June 6, 1822 (a Thursday)

Alexis St. Martin with his wife in his later years.

Alexis St. Martin with his wife in his later years.

On this date, Alexis St. Martin was working at a fur-trading post in Mackinac Island in Lake Huron when he was accidentally shot with a gun at close range. The charge of the gunshot blew a fist-sized hole through his side and into his stomach. The following account from Gurdon S. Hubbard is the only eyewitness description of the incident.

This St. Martin was at the time one of the American Fur Company’s engages, who, with quite a number of others, was in the store. One of the party was holding a shotgun (not a musket) which was accidentally discharged, the whole charge entered St. Martins body. The muzzle was not over three feet from him — I think not over two. The wadding entered, was well as pieces of his clothing; his shirt took fire; he fell, as we supposed, dead.

William Beaumont, a US Army surgeon stationed at a nearby army post, treated the wound. Although St. Martin was a healthy 28-year-old [1], he was not expected to recover due to the severity of his wound. Nevertheless, he did so under Beaumont’s care, and when the wound healed itself, the edge of the hole in the stomach had attached itself to the edge of the hole in the skin, creating a permanent gastric fistula. The strong stomach acid essentially disinfected the wound from the inside out, making it safe to not sew it up.

The trading post where St. Martin was shot still stands today in Michigan.

The trading post where St. Martin was shot still stands today in Michigan.

Beaumont recognized the wonderful opportunity he had in St. Martin to investigate the mysterious process of digestion. For centuries, the stomach was thought to produce heat that somehow cooked foods. Alternatively, the stomach was imagined to be like a mill, a fermenting vat, or a stew pan. Beaumont performed two kinds of experiments on the digestive processes from 1825 to 1833. First, he observed the fluids discharged by the stomach when different foods were eaten (in vivo). Second, he extracted samples of the stomach’s content and put them into glass tubes to determine the time required for “external” digestion (in vitro).

Expressing his dislike for his role, St. Martin periodically disappeared. In 1832, to secure his experimental subject, Beaumont signed St. Martin to a 1-year contract. Per the contract, St. Martin was to “obey, suffer and comply with all reasonable and proper orders or experiments” for $150 and room, board, and clothing. In 1833, St. Martin went home to Canada, never to return to Beaumont’s care. The difference in social status and wealth makes Beaumont’s use of St. Martin ethically questionable.

Beaumont published the first results of his experiments on St. Martin in the Philadelphia Medical Recorder for January 1825, and full details in 1838 as Experiments and Observations on the Gastric Juice, and the Physiology of Digestion. He ended his treatise with a list of fifty-one inferences based on his 238 separate experiments. Although working away from the centers of medicine, Beaumont used findings from Spallanzini, Carminiti, Viridet, Vauquelin, Tiedemann and Gmelin, Leuret and Lassaigne, Montegre, and Prout. Even with their information, he still obeyed the scientific method, basing all his inferences on direct experimentation.

Beaumont proved once and for all that digestion in the stomach was chemical — a product (mostly) of the gastric juice itself which Beaumont surmised, correctly, was composed largely of hydrochloric acid. Beaumont’s important experiments quickly reached an international audience. In the United States, Dunglison’s 1844 second edition of Human Health included a 3-page appendix of Beaumont’s “…time required for the stomachal digestion of different alimentary substances,” and Cutter’s popular Anatomy and Physiology Designed for Academies and Families (1848) included Beaumont’s results for the mean times for digesting foods. In France, Claude Bernard cited Beaumont’s work in his 1865 Introduction to the Study of Experimental Medicine.

Beaumont’s accomplishment is even more remarkable because the United States, unlike England, France, and Germany, provided no research facilities for experimental medicine. Beaumont, a “backwoods physiologist,” inspired future studies of gastric emptying, intestinal absorption, electrolyte balance, rehydration, and nutritional supplementation with so-called sports drinks.

[1] For some reason, St. Martin’s age at the time was given by Beaumont as 18 years, and the error was not corrected until the Canadian Physiological Society marked his grave in 1962. Often referring to his patient as a “lad,” the doctor was actually just nine years his senior. It is possible that Alexis for some reason falsified his age throughout his dealings with Beaumont, or even that someone else stated the age and the wounded man was never actually asked. On the other hand, others think that it was not an error. “I doubt that Beaumont, who showed himself to be a notoriously accurate observer, would not have noticed the difference between a youth of 18 and a grown man of 28,” said Sylvio Leblond, MD. “I do not believe that Alexis had any reason to state that he was ten years younger than his correct age, and I feel certain that the thought would never have occurred to him…It is reasonable to conclude, then, that he was…18 or 19 in 1822.”

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