
On the 6th of June 1822 , at Fort Mackinac, a fur trading post in northern
Michigan, an 18 year-old man named Alex St. Martin was loading up his canoe for
another hard day in the woods. St. Martin was a French Canadian fur trapper, a
tough breed to begin with; but before lunch time he would prove himself to be
of heartier stock than the average voyageur. Sometime that morning, a gun
accidentally went off. Word arrived with the Fort’s doctor, William Beaumont,
that St. Martin had been shot. He rushed to the scene and inadvertently
stumbled into one of the most fruitful partnerships in medical history.
St. Martin lay bleeding in the street with a hole in his
rib-cage about the size of the palm of his hand. Through the hole spilled all
manner of gore. There were bits of bone, muscle, and even part of a lung. But
what caught Dr. Beaumont’s eye was the meat, bread, and coffee which, hours
earlier, had been St. Martin’s breakfast. The bullet, it appeared, had punched
a hole into the man’s stomach. Beaumont stitched up the wound, and over the
next several weeks, performed a number of surgeries without the aid of
anesthetic or disinfectant. St. Martin miraculously survived all this, but understandably
grew fed up with surgeries. The end result was that he reached a stable
condition but still had a hole in his stomach.
The medical term for the hole is a fistula. Today,
farmers routinely give them to cows so they can monitor their digestion, but back
in 1822 it was a new and valuable concept. In the early 19th century,
the stomach was something of a mystery. We knew that food went in and waste
came out, but we had basically no idea what went on in between to turn food
into muscle and energy. The opportunity wasn’t wasted on Dr. Beaumont who,
under the guise of charitable action, offered St. Martin a job as a handyman at his home to
make up for the fact that he could no longer trap. With few options, St. Martin
agreed to take the job.
Things presumably started out normally enough, but
eventually Beaumont somehow convinced St. Martin to allow for a few
experiments. In 1825, Beaumont began lowering bits of food through the fistula
and into St. Martin’s stomach on pieces of string. He would pull the items out
after various amounts of time and record how digested they were. This is how
science learned that hard-boiled eggs take three and half hours to digest and
boiled animal brains take an hour and 45 minutes. Beaumont also took to tasting
the stomach juices and the fistula itself to measure acidity… In short, things got weird.
In fact, they got so weird, that eventually St. Martin had
enough and fled back to Canada where he started a family and even began
trapping again. Beaumont didn’t give up; he wrote letters, pleading with St.
Martin to come back, offering him money and land to support his family.
Apparently having a hole in your stomach is a significant disadvantage in the
fur trapping game, because St. Martin did agree to go back after several years.
It was during this second stint as Beaumont’s live-in guinea
pig, that the fistula experiments really began to advance science.
Beaumont eventually discovered that when food was introduced to the stomach,
papillae emerged from the stomach wall and secreted a clear fluid that was the
means of digestion. This was the first evidence that digestion is a chemical,
and not a mechanical, process. Beaumont eventually proved this idea by removing
some stomach acid and observing digestion outside the body.
This work made Beaumont famous. He toured the world
demonstrating his findings, often with St. Martin in toe as a medical side-show
of sorts.
St. Martin lived out the rest of his life (he lived to be
either 78 or 84 depending on who you ask - either way, a long life) as an oddity. Upon his death in 1880, his family opted
to delay burial so his body could begin to rot, eliminating the chance that
doctors would dig him up for an autopsy. If we can take one additional thing
away from St. Martin’s life story, it is that scientific leaps sometimes come
at a cost. Modern medicine owes a pretty big debt to tough and tolerant
patients like him.
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