"In teaching the treatment of disease and accident, all careful teachers have first to show the student how to recognise accurately the case. The recognition depends in great measure on the accurate and rapid appreciation of small points in which the diseased differs from the healthy state. In fact, the student must be taught to observe. To interest him in this kind of work we teachers find it useful to show the student how much a trained use of the observation can discover in ordinary matters, such as the previous history, nationality, and occupation of a patient."The above quote is by Dr Joseph Bell (1837-1911), who was a professor of clinical surgery at Edinburh University. He came from a distingushed medical family. His great grandfather being Benjamin Bell, also a noted forensic surgeon. Another relative was Charles Bell, who described (and had named after him) the condition known as Bells' Palsey. Whenever Queen Victoria was in Scotland, Bell was her personal surgeon, and later was honorary surgeon to Edward VII. He was well known and respected before Arthur Conan Doyle met him, having published a number of medical textbooks, and prolific journal articles, and for 23 years he was editor of the Edinburgh Medical Journal.
He was a popular lecturer at the university, his lectures invariably attended to capacity. It was whist studying medicine at Edinburgh in 1877 that Arthur Conan Doyle first met Bell, and was immediately impressed. Doyle proved to be a first rate student, and Bell in turn was equally complimentary, writing of Doyle "Dr. Conan Doyle's education as a student of medicine taught him how to observe, and his practice has been a splendid training for a man such as he is, gifted with eyes, memory, and imagination. Eyes and ears which can see and hear, memory to record at once and recall at pleasure the impressions of the senses, and imagination capable of weaving a theory or piecing together a broken chain or unravelling a tangled clue. Such are the implements of his trade to a successful diagnostician." He went on to add that Doyle's gift as a natural story teller in combination with these attributes only made it a matter of choice as to wether he wrote detective stories, or saved his strength for a great historical romance.
By the end of Conan Doyle's second year at the University Bell selected him to be his clerk and assistant at the Royal Infirmary's open clinic. In this position Conan Doyle often heard Bell make "amazing" deductions whilst leading students on his rounds. On one occasion he witnessed Bell telling students that a new patient was a recently discharged non-commisioned officer who had been serving in a Highland regiment stationed in Barbados. Going on to explain "You see gentlemen, the man was a respectful man but did not remove his hat. They do not in the army, but he would have learned civilian ways had he been long discharged. He has an air of authority and is obviously Scottish. As to Barbados, his complaint is elephantiasis, which is West Indian, and not British."
On another occasion, also witnessed by Doyle, a mans address, combined with the callused ball of his thumb indicated to Bell that the man was a sailmaker. The reasoning being that he lived on a street near the docks, and sail makers typically have calloused thumbs from stitching the heavy canvas sails.
Many other incidents of similar nature were witnessed by Doyle and were often used in Sherlock Holmes stories later. In A Study In Scarlet, Holmes explains to Watson why he concludes that a man had recently been in Afghanistan. "Here is a gentleman of a medical type, but with the air of a military man. Clearly an army doctor then. He has just come from the tropics, for his face is dark, and that is not the natural tint of his skin, for his wrists are fair. He has undergone hardship and sickness as his haggard face says clearly. His left arm has been injured. He holds it in a stiff an unnatural manner. Where in the tropics could an English army doctor have seen much hardship and got his arm wounded? Clearly in Afghanistan."
