of our romantic West.</p> + +<p>In <i>The Valley of Fear</i>, we come across an interesting analogy. +Holmes remarks to Watson that Porlock, although unimportant in his own +right, nevertheless takes on importance through his close touch with +the master criminal Professor Moriarty. He spoke of the relationship of +the two men as that of the pilot fish to the shark, or of the jackal +to the lion; that is, one was insignificant and the other formidable. +In this same story, our attention is called to two other mammals—the +wolf and the caribou. In <i>The Adventure of the Speckled Band</i>, we +are introduced to two African animals, the cheetah (reputed to be the +fastest animal on earth) and the baboon. And in <i>The Adventure of +<span class="pagenum" id="Page_100">[Pg 100]</span> +the Creeping Man</i>, reference is made to one of the higher apes, the +langur, which is described as a large animal with a black face living +on the slopes of the Himalayas.</p> + +<p>When we read about large mammals, big-game hunting comes to mind, +at least to the sportsman. Several allusions to this exciting and +dangerous sport are found in the tales. In <i>The Naval Treaty</i>, we +read, “... it has the sort of excitement about it that the sportsman +feels when he lies beside the water course and waits for the big game.” +In <i>The Adventure of Black Peter</i>, we read again of the hunter’s +thrill while lying in wait for some unknown large beast to approach the +water hole.</p> + +<p>When Sherlock Holmes ironically introduces the terrible Colonel Moran +to Dr. Watson and Lestrade, he says, among other things, that the +Colonel is an outstanding big-game hunter, practically without peer, +and that his bag of tigers remains unrivaled (<i>The Adventure of +the Empty House</i>). In <i>The Adventure of the Bruce-Partington +Plans</i>, Holmes notes that it was such a foggy day in London that a +thief or murderer could roam the streets and pounce on his prey like +a tiger in the jungle. In another instance, Holmes tells Watson about +Count Sylvius, the famous big-game hunter who had stolen the Crown +diamond. The nonchalant detective facetiously remarks that if the +Count could add him (Holmes) to his bag of big game, it would be an +outstanding triumph (<i>The Adventure of the Mazarin Stone</i>).</p> + +<p>The numerous allusions to animal life in the tales show clearly that +Dr. Watson was keenly interested in zoology. This is not unexpected, +since he was a physician, and, as everyone knows, a student of medicine +has a broad training in the biological sciences. It is doubtful whether +a man untrained in biologic science could have used the references to +animals as accurately and as effectively as did Dr. Watson.</p> + +<p>Where did he obtain his love for zoology? Solely from his preparatory +<span class="pagenum" id="Page_101">[Pg 101]</span> +studies in medicine? Probably not. Dr. Watson was an athlete and an +outdoor man. Such men frequently take a pronounced interest in plant +and animal life, since it is before their eyes a good part of the time.</p> + +<p>We may conclude, then, that Dr. Watson was not only a physician, an +amateur detective, an athlete, and a man of letters, but a zoologist as +well. In this age of specialization, it is refreshing to reflect that +Dr. Watson had such a wide range of interests.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_102">[Pg 102]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSON_CARDIOLOGIST"> +DOCTOR WATSON, CARDIOLOGIST</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“Marsten had sprung out of his chair in a paroxysm of anger, when he +suddenly pressed his hand to his side, his face turned a dusky hue, +and he fell backward....”</p> + +<p class="right"> +<i>The Sign of the Four</i></p> +</div> + + +<p>Dr. Watson did not profess to be a cardiologist, but rather a general +practitioner of medicine. There are more allusions to minor surgery +and to nervous disorders in the tales than there are to diseases of +the heart or circulation. There are, however, several references to +the latter which are of historical interest to medical students and +practicing physicians.</p> + +<p>Let us examine some of the references to cardiovascular conditions. In +<i>The Sign of the Four</i>, a sudden cardiac death already cited above +is described:</p> + +<div class="blockquot"> + +<p>Marsten had sprung out of his chair in a paroxysm of anger, when he +suddenly pressed his hand to his side, his face turned a dusky hue, +and he fell backward, cutting his head against the corner of the +treasure-chest. When I stooped over him, I found to my horror that he +was dead.</p> +</div> + +<p>The cause of death in this instance, so dramatically described, +presumably was produced by a coronary occlusion. It is noteworthy that +the patient was “in a paroxysm of anger” at the time he was stricken. +One is reminded of John Hunter, the famous English anatomist, who in +later life suffered from severe angina pectoris. He is reputed to have +<span class="pagenum" id="Page_103">[Pg 103]</span> +said that he was at the mercy of any rascal who saw fit to make him +angry. Any intense emotion, of course, is capable of producing profound +effects on the cardiovascular system.</p> + +<p>It will be remembered in the novel, <i>The Hound of the +Baskervilles</i>, that Sir Charles Baskerville had a cardiac disorder. +His friend and physician, Dr. James Mortimer, had concurred that “Sir +Charles’ health has for some time been impaired, and points especially +to some affection of the heart manifesting itself in changes in colour, +breathlessness, and acute attacks of nervous depression.” One evening, +when Sir Charles was taking his customary walk between the rows of +yew trees, he saw the awesome hound; he became greatly frightened and +ran as fast as he could toward Baskerville Hall. He fell dead before +he reached the house. In this instance, the intense mental excitement +and the tremendous physical effort caused heart failure—perhaps +ventricular failure produced by a diseased myocardium rather than a +coronary occlusion.</p> + +<p>Physical exertion does not necessarily produce a coronary occlusion. It +was once thought that patients suffering from angina pectoris, or who +actually had coronary disease, should not exert themselves physically. +They were warned, for example, not to run to catch a streetcar. A +more liberal view is held today; most patients are urged to exercise +themselves. In point of fact, many coronary occlusions occur when the +patient is at complete rest or performing some slight task.</p> + +<p>An interesting allusion to cardiac neurosis may be found in <i>The Sign +of the Four</i>. When Dr. Watson was introduced to Thaddeus Sholto, +the latter became greatly excited and said: “A doctor, eh?... Have +you your stethoscope? Might I ask you—would you have the kindness? +I have grave doubts as to my mitral valve, if you would be so very +good. The aortic I may rely upon, but I would value your opinion upon +the mitral.” After Dr. Watson had listened to Sholto’s heart, and had +assured him that he had no cause for uneasiness, the patient turned to +<span class="pagenum" id="Page_104">[Pg 104]</span> +Miss Morstan and said: “You will excuse my anxiety, Miss Morstan ... I +am a great sufferer, and I have long had suspicions as to that valve. I +am delighted to hear that they are unwarranted.”</p> + +<p>The above clearly depicts a man who is unduly, and probably needlessly, +alarmed about the condition of his heart; the diagnosis of cardiac +neurosis can obviously be made. This could have been brought about by +some physician who, in an ill-advised moment, had hinted to the patient +that he might be suffering from a cardiac disorder. Such a condition +is spoken of as “iatrogenic heart disease.” Unfortunately, a good many +people suffer from cardioneurosis, and the majority probably would be +benefited by consulting a psychiatrist. The doctor might be able to +ascertain the underlying cause for the patient’s fear.</p> + +<p>These passages from <i>The Sign of the Four</i> show that Dr. Watson +was acquainted with valvular heart disease; they are, however, rather +farfetched, if not ludicrous, and probably could not be appreciated +by the nonmedical reader. Watson does not often attempt to show his +erudition or weary his readers by employing technical terms. A good +example of this matter-of-factness may be found in <i>The Crooked +Man</i>: “The injury from which this unfortunate veteran was suffering +was found to be a jagged cut some two inches long at the back part +of his head, which had evidently been caused by a violent blow from +a blunt weapon.” The above is written in a language that anyone can +understand.</p> + +<p>In the novel <i>A Study in Scarlet</i>, may be found an interesting +reference to an aortic aneurism. Jefferson Hope told Dr. Watson to put +his hand over his heart. Watson writes:</p> + +<div class="blockquot"> + +<p>I did so, and became at once conscious of an extraordinary throbbing +and commotion which was going on inside. The walls of the chest seemed +to thrill and quiver as a frail building would do inside when some +powerful engine was at work. In the silence of the room I could hear +<span class="pagenum" id="Page_105">[Pg 105]</span> +a dull humming and buzzing noise which proceeded from the same source.</p> +</div> + +<p>Dr. Watson promptly diagnosed it as an aortic aneurism. Just before +Watson made his examination, Jefferson Hope had put up a terrific +struggle to escape capture, and it had taken four men to subdue him:</p> + +<div class="blockquot"> + +<p>So powerful and fierce was he that the four of us were shaken off +again and again. He appeared to have the convulsive strength of a man +in an epileptic fit. It was not until Lestrade succeeded in getting +his hand inside his neckcloth and half strangling him that we made him +realize that his struggles were of no avail.</p> +</div> + +<p>The remarkable thing is that this man was suffering from an aortic +aneurism which was on the point of bursting. Why the aneurism did not +burst during the terrific struggle will always be a mystery. We find +later in the story that it subsequently did burst.</p> + +<p>Several references to the pulse may be found in the tales. When +the pompous if dignified Thorney Huxtable, M.A., Ph.D., collapsed +in Holmes’ living room, Dr. Watson attended him, and described the +condition as one of severe exhaustion; he spoke of the pulse as being +thready in character (<i>The Adventure of the Priory School</i>). In +<i>The Adventure of the Stock Broker’s Clerk</i>, a man had tried +to hang himself, but Dr. Watson helped rescue him just in time. The +patient was placed on the floor, and the good doctor immediately felt +his pulse; he reported that it was feeble and intermittent.</p> + +<p>At the time Dr. Watson practiced medicine, more attention was probably +paid to the study of the pulse than now obtains. The experienced +physician knows that considerable information can be obtained by +<span class="pagenum" id="Page_106">[Pg 106]</span> +studying the pulse. Not only can the rate be ascertained, but the +character of the beat as well: whether it is full or bounding, or +thready or feeble, and the like. By digital pressure on the radial +artery, a rough idea can be obtained of the systemic blood pressure, +and at the same time some information can be gained as to whether the +artery shows any sclerosis.</p> + +<p>Some physicians of the older school feel that the younger generation +of physicians neglects the pulse, and its study is becoming a lost +art. The more recently trained physicians are more apt to depend upon +certain instruments of precision. Be that as it may, we have already +seen that Dr. Watson attempted to gain as much information as he could +by feeling the pulse.</p> + +<p>On one occasion (<i>The Adventure of Shoscombe Old Place</i>), +Dr. Watson speaks of a failing heart; he describes a patient who +had a dropsical condition. When reading about a failing heart +in English medical literature, one cannot but think of William +Withering (1741-99), who was the first physician to employ digitalis +therapeutically as a single pharmacologic agent. He reported his +findings many years before Dr. Watson practiced medicine. It is +singular that Dr. Watson never mentioned any digitalis preparation in +the Sherlock Holmes stories. He does mention amyl nitrite, but not in +connection with any heart condition; he also mentions morphine as a +drug to assuage pain, but again not in connection with the heart.</p> + +<p>Since the time Dr. Watson practiced medicine in London, great strides +have been made in the diagnosis and treatment of cardiovascular +disorders. The electrocardiogram and other instruments have been +developed for diagnosing disorders of the heart and vessels. Methods of +treatment, such as the use of antibiotic drugs, and agents for reducing +high blood pressure, have been of inestimable value.</p> + +<p>In this country during the past few years, the citizens have become +<span class="pagenum" id="Page_107">[Pg 107]</span> +increasingly aware of the value of research in cardiovascular disease. +It is noteworthy that a part of this interest was stimulated by the +fact that President Dwight D. Eisenhower suffered a coronary occlusion +and later a mild cerebral accident.</p> + +<p>In conclusion, when Dr. Watson practiced medicine, he did not have any +effective drugs at his disposal to combat hypertension, or any drugs, +such as dicumarol, to lessen the danger of further coronary occlusions. +We may be assured, however, that those agents he did have were used to +the best of his ability, and he did all he could to restore the patient +to health. No man could do more.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_108">[Pg 108]</span></p> +<h2 class="nobreak" id="THE_PHYSIOLOGIC_DOCTOR_WATSON"> +THE PHYSIOLOGIC DOCTOR WATSON</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“Surely your medical experience will tell you, Watson, that weakness +in one limb is often compensated for by exceptional strength in the +other.”</p> + +<p class="right"> +<i>The Man with the Twisted Lip</i></p> +</div> + + +<p>Since I am a professional physiologist, references made to physiologic +matters in the tales are of especial interest to me. Physiology, as the +term is now used, may be defined as the science which deals with the +function of an organism and its parts, in contrast with anatomy, which +is concerned only with the structure of an organism.</p> + +<p>Dr. Watson took his work at the University of London Medical School, +and was graduated in 1878—eighty years ago. We may assume that he +received good training in physiology; at any rate, he apparently had +a healthy respect for this important science. Let us examine the +references he makes to physiologic matters in the tales.</p> + + +<p class="nindc space-above2"> +<i>Physiologists</i></p> + + +<p>In <i>The Adventure of the Creeping Man</i>, a physiologist, Professor +Presbury, is the central figure. Dr. Watson speaks of him as a renowned +“Camford” physiologist. The word “Camford” is a happy choice. It +strikes one that it could be a combination of two words, Cambridge +and Oxford. Whether Dr. Watson had these two famous schools in mind, +I cannot say, but I am inclined to believe he did. It is noteworthy +<span class="pagenum" id="Page_109">[Pg 109]</span> +that he depicts Professor Presbury as a wealthy man. On one occasion, +Sherlock Holmes and Doctor Watson called at Presbury’s home. The good +doctor wrote glowingly about the physiologist’s charming house and +beautiful grounds, and emphasized that the professor was surrounded +with every sign of luxury.</p> + +<p>This is truly an unusual picture, for not many professional +physiologists are wealthy, and they certainly are not surrounded with +luxury. Professor Presbury, fortunately, was an exception. He must have +been a wealthy man in his own right, or have married a woman of means, +for surely he did not become wealthy by teaching physiology.</p> + +<p>Professor Presbury’s assistant, Mr. Trevor Bennett, is interestingly +pictured as a handsome, tall young man, and elegantly dressed. He +was portrayed as having the shyness of the student rather than the +self-possession of a man of the world. We can readily understand his +shyness and his studious manner, but it is more difficult to imagine +his elegant appearance. Bennett, we find later, had a medical degree, +so perhaps he enjoyed a consulting clinical practice, which might +account for his exceptional elegance.</p> + +<p>Mr. Bennett’s careful grooming is in contrast to the usual situation, +because physiologists, I fear, do not have the reputation for being +well-dressed people. They are apt to be somewhat indifferent about +their personal appearance, especially when at work in the laboratory. +This is quite understandable, since they often work with such animals +as cats, dogs, and monkeys, and with even larger animals like sheep, +goats, and pigs. Some of the more fastidious scientists don old clothes +for such occasions, but this is not always convenient. At any rate, the +average physiologist is not known for his elegant appearance—and for +good measure, I will throw in the pharmacologists also! Several living +examples of each could be cited to prove my point, but I must refrain +from embarrassing my distinguished friends and colleagues. At least +<span class="pagenum" id="Page_110">[Pg 110]</span> +Mr. Bennett may be considered an exception.</p> + + +<p class="nindc space-above2"> +<i>Endocrinology</i></p> + + +<p>In the story discussed above, the author uses the theme of +endocrinology. Professor Presbury, widower in his early sixties, had +fallen madly in love with a very young girl. In his desire to regain +his lost youth, the professor administered to himself injections of +serum prepared from apes. A conniving Prague scientist had prepared the +material from the langur, which Watson dramatically described as one of +the higher apes, distinguished by a black face, and an inhabitant of +the slopes of the Himalayas.</p> + +<p>According to the story, the serum had a profound effect on the +professor. Following the serum injections, which he took at nine-day +intervals, he acquired the characteristics of an ape, not only by +simulating the mode of locomotion of this animal but by developing, +also, an uncanny ability to climb.</p> + +<p>One night, following a serum injection, the professor got into grave +difficulty when his heretofore faithful wolfhound Roy, which he was +bedeviling, attacked him viciously. As Sherlock Holmes told Dr. Watson, +the wolfhound thought he was attacking the monkey, not his master. +Presbury was saved by the quick action of Holmes and Watson.</p> + +<p>The plot is fantastic, but interestingly told. Today this story would +be regarded as science-fiction. It was written at a time when the +subject of rejuvenescence had been made popular by the endocrine +studies of Steinach and of Voronoff, the European scientists. The +father of endocrinological studies was, of course, Charles-Edouard +Brown-Séquard, who had reported his studies on testicular extracts in +1889. Dr. Watson was undoubtedly familiar with Brown-Séquard’s work. +In <i>The Adventure of the Creeping Man</i>, Holmes points out a moral +when he remarks to Watson that, if one leaves the straight road to +<span class="pagenum" id="Page_111">[Pg 111]</span> +destiny, even the highest type man may revert to the animal.</p> + + +<p class="nindc space-above2"> +<i>Digestion</i></p> + + +<p>Let us turn to the physiology of digestion. Dr. Watson obviously felt +that one should eat sparingly if brain work is to be done. We find him +saying that his friend Holmes had eaten no breakfast, because in his +more intense moments he allowed himself no food. Holmes contended that +he did not have energy to spare for both nerve force and digestion +(<i>The Adventure of the Norwood Builder</i>). On another occasion, +Holmes, when talking to Doctor Watson, emphasized the fact that +starvation refines the faculties. He insisted that during digestion the +brain is robbed of blood, because blood is needed in the splanchnic +area. Holmes insisted that he himself was a brain, and the rest of his +body a mere appendix (<i>The Adventure of the Mazarin Stone</i>).</p> + +<p>The ideas expressed in the above paragraph hold our physiologic +interest because, at the time Watson wrote, the concept he expressed +was the accepted one. Later work has shown that this theory is not +tenable. The modern view is that digestion does not influence the +blood supply to the brain. In point of fact, nature has taken careful +precautions to ensure the brain of a rich blood supply at all times +under normal physiologic conditions.</p> + +<p>Although the brain does not suffer in its blood supply during +digestion, it is well known that the body is capable of shunting blood +to those regions which are functioning and are, therefore, in need of +it. If a hearty meal is eaten, a rich supply of blood is required to +digest and absorb it. Athletes know that a large meal should not be +eaten before taking strenuous exercise. Indeed, if a substantial amount +of food be eaten preceding intense physical exertion, the athlete may +become nauseated or even vomit.</p> + +<p><span class="pagenum" id="Page_112">[Pg 112]</span></p> + +<p>The voluntary muscles need blood when functioning, and the greater the +amount of exercise, the more blood is needed. The circulatory system +cannot supply both the splanchnic region and the skeletal muscles under +these conditions, so some part of the body must suffer. The nausea and +vomiting are, in a measure at least, produced by anemia of the stomach. +In the example just given, there is also a nervous component, which in +some individuals plays an extremely important part.</p> + +<p>Let us return to the blood supply of the brain. There is some evidence +that the brain needs a slightly increased blood supply during lively +mental activity, but not all physiologists will accept these findings. +However, this may safely be stated: the metabolism of the brain is high +at all times and is not affected by mental work. If one indulges in +“heavy thinking,” one simply directs the activities of the nerve cells +in the brain, which already are active.</p> + +<p>If we accept the hypothesis that increased mental activity does call +for slightly more blood to the brain, then the mind actually may be +more keen and alert when the circulatory system does not have to +sustain the burden of digestion and absorption of food. The fact that +there is often a feeling of well-being following a satisfying meal does +not negate this concept. There are those who maintain that the mind +functions best during a state of moderate fasting. Dr. Watson evidently +believed this, as has been previously stated. All physiologists would +not agree with this concept. Undoubtedly, there is a wide individual +variation in this regard, and it would be unwise to make a sweeping +generalization.</p> + + +<p class="nindc space-above2"> +<i>A Weaker Sex?</i></p> + + +<p>Dr. Watson implies, in <i>The Adventure of the Devil’s Foot</i>, that +physiologically the female has a weaker constitution than the male. +In this story, it will be recalled that two men and one woman were +<span class="pagenum" id="Page_113">[Pg 113]</span> +exposed to the fumes of the powdered devil’s-foot root. Watson stated +that only the woman was killed, presumably because she was the more +sensitive. This is indeed a challenging statement.</p> + +<p>Considerable proof can be adduced to show that the female is hardier +than the male. The old cliché, “the weaker sex,” can be seriously +questioned. It is well known, for example, that women can withstand a +high blood pressure for years. In some instances, although by no means +all, it seems to do them but little harm, since in spite of it they may +live to a ripe old age. Hypertension in the male is generally a serious +condition. Many men die comparatively young from heart failure or from +cerebral hemorrhage due to hypertensive states.</p> + +<p>Recently, it has been shown that female animals, such as rats, can +withstand acute oxygen-want far better than males. I do not wish to +belabor the point that the female may be hardier than the male, but two +more bits of evidence can be presented. Data compiled by life-insurance +companies definitely show that there are more widows in this country +than widowers. Lastly, more boy babies die than girl babies.</p> + +<p>These arguments seem to prove convincingly that the male and not the +female is the weaker sex. The problem, however, is not as simple as +this, but space does not permit further critical treatment of the +subject. In fairness to Dr. Watson, it must be stated that many of the +facts just presented were not known when he wrote his entertaining but +gruesome story about the devil’s-foot root.</p> + + +<p class="nindc space-above2"> +<i>Mental Development in the Young</i></p> + + +<p>We find, in <i>The Adventure of the Sussex Vampire</i>, an interesting +and significant reference to mental development in the young. Holmes, +speaking of a child, remarked in this story that the child probably had +a very well-developed mind, because his body had been circumscribed in +<span class="pagenum" id="Page_114">[Pg 114]</span> +action. Obviously, a child who has a definite physical handicap cannot +romp and play like other healthy, vigorous children. He is forced to +find other outlets, and as a result probably reads a great deal, and is +likely, moreover, to be thrown in with older people. As a consequence, +his mind presumably is more precociously trained. There are many +physically handicapped children, and this entire matter deserves more +critical psychologic study than it has so far received.</p> + + +<p class="nindc space-above2"> +<i>Curare and Physiology</i></p> + + +<p>Dr. Watson was acquainted, at least to a degree, with the action of +curare. Actually, he used it as a lethal agent in two of his tales: in +his novel <i>A Study in Scarlet</i>, and in his story, <i>The Adventure +of the Sussex Vampire</i>. In the former, he was careless of the way he +handled curare in his plot, for he ascribed actions to this drug which +it simply does not possess. But in the latter instance, he uses curare +in a masterly manner. He points out, for example, that if a child were +pricked with an arrow which had been dipped in a solution of curare, +death might ensue by muscular paralysis if the curare were allowed +to be absorbed. Incidentally, this story can be highly recommended +not only to physiologists and pharmacologists but to all medical and +biological students as well.</p> + +<p>It is likely that Watson became familiar with curare in his work in +the physiology laboratory, for about twenty years before he enrolled +in medical school, Claude Bernard, the famous French physiologist, had +published his studies on curare.</p> + + +<p class="nindc space-above2"> +<i>Muscle Physiology</i></p> + + +<p>Let us now consider references to muscle physiology. Both Sherlock +Holmes and Dr. Watson are portrayed as splendid athletes. In <i>The +<span class="pagenum" id="Page_115">[Pg 115]</span> +Hound of the Baskervilles</i>, Watson writes about their heroic +efforts to save Sir Henry from the awesome hound. He states that he +had never seen Holmes run as fast as he did that night. He remarks +further that he (Watson) was reckoned fleet of foot, but Holmes easily +outpaced him. In physiologic parlance, the muscles of Holmes and Watson +presumably had short reflex times. Some men are born fast runners. The +exact reason for this is not fully understood. Probably the entire +neuromuscular apparatus, including the higher nervous centers, is +implicated. Another factor is the mechanical advantage involved in the +muscle-bone relationship. All these factors undoubtedly have to do with +heredity. The entire picture is complicated. We do know, however, that +training alone cannot produce champions.</p> + +<p>In another instance, Holmes discusses with Watson the footprints +found in the yew alley, which were presumably made by Sir Charles +Baskerville. It looked as if he had walked on tiptoe for at least a +part of the way. Watson asked why Sir Charles had walked on tiptoe. +Holmes instantly replied: “He was running, Watson—running desperately, +running for his life, running until he burst his heart and fell dead +upon his face.”</p> + +<p>On another occasion, Holmes described the gait of a man: “... he was +running hard with occasional little springs, such as a weary man +gives who is little accustomed to set any tax upon his legs” (<i>The +Adventure of the Beryl Coronet</i>). On still another occasion, we find +an interesting reference to muscle physiology—one which only recently +has been scientifically demonstrated. In <i>The Man with a Twisted +Lip</i> Holmes makes this pregnant remark: “He is a cripple in the +sense that he walks with a limp; but in other respects he appears to be +a powerful and well-nurtured man. Surely your medical experience will +tell you, Watson, that weakness in one limb is often compensated for by +exceptional strength in the other.”</p> + +<p>Muscle physiology is a highly specialized field. Considerable +<span class="pagenum" id="Page_116">[Pg 116]</span> +information is known about the chemical changes which take place during +muscular contractions, but much more needs to be learned. One of the +factors of supreme interest is the short period of time required for +these complicated chemical and heat reactions. The problem is of more +than academic interest, for it must be remembered that, in spite of all +the modern machines at man’s disposal, the greater part of the work in +this world is still done by muscular activity.</p> + +<p>Any light thrown on the exact mechanism of muscle contraction +may eventually prove to be of extreme practical benefit. It is +indeed difficult to overemphasize this point. Finally, there are +certain serious disorders of muscular functioning which may not +only incapacitate individuals but actually cause their death. The +distressing condition of patients suffering from muscular dystrophy +is a poignant example. For this reason, if no other, a complete +understanding of muscular contraction is of paramount importance.</p> + +<p>Since the time when Dr. Watson studied physiology—eighty years +ago—there have been vast developments in this field of science. There +is hardly an area of scientific endeavor in which more research has +been done or is in progress.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_117">[Pg 117]</span></p> +<h2 class="nobreak" id="SHERLOCK_HOLMES_AND_DOCTOR_WATSON_PERENNIAL_ATHLETES"> +SHERLOCK HOLMES AND DOCTOR WATSON, PERENNIAL ATHLETES</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“Sherlock Holmes was a man who seldom took exercise for exercise’s +sake ... he looked upon aimless bodily exertion as a waste of energy.”</p> + +<p class="right"> +<i>The Adventure of the Beryl Coronet</i></p> +</div> + + +<p>Sherlock Holmes and Dr. Watson were unquestionably men of outstanding +athletic ability. Holmes was a single-stick player, a boxer, and a +swordsman (<i>A Study in Scarlet</i>). Watson had played rugby in +college, and probably had engaged in other collegiate sports. They were +strong men, quick of action and fleet of foot.</p> + +<p>Quickness of action surely was needed to save Sir Henry Baskerville +from the hound. It will be recalled that the fog from the Grimpen Mire +that autumn night had spread over the path which Sir Henry was to +follow from Stapleton’s house to Baskerville Hall. As a consequence, +the visibility was so low that Sherlock Holmes and his companions +could not see the hound until it was dangerously close to its intended +victim. Watson describes the episode dramatically: “Never have I seen +a man run as Holmes ran that night. I am reckoned fleet of foot, but +he outpaced me as much as I outpaced the little professional” (<i>The +Hound of the Baskervilles</i>). At any rate, we know that these +determined men, led by Holmes, reached Sir Henry just in time and +killed the hound before it could harm him.</p> + +<p>Watson’s statement, “Never have I seen a man run as Holmes ran that +night,” bespeaks high praise of Holmes as an exceptionally fast +man. Watson, when a college student, had doubtless seen first-class +trackmen perform, but nevertheless he distinctly implies that Holmes +<span class="pagenum" id="Page_118">[Pg 118]</span> +as a runner was in a class by himself. Holmes was making an effort to +save a man’s life, but so were Watson and Lestrade, the Scotland Yard +detective. Holmes, it is true, had the build of a trackman, since he +was tall and lithe, whereas Watson had a decidedly burly physique, and +Lestrade is described as rather short in stature. Watson, despite his +stocky build, admits that he himself was a sprinter of parts, but he +was obviously no match for Holmes.</p> + +<p>Not only was Holmes a fast runner, but a skilled boxer as well. Watson +writes: “He was undoubtedly one of the finest boxers of his weight I +have seen ...” (<i>The Yellow Face</i>). A real compliment, for Watson +was a keen sportsman who probably had had occasion to attend many +boxing matches. Holmes was six feet tall—at least he so described +himself (<i>The Adventure of the Three Students</i>). The suggestion +has been made that he weighed about 11 stone (154 pounds) and had +a physique resembling that of Bob Fitzsimmons,<a id="FNanchor_5" href="#Footnote_5" class="fnanchor">[5]</a> that is, he was +rangy. A boxer with a long reach has, of course, a decided advantage. +Holmes, too, was fast on his feet, as previously mentioned. Added to +these attributes, he had a superior intelligence, which enabled him +to analyze his opponent’s tactics and to outsmart him. He doubtless +was a dangerous man in the ring. There is evidence that this is so. He +gave an extremely good account of himself when he tackled such rough +customers as Roaring Jack Woodley (<i>The Adventure of the Solitary +Cyclist</i>), Joseph Harris (<i>The Naval Treaty</i>), and an anonymous +ruffian (<i>The Final Problem</i>); furthermore, the professional boxer +McMurdo (<i>The Sign of the Four</i>) had a high regard for Holmes’ +boxing ability.</p> + +<p>Besides being a runner and a boxer, Holmes was a wrestler of no mean +ability. He tangled with such villains as Colonel Sebastian Moran, the +second most dangerous man in London (<i>The Adventure of the Empty +House</i>); Professor Moriarty, the Napoleon of crime (<i>The Final +<span class="pagenum" id="Page_119">[Pg 119]</span> +Problem</i>); and the vigorous and powerful German master spy Von +Borck (<i>The Last Bow</i>). It has been suggested,<a id="FNanchor_6" href="#Footnote_6" class="fnanchor">[6]</a> and I believe +rightly, that Holmes used “baritsu” when dealing with these dangerous +characters. They were real killers and would have stopped at nothing. +Sherlock Holmes could not afford to take chances when he encountered +them. In many instances, Holmes had the dependable and powerful Watson +at his side; but whether alone or in company, we know he nearly always +got his man.</p> + +<p>We infer, especially from a certain episode, that Holmes possessed +muscles of steel and had an iron grip. It will be remembered that +on one occasion the fierce and gigantic Dr. Grimesby Roylott strode +unannounced into the chambers at 221B Baker Street. In a fit of temper, +he seized a poker, “... and bent it into a curve” (<i>The Adventure +of the Speckled Band</i>). After the unpleasant visitor had left, +Holmes without much apparent effort straightened the poker out—a task +requiring more strength than the initial bending.</p> + +<p>I have always felt that, in spite of this startling demonstration on +the part of Holmes, for sheer bull-like strength Dr. Watson undoubtedly +excelled him. It is true that once at least Watson met his match. +He relates that on one occasion he was assaulted by an extremely +powerful and active man who sprang upon him and nearly choked him +to death (<i>The Disappearance of Lady Frances Carfax</i>). This is +an unusual incident, and Watson must have been unprepared, for in a +rough-and-tumble fight he could take care of himself in fast company. +He had the courage and tenacity of an English bulldog, and, what is +more important, knew how to use his strength. Watson did not pretend to +be as quick on his feet as Holmes, but he had the other qualities just +mentioned to a superlative degree, and these count for a great deal in +a catch-as-catch-can bout. Holmes was cognizant of Watson’s prowess, +for once the great detective stated that when a man was in a tight +<span class="pagenum" id="Page_120">[Pg 120]</span> +place there was no better man to have on one’s side than Watson.</p> + +<p>An interesting query can be posed: How did these men keep themselves in +reasonably sound physical condition? Watson does not help us to answer +this question satisfactorily, for he has this to say about Holmes:</p> + +<div class="blockquot"> + +<p>Sherlock Holmes was a man who seldom took exercise for exercise’s +sake. Few men were capable of greater muscular effort, and he was +undoubtedly one of the finest boxers of his weight that I have ever +seen; but he looked upon aimless bodily exertion as a waste of +energy, and he seldom bestirred himself save where there was some +professional object to be served. Then he was absolutely untiring and +indefatigable. That he should have kept himself in training under such +circumstances is remarkable, but his diet was usually of the sparest, +and his habits were simple to the verge of austerity.</p> + +<p class="right"> +<i>The Adventure of the Beryl Coronet</i></p> +</div> + +<p>Watson makes two statements which especially require critical comment: +the first one, “Few men were capable of greater muscular effort ...” +and the second, “Then he was absolutely untiring and indefatigable.” +These statements are not convincing, because they are not consistent. +Watson plainly indicates that Holmes did not believe in training; and +when the record is examined, we discover that actually both Holmes and +Watson led sedentary lives. Neither of them engaged in any sport while +residing at 221B Baker Street. The only exercise they took, when not +working on a case, was walking.</p> + +<p>It might be in order to digress a moment and speak of the physiology +of exercise. As far as physical training is concerned, we know that +there is no substitute for strenuous exercise. The physiology of +training is not yet well understood, and but few objective criteria +<span class="pagenum" id="Page_121">[Pg 121]</span> +are recognized. There is one criterion, however, which is widely +known, and that is the muscular hypertrophy produced by exercise. The +classical example is the tremendously developed muscles of the arm of +the blacksmith. Most of us in childhood learned Longfellow’s apt lines: +“The smith, a mighty man is he, with large and sinewy hands; And the +muscles of his brawny arms are strong as iron bands.”</p> + +<p>Besides muscular development, there are other factors, although +less objective in character and less clearly understood, which are +brought about by training. Among these are adaptive changes in the +cardiovascular and respiratory system, and certain chemical changes in +the blood.</p> + +<p>Several examples can be given to show that Dr. Watson appreciated the +physiologic symptoms brought about by lack of physical training. On +one occasion, he describes the unexpected visit to 221B Baker Street, +upon a winter’s morning, of Mr. Alexander Holder, the financier of +Threadneedle Street. “He was a man of about fifty, tall, portly, and +imposing ... he was running hard, with occasional little springs, such +as a weary man gives who is little accustomed to set any tax upon his +legs.” Watson continues: “... the man, puffing and blowing, rushed at +our door ...” (<i>The Adventure of the Beryl Coronet</i>). This excited +and distracted individual finally composed himself and apologetically +explained that, instead of taking a cab (because cabs go slowly through +the snow), he had hurried to Baker Street on foot. Said he: “That +is why I was so out of breath, for I am a man who takes very little +exercise.” In this connection, one is reminded of Lewis Carroll’s lines:</p> + +<div class="poetry-container"> +<div class="poetry"> + <div class="stanza"> + <div class="verse indent0">“But wait a bit,” the Oysters cried,</div> + <div class="verse indent4">“Before we have our chat;</div> + <div class="verse indent0">For some of us are out of breath,</div> + <div class="verse indent4">And all of us are fat.”</div> + </div> +</div> +</div> + +<p><span class="pagenum" id="Page_122">[Pg 122]</span></p> + +<p>On another occasion, Watson discloses that, because of his sedentary +life, he became “blown” and was forced to slow down, whereas Holmes +never faltered, because he was always in training. Watson admitted +that his sedentary life had begun to tell upon him and he had to +fall behind. Holmes, on the other hand, never slackened his pace, +and apparently had an inexhaustible supply of nervous energy (<i>The +Adventure of the Solitary Cyclist</i>).</p> + +<p>Another example is found in <i>The Hound of the Baskervilles</i>. It +will be remembered that, on a damp, sullen evening, Dr. Watson and Sir +Henry attempted to catch the escaped criminal Selden, who was hiding +out on the moor. Watson, in his report to Holmes, writes:</p> + +<div class="blockquot"> + +<p>We were both swift runners and in fairly good training, but we soon +found that we had no chance of overtaking him.... We ran and ran until +we were completely blown, but the space between us grew ever wider. +Finally we stopped and sat panting on two rocks....</p> +</div> + +<p>In this instance, Watson mentions that he was in fairly good physical +condition, although he does not tell us how he managed to reach +that state. We must assume that he had been keeping his weight +down by dieting and probably taking long walks on the lonely moor. +These two factors alone, however, are not sufficient to fit a man +for extraordinary and prolonged physical exertion. As pointed out +previously, the only way this can be done is by daily, well-regulated, +arduous exercise.</p> + +<p>In the matter of physical fitness, there is another side of the shield +which we must examine. A few individuals, although not many, in spite +of their sedentary habits, are apparently at all times physically fit. +The muscles of these men seem to keep their firmness and power even +though they are but little used. This is difficult to understand. +Sherlock Holmes probably was one of these unusual people.</p> + +<p><span class="pagenum" id="Page_123">[Pg 123]</span></p> + +<p>I doubt whether Watson would fit into this category. The good doctor +probably had a tendency to put on weight rather easily, and one gets +the impression from reading the tales that Watson liked his three +square meals each day. He was, to my mind, a typical beefeater. +Furthermore, he smoked a great deal, but for that matter so did Holmes. +Smoking is thought to interfere with physical fitness; it is said to be +“hard on the wind.” Athletes in training are invariably forbidden to +smoke. Just how smoking affects physical fitness is not known. It is +generally conceded, however, that tobacco in any form, especially if +used to excess, reduces both mental and physical efficiency. There is +considerable scientific proof for this statement, although this is not +the place to present it.</p> + +<p class="space-above2"> +The beneficial effect of even a moderate amount of exercise has been +questioned by otherwise intelligent men. A brilliant colleague of mine, +for example, contends that the only thing exercise does is to make one +fit for still more exercise <i>ad infinitum</i>. Well, in a measure +this is true, for exercise really is the basis of training, as has been +repeatedly emphasized. One famous educator in this country has publicly +stated that, when he feels like exercising, he lies down until the +feeling passes away. Then there is the story of Chauncey Depew, who +lived to the age of ninety-four. When asked what exercise he took to +maintain his health, he replied: “The only exercise I have ever taken +is to serve as pallbearer for my friends who exercised.” I suspect +that these members of the intelligentsia, in their zeal to make their +points, have purposely overstated their case.</p> + +<p>Be that as it may, many people insist that a certain amount of exercise +causes them to feel better. Admittedly, it is difficult for them +to explain just what is meant when they say “feel better”—it is a +subjective rather than an objective matter. Several reasons can be +mentioned, however, why moderate exercise seems beneficial to many +people.</p> + +<p>To those whose work keeps them constantly at a desk, exercise comes as +<span class="pagenum" id="Page_124">[Pg 124]</span> +a welcome relief from monotony. Physiologically, we know that a change +of occupation in many instances is as good as a rest. A brisk walk +through the park—or better still, in the country—brings to the eye a +shifting panorama and relieves boredom and fatigue. Many people enjoy +sports, such as a leisurely swim or a short round of golf. The pursuit +of these not only calls for exercise, but rests the mind from vexing +problems. In fact, there is something intangible about it all; in many +individuals, a pronounced psychic component unquestionably plays an +important part. Keeping fit, for example, often produces a mental lift +and makes some people feel quite content with themselves. This feeling +may assume sizable, if not untoward, proportions. The person who takes +exercise regularly, who keeps his waistline down, and maintains himself +in a fairly good physical state, may feel smug and distinctly superior. +He often looks down with pity at his friends who do not believe “in +exercise for exercise’s sake,” and, we might add, whose figures confirm +and illustrate the fact.</p> + +<p>In discussing the philosophy of exercise, we wish to make clear that +there is no proof that strenuous muscular activity is beneficial to +the body. Indeed, great physical exertion in those past middle age +may be deleterious to the organism. The late distinguished English +physiologist, Professor F. A. Bainbridge, has happily stated: “The +exercise consequent upon the ordinary activities of life is sufficient.”</p> + +<p>Exercise, however, should not be counted upon to bring about +weight reduction. It has been shown, for example, working with +marathon runners at the Harvard Fatigue Laboratories, that it took +two and one-half hours of steady running to burn up two pounds of +carbohydrates. It has been facetiously pointed out that the most +telling exercise leading to a trim figure is the simple procedure of +pushing the chair away from the dining table.</p> + +<p>The current belief is that people who keep reasonably fit appear +<span class="pagenum" id="Page_125">[Pg 125]</span> +healthier than those who do not. Watson caught this thought when he +wrote that Mr. Garrideb had a cadaverous face, his skin was dull, and +it resembled that of a person who never exercised (<i>The Adventure of +the Three Garridebs</i>).</p> + +<p>In passing, we find a reference concerning a means of taking exercise +which shows the austere Holmes in a light frame of mind. He twits +Watson about an individual’s using only one dumbbell, and facetiously +states that such a person would not develop his muscles symmetrically, +and as a consequence might suffer from curvature of the spine (<i>The +Valley of Fear</i>). Holmes does not tell the whole story. The +single dumbbell which worried him could have been used alternately +by the right and left hand, and thus unilateral development would be +prevented. Watson, as a medical man, knew this; but like a good soldier +he let Holmes have his fun and made no reply.</p> + +<p>In conclusion, we may say that the principal question we have raised +still remains unanswered: that is, how did Holmes and Watson keep +themselves in good physical condition? This will always be a mystery. +Search as we will, we can find no evidence that either Holmes or Watson +kept himself in training. This seems remarkable since there were times +when they needed strength and stamina in order to put their foes out +of commission, and indeed there were occasions when their very lives +depended upon it.</p> + +<p>It is difficult to believe that unless Holmes and Watson kept +themselves in fairly good condition they could have held their own +against strong and desperate men, who presumably were in good fighting +form. When one considers how important it was for our heroes to keep +physically fit, one is drawn to the irresistible conclusion that they +actually took much more exercise and kept themselves in far better +training than appears in the tales. Besides their long walks through +London, they probably took setting-up exercises at 221B Baker Street. +They may even have done some weight lifting or have used dumbbells +(since Holmes was so concerned about finding a single dumbbell); +<span class="pagenum" id="Page_126">[Pg 126]</span> +perhaps they boxed with each other. It is even possible that they did +some swimming. It will be recalled that, after his retirement, Holmes +frequently went swimming (<i>The Adventure of the Lion’s Mane</i>). +They may have engaged in still other forms of exercise. I, for one, am +ready to believe that they did not lead such sedentary lives as Dr. +Watson would have us think.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_127">[Pg 127]</span></p> +<h2 class="nobreak" id="THE_THERAPEUTIC_DOCTOR_WATSON"> +THE THERAPEUTIC DOCTOR WATSON</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +“I had obtained good results in such cases by the inhalation of +nitrite of amyl....”</p> + +<p class="right"> +<i>The Resident Patient</i></p> +</div> + + +<p>John H. Watson, M.D., practiced medicine in the city of London in the +early eighties of this past century. This was a long time ago—nearly +seventy-five years. At the time of which we write, Roentgen had not +as yet discovered the X-ray, and Ehrlich’s “606” (salvarsan) was not +available for the treatment of syphilis. Banting and Best, the Canadian +physiologists, had not given insulin to the world, nor had Minot and +Murphy of Harvard discovered that liver extract was an efficient +agent in the treatment of pernicious anemia, a heretofore fatal blood +disease. The sulfonamide drugs and the antibiotics, such as penicillin +and streptomycin, presumably were only a dream.</p> + +<p>From what has been related, it appears that Dr. Watson’s therapeutic +armamentarium, insofar as efficacious drugs are concerned, was sadly +limited. But the fact must not be forgotten that he had at his command +a number of powerful medicines: morphine, cocaine, belladonna, and +strychnine, to name a few.</p> + +<p>Let us turn to the stories and see what medicines Dr. Watson used in +his practice and under what conditions they were employed.</p> + +<p>It appears that iodoform and silver nitrate were well known drugs, +for Holmes on one occasion remarked to him: “... if a gentleman walks +into my rooms smelling of iodoform, with a black mark of nitrate of +<span class="pagenum" id="Page_128">[Pg 128]</span> +silver upon his right forefinger.... I would be dull indeed if I do not +pronounce him to be an active member of the medical profession” (<i>A +Scandal in Bohemia</i>).</p> + +<p>Iodoform was introduced as an antiseptic about the year 1879. For +many years it was widely employed as a dusting powder, especially +to diminish infection of open wounds and to promote granulation. +Its persistent and penetrating odor, as well as its relative +ineffectiveness, gradually brought it into disfavor. This is probably +just as well, for its use is not entirely without danger, especially +when iodoform is applied over an extensive area where a good deal of it +can be absorbed.</p> + +<p>Silver nitrate still enjoys a wide usage. It is employed to produce +astringent, antiseptic, and caustic effects. Even many laymen know that +silver nitrate will remove “proud flesh.” Unfortunately, it has the +property of staining the skin “with a black mark” (as Holmes remarked), +which incidentally is often difficult to remove. It may persist until +it is virtually worn off, although recent and superficial stains can be +removed by painting the area with a ten per cent solution of potassium +iodide.</p> + +<p>As might be expected, Dr. Watson found it necessary on several +occasions to resort to morphine to alleviate pain. We find, for +example, that when Kitty Winter, the cast-off mistress of the +infamous Baron Gruner, threw vitriol in the Baron’s face, Dr. Watson +administered a hypodermic of morphine to the wretched Baron to ease the +intense suffering (<i>The Adventure of the Illustrious Client</i>). +On another occasion, when Professor Presbury was savagely attacked by +his wolfhound, Watson immediately gave morphine to the unfortunate +professor (<i>The Adventure of the Creeping Man</i>). In still another +instance, when Carlos, the mastiff, had attacked Rucastle, Watson +probably would have used morphine had he had it in his possession. +He wrote: “I did what I could to relieve the pain” (<i>The Adventure +of the Copper Beeches</i>). He did not state, however, what agent he +employed.</p> + +<p><span class="pagenum" id="Page_129">[Pg 129]</span></p> + +<p>On one occasion, at least, it was necessary to administer morphine +to Sherlock Holmes. He had been attacked and beaten severely by two +ruffians. Sir Leslie Oakshott, the eminent London surgeon, had been +called in on the case. He later tersely remarked to Watson that +Holmes suffered from lacerated scalp wounds, and there were also some +bruises. It had been necessary to take several stitches. Morphine had +been administered (<i>The Adventure of the Illustrious Client</i>). +Morphine, because it is a dangerous habit-forming drug, should be +used only when absolutely indicated. It is noteworthy that Dr. Watson +administered morphine only when the patient had suffered a grave +physical injury. He is to be commended for his conservative attitude.</p> + +<p>On many occasions, when assisting Sherlock Holmes with his cases, +Dr. Watson found it necessary to administer a stimulant to those +individuals who had suffered a physical injury or had been under great +emotional stress. His favorite remedy for such conditions was brandy. +Numerous instances may be cited when this agent was employed as an +emergency measure. Dr. Watson obviously believed firmly in the efficacy +of brandy as a stimulant, and, indeed, claimed to have saved the life +of an individual by its use:</p> + +<div class="blockquot"> + +<p>Mr. Melas, however, still lived, and in less than an hour, with the +aid of ammonia and brandy I had the satisfaction of seeing him open +his eyes, and of knowing that my hand had drawn him back from that +dark valley in which all paths meet.</p> + +<p class="right"> +<i>The Greek Interpreter</i></p> +</div> + +<p>Dr. Watson in this beautiful passage expresses the wish of every +physician.</p> + +<p>Brandy and whiskey were not the only stimulants used by Dr. Watson; in +point of fact, he employed several others. We have noted previously +that ammonia was administered along with brandy to Mr. Melas, the +<span class="pagenum" id="Page_130">[Pg 130]</span> +Greek interpreter. Physicians will recall that ammonia is the principal +ingredient in so-called smelling salts. The vapors of ammonia when +inhaled stimulate the medullary centers, causing an increase in +respiration, and by action on the vasomotor center produce a rise in +blood pressure.</p> + +<p>In his heroic efforts to save the life of a woman who had been +chloroformed nearly to death, Dr. Watson gave ether intravenously with +successful results (<i>The Disappearance of Lady Frances Carfax</i>). +At any rate, he records that the patient regained consciousness. Ether +is not often given in this manner as a stimulant, and the question +could be raised whether it was indicated under the condition which +faced Dr. Watson. I am afraid that this was an instance in which the +patient lived in spite of the treatment.</p> + +<p>A popular and effective stimulant, namely, caffeine, was used to bring +a young woman out of a stuporous state produced by opium. Dr. Watson +relates that a couple of cups of very strong coffee brought her out of +this state (<i>The Adventure of Wisteria Lodge</i>). Dr. Watson used +the classical agent. Strong coffee is still used today in morphine +poisoning, although relatively new preparations, such as metrazol, +nikethamide, and amphetamine are at present the drugs of choice. Coffee +is, of course, easy to obtain, is a relatively harmless stimulant, and +has the pleasing virtue of not producing disagreeable aftereffects.</p> + +<p>On one occasion, the nature of the stimulant administered was not +disclosed. We find the following: “... while his nurse poured him out +a glass of some stimulating medicine” (<i>The Naval Treaty</i>). We +can only guess at the contents of the glass, but more than likely it +contained either brandy or whiskey. We have previously pointed out that +these agents were frequently prescribed as stimulants.</p> + +<p>Dr. Watson, strangely enough, administered amyl nitrite to a patient +who presumably was suffering from catalepsy. He writes, “I had +<span class="pagenum" id="Page_131">[Pg 131]</span> +obtained good results in such cases by the inhalation of nitrite of +amyl....” (<i>The Resident Patient</i>). It will be recalled that +this rather rare condition is characterized by a rigidity of all the +skeletal muscles; the patient, as a consequence, tends to remain in any +position in which he is placed. The reason Dr. Watson used amyl nitrite +in this instance is not clear. The nitrites are frequently prescribed +to reduce systemic blood pressure or to relieve angina pectoris. Surely +there is no evidence in the literature that the nitrites are of aid in +cataleptic states. We can dismiss the matter by assuming that in this +instance Dr. Watson used amyl nitrite empirically.</p> + +<p>Oil is mentioned as a therapeutic agent in at least two of the +stories. Both Dr. Watson and Sherlock Holmes had occasion for its use. +When Baron Gruner had vitriol thrown in his face, Dr. Watson tried +to alleviate the poor wretch’s pain by bathing his face in oil and +applying cotton to the raw areas (<i>The Adventure of the Illustrious +Client</i>).</p> + +<p>On another occasion, Holmes relates how he treated Murdoch, who had +come into contact with the giant jellyfish. He used cotton-wool which +had been soaked in salad oil; and he related that this application +greatly relieved the pain (<i>The Adventure of the Lion’s Mane</i>). +This adventure took place in the country, and we may assume that there +was little, if any, medication on hand. The patient was suffering +intensely, and Holmes did what he could to assuage the pain with the +material he had at his disposal. He showed real ingenuity by making use +of a homely preparation. Morphine obviously was badly needed, and it +is a pity that Dr. Watson was not there to administer it. But it must +be remembered that, at the time this happened, Holmes had retired to +the Sussex Downs and Dr. Watson was in London. A perusal of the story +shows, however, that the patient had been given liberal quantities of +brandy, so perhaps he got along fairly well without morphine after all.</p> + +<p><span class="pagenum" id="Page_132">[Pg 132]</span></p> + +<p>Dr. Watson used carbolized bandages to dress the hand of the +unfortunate hydraulic engineer who had, a few hours previously, +lost his thumb in an adventure which nearly cost him his life. “I +sponged the wound, cleansed it, dressed it, and finally covered it +over with cotton wadding and carbolized bandages” (<i>The Adventure +of the Engineer’s Thumb</i>). Carbolized bandages are no longer used +in present-day surgery. Historically, it is of interest to record +that carbolic acid became widely known as an antiseptic through its +introduction by Lister in 1867.</p> + +<p>Dr. Watson does not often mention hypnotics. We find in one of his +stories that it was the custom of an invalid, Mr. Percy Phelps, to take +some sleeping potion: “... you did not take your usual draught that +night” (<i>The Naval Treaty</i>). We shall never know what the “usual +draught” contained. The barbiturates which are so widely used today +were unknown when Dr. Watson practiced medicine. Bromides were employed +not only for sedation but for inducing sleep as well. The draught of +which Watson spoke might have contained chloral hydrate, for it once +enjoyed wide usage as a hypnotic. It is a potent and dangerous drug +and, as generally known, is used by gangsters (among others) in what +are inelegantly but expressively referred to as “knockout drops.”</p> + +<p>An interesting reference is found to an alterative in one of the +stories (<i>The Disappearance of Lady Frances Carfax</i>). Holmes, +meeting Watson in an establishment which specialized in Turkish baths, +asked his friend why he insisted upon this type of therapy. The latter +replied that a Turkish bath is actually an alterative in medicine. He +explained further that an alterative was a cleanser of the system. +An “alterative” is defined in <i>Webster’s Unabridged Dictionary</i> +as: “A medicine or treatment which gradually induces a change, and +restores healthy functions without sensible evacuations.” A modern +medical dictionary states: “An obsolete term originally used for drugs +said to reestablish healthy functions of the system.” (<i>Dorland’s +<span class="pagenum" id="Page_133">[Pg 133]</span> +Illustrated Medical Dictionary</i>. Philadelphia: W. B. Saunders +Company, 1947).</p> + +<p>Present-day medical students probably never heard of alteratives. Many +middle-aged physicians, however, will remember them well, for formerly +alteratives were used extensively in therapeutics, and included the +following preparations: iodine, arsenic, iron, and the compounds of +mercury. Nowadays, a more scientific attitude is taken toward these +agents, and they are prescribed only if there is a specific need for +them: for example, iron for certain anemias, mercury for syphilis, +and so on. If one considers the esteem in which alteratives were held +in the latter part of this past century—and, for that matter, in the +early part of the present one—it is surprising that Dr. Watson did not +mention alteratives more frequently.</p> + +<p>One wishes that Dr. Watson had mentioned other drugs used in his +practice. In the early part of the twentieth century, a survey +in England showed that physicians considered that from thirty to +thirty-five drugs were necessary to practice medicine satisfactorily. +In the stories of Sherlock Holmes, the names of about a dozen occur. +Dr. Watson probably mentioned only those which for the main part are +familiar to the layman.</p> + +<p>Drugs are, of course, an important part of the armamentarium of +doctors, especially those engaged in general practice. From the +evidence at hand, obviously Dr. Watson was not a therapeutic nihilist, +but neither can he be accused of prescribing drugs loosely or in +excessive doses.</p> + +<p>The matter of overdosing with drugs calls for a brief comment. The +famous poet-physician, Oliver Wendell Holmes, wrote: “If the whole +<i>materia medica</i> (excepting opium and ether) as now used, +could be sunk to the bottom of the sea, it would be all the better for +mankind—and all the worse for the fishes.” These were harsh words; +but when written, timely. The indiscriminate use of drugs was directly +responsible for the genesis of the ill-conceived homeopathic system +<span class="pagenum" id="Page_134">[Pg 134]</span> +of medicine founded by Hahnemann. The followers of this school used +drugs in such minute doses that they were virtually ineffectual. It is, +indeed, an ill wind which blows no good, for the rise of homeopathy had +a sobering influence on many physicians of the allopathic school who +were using drugs lavishly, but not well. Let us not forget, however, +that the prescribing of drugs plays only a part—albeit an important +one—in the successful practice of medicine.</p> + +<p>In conclusion, we may think of Dr. Watson briskly setting out to +answer the call, carrying his trusty bag filled with the recognized +and popular drugs of that period. He undoubtedly prescribed these +fairly liberally, and firmly believed in their curative powers. +Most of Dr. Watson’s patients probably got well with the aid of, or +perhaps in spite of, his prescriptions. Those who were not helped by +his medication were undoubtedly benefited by his kindliness and his +sympathetic understanding of their ailments.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<p><span class="pagenum" id="Page_135">[Pg 135]</span></p> +<h2 class="nobreak" id="DOCTOR_WATSON_GENERAL_PRACTITIONER"> +DOCTOR WATSON, GENERAL PRACTITIONER</h2> +</div> + +<div class="blockquot"> + +<p class="nindc"> +One night ... there came a ring to my bell, about the hour when a +man gives his first yawn and glances at the clock. I sat up in my +chair.... I groaned for I was newly back from a weary day.</p> + +<p class="right"> +<i>The Man with the Twisted Lip</i></p> +</div> + + +<p>John H. Watson, M.D., was born in England in 1852. He was graduated +from the University of London Medical School in 1878 (<i>A Study in +Scarlet</i>), and took his internship at St. Bartholomew’s Hospital.</p> + +<p>Since England was then engaged in a war on the Afghan frontier, +Dr. Watson became attached as a military surgeon to the Fifth +Northumberland Fusiliers. The English were badly defeated on July 27, +1880 by a large Afghan force at Maiwand. Dr. Watson received a painful +wound—a Jezail bullet hit him in the shoulder. Later he contracted +typhoid fever in a base hospital at Peshawar. He was eventually +discharged from the army and returned to London with a very modest +disability pension.</p> + +<p>Not long after this, he met Sherlock Holmes through a mutual +acquaintance, and they obtained comfortable living quarters at 221B +Baker Street. While living with Holmes, Dr. Watson, as we know, +assisted him in many of his cases and served as his chronicler.</p> + +<p>After a time, Dr. Watson married and set up as a general practitioner +in London. Doubtless, many of his experiences in his practice are +reflected in his writing. It is in order to consider some of the +<span class="pagenum" id="Page_136">[Pg 136]</span> +references made to the general practice of medicine in the tales.</p> + +<p>In one of Watson’s early stories, <i>A Scandal in Bohemia</i> (written +about seventy years ago), we find Holmes saying to Dr. Watson:</p> + +<div class="blockquot"> + +<p>As to your practice, if a gentleman walks into my rooms smelling +of iodoform, with a black mark of nitrate of silver upon his right +forefinger and a bulge on the side of his top-hat to show where he has +secreted his stethoscope, I must be dull indeed, if I do not pronounce +him to be an active member of the medical profession.</p> +</div> + +<p>As Holmes stated, if an individual smelled of iodoform, had silver +nitrate stains on his fingers, and carried his stethoscope in his hat, +it would not be difficult to pronounce him a medical man. Iodoform, +which was once widely used, is employed but little today, and it would +be poor taste for a physician making professional calls to carry its +odor with him. Silver nitrate is still widely used, but most physicians +make an earnest effort to keep their hands looking neat and free of +stains.</p> + +<p>Dr. Watson had an appropriate sense of the fitness of things, +and appreciated the fact that a physician should comport himself +with dignity both in manner and in dress. Dr. Watson writes: “The +rough-and-tumble work in Afghanistan, coming on the top of a natural +Bohemianism of disposition, has made me rather more lax than befits +a medical man” (<i>The Musgrave Ritual</i>). In speaking of dress, +Watson states: “His dress was quiet and sober—a black frock coat, dark +trousers, and a touch of color about his necktie” (<i>The Resident +Patient</i>).</p> + +<p>It is hardly necessary to say that the modern physician no longer +carries his stethoscope in his hat. An interesting reference is found +in the story just mentioned concerning how the general practitioner +carried his instruments. One evening, Holmes and Watson returned from +<span class="pagenum" id="Page_137">[Pg 137]</span> +a walk and found a brougham waiting at their door. Holmes remarked +that it belonged to a general practitioner. Watson writes: “I was +sufficiently conversant with Holmes’ methods to be able to follow his +reasoning, and to see the nature and state of the various medical +instruments in the wicker basket which hung in the lamplight inside the +brougham....”</p> + +<p>A fact not generally known in this country is that a red lamp was once +the sign of the general practitioner. Reference is made to this in +<i>The Adventure of the Six Napoleons</i>. Watson writes that a bust of +Napoleon, owned by a Dr. Barnicott, was found broken near his red lamp.</p> + +<p>A pleasing manner is surely a desirable trait in a physician. There +are doctors whose mere presence in the sickroom makes a patient feel +better. Dr. Watson is depicted as a person not only eager to help his +patients but also as a kind and sympathetic individual—attributes +that are most commendable in all physicians. Once when Dr. Watson was +speaking of a lady who was emotionally upset, he writes: “We soothed +and comforted her by such words as we could find.” Somewhat later, he +states: “I am an old campaigner.... If I can be of any assistance, +either to you or my friend here, I should be indeed happy” (<i>The +Man with the Twisted Lip</i>). In <i>The Adventure of the Sussex +Vampire</i>, Dr. Watson again states that he would be glad to be of +any service. Later, when he was asked to see a lady who had suffered a +great nervous shock, he explains how he stepped up to the bed on which +she was lying and spoke a few reassuring words to her, while he took +her pulse and temperature.</p> + +<p>Dr. Watson, like many practitioners, presumably had patients whom he +felt he was not helping, and who were taking an inordinate amount of +his time and energy. It is likely that he persuaded them to seek the +aid of some other physician. Holmes probably sensed this, for on one +occasion Dr. Watson asked whether a certain individual was Holmes’ +client. The detective remarked that he supposed so, since Scotland +<span class="pagenum" id="Page_138">[Pg 138]</span> +Yard had sent this individual to him on the same principle that some +doctors refer their incurable patients to quacks, with the idea that +nothing can be done for them anyway, and that whatever happens they are +no worse off than they were formerly. Dr. Watson made no reply. One +does not like to think that an ethical practitioner would knowingly +send any patient to a quack. Holmes probably was in a facetious mood +when he made this remark, and was simply teasing Watson, who was not +known for his sense of humor.</p> + +<p>Dr. Watson clearly recognized a doctor’s responsibility to his patient, +because in <i>The Sign of the Four</i> he writes: “Remember that I +speak not only as one comrade to another but as a medical man to one +for whose constitution he is to some extent answerable.” In <i>The +Dying Detective</i>, Holmes twitted Watson by reminding him that +he was after all only a general practitioner with rather mediocre +qualifications. This hurt Dr. Watson, and his comment was that Holmes +might be his master elsewhere, but not in the sickroom. Here undeniably +Watson was his master.</p> + +<p>Like other general practitioners, Dr. Watson undoubtedly had hard days, +but presumably he answered night calls. The following occurs in <i>The +Man with the Twisted Lip</i>:</p> + +<div class="blockquot"> + +<p>One night ... there came a ring to my bell, about the hour when a man +gives his first yawn and glances at the clock. I sat up in my chair, +and my wife ... made a little face of disappointment.... I groaned, +for I was newly back from a weary day.</p> +</div> + +<p>Obviously, Dr. Watson had never had a lucrative practice, for he +states: “Everyone was out of town, and I yearned for the glades of the +New Forest or the shingle of Southsea. A depleted bank account had +caused me to postpone my holiday....” (<i>The Resident Patient</i>). +In a similar vein, “I have nothing to do today. My practice is never +<span class="pagenum" id="Page_139">[Pg 139]</span> +very absorbing” (<i>The Red-Haired League</i>). In <i>A Scandal in +Bohemia</i> occurs a reference which further indicates that Dr. Watson +was not a busy practitioner: “At three o’clock precisely I was at +Baker Street, but Holmes had not yet returned.... I sat down beside +the fire, however, with the intention of awaiting him however long he +might be.” This shows that Dr. Watson was not loath to be absent from +his practice in the middle of the day for an indeterminate length of +time. Apparently, he thought nothing of this, but sat down calmly out +of reach of his patients to wait for his friend.</p> + +<p>We must not infer, however, that his practice was always dull, for on +one occasion he explains that he had pressing professional business of +his own, and it was not possible for him to accompany Holmes (<i>The +Adventure of the Illustrious Client</i>). And again: “A professional +case of great gravity was engaging my attention at the time, and the +whole of next day I was busy at the bedside of the sufferer” (<i>The +Red-Haired League</i>). Also, once when Holmes suggested that he and +Watson go out of town, the latter writes that although it was easy for +Holmes to go almost any time, he (Watson) had to do a certain amount +of planning and hurrying because his practice was not inconsiderable. +Holmes was cognizant of the fact that Watson had definite obligations, +for once Holmes told a client that not only was he a busy man but +that Dr. Watson had his patients to consider (<i>The Adventure of the +Creeping Man</i>).</p> + +<p>Apparently, at the time Watson wrote, it was common for physicians +to buy and sell their practice. Several references are made to this +custom. Watson describes how he had purchased his practice:</p> + +<div class="blockquot"> + +<p>I had bought a connection.... Old Mr. ... from whom I purchased it, +had at one time an excellent practice, but his age, and an affliction +<span class="pagenum" id="Page_140">[Pg 140]</span> +... had very much thinned it.... Until when I purchased it from him +it had sunk from twelve hundred to a little more than three hundred a +year.</p> + +<p class="right"> +<i>The Stock Broker’s Clerk</i></p> +</div> + +<p>It must be remembered that at that time the English pound was worth +almost five dollars; so the practice described by Dr. Watson had been +bringing in about $6,000 per year, but had sunk to $1,500. In those +days, of course, money went much further than it does now, and $6,000 a +year was a splendid income.</p> + +<p>On another occasion, Watson relates that, at the request of Holmes, who +wanted Watson to come to live with him at Baker Street, he sold his +small Kensington practice at a rather good figure to a young doctor. A +few years later, he found that the purchaser was a distant relative of +Holmes, and it was the latter who actually had put up the money (<i>The +Adventure of the Norwood Builder</i>).</p> + +<p>Dr. Watson takes sly digs at specialists. Once he remarks that a +certain individual was an excellent antagonist, and that he was as +cool as ice, silky voiced and soothing as a fashionable consultant +(<i>The Adventure of the Illustrious Client</i>). And another time, he +states that he read in his friend’s eye the arrogance which a learned +specialist might experience who had been called to see a case only to +find the patient had measles (<i>The Adventure of the Abbey Grange</i>).</p> + +<p>As to the drugs used in Watson’s day, only about a dozen are mentioned. +Among them were ammonia, amyl nitrite, brandy, caffeine, ether, +chloroform, iodoform, carbolic acid, curare, and silver nitrate. A +survey made in England in the early part of this century showed that +physicians considered from twenty to twenty-five drugs necessary to +practice medicine satisfactorily. If a survey were made today, it is +likely that more would be listed, because during the past few years +potent antibiotic agents have been discovered and great strides +<span class="pagenum" id="Page_141">[Pg 141]</span> +have been made in chemotherapy. Oliver Wendell Holmes, the famous +poet-physician, if living today, could not write as he did in the last +century: “If the whole materia medica (excepting opium and ether) as +now used could be sunk to the bottom of the sea it would be all the +better for mankind—and all the worse for the fishes.”</p> + +<p>We may think of the faithful Dr. Watson answering a call, perhaps late +at night, his stethoscope concealed in his hat, and his trusty medical +bag filled with the acceptable drugs. We can picture him further, +riding along in his hansom—the lights of which shine dimly through +the fog—rattling over the cobblestones of the old London streets, +carrying on the tradition of his noble profession. And we pray that +this priceless tradition will continue as long as mankind suffers from +illnesses of the mind or body.</p> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<div class="footnotes"><h3>FOOTNOTES:</h3> + + +<div class="footnote"> + +<p class="nind"><a id="Footnote_1" href="#FNanchor_1" class="label">[1]</a> +Cassamajor, Louis, “Brain Fever,” <i>Journal of the +American Medical Association</i>, CXLIX (1952), 1443-46.</p> + +</div> + +<div class="footnote"> + +<p class="nind"><a id="Footnote_2" href="#FNanchor_2" class="label">[2]</a> +Klein, W. E., and R. H. Bradshaw, “Portuguese Man-of-War +Sting,” <i>Armed Forces Medical Journal</i>, II (March, 1951), 509-512.</p> + +</div> + +<div class="footnote"> + +<p class="nind"><a id="Footnote_3" href="#FNanchor_3" class="label">[3]</a> +Waite, C. L., “Medical Problems of an Underwater +Demolition Team,” <i>Armed Forces Medical Journal</i>, II (Sept., +1951), 1317-26.</p> + +</div> + +<div class="footnote"> + +<p class="nind"><a id="Footnote_4" href="#FNanchor_4" class="label">[4]</a> +Sollman, T., <i>A Manual of Pharmacology</i> +(Philadelphia, W. B. Saunders Co., 6th ed., 1946), p. 104.</p> + +</div> + +<div class="footnote"> + +<p class="nind"><a id="Footnote_5" href="#FNanchor_5" class="label">[5]</a> +H. T. Webster, “Observations on Sherlock Holmes as an +Athlete and Sportsman,” <i>The Baker Street Journal</i>, III (1948), +No. 1, pp. 24-31.</p> + +</div> + +<div class="footnote"> + +<p class="nind"><a id="Footnote_6" href="#FNanchor_6" class="label">[6]</a> +H. T. Webster, <i>op. cit.</i></p> + +</div></div></div> + + +<hr class="chap x-ebookmaker-drop"> + +<div class="chapter"> +<div class="transnote spa1"> +<p class="nindc"><b>TRANSCRIBER’S NOTES</b></p> + + +<p>Simple typographical errors have been silently corrected; unbalanced +quotation marks were remedied when the change was obvious, and +otherwise left unbalanced.</p> + +<p>Punctuation and spelling were made consistent when a predominant +preference was found in the original book; otherwise they were not +changed.</p> + +<p>Inconsistent hyphens left as printed.</p> +</div></div> + +<div style='text-align:center'>*** END OF THE PROJECT GUTENBERG EBOOK 75869 ***</div> +</body> +</html> + diff --git a/75869-h/images/cover.jpg b/75869-h/images/cover.jpg Binary files differnew file mode 100644 index 0000000..66a9eb6 --- /dev/null +++ b/75869-h/images/cover.jpg diff --git a/75869-h/images/logo.jpg b/75869-h/images/logo.jpg Binary files differnew file mode 100644 index 0000000..2347ac2 --- /dev/null +++ b/75869-h/images/logo.jpg diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..b5dba15 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This book, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. 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