Observe carefully, deduce shrewdly: Dr. Joseph Bell.
Article Type: Essay
Subject: Forensic pathologists (Biography)
Forensic pathologists (Works)
Forensic pathologists (Appreciation)
Forensic pathologists (Portrayals)
Author: Ramsland, Katherine
Pub Date: 09/22/2009
Publication: Name: The Forensic Examiner Publisher: American College of Forensic Examiners Audience: Professional Format: Magazine/Journal Subject: Health; Law; Science and technology Copyright: COPYRIGHT 2009 American College of Forensic Examiners ISSN: 1084-5569
Issue: Date: Fall, 2009 Source Volume: 18 Source Issue: 3
Persons: Named Person: Doyle, Arthur Conan Biographee: Bell, Joseph; Bell, Joseph; Bell, Joseph; Bell, Joseph
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 205905785

In 1877, a young Arthur Conan Doyle went to study medicine in the progressive atmosphere of Scotland's University of Edinburgh. During his second year, he clerked at the Royal Infirmary for Dr. Joseph Bell, a lean, fortyish professor with an aquiline nose, decisive manner, and piercing eyes. Bell, a noted pathologist, was Queen Victoria's personal physician whenever she was in Scotland, because she liked what she observed in his wards. This in itself gave him an air of authority, but he also taught "The Method"--a disciplined approach to deducing subtle facts about patients from swift, keen observation.

Conan Doyle interviewed new patients before Bell saw them, but Bell hardly seemed to need the assistance. Without asking a single question, Bell could state many facts that matched his clerk's notes about these virtual strangers. He relied on such things as tattoos, skin disorders, accents, scars, and even the color of soil on their shoes. He seemed a virtual wizard, and Conan Doyle was sufficiently impressed to later transform Bell into a fictional character--Sherlock Holmes. In Conan Doyle's only filmed interview he firmly attested to his mentor's influence, and in a letter to Bell he once wrote, "It is most certainly to you that I owe Sherlock Holmes." Bell even wore a cloaked coat and deerstalker cap.

Yet in many ways, Bell was not Sherlock Holmes. He cared about people, had a wry sense of humor, and was highly compassionate. To colleagues he wondered if Conan Doyle had seen his better side. While Bell is not as famous as British pathologists like Bernard Spilsbury or Francis Camps, who drew a great deal of media attention and published popular books about crimes, Bell's influence is just as enduring. Given his indirect inspiration to several leading lights in the field of crime investigation, he is rightfully credited as a forensic forefather.

The Method

Bell grew up during the mid-1800s in a medical family and became protege to a renowned Scottish physician, Dr. James Syme. He married and had three children, although his wife died young. An amateur poet, birdwatcher, and avid shooter when not at work, Bell drove a pair of bay horses he'd named Major and Minor. Far-sighted and aware of the needs of patients, he organized systematic lectures for nurses and agreed to teach the first female medical students, against whom there was substantial prejudice. For twenty-three years, Bell edited the Edinburgh Medical Journal as a firm proponent of science, and he authored several important medical texts. He also devoted considerable time to handwriting analysis and dialectology--the identification of accents, linguistic oddities, and speech patterns--which he added to his Method.

Bell's classes were always crowded as he demonstrated how to sort out important material from the "lumber room of the mind." The successful diagnosis, he told students, rested on three things: "Observe carefully, deduce shrewdly, and confirm with evidence." For him, the Method--the "accurate and rapid appreciation of small points in which the diseased differs from the healthy state"--was one of the most important things he could impart to young medical minds. Among the reasons was that impressing patients with such intimate knowledge inspired their cooperation in the healing process. It was paramount, then, to make a study of people.

"Nearly every handicraft writes its sign-manual on the hands," Bell once wrote. "The scars of the miner differ from those of the quarryman. The carpenter's callosities are not those of the mason. The soldier and sailor are different in gait." Ornaments, tattoos, and clothing added more dimension, as did posture and demeanor. But "mere acuteness of the senses" was not enough. One also had to study in minute detail subjects that would aid in making distinctions: the diverse odors of poison, for example, or of different perfumes.

As Bell walked energetically around the lecture room, he impressed upon his students the importance of performing a close and critical study before diagnosis. To demonstrate, he would bring in one of his waiting out-patients--someone he did not know--and from subtle clues he'd describe details about that person's occupation, health, and recent activities. In one case, an elderly woman dressed in black entered, and Bell asked, "Where is your cutty pipe?" Startled, she produced it from her purse. Bell then told his students that from a small ulcer on her lower lip and a glossy scar on her cheek, he knew she used a short-stemmed pipe that lay close to her cheek when smoking.

Convinced that nuances mattered, Bell asserted that nothing was more useful to medical work than finely honed sensory observation, guided toward a specific purpose. Whenever he called on students to try the Method, he'd urge them not to touch a patient, but to "use your eyes, sir, use your ears, use your brain, your bump of perception ..." and "never neglect to ratify your deductions." That is, once they'd deduced information, they had to check each notion with the patient. (There were times when a patient contradicted Bell, and while he admitted to sometimes being wrong, he might also be vindicated by proving a lie.)

Among Bell's training tricks was to pass around an amber-colored fluid, which he described to students as a potent drug that tasted quite bitter. Still, because they must learn how different substances tasted and smelled, they'd have to follow his example. He would dip his own finger, taste it, and make a face, and then pass it to a student. The concoction did taste quite bad, but each aspiring physician obediently tasted. Bell would then tell them that they'd missed the most important part of the experiment: he'd used one finger to dip into the liquid, but placed a different finger into his mouth. He hadn't tasted the bitter brew at all. Thus, they'd seen but not "truly observed" him.

Among his lessons, Bell also described the problem with tunnel vision. "The fatal mistake which the ordinary policeman makes is this," he said, "that he gets his theory first and then makes the facts fit it, instead of getting his facts first and then making all his little observations and deductions until he is driven irresistibly by them into an elucidation in a direction he may never have originally contemplated." That is, hypothesize for guidance, but remain flexible and observant.

Forensic Applications

In 1892, Bell told a reporter that he'd been engaged for two decades in the practice of medical jurisprudence for the Crown, but since he considered the details to be private, he refused to reveal anything more. However, he seems to have been at work in the sensational case of Elizabeth Chantrelle.

Elizabeth Dyer was a fifteen-year-old student of the charismatic Eugene Marie Chantrelle, a French immigrant. He seduced her and then had to marry her. For the next ten years, he degraded and abused her, bragging that he could kill her in any number of ways. In 1877, Chantrelle insured his wife against her wishes for a considerable sum. Three months later, Elizabeth fell seriously ill. Her maid found her unconscious in her room and fetched the doctor. When they returned, the maid noticed odd changes: a half-full glass of lemonade on the bed table was now empty and some orange segments and grapes were gone, yet Elizabeth was still unconscious. Chantrelle was at the window, from where he quickly moved, as if to keep from drawing attention to that area. Also, there was now a smell of coal gas in the air.

The doctor thought Elizabeth had suffered from accidental coal gas poisoning; he removed her to a clinic, but she soon died. He called in a noted toxicologist from the university, Sir Henry Littlejohn, who enlisted Bell as a consultant. They examined the deceased woman, but contrary to the physician's impression, they thought her symptoms were consistent with narcotic poisoning. They informed the police, and Chantrelle was arrested.

To acquire more evidence, Littlejohn and Bell collected vomit from the pillow and nightgown. Under analysis, it proved to contain a solid form of opium. Then an investigation turned up Chantrelle's recent purchase of thirty doses. Although he protested his innocence and claimed he'd smelled gas in the room, the maid affirmed that she'd noticed this odor only after retrieving the doctor. The gas company found a broken gas pipe just outside the victim's bedroom window, and Bell located a gasfitter who had once repaired this very pipe under Chantrelle's watchful eye--and attested to Chantrelle's keen interest in how it worked. The circumstances seemed clear: Chantrelle had poisoned his wife with opium and staged her room to resemble an accidental death from a burst gas pipe.

The murder trial lasted four days, and deliberations took just over an hour. With Littlejohn's powerful testimony, Chantrelle was convicted. On May 31, 1878, just before the noose was put around his neck, he puffed on his cigar, removed his hat, and said, "Bye, bye, Littlejohn. Don't forget to give my compliments to Joe Bell. You both did a good job in bringing me to the scaffold."

Ten years later, Bell became involved in another case--Jack the Ripper. After five murders of prostitutes in London's Whitechapel slums went unsolved during the fall of 1888, Scotland Yard sought help from specialists around Britain. Among them was Dr. Littlejohn. When he received the full report of the investigation and autopsies, along with a suspect list and some of the "Ripper" letters, he gave a copy to Bell for handwriting analysis. Separately, Bell and Littlejohn studied the murders and derived a conclusion. They then exchanged their work, and each was gratified to see that they'd picked the same suspect. To a journalist, Bell said, "When two men set out to investigate a crime mystery, it is where their researches intersect that we have a result." They sent their reports to Scotland Yard, but unfortunately, no such reports are in the archives and there was no recorded comment, so it remains speculative as to which suspect they picked. Yet Ripper expert Donald Rumbalow believes that, from among the suspects that Scotland Yard had considered seriously at the time, Bell would most likely have selected Montague Druit, a young unsettled physician who feared his mother's schizophrenia and who committed suicide after the last official murder.

Bell also participated in what Scottish newspapers called "the biggest crime of the decade," a case of fraud and murder. In 1890, Alfred Monson became the private tutor for a young man named Cecil, heir to a considerable fortune. Monson was apparently a patient man, for it was three years before he took out a substantial insurance policy on his young charge, with himself as benefactor. He told the agent that he'd loaned Cecil a lot of money against his inheritance and the policy was to protect his own stake. It was granted.

Monson then took Cecil out in a boat, which sprang an "unexpected" leak, and sank. But they were close enough to land for the boy to get ashore. Stymied, Monson took the boy shooting the next day, and this time a tragic "accident" claimed his life. Monson quickly filed for the insurance payout, but then learned that the policy was invalid. The company alerted police about the circumstances, and Cecil's body was exhumed for detailed examination.

Littlejohn and Bell performed the autopsy and wound analysis. They determined the fatal shot could not have come from Cecil's weapon and teamed up with a ballistics expert, Dr. Patrick Heron Watson (the inspiration for Holmes's sidekick), to support a charge of murder. All three said the boy had been killed by an assailant who stood about 8 to 10 feet away. Newspapers made much of the fact that Watson and Bell were on the same team, and even dubbed Bell "the original Sherlock Holmes." Using human skulls, these experts demonstrated how the triangular wound could not have come from Cecil's gun, not unless he had abnormally long arms. With more than 100 witnesses, the Crown made a case that Monson was a conman who had insured and then murdered his charge. However, the judge warned the jury against using Monson's questionable character as a factor in deliberations. They acquitted, based on insufficient evidence. Monson nevertheless got himself arrested again on another charge of insurance fraud and landed in prison anyway.

Lasting Legacy

Bell insisted that a physician's duty was to consider minutia that most people would view as a trifle and to utilize the wealth of information it provides. Apparently Conan Doyle absorbed this lesson well. In 1886, he completed a story about the "consulting detective" Sherlock Holmes, who relied on observation and logical deduction to help solve crimes. The first of what would become a series of tales was A Study in Scarlet. Ward, Lock & Co. published it in 1887 as part of a Christmas annual. It found success the following year as a book. (For a later edition, Bell even penned a foreword.) Due to its popularity, the series about the immortal detective ran until 1927, and among the reasons Holmes endured was the technical expertise that Conan Doyle added, as well as the clear explanation of how he deduced facts from clues. As forensic science merged with crime investigation, Holmes became the prototype of the brilliant detective who has an intellectual edge over the ordinary "copper."

No doubt, this is why so many investigators sought to emulate him. Sydney Smith, an assistant to Littlejohn before he came into his own as a renowned forensic expert, was impressed by Holmes's three directives: the power of observation, the power of deduction, and a wide range of exact knowledge. Using these guidelines as his touchstone reminded him to always look beyond the obvious. In France, Edmond Locard wanted to develop a crime laboratory just like his hero, Sherlock Holmes; when he failed to persuade the police in Lyon to support it, he paid for the world's first private crime lab himself. It opened for business in 1911, the year that Joseph Bell died. The list of other crime analysts and investigators who followed in Holmes's footsteps is long, with one after another labeled "the real life Sherlock Holmes." But Joseph Bell was truly the prototype.

The Joseph Bell Centre for Forensic Statistics and Legal Reasoning (JBC) in Edinburgh still honors the late pathologist and promotes his ideas by applying academic research to the field of criminal justice. It offers training, both on-site and online, to expand the skills of lawyers, forensic scientists, law enforcement officials, law students, IT security staff, and the judiciary.

In 2006, the Royal College of Surgeons opened an exhibit in Surgeon's Hall, "Conan Doyle and Joseph Bell, the Real Sherlock Holmes," to recognize the link between Bell, Edinburgh, and Conan Doyle's tales. In a letter now owned by Bell's descendants, Conan Doyle noted the similarity of Bell's approach to that of Holmes: "I do not think that his analytical work is in the least an exaggeration of some effects which I have seen you produce in the outpatient ward." While Conan Doyle's son mounted an aggressive protest against the claim that Bell had been such an inspiration, plenty of scholarship attests to its truth. And Bell, plagued by reporters, wasn't always happy about it.

Even after Bell retired, he continued to see patients in the country, and on October 4, 1911, he died peacefully. His funeral, attended by many grateful patients, former students, and respectful colleagues, was one of the largest Edinburgh had ever seen.


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By Katherine Ramsland, PhD, CMI-V

Katherine Ramsland, PhD, CMI-V, has published 35 books, including The Devil's Dozen: How Cutting Edge Forensics Took Down 12 Notorious Serial Killers and Beating the Devil's Game: A History of Forensic Science and Criminal Investigation. Dr. Ramsland is an associate professor of forensic psychology and the department chair at DeSales University in Pennsylvania. She has been a member of the American College of Forensic Examiners since 1999.
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