It was 1822. A blast shattered the ambiance of the American Fur Company’s store on Mackinac Island, and a young French Canadian voyageur fell to the ground, a gaping hole in his abdomen. Alexis St. Martin, an employee of the fur company, had been struck down by the accidental discharge of a musket loaded with birdshot. Fortunately for St. Martin, Mackinac Island harbored an American fort, and a dedicated and talented army surgeon named William Beaumont.
Beaumont treated the wound, which was “more than the size of the palm of a man’s hand”, but gave little hope of St. Martin living beyond thirty-six hours. Sections of the lung and stomach, burnt and perforated, protruded from the hole. Nevertheless, Dr. Beaumont treated and dressed the wound and his plucky patient survived. For seventeen days all of the food St. Martin consumed promptly flowed back out of the opening, but “nutritious enemas” sustained the voyageur until his gut once more began to function. He was left with a permanent gastric fistula, which presented Beaumont with the unique opportunity to study human digestive physiology.
As St. Martin’s health returned, Dr. Beaumont hired him as a handyman. In addition to chopping wood and other various odd jobs, his duties also included making available to the doctor his “perforation, resembling in all but a sphincter, the natural anus.” Beaumont tied silk strings to chunks of various types of food including “high seasoned alamode beef, raw salted fat pork, raw lean fresh beef, boiled corn beef, stale bread, and raw cabbage” and inserted them into the orifice. He would pull the food back out after one, two and three hour intervals to determine the rate of digestion. Not surprisingly, St. Martin complained of some indigestion after these manipulations.
Observations included that gastric juice was maintained at a temperature of 100 degrees Fahrenheit and was capable of digesting meat in about two hours. Boiled chicken digested less quickly than beef, and vegetables appeared to be slowest of all. Beaumont used his observations of St. Martin to publish Experiments and Observations on the Gastric Juice and the Physiology of Digestion, which gained him a great deal of prestige in the scientific community. By September 1825, St. Martin had had enough poking and prodding of his supernumerary orifice and skipped the country to return home and marry. Evidently his injuries hadn’t affected his reproductive capacity as he eventually fathered six children.
In 1829, Dr. Beaumont succeeded in tracking down his favorite guinea pig and brought Alexis and his family to Fort Crawford, Wisconsin where he was stationed. The doctor interspersed his duties caring for malaria victims with further experimentation on St. Martin. Since Alexis would sometimes get rather peeved with the manipulation involved, one observation Dr. Beaumont made was that anger slows the digestive process. Apparently Alexis was not the only member of his family with a temper. His brother Etienne had also joined the family in Fort Crawford, and a local wag named Charette had taken to mocking Alexis as “the man with the lid on his stomach.” Etienne decided to allow Charette to share the experience by stabbing him viciously.
By April 1831, Alexis’ wife Marie was getting restive and he once again departed his physician’s company, taking his family 2,000 miles in an open boat to return to Quebec. In late 1832, Dr. Beaumont commenced his third and final series of experiments with St. Martin in Washington, DC. Taking advantage of proximity to the ocean and seafood, Beaumont placed twelve raw oysters directly into his subject’s stomach. It was not recorded if there was any aphrodisiac effect. St. Martin’s family had not accompanied him on this trip. In the spring of 1833 Alexis received word that one of his children had died and he hastened back to Canada. Although plans were made for him to return, he and Dr. Beaumont were never to meet again.
One question asked, even in Dr. Beaumont’s time, was why the physician never undertook the relatively simple procedure of closing St. Martin’s gastric fistula and letting him get on with his life. While the French Canadian functioned well despite the fistula, it required a constant plug and dressing to avoid leakage, and could not have been very comfortable. Beaumont’s apparent ethical lapse resulted in a rather interesting defense in the Darnes-Davis murder trial. In 1840, a St. Louis politician named Darnes took exception to the written opinion of newspaper editor Davis and smashed in his head in with a cane. The surgeon trephined the skull to treat the Davis, but to no avail. The defense lawyer argued that the surgeon had caused Davis’ death by opening up his skull out of the same principle of curiosity as that which kept St. Martin’s fistula unrepaired. This apparently convinced the jury to let the politician get off with a $500 fine.
Dr. Beaumont continued a successful medical practice in St. Louis until March 1853, when he slipped on an icy stair and suffered a severe closed head injury. He died April 25 of an occipital hematoma. I’m unaware if the physician who treated him attempted to “observe his brain function” by performing trephination of the skull.
St. Martin, though reputed to enjoy more than the occasional glass of wine, lived to the age of 86, dying on June 24, 1880. In an attempt to thwart those wishing to perform an autopsy, the family left the body in the hot sun for days to hasten decomposition, then buried the body eight feet deep in coffin heaped with heavy rocks. Additionally the location of the grave was unmarked. A granddaughter finally revealed the site of Alexis’ interment in 1962.
While hospitals and medical centers in the United States memorialize Dr. William Beaumont, Alexis St. Martin is remembered by a single plaque erected near his grave. This was dedicated in June 1962 by the Canadian Physiological Society to the man who “Through his affliction… served all humanity.”
Article previously appeared in The Medical Post.
Dr. William Beaumont via Wikimedia Commons
Drawing of Alexis St. Martin by Dr. William Beaumont via Wikimedia Commons