Sherlock Holmes and "Brain Fever"

SHERLOCK HOLMES AND "BRAIN FEVER" RICHARD M. CAPLAN* A curiosity, isn't it, how so much of the interest and scholarly writing about Sherlock Holmes depends on the "coincidences" that cause revealing letters or manuscripts to just "turn up"? Well, now that such coincidences have occurred to me, too, I no longer view them as random happenstance. Rather, it's like the discovery of new information or insights in any branch of knowledge. What's needed is to be on the prowl, so to speak, always sniffing the wind. And then, naturally, one has to expend the energy to search, either by pawing through some old archive or by designing and conducting "the crucial experiment." All this isjust a paraphrase of Pasteur's well-known comment, "Chance favors the prepared mind," plus an introduction to correspondence about Holmes that recently came to my notice and that I think may interest you. First, though, I'll describe how I came on it, and then I'll fill in some medical history that illuminates the correspondence. Having for some years had an interest in the great Victorian surgeon Dr. Jonathan Hutchinson, I learned that his phenomenal range of interests was expressed in part by his proclivity to establish instructional museums. Much ofhis medical collection of fascinating drawings, photographs , and related materials had been displayed for years at London's Medical Graduates' Hospital and Polyclinic. Soon after his death in 1913, the displays were taken down and would probably have been lost. Sir William Osier, then the Regius Professor of Medicine at Oxford, fortunately learned that the material was available, and, to protect and preserve it, he bought it and shipped it to the medical history library of The Johns Hopkins Medical School, which he had helped found before accepting the call to Oxford. The remnants of Hutchinson's Polyclinic museum lay in storage in Baltimore until 1953, when it was subdivided, the more choice material saved to prepare an instructional exhibit, and the rest given to the Countway Library at Harvard. When The Johns * University of Iowa College of Medicine, Iowa City, Iowa 52242.© 1987 by The University of Chicago. AU rights reserved. 0031-5982/87/3003-0533101.00 Perspectives in Biology and Medicine, 30, 3 ¦ Spring 1987 | 433 Hopkins exhibit was dismantled, the materials were wrapped in large packets and put into storage again. On a visit to Baltimore I had the privilege of viewing that splendid archive. To my knowledge most of the specimens have not been published and will languish again deep in the stacks until the next Hutchinson enthusiast learns they are there. The materials included some memoranda that Hutchinson obviously prepared for his own use, such as sketches to indicate how materials should be displayed, and miscellaneous correspondence, some seemingly related or attached to drawings or other visually instructive items. There were, additionally, a few pieces of correspondence that seemed unrelated to other material, and for which I cannot account. It is such a tidbit I pass along for its considerable Sherlockian interest. First, I want to speak about brain fever. To the modern ear that sounds as if it must mean something like encephalitis, or maybe meningitis . But when one reads the Sherlockian canon, one encounters a number ofpersons who suffered from "brain fever," or so it was stated by Dr. Watson. In a 1980 article in the Journal of Clinical Psychiatry entitled "Holmes, Watson and Neurology," R. P. Brenner said: This illness appeared acutely following stress and was characterized by varying degrees of delirium, insanity, hysterical behavior, and in some cases fever. However , with the exception of Rachel Howells ["The Musgrave Ritual"] and Percy Phelps ["The Naval Treaty"], the illness was not well described. Although this term was originally used in the 19th century . . . "brain fever" as used in the canon, represents an acute reaction to stress and is psychiatric in nature, perhaps representing a transient situational disturbance or a brief reactive psychosis. [1] In his 1959 book, A Doctor Enjoys Sherlock Holmes [2], Dr. Edward Van Liere includes a chapter, " 'Brain Fever' and Sherlock Holmes" (pp. 2530 ), in which he discusses some historical information about that clinical curiosity and relates it to characters in...