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Published in The Serpentine Muse,

Vol. 17, No. 4  Fall 2001

used with permission



Marilynne McKay

Author's note: this presentation originated at Autumn in Baker Street 1998 — the final version was read at the Sir James Saunders Society meeting of the American Academy of Dermatology in 2000.

My story begins with The Sussex Vampire. The telegram read in part:

SIR: Our client, Mr. Robert Ferguson ...has made inquiry... we have recommended [he] call upon you...We have not forgotten your successful action in the case of Matilda Briggs.

"Matilda Briggs was not the name of a young woman, Watson," said Holmes in a reminiscent voice. "It was a ship which is associated with the giant rat of Sumatra, a story for which the world is not yet prepared."

Well, today WE are prepared – so let us ask the obvious questions: What did the Matilda Briggs have to do with Sumatra? And what was the "professional service" that Sherlock Holmes did for Sir James Saunders?

Well, as it happens, all three references to Sumatra in the Canon surely refer to the same nasty business. The most spectacular aspect was detailed by Watson in The Dying Detective. (You no doubt recall the physical signs of Holmes' feigned illness – the crusted beeswax on the lips, for instance? The topic of moulages or wax models of afflictions is of particular historical interest to dermatologists. The famous Musee de Moulages at the Hτpital Saint-Louis in Paris is entirely devoted to dermatologic diseases.) In The Dying Detective we encountered Mr. Culverton Smith, a well-known resident of Sumatra. When his nephew Victor Savage died of a deadly Sumatran "coolie disease," Holmes suspected Culverton Smith of foul play, narrowly averting the death-dealing little prick himself.

Victor was a small cog in the monstrous Sumatran machine. As Watson notes in the introduction to The Reigate Squires, Baron Maupertuis and the Netherland Sumatra Company were intimately concerned with both politics and finance. You recall that the solution of this case left Holmes exhausted in Lyon even while Europe rang with his name and his room was "ankle-deep with congratulatory telegrams."

Naturally, smuggling had been involved – Pinkerton agents found contraband in numerous ships on several oceans. It was on the Matilda Briggs, however, that the mysterious parcel was discovered – a small wooden chest containing only coil upon identical coil of long glossy auburn hair. The entire box was taken apart and searched, and the contents were examined and analyzed. The hair appeared to be human, and despite its color, of Asian origin.

In due time, the box of hair was brought to Holmes, who was masterminding the unraveling of the Sumatran case. A report from Scotland Yard includes this note:

Holmes gave the hair a cursory examination, then turned abruptly and strode to the mantle where he filled his pipe with tobacco from a Persian slipper. He puffed thoughtfully as he turned to regard the open box.

"I smell a rat," said Holmes.

Whatever did he mean?

Well, if we consult a dictionary contemporary with the source, say Webster's Revised Unabridged Dictionary of 1913, we find:

Rat: definition 2. A round and tapering mass of hair, or similar material, used by women to support the puffs and rolls of their natural hair.

Now, in the late 19th century, ladies wore their hair high on the back of the head, often with hanging curls. A chignon of false hair was often added. By the turn of the century, the pompadour reached its height (so to say). Puffed above the forehead and close at the sides of the head, there was a large knot at the back of the neck. The hair was combed up over a "rat" made of a roll of hair around the head.

Why was it called a RAT? Well, think of the wad of hair that accumulates in your own hairbrush. If you have long hair, it bears a rather remarkable resemblance to a small rodent. Since one's own hair makes the most satisfactory bulking agent for a pompadour, ladies would naturally save their rats to make up these larger rolls. (They were tucked into the "hair receiver," a decorated china bowl with a lid in which there was a round hole to tuck milady's rats of hair.)

Although one's own natural hair was preferred for styling, imported hair was also used – long and thickly textured Asian or Malaysian hair was prized. It could be bleached out and dyed to match the wearer's color, but this was expensive, as dyes were very hard to match.

Now most young women did not need hairpieces. They used them, of course, to improve upon their natural endowments (much as the Wonderbra is used today). It is possible, however, to lose one's hair. As dermatologists, we are familiar with hair loss, but I thought it might be interesting to review some turn-of-the-last-century medical papers on the subject. Imagine my surprise when I discovered a monograph on hair loss by the great Victorian dermatologist, Sir James Saunders.

In his masterful review of types of hair loss, Sir James called attention to the different hair growth patterns in men and women. With the onset of puberty, temporal thinning occurs in men and, to a lesser extent, some women. What is not as commonly known, however, is that women do experience hair thinning – some is due to age, but the major cause is genetic. Although a woman with a strong family history of baldness won't go completely bald, she will often experience thinning over the entire vertex, or top of the head. This is called androgenetic alopecia and it can start as young as the late twenties if there is a strong family history on either side.

Sir James also discussed alopecia areata, or "baldness in areas." We now believe that most cases of alopecia areata are autoimmune in nature, but this etiology was not a consideration in the 19th century. There was more concentration then on the role of stress in initiating the problem. A fascinating aspect of alopecia areata is that in older people, the non-pigmented or gray hairs are not affected as quickly as the pigmented hairs. This is the source of stories about someone undergoing emotional shock and "turning gray overnight." The dark hairs are lost rather suddenly, and only the gray ones are retained. New hair regrowth is often gray too (it acquires color later) although sometimes the hair never darkens again.

Saunders' monograph included a remarkably cogent discussion of the psychologic factors involved in hair loss, especially among women. Sir James described several case histories with a detail that was surely admired by Holmes. In fact, one case stood out so distinctively that I'd like to share it with you. A patient identified in his monograph by the initials "V.M." had been afflicted with recurrent hair loss since the age of 14 (she was then 20). Her bald patches had episodically regrown hair, but new areas of fallout would occur after a few months, a cycle that Sir James documented with photographs in his publication. The newest and most extensive episode, however, involved loss of the hair on her frontal scalp, rendering the top of her head almost bald. This classically masculine pattern of hair loss had evidently tipped her mind into the realm of madness.

As V.M.'s alopecia progressed, Sir James wrote that she began wearing a veiled cap and removed all the mirrors from her house. She became morose and tearful, muttering constantly about a "family curse." She stayed indoors, even stopping her visits to Sir James' hair loss clinic. He was puzzled by V.M.'s strange hysteria, as she had managed her previous episodes of hair loss in an extremely calm and rational fashion.

Author's Note: The following transcript of events was discovered in Sir James Saunders' office many years later, beneath a stack of frayed magazines that he was evidently aging for his waiting room. The cover letter was to Watson's literary agent, c/o The Strand, asking him to forward these "notes for his consideration," although the packet was evidently never mailed, but passed down in the family as a curiosity.

My patient's distress was such that I did not dare suggest that she pose for a photographer, but using scissors and paste, I superimposed a high bald forehead on one of my previous photographs of her face. I did not see a resemblance to anyone in particular, but I did not think it proper to consult the press. I accordingly traveled one evening to Baker Street, where I related to Mr. Sherlock Holmes and Dr. Watson the story of this unfortunate young woman whom I had grown to admire over the years.

Violet More had been brought up by her mother, an educated woman from a good family. Violet knew nothing of her father, however – Mrs More would not speak of him, and it was assumed that he was dead. Violet was intelligent, with a gift for mathematics that won her the opportunity to pursue university studies, but I was dismayed when she confided her desire to become a nun just before her mental derangement put a stop to all her plans.

I showed my "before" and "after" versions of Violet's picture to Holmes, who studied them with great interest.

"Can you arrange for me to meet her?" he asked.

Three days later, Holmes and Watson joined me outside the More residence. Holmes carried a package under his arm.

We were joined in the sitting-room by a veiled figure who greeted me with an outstretched hand. Her rounded shoulders proclaimed an obvious depression. I introduced Holmes and Watson to her, then sat beside her on the sofa.

Holmes spoke without preamble. "Miss More, what do you know of Professor James Moriarty?"

"How... how did you know?" stammered Violet.

"What I know is not the issue – I asked what you know of the Professor, Miss More."

She took a moment to regain her composure, and then straightened her back with resolve. "I attended a series of his lectures on mathematics and astronomy last year," she began. "They were masterpieces of logic and reason, and I was thrilled to be able to understand his theorems. I was the only woman at the lectures, but he took my questions seriously and when the series was over, he invited me to join a tutorial with two of his best students. It was the most mentally stimulating experience of my life."

"Then I invited the Professor and his students to my home for dinner. It was my mother's idea, because she was so pleased with my enthusiasm for my mentor." Her veiled head tilted toward the carpet. "It was on that night that it all went wrong."

"When I introduced Professor Moriarty to my mother, she was unable to speak. She became pale and almost fainted. The housekeeper and I helped her to her room, where she remained the rest of the evening. The next day she told me that I could no longer study with him, that he was an unspeakably evil man who had brought grief and horror to untold numbers of innocent people. I beseeched her for more information, but she was adamant. I sent the Professor a letter of regret and gave up my tutorial." She sighed. "What had been my greatest joy turned to disappointment, and my mother was the agent of my anguish."

I looked toward Holmes and Watson and explained, "It was shortly after that when Violet again started to lose her hair..."

"Stop," said Violet, interrupting me with an upraised hand. "Let me show you." Unwrapping her veil, she defiantly turned her face to Holmes.

Even with the preparation of having seen the modified photographs, the resemblance was striking. Her forehead domed out in a white curve, an obvious replica of Professor Moriarty. Her deep-set eyes gleamed with distress. The two men sat immobile as they observed her.

"Now you know," she said flatly, "just as I do. Professor Moriarty is my father. It's now clear why mother would never speak of him. It all fits – my natural proclivity for mathematics, my mother's horror on seeing the Professor in our home. Our family name of More has obviously been shortened from Moriarty – assuming that he even gave his name to my mother in the first place," she finished bitterly.

"No!" exclaimed Holmes, rising from his chair. "That is quite impossible!"

Everyone turned as the tall figure rapidly crossed the room. Holmes spoke earnestly, directly to Violet. "Believe me. You are not the Professor's daughter, although he has indeed had an unfortunate association with your family. I have investigated Moriarty thoroughly and your mother is quite correct about his reputation. After my conversation with Sir James a few nights ago, however, I took the liberty of making some inquiries about your family. I cannot reveal my source of information, but I assure you that he is highly placed in Her Majesty's service.

"Your father, a gentleman of impeccable reputation, has been an undercover operative for the past twenty years. He has gone by several names to protect not only himself but also you and your mother. He has thwarted some of the world's most dangerous scoundrels, including Moriarty, the worst of them all. Your father has been our man in Sumatra, living aboard the Matilda Briggs. He was spirited safely out as the net closed around the Baron's villains in the recent scandal. I am pleased to tell you that your father is safe and sound and will be returning home within the next few months. Your mother is at this very moment hearing the news at Whitehall."

"Oh, Mr. Holmes!" exclaimed Violet, tears shining in her eyes.

Holmes smiled and continued, "In the meantime, I have a package for you. For the past month, we have been trying to understand the significance of this mysterious parcel from the Matilda Briggs, and it is now obvious that it was meant to come from your father to you." Holmes brought the box out from behind his chair and placed it on her lap.

Violet opened the lid and drew out a shining auburn coil with a cry. "It's hair! And my very own color!"

"I thought as much – that is why I brought it along. Your father obviously had your interests at heart. It's a giant rat from Sumatra, of the finest quality."

I smiled at Violet and said reassuringly, "I doubt that it will be needed for very long, however. I suspect that this bout of alopecia will turn out to be a self-limited problem."


Later that afternoon at my Harley Street office, I prepared for my weekly hair loss clinic. The patients are difficult, but for the most part, I enjoy the challenge – and a success like Violet makes all the work worthwhile. Only a few patients have been disagreeable, and I have gradually managed to discharge them from my practice. One especially stands out in memory – she had not only been contemptuous of my advice, but had threatened me with a public notice of her dissatisfaction in the agony column. I shuddered, recalling the tall, thin, angry woman with the thinning scalp hair that was clearly an inherited pattern... I could almost hear her strident, angry voice when I thought of her... At that moment, I looked up from my desk to see my distraught nurse attempting to stop the determined advance of an irate patient who was forcing her way into my consulting suite.

Could it be...? Yes, there was her too-familiar name on the afternoon schedule. With new-found insight, I rose slowly to my feet for another confrontation with the infuriating Miss Moriarty.