福爾摩斯的演繹思維

世欽

What Sherlock Holmes Taught Us About the Mind

福爾摩斯系列小說是人們閑暇時極好的消遣讀物，但如今它們竟然出現在醫學教授列給學生的專業書單中。這究竟是怎么回事呢？相信大家都曾被這位小說中杜撰的天才偵探在破案時所展現出來的細致觀察力和嚴密的邏輯推理力所折服，是的，這便是醫學院的學生們要學習的內容。醫院就如犯罪現場，我們需要精密的頭腦和理性思維來為病人診斷。

1. embark on： 開始（工作），從事。

2. fusty： 傳統的，老式的；anatomical： 解剖的，（人體或動物體）結構上的；volume： 書籍；The Complete Sherlock Holmes：《福爾摩斯探案全集》。

3. 一個虛構的偵探究竟能教給一位胸懷大志的神經學家什么呢？on earth： 究竟；aspiring： 有志氣的，有抱負的；neurologist： 神經學家。

4. 無論你的專業是什么，書中的深刻見解都能為我們的理性思維藝術提供很好的指導。 expertise： 專門知識，專業技能；insight： 深刻見解；rational： 理性的。

5. 利斯指出，福爾摩斯的創造者阿瑟·柯南·道爾本身就是個內科醫生，有證據表明他以當時一位出色的醫生——愛丁堡皇家醫院的約瑟夫·貝爾為原型塑造了福爾摩斯這個人物。Arthur Conan Doyle： 阿瑟·柯南·道爾（1859—1930），生于蘇格蘭愛丁堡，因塑造福爾摩斯而成為偵探小說歷史上最重要的作家之一，堪稱偵探懸疑小說的鼻祖；physician： 內科醫生；infirmary： 醫務室，醫院。

6. try ones hand at： 一試身手。

7. 但利斯懷疑隨著故事的不斷展開，柯南·道爾可能也從其他醫生身上汲取了靈感，比如威廉·高爾斯，他的作品被稱為是“神經學的圣經”。

8. specialise in： 專門研究；neurodegenerative： 神經組織退化的，神經變性的；doctoral： 博士的； mutual： 共同的；Rudyard Kipling： 拉迪亞德·吉卜林，英國小說家，詩人。

9. diagnosis： 診斷；clinical demonstration： 臨床示范；silver： 指Russell-Silver syndrome，一種罕見的先天疾病，主要特征為身材矮小，且通常在身體二側呈現左右不對稱；syphilis： 梅毒。

10. 作為醫生，應該養成且永遠保持一個習慣，就是在病人走進房間時就開始觀察，注意他的外觀和步態。acquire： 獲得，學到；omit： 遺漏，疏忽；aspect： 面貌，神態；gait： 步態，步法。

11. 如果你能夠做到這一點，那么你應該早就能看出他走路一瘸一拐。另外你現在肯定也看出他面色異常了，而事實上，你應該早就能注意到這一點。lame： 瘸的；tint： 色彩，色調。

12. remarkably： 非常地；profile： 描……的輪廓，扼要描述；scant： 不足的，缺乏的。

13. inconsequential： 不重要的，無足輕重的。

14.“我一直以來都秉承見微知著的信念，”柯南·道爾在《身份案》中寫道。axiom： 原理， 格言；infinitely： 無限地，極其。

15. preconception： 事先形成的觀點或思想； fog： v. 使迷惑，使困惑。

16. unprejudiced： 沒有偏見的，公正的；order of the day： 日常的事，慣例。

17. chastise： 嚴懲，譴責；“The Scandal of Bohemia”：《波西米亞丑聞》，福爾摩斯系列中一則短篇小說。

18. 當你面對一個全然不熟悉的病例時，那就暫時忘掉腦海中所有的病癥類型和名字。

19. sui generis：（拉丁語）獨特的，特殊的；as such： 就其本身而論。

20. rival： 與……匹敵，比得上。

21. disturbance：（精神或身體的）失常； hysteria： 癔病，歇斯底里。

22. 我看完床頭卡又查看了他的牙齦，發現了畫家這個職業給他造成的影響——牙齦上有一條明顯的鉛線，就像床頭卡上記錄他職業的文字一樣清晰可見。gum： 牙齦； conspicuous： 明顯的，顯而易見的； lead-line： 鉛線，為鉛中毒特征性體征。

23. infer： 推斷，推理；pigment： 顏料，色料。

24. 類似的例子還有很多：這兩個人都善于“反向推理”，比如逐一剖析導致某種疾病（對于高爾斯來說）或某宗謀殺案（對于福爾摩斯來說）的所有可能性。dissect： 剖析，仔細分析。

25. 福爾摩斯的一句名言很好地總結了這種方法：“排除了所有的不可能，剩下的即使再不可能，那也是事實的真相。”aphorism： 格言，警句；eliminate： 排除；improbable： 不大可能的。

26. confess： 承認，懺悔；mole： 飛蛾。

27. humility： 謙遜；curse： 詛咒； afflict： 使受痛苦，折磨。

28. 最近幾年，倫敦大學學院的認知神經學家依迪爾·道爾記錄了很多醫學和法學“專家”由于偏見而影響了判斷的案例——有的甚至是生死攸關。cognitive： 認知的，認識的； document： v. 記錄；apparent： 表面上的，貌似真實的；forensic： 法庭的，法醫的；bias： 偏見；life or death： 事關生死的，生命攸關的。

29. deduction： 推斷。

30. fine： 優秀的，杰出的；mystery： 謎題。

Soon after Andrew Lees embarked on1 his medical career at University College Hospital London， one of his superiors gave him a rather strange reading list. Rather than the usual fusty anatomical volumes， it included The Complete Sherlock Holmes.2

What on earth could the fictional detective teach an aspiring neurologist？3 As it turns out， a good deal， as Lees recently wrote in a paper in Brain journal. Whatever your expertise， the insights provide a welcome lesson in the art of rational thinking.4

As Lees points out， Holmes creator Arthur Conan Doyle was a physician himself， and there is evidence that he modelled the character of Holmes on one of the leading doctors of the day， Joseph Bell of the Royal Edinburgh Infirmary.5 “I thought I would try my hand at6 writing a story where the hero would treat crime as Dr Bell treated disease，” Doyle recalled in a 1927 interview.

But Lees suspects that as his stories developed， Conan Doyle may have also drawn some inspiration from other doctors， such as William Gowers， who wrote the “Bible of Neurology”.7 （Conan Doyle himself had specialised in neurodegenerative disease as a doctoral student， and he and Gowers had a mutual friend in the author Rudyard Kipling.8）

Gowers often taught his students to begin their diagnosis from the moment a patient walked through the door， as seen in a record of one of his clinical demonstrations， later published as “A Clinical Lecture on Silver and Syphilis”：9 “Did you notice him as he came into the room？ If you did not then you should have done so. One of the habits to be acquired and never omitted is to observe a patient as he enters the room； to note his aspect and his gait.10 If you did so， you would have seen that he seemed lame， and you may have been struck by that which must strike you now—an unusual tint of his face.11”

Its remarkably similar to Holmes habit of profiling each person he meets based on the scantest of clues，12 as reimagined in the BBCs remake of the classic stories：

In particular， it was the importance of the seemingly inconsequential13 that seems to inspire both men. “It has long been an axiom of mine that the little things are infinitely the most important，” Conan Doyle wrote in “A Case of Identity”.14

Both Gowers and Holmes also warned against letting your preconceptions fog your judgement.15 For both men， cool， unprejudiced observation was the order of the day.16 It is for this reason that Holmes chastises Watson in “The Scandal of Bohemia”：17 “You see， but you do not observe. The distinction is clear.” Or in the words of Gowers： “The method you should adopt is this： Whenever you find yourself in the presence of a case that is not familiar to you in all its detail， forget for a time all your types and all your names.18 Deal with the case as one that has never been seen before， and work it out as a new problem sui generis， to be investigated as such.”19

Occasionally， Gowers real-life powers of observation appear to have rivaled20 Holmes fictional hero. Consider his study of a man initially misdiagnosed with a psychological disturbance similar to hysteria：21

“I looked casually at the bed-card and at once my eye was caught by the record of his occupation ‘Painter. I looked from the bed-card to his gums， and there I saw written in equally distinct characters the record of the effect of his occupation—in a conspicuous lead-line.”22 By simply using his eyes to see what others had missed， Gowers correctly inferred that the man was being poisoned by his pigments.23

There are many other examples： how both men “reasoned backwards”， for instance， dissecting all the possible paths that may have led to a particular disease （in Gowers case） or murder （in Holmes）.24 This line of approach is perhaps best summarised as Holmes most famous aphorism： “When you have eliminated the impossible， whatever remains， however improbable， must be the truth.”25

But perhaps the most important lesson to be learned， from both Gowers and Holmes， is the value of recognising your errors. “Gentlemen—It is always pleasant to be right， but it is generally a much more useful thing to be wrong，” wrote Gowers， while Holmes admits： “I confess that I have been blind as a mole，26 but it is better to learn wisdom late than never to learn it at all.”

This humility is key in beating the “curse of expertise” that afflicts so many talented and intelligent people.27 Over the last few years， the cognitive neuroscientist Itiel Dror of University College London has documented many instances in which apparent experts in both medicine and forensic science have allowed their own biases to cloud their judgements—sometimes even in life or death situations.28

Whatever the exact nature of Gowers influence on Conan Doyle， Holmes lessons today offer a larger lesson in the power of logical thought. Even the most advanced technology can never replace the powers of simple observation and rational deduction29. As Lees says， the hospital “is still a crime scene”—and we still need the finest minds to solve those mysteries.30 As he found all those years ago， if you want to train your powers of deduction， you could do a lot worse than read （or reread） Sherlock Holmes.