by Richard L. Vaught, M.D.
I will begin by quoting footnote 68 to A Study in Scarlet in William Baring-Gould's The Annotated Sherlock Holmes:
In A Study in Scarlet we see Holmes and Watson looking down from the second (American usage) story of their sitting room across wide Baker Street. Holmes pinpoints a stranger as a sergeant of Marines, partly from the tattoo of a blue anchor on the back of the fellow's hand. "Now," says Mr. Jerry Neal Williamson, in 'And Especially Your Eyes,' "only a man with tremendous 'long- vision' could recognize at such distance what might have been dirt, a scar, a birthmark, a shadow, or a mole." Immediately after this remarkable evidence of Holmes' uncanny distance clarity the sleuth threw Watson a note brought him by the commissionaire, saying 'Would you mind reading it to me aloud?'" Holmes, Mr. Williamson deduces, was farsighted: " he suffered from hypermetropia . The basic handicap of a hypermetropic individual can be quickly summed up. This person sees things at a distance with perception and clarity, while he finds it difficult to read clearly anything inches and sometimes feet from his eyes. It is the opposite of myopia; and it assuredly describes Sherlock Holmes." Mr. Williamson, we cannot help but feel, is correct; again and again, as we shall see, Holmes asks Watson(or another) "Would you read it to me aloud?"
Although Mr. Baring-Gould readily concedes Mr. Williamson is correct in his observation of Holmes's hypermetropia, I cannot agree with the conclusion. The statement is good so far as it goes, but it obviously includes only the one incident, which is misinterpreted, and ignores large amounts of data contained in the Canon which tend to contradict it.
Holmes was Far-sighted?
Examples which support Mr. Williamson's contention that Holmes had hyperopia, or far-sightedness,
are:
A. The one which he mentions in A Study in Scarlet, where Holmes was able to see and identify a tattoo on the back of the hand of a retired sergeant of Marines from an upstairs window across a wide street. Therefore Holmes obviously had good distant visual acuity--in fact, probably better than most people.
B. In The Yellow Face Holmes reads the name on the inside of Mr. Grant Munro's hat from across the room. This, too, supports the idea of hypermetropia and excellent distant visual acuity.
C. In The Hound of the Baskervilles Holmes is sitting in what has previously been described as a rather dark, gloomy room and notices a painting on the far wall which he instantly recognizes, but which required close scrutiny and approximation of the candle for Watson to recognize the resemblance.
There are other general indications of good distance vision throughout the Canon; however, there are also several points which refute the idea of hyperopia.
Holmes was Near-sighted?
Examples which indicate that Holmes had myopia are:
A. "Would you mind reading it to me aloud?" This example form A Study in Scarlet ignores that fact that Holmes had already read the letter. Other instances in the Canon also have Watson or another reading something aloud after the Master had previously read it himself.
B. Also in A Study in Scarlet Holmes is reading a seventeenth-century book described as a "little brown-backed volume." Most such books were printed with very small type which was crowded together with very little attention to optic spacing.
There are indications throughout the Canon that Holmes was a bibliophile as well as an avid reader of newspapers.
C. In A Scandal in Bohemia Watson says "Holmes remained in our lodgings in Baker Street, buried among his old books ".
D. In The Adventure of the Lion's Mane Holmes says, "I am an omnivorous reader with a strangely retentive memory for trifles."
E. In The Hound of the Baskervilles Holmes is described as examining a piece of paper for clues and "holding it only an inch or two from his eyes." Therefore we must assume he had excellent accommodation, since no hyperope can read or examine an object only a few inches from his eyes. In fact, a punctum proximum or "near point" of focus of only an inch or two or even four inches, (which would require ten diopter of focus) is very difficult to accept in the usual context of normal vision. We will return to this point later.
F. Only in The Adventure of the Golden Pince-Nez where Holmes has spent the day studying a palimpsest with his lens does he complain that it is trying work for his eyes. In no other story do we hear any complaint of headaches, blurring of vision, or eye troubles. Therefore, we must assume he had good accommodation and a comfortable reading distance.
G. In The Sign of Four Holmes "whipped out his lens and a tape measure and hurried about the room on his knees, measuring, comparing, examining, with his long, thin nose only a few inches from the planks." This, again, would suggest good accommodation at close distance, although the use of the lens may alter this considerably. We are told in The Hound of the Baskervilles Holmes used a convex lens. This is the common "magnifying glass." A standard bi-convex hand lens was referred to as a "Coddington." Even with the use of a lens, the hypermetrope would tend to hold the lens a little farther from his eyes than would an emmetrope or a myope, and to have his nose only a few inches from the planks did not leave much room for any long focal points. This, too, could be taken to suggest that Holmes was not hyperopic, and in fact even suggests myopia.
Another factor which tends to indicate the possibility of Myopia is Holmes's often-referred-to lack of confidence in his marksmanship with a pistol. Since when using a pistol one has the entire length of one's arm in which to bring the sight into focus, only the grossest hyperope would have difficulty in focussing and aiming the pistol. Whereas a myope might have considerable trouble because of the closeness of the firing mechanism to his face at a reasonable focal distance. The most noted example of this occurs in The Adventure of the Three Garridebs where both Holmes and Watson have pistols drawn. But Killer Evans whips out his own pistol from inside his jacket, fires two shots, and wounds Watson. Instead of firing at Evans, Holmes steps forward and hits the killer on the head. Other instances where Holmes "clapped the pistol to the man's head" are in The Adventure of the Beryl Coronet, The Adventure of the Dancing Men, and in The Adventure of the Mazarin Stone. In The Adventure of the Six Napoleons, Watson tells us, "Holmes suggested that I should take my revolver with me. He had himself picked up the loaded hunting-crop which was his favorite weapon." Surely we have to agree the Master was no expert shot. This would go better with the idea of a man with myopia rather than a man with hypermetropia.
One thing confuting this is found in The Musgrave Ritual, where Holmes is described as sitting in his chair and shooting a large "V.R." into the plaster with his hair-trigger pistol. We should note it was done slowly and deliberately, while comfortably relaxed in a chair. We note also it was done with a low-powered gun which even a myope might safely hold close to his face. This is another point to which we will return.
Holmes Had Normal Vision?
As regards normal vision, one must consider Holmes's excellent night vision such as is described in
The Adventure of the Empty House, where he led Watson through the "pitch-dark" house. Also, in The Adventure of Charles Augustus Milverton Holmes is described as having "remarkable powers, carefully cultivated, of seeing in the dark." Therefore, he obviously had good peripheral vision, since learning to use one's peripheral vision is the only way one can reasonably "carefully cultivate" one's power of seeing in the dark. This also goes along with the idea of integrated senses which we shall discuss shortly.
In The Adventure of the Golden Pince-Nez it is obvious Holmes has some knowledge of lenses, as he carefully examines the glasses and describes the vision problems of the owner. One must infer Holmes felt his vision was quite adequate for the demanding work in which he was engaged and felt he did not need glasses. Presumably, if Holmes felt glasses would improve his vision and his ability to perform his chosen work, he would have provided for them, just as in The Musgrave Ritual he described how he spent much time in the British Museum "studying all those branches of science which might make me more efficient."
Another point which may be helpful in arriving at our conclusions is the fact that nowhere in the Canon is Holmes described as wearing glasses for either distance or near work, and in fact he is not wearing glasses at age 55 in The Adventure of the Lion's Mane, nor does he wear them at age 60 in His Last Bow.
It has long been accepted that people who lose their accommodation earlier in life tend to die younger than those who keep their accommodation for a longer period. Loss of accommodation parallels loss of other bodily functions due to age. As corroboration, in Baring-Gould's Sherlock Holmes of Baker Street he is determined to have lived to the age of 103 years!
The Solution
Thus far we have good documentation, first, that Holmes had hypermetropia; second, that Holmes
was probably myopic; and third, that Holmes probably had normal vision. We must see what kind of sense we can make out of all this data.
Integrated Senses
Throughout the Canon, Holmes is obviously a man who is well organized and has good retention
of information. He has an acute awareness of his surroundings and of his location in space. He has a cat-like quality; he is well co-ordinated, sure- footed, agile, and alert. This cannot be separated from his general keen powers of observation, and one would assume he probably has a complete integration of all senses where all modalities are recorded simultaneously, as opposed to the non- integrated "one-at-a-time" type of sensory probing. In The Strand Magazine of October 1901, in the advertisement for The Hound of the Baskervilles, Holmes is referred to as the man "with eyes in the back of his head." In A Study in Scarlet Watson noted that Holmes "is an expert singlestick player, boxer, and swordsman." In The Adventure of The Speckled Band Holmes remembers and accounts for all of the various sounds and smells noted on the night of the young lady's death. There are numerous other examples, but the point is that a person who has significant visual difficulties is seldom this well co-ordinated and receptive to his surroundings without corrective lenses.
Holmes Had Antimetropia!
At this point we shall try to make some sense of all the divergent data we have gathered. In order to
accomplish this we shall introduce a new term: "antimetropia." In simple terms, this means the subject is near-sighted in one eye, and far-sighted in the other. A rather shocking thought at first, but on careful consideration it will be found to explain the Master's puzzling visual status much better than simple hypermetropia. He could suppress the image from one eye or the other and use the appropriate eye for sharp monocular vision. Thus, with the one hypermetropic eye Holmes could easily see and focus upon tattoos across the street or read small print inside hat linings, while with equal ease he could use the myopic eye to do close work in reading and search for clues with his nose only a few inches from the planks. Monocular vision, or vision using only one eye, is often sharper and clearer than binocular vision. For instance, when aiming a rifle or pistol most people tend to use one eye and close the other to prevent confusion of the two images. It is a medical truism that, although a one-eyed man does not have two eyes to work together, neither does he have two eyes that work against each other. The man with only one eye almost never complains of any type of headache related to reading. The primary objection to either antimetropia or monocular vision would be a loss of depth perception. However, there are many people with only one eye who have good depth perception. In this situation one gains depth perception much as does a chicken or a pheasant--by using movements of the head, which give an indication of the depth or distance by acting as a range finder using parallax. In fact, in several areas in the Canon, Holmes is described as moving almost "bird-like." We shall see later, however, that Holmes was also able to use both eyes together for depth perception.
Antimetropia would also help to explain Holmes's distrust of his ability with a pistol. Since we know he is right-handed, if one assumes it was his right eye which was myopic this would leave one with a situation wherein to aim the pistol properly he would have to hold it quite close to his face, which could be rather dangerous. An even better explanation would be simply that Holmes was right- handed and left-eyed. In other words, the left eye was his dominant eye, whereas the right eye was the suppressed eye. By holding a pistol in the right hand, and aiming with the left eye, one would tend to fire too far to the left.
We are told Holmes "carefully cultivated" his ability to see in the dark--that is, his peripheral vision. Since night vision is of importance only on occasion, it is reasonable to assume that he was at least as assiduous in developing his macular vision, which is used under normal lighting conditions and consequently used much more frequently. The key word in this situation is accommodation. This is the ability to change the curvature of the lens so objects at varying distances are brought into focus on the retina. Many of the eye exercises which are used clinically today are designed specifically to increase the range of accommodation. It is entirely possible Holmes, with his knowledge of lenses and his recognition of the importance of good vision in performing his chosen work, may have used or even invented orthoptics and the "accommodation rock." This is a simple, but effective, exercise wherein one alternately occludes first one eye and then the other, causing each eye to have to accommodate to the range of the test object, then relax, accommodate, etc. This exercise would be particularly useful in a situation where there is a difference in focus between the eyes, as in antimetropia.
A mild degree of hyperopia in one eye and myopia in the other would still leave him excellent peripheral vision, and, with training, anything up to one diopter variation in each eye could easily be accommodated so both eyes would work together for binocular vision, stereo, and depth perception. Using Donder's scales we find the average person at age 40 years has a total amplitude of accommodation of 4.5 diopters. The usable amplitude is approximately one-half of this, or 2.25 diopters. However, with practice and training, one can greatly increase the usable amplitude of his accommodation to make use of the extra 2.25 diopters available to him, at least for short periods of time.
Drugs and Tobacco
Although there is mention in the Canon of Holmes's habit of using drugs such as cocaine and
opium, it is obvious he was not using these drugs during his major cases. These drugs cause the pupils to contract down to "pin-point" pupils. Interestingly, "pin-point" pupils would actually increase his focusing range and enhance his depth perception, but a good strong light would be needed, and we have ample proof Holmes functioned quite well in shadows, poor light, and in darkness. So, although there have been those who have suggested that some of Holmes's brilliant insight and mental clarity might have been related to his use of drugs, the evidence of his visual acuity refutes these claims.
Another of Holmes's habits to which Watson has given ample testimony is that of smoking cigarettes, cigars, and especially pipes, with a particular fondness for shag tobacco. The best example occurs in The Man with the Twisted Lip in which Holmes sits up all night smoking shag, and Watson awakens the next morning to find that "The pipe was still between his lips, the smoke still curled upwards, and the room was full of a dense tobacco haze, but nothing remained of the heap of shag which I had seen upon the previous night."
It is my contention that, despite Holmes's consumption of large amounts of tobacco, he did not inhale, but was instead simply a puffer. People who inhale large amounts of tobacco smoke (and Holmes would be an excellent candidate if he did inhale) often develop what is known as nicotine amblyopia. Amblyopia is a term indicating loss of vision, and this is exactly what one gets secondary to large quantities of nicotine from smoking. Nicotine amblyopia is at least partially reversible in most cases, but one must stop smoking completely and stay away from tobacco for a minimum of several months. Holmes was also considered to be an excellent athlete, boxer, etc., and was described as running two miles, evidently without slowing his pace, and with no signs of being short of breath.(CHAS) Since Holmes obviously was not short-winded and had no evidence of amblyopia, we may infer he did not absorb much nicotine and, therefore, was not an inhaler.
Summary
It is my contention, then, by using the facts concerning Holmes's vision which are available to us in
the Canon, one may make several fairly positive inferences.
1. Holmes had approximately one-half- to one-diopter hypermetropia in his left eye, and one-half to one-diopter myopia in his right eye. In other words, Holmes had antimetropia!
2. He had enough amplitude of accommodation that he could use both eyes together if desired, or, when the situation warranted, he could use his left eye for excellent distant vision while suppressing the image from the right eye, and use the right eye for close work while suppressing the image from the left eye.
3. Holmes could gain depth perception by using his accommodation to focus both eyes together or he could use parallax.
4. He obviously had good peripheral vision and had specifically trained himself to use it so he would be prepared when he needed it following the example of A. Lincoln.
5. Holmes probably used and possibly invented, orthoptics and the "accommodation rock" in order to train himself for his chosen work.
6. Although Holmes used narcotic drugs at one time or another, he did not use them while on a case. His brilliant insight was due not to drugs but to his own amazing abilities of deduction and retention of information.
7. Holmes had completely integrated sensory perception, including excellent auditory and visual retention.
8. He obviously had a good diet to maintain such excellent night vision, which would indicate his spells of fasting while on a case did not last very long.
9. Holmes, despite his consumption of large amounts of tobacco, was not an inhaler, but simple a puffer.