The Case of the Case History: Detecting the Medical Report in Sherlock Holmes

Critics have examined both the influence of the medical case model and the newer laboratory sciences on Arthur Conan Doyle's Sherlock Holmes tales, but they have often overlooked key aspects of the stories' turn-of-the-century historical context. I argue that in response to the indefinite rewards offered by the up-and-coming laboratory sciences and the grandiose claims of many of those practicing these sciences, Conan Doyle chose to circle back to an earlier clinical method and to echo a type of case narrative that provides both closure and disclosure via post-mortem exam. Thus, Conan Doyle's stories, with their breakdown into Watsonian history and Holmesian summation, register the value of clinical procedures by using the established medical case study that ends in autopsy as a template. In his fictional echoing of the case culminating in post-mortem exam, Conan Doyle's Holmes stories draw attention to the accuracy of knowledge that only such cases can provide, and in doing so, Conan Doyle highlights the uncertainty inherent in both many Victorian medical practices and the unproven laboratory sciences of the day – an uncertainty, the tales suggest, that could only be remedied by accruing information through this particularly revealing type of case documentation. In the process, the Holmes tales reflect on the case's unique ability to narrate a type of resolution which cannot be otherwise represented. In its emphasis on making comprehensible that which defies mastery through other means lies the case's essential fit with literary narrative more generally – and narratives of detection like the Holmes stories, in particular.