“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.