How new book Sleuth-Hound tells dark story behind the creation of Sherlock Holmes – and the real man who may have inspired iconic detective

Your book Sleuth-Hound is subtitled The Case of the Real Sherlock Holmes. But that’s Basil Rathbone, right?

Most people think that Holmes began at 221b Baker Street, with the hat, the pipe and the cocaine. But he actually began on a hospital ward in Edinburgh, where a surgeon named Joe Bell was teaching medical students how to read a human body like a crime scene.

Bell could tell everything about a patient before they ever opened their mouths – where they came from, what they did, everything. Their hands, a callus, a stain, a limp… to him, all of these were clues if you only knew how to see them. And in 1878, Arthur Conan Doyle became one of his medical students.

Huh? I don’t remember The Tummy Upset of the Baskervilles.

At the beginning of Sleuth-Hound, you’ll think you’re reading Sherlock Holmes! The book opens with a patient being brought to Bell, who declared that the man was in the army, but the patient denied it. So Bell had him stripped to the waist – and there was a letter D tattooed on his chest, because he was an army deserter. Then there’s a story of a woman who came in and Bell asked her to show him her pipe.

She was embarrassed because smoking was considered an unfeminine trait. But he insisted, and eventually she produced the pipe, and he explained to his students that he knew she had one because she had a superficial burn on her cheek and a cancerous sore on her lip that you’d only get from a lifetime of smoking. He just had this incredible way of seeing the world, of seeing clues, but then also building a narrative.

Any other incriminating evidence?

There are some physical similarities. When Bell was a young surgeon, there was a lot of diphtheria around – where you grow this leathery membrane over your airways – and a lot of children died of it. So, Bell devised a pipette to suck the mucus out of a child’s throat, but got infected himself. He almost died from it, and it permanently affected his speech and walking so he had a high, discordant voice and unusual gait – like Holmes.

It still seems a stretch to say this medical lecturer became the world’s most famous detective.

I got access to Bell’s diary, which had been locked away for over 100 years, and I learnt that he was actually doing what Holmes did: working unofficially with the police. Edinburgh’s police surgeon was a fascinating man named Henry Duncan Littlejohn, a pioneer of fingerprinting and courtroom photography. And together, he and Bell worked on some of the highest-profile murder cases of the 19th century, like that of Eugene Chantrelle, who was a respectable and charming man, whose wife turned up one day very, very ill.

Everyone thought the cause was a broken gas pipe. Littlejohn investigated, and I believe Bell helped him. I couldn’t find definitive proof, but there was a little clue: when Chantrelle was convicted of poisoning his wife and sentenced to death, he went to the scaffold, scanned the crowd, locked eyes with Littlejohn and said, “Give my regards to Joe Bell. He did a good job putting the noose around my neck.” It’s such a Sherlockian moment! You can almost hear the trap-door in your mind, the fall, his neck breaking.

And the other thing about Chantrelle is that he was drinking buddies with Robert Louis Stevenson, and became one of the inspirations for The Strange Case of Dr Jekyll and Mr Hyde.

It’s all quite dark, isn’t it?

Yes, my last two books were The Butchering Art, about Joseph Lister and antiseptic surgery; and The Face Maker, about Harold Gillies, who rebuilt soldiers’ faces after the First World War. I decided I needed to write something lighter, but ended up doing this one – which also includes Jack the Ripper and a “baby farmer” who murdered infants, because Bell and Littlejohn investigated both of those cases, too.

No chance of a happy ending, then?

Well, there is an intriguing bit at the very end of Sleuth-Hound. Doyle and Bell teamed up to overturn the murder conviction of a man on death row in Sing Sing prison in, New York. So you have this moment where the creator of Sherlock Holmes, and the inspiration for Sherlock Holmes, were out in the real world together, fighting injustice.

I do think that the Holmes tales put pressure on the police to improve, to become proper forensic investigators, which they weren’t previously. That idea of detective work is what Bell gave to Doyle, who gave it to Sherlock Holmes – who then gave it to the world.

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Sleuth-Hound is available now on BBC Sounds.

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