Doyle has been described as a prototype of his age, holding a belief in the concept of honor and commitment to a chivalric code of behaviour (8). Would such a man have himself experimented with drugs? From a modern viewpoint this would be inconceivable, but in the late 19th century there was no moral, medical or legal censure on such exploration. Indeed, while a 3rd year medical student Doyle engaged in auto-experimentation with tincture of gelsemium, publishing his findings in the British Medical Journal on 20 September 1879 (9). Did he also conduct experiments with cocaine? His knowledge of the drug is reasonable in that it is used by Holmes, who uses other stimulants to excess (once drinking two large pots of coffee in a day � The Hound of the Baskervilles ). Individuals with unstable affective response (like Holmes) are most prone to cocaine abuse and a � self-treating � hypothesis, now in vogue, suggests that choice of drugs of abuse often reflect an individual�s attempt to correct their behavioural or mental disorder (10). Holmes states that his mind � rebels at stagnation. Give me problems, give me work, give me the most abstruse cryptogram, or the most intricate analysis, and I am in my own proper atmosphere, I can dispense then with artificial stimulants � ( The Sign of Four ). In A Scandal in Bohemia Doyle errs in referring to cocaine in describing � the drowsiness of the drug �. This error is puzzling. Cocaine was recognized widely as a stimulant and given Doyle�s attempt to specialise as an oculist, where cocaine was used as an anaesthetic, it is likely that he was well versed with the drug. His clear depiction of cocaine addiction in The Sign of Four. published before A Scandal in Bohemia, and accurate depiction of other drugs (6) suggests that this is one of Doyle�s infamous errors of detail. In The Sign of Four it is suggested that Holmes also abused morphine and Doyle may simply have forgotten to which drug he was referring. Doyle wrote very quickly, sometimes not even revising his draft, and in his memoirs admits that he has neverSherlock Holmes’s Cocaine Habit been nervous about details and that his readers reprimanded him for his lapses (11).
The most singular aspect of cocaine in the Holmes stories is not Holmes�s habit, but rather Watson�s reaction to it. In spite of celebrated cases of cocaine addiction (e.g. Dr. W. S. Halsted) and even reports of death from cocaine use as early as 1891, there was no general medical condemnation of cocaine use in the late 19th century. The retired Surgeon General of the U. S. Army extolled its fatigue reduction and mood-elevating properties, while others vigorously promoted cocaine as an anaesthetic, a cure for alcoholism and opium abuse. Freud�s endorsement of cocaine at the time was extreme, suggesting that its therapeutic use might even do away with inebriate asylums (12). Against this professional acclaim, we see Watson admonishing Holmes: � But consider! Count the cost! Your brain may, as you say, be roused and excited, but it is a pathological and morbid process, which involves increased tissue change, and may at least leave a permanent weakness. You know, too, what a black reaction comes upon you. Surely the game is hardly worth the candle. Why should you, for a mere passing pleasure, risk the loss of those great powers with which you have been endowed? 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 � ( The Sign of Four ). One hundred years after this was published we are beginning to confirm Dr. Watson�s knowledge (13). Previous medical explorations (12) of Holmes drug use concluded by stating that, following a cure, cocaine ceased to be a problem for him in 1894.
The then current medical notion was that � cure � was a viable goal for addictive behaviour. Watson knew better. In The Adventure of the Missing Three-Quarte � (published in 1904 and dated to December 1896 (14) in Holmes�s time) Watson tells how he gradually weaned him from the drug mania but relates that � I was well aware that the fiend was not dead but sleeping; and I have known that the sleep was a light one and the waking near in periods of idleness �. Again, this reflects current models of addiction, which document low probability of complete abstinence over the long term. What influence might this public account of drug use have had on the reading public? It has been suggested (15) that some literary descriptions of drug induced states have enticed readers into use of drugs. In the case of Sherlock Holmes, there is no evidence to support that this occurred and it may be argued that the destructive portrayal of the drug may have limited its abuse. Even the cocaine � epidemic � of 1916 seems more of press hysteria than factual (16). The English media vehicle for most of Holmes adventures was The Strand magazine; its popularity (selling 300,000 copies in the first month) was an unprecedented event in English publishing history (5). A newly literate public looked to Holmes as an era hero, demonstrated by the public outcry when Doyle hurled him over the falls of Reichenbach in 1893. Doyle�s constant theme in his writings, that of moral weakness, was not lost on this audience in their perception of Holmes�s cocaine habit. Sherlock Holmes in addition to providing a literature of entertainment with perennial attraction is an example of an accurate illustration of recreational drug abuse and its consequences. Doyle�s portrayal of the seriousness of this addiction likely grew to be shared by his colleagues, but this attitude lapsed in time (17) only to be restated in the 1980�s. Doyle�s window on medical history reminds us that in addition to a fascination with the past we can also scrutinize it for applicable modern lessons.
About the author:
J. Thomas Dalby, Ph.D. is a a long-time member of The Singular Society of the Baker Street Dozen. He is a forensic psychologist who has consulted in more than 7,000 criminal, civil, and administrative law matters and given expert testimony in more than 500 trials. The author of over 90 professional publications, Dr. Dalby is an adjunct associate professor of psychology, psychiatry, and clinical psychology at the University of Calgary.
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