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The States of Exhaustion Of Mr. Sherlock Holmes

George Vash, MD
JAMA. 1966;197(8):664-665. doi:10.1001/jama.1966.03110080104039.
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To the Editor:—  Drs. Astrachan and Boltax have a perfectly good case in questioning a paranoia of Sherlock Holmes (196:1094, 1966), but they hardly make a good case for a manic-depressive disorder. Who ever heard a depressive patient, in the depths of his depression, say, "My mind rebels in stagnation" and demand problems and work?Instead, Mr. Sherlock Holmes is suffering from a mood common in normal human beings, namely, occasional inertia. Most creative people admit that they are not equally productive at all times. There are few Schuberts who simply spill beauty and create masterpieces constantly.Stimulation, the challenge, is necessary to act as a starter, which will keep the motor turning until it catches the spark and takes over. Another aspect of Holmes, which is intensely human, is his exhaustion after superhuman effort. As mentioned in A Study in Scarlet, and again in The Reigate Puzzle, "a


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