Chapter IV: Part 4

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.