food for thought

you'll notice in my exploration of the driftless zone that i suggest a visit to the fort crawford medical museum. the medical museum is now part of the prairie du chen museum. i thank the prairie du chen historical society for maintaining this museum but urge them to go more in depth. is your appetite whet by the following: "The museum boasts more than 50 exhibits in 3 buildings, which reflect the historical society's mission to tell the story of Prairie du Chien with emphasis on Fort Crawford, especially the amazing story of Dr. William Beaumont."? i fear not, and so allow me to share with you the amazing story of dr. william beaumont...

you can read the full story on dr. beaumont on this quite nice genealogy page. but for your digestive ease i shall copy the choicest bits of this amazing story here. dr. beaumont was born somewhere back some time ago. for awhile he resided on mackinac island. mackinac island is pretty neat because i rode my bicycle there once, and once there all you can ride are bicycles or carriages. i also think mackinac island fudge ice cream (an old favorite) gets it name from this island. last but not least, the island boasts a pretty grand hotel:


the hotel was built in 1887. dr. beaumont occupied fort mackinac in 1819. and it is here, on mackinac island, that things start to get amazing! let's dig in.

A CHEAP SHOT
On June 6, 1822, in the American Fur Company on Mackinac Island, a French-Canadian voyageur named Alexis St. Martin was shot in the upper left abdomen; the musket wound was "more than the size of the palm of a man's hand," Beaumont wrote, and affected part of a lung, two ribs, and the stomach. Dr. Beaumont treated the wound, but he was repeatedly unsuccessful in fully closing the hole in St. Martin's stomach; for a while, the hole had to be covered to prevent food and drink from coming out. St. Martin was now unable to work as a voyageur, so in April 1823 Beaumont hired him as the family's live-in handyman — chopping wood, mowing a field, etc.

CAN YOU HOLD YOUR STOMACH
The hole in St. Martin's side was a permanent open gastric fistula, large enough that Beaumont could insert his entire forefinger into the stomach cavity. If you want more detail, please see the fine print*.

SEIZING THE WINDOW OF OPPORTUNITY
It was not until August 1, 1825 that Dr. Beaumont — now stationed at Fort Niagara — began his experiments with St. Martin, becoming the first person to observe human digestion as it occurs in the stomach. Beaumont tied quarter-ounce pieces of food to the end of a silk string and dangled the food through the hole into St. Martin's stomach. (The food items were "high seasoned alamode beef," raw salted lean beef, raw salted fat pork, raw lean fresh beef, boiled corned beef, stale bread, and raw cabbage.) St. Martin went back to his household duties. Beaumont pulled out the string one, two, and three hours later, to observe the rate of digestion for the different foods. Five hours after he first put the food into St. Martin's stomach, Beaumont removed the food pieces because St. Martin was suffering stomach distress. The next day, St. Martin still had indigestion, which Beaumont treated.

On August 7, 1825, Beaumont had St. Martin fast for 17 hours, and then took the temperature of St. Martin's stomach (it was 100 degrees) Beaumont removed gastric juice from St. Martin's stomach, then observed the rate of digestion of a piece of corned boiled beef "test-tube" style, while also placing the same-sized piece of meat directly into St. Martin's stomach. The stomach digested the meat in two hours; the vial of gastric juice took 10 hours (maintained at about 100 degrees). The next day, Beaumont repeated the experiments using boiled chicken, which he found digested slower than the beef. The experiments showed that gastric juice has solvent properties. In September, St. Martin returned home to Canada (where he married and had children), so Beaumont was unable to experiment on him further at this time.

YOUR LOVE IS LIKE BAD MEDICINE
In June 1829, Alexis St. Martin returned to the Beaumonts, this time bringing his wife and family to Fort Crawford. Beaumont was busy with his medical work so did not have time to resume experiments with St. Martin until December 1829 through March 1830. One set of observations was to try to determine any relation between digestion and weather. By observing St. Martin on different days and times and in varying weather conditions, Beaumont saw that dry weather increases stomach temperature, and humid weather lowers it (a healthy stomach being 100 degrees).

Dr. Beaumont was busy treating patients with "intermittent fever" during the area's summer flood and fall rains in 1830. In January 1831, Beaumont just observed the normal process of digestion in the stomach. St. Martin would eat a normal meal and resume his work, and Beaumont would periodically take samples from St. Martin's stomach. Another experiment compared what happened to food placed in a vial of gastric juice (temperature not controlled), food placed in a container of water, and food eaten by St. Martin; he learned that gastric juice needed heat to digest (i.e., that cold gastric juice has no effect on food). Beaumont used more variety of food samples while at Fort Crawford; he found that vegetables are less digestible than other foods, and milk coagulates before the digestive process. St. Martin sometimes became irritable doing experiments (it was stressful for him to have food removed from his stomach), and Beaumont observed that being angry can hinder one's digestion. In April 1831, St. Martin and his family left for their home in Canada, traveling by canoe or portage all the way to Montreal.

THE WORLD WAS THEIR OYSTER
In late 1832, Beaumont began a leave from the Army, intending to conduct further experiments on the digestive system. He located Alexis St. Martin in October, dropped off his wife Deborah and children in Plattsburgh (where Deborah's family lived), and traveled with St. Martin to Washington, D.C. Beaumont again tried different foods with St. Martin, including raw oysters, sausage, mutton, and "boiled salted fat pork." Beaumont focused on gastric juice, but did not study the importance of saliva on digestion; sometimes, he put food directly into St. Martin's stomach (once, he put in 12 raw oysters). He also observed that exercise helped the production and release of gastric juice. (Another limitation on Beaumont's work is that he could not obtain a chemical analysis of the gastric juice, as chemical analysis was severely limited in the mid-nineteenth century.)

In mid-April 1833, Beaumont went to Plattsburgh, New York, where Beaumont was reunited with his family and began work on publishing his observations in a book, "Experiments and Observations on the Gastric Juice and the Physiology of Digestion." Dr. William Beaumont's cousin, Dr. Samuel Beaumont, had published a small newspaper prior to becoming a doctor himself (he apprenticed under William), so Samuel was quite helpful to William with the book's initial printing in 1833 (and with its second edition in 1846). Sometime in April or May 1833, St. Martin left for Canada due to the death of one of his children; he expected to rejoin Beaumont by June 1 for more experiments, but as it turned out, St. Martin and Dr. Beaumont never again saw each other.

BAD MEDICINE IS WHAT I NEED
Alexis St. Martin lived 58 years after his accident. After returning home to Canada for good, he worked as a farmer and itinerant laborer ("chopping wood by the cord," he described it). After the doctor's death, St. Martin did make a brief visit in 1856 to Dr. Beaumont's home in St. Louis, where he spoke with Deborah Beaumont. After Deborah's death, St. Martin frequently corresponded with Dr. Beaumont's son Israel; in 1879, he wrote that he had "been ill for six years...I am suffering a little from my gastric fistula, and my digestion grows worse than ever." His lawyer, Judge Baby of Montreal, said that St. Martin was "very much addicted to drink" in his 80's.

When St. Martin died at age 86 on June 24, 1880 in St. Thomas de Joliette, Canada, his family deliberately let his body decompose in the hot sun for four days and then buried it in the Catholic churchyard in a deep unmarked grave, with heavy rocks atop the coffin, hoping to prevent anyone from examining his stomach or performing an autopsy. Years later, to commemorate St. Martin's contribution to medical science, a committee finally persuaded one of St. Martin's granddaughters to disclose the grave's location; in 1962, a plaque was placed on the church's wall near the grave, stating Alexis' history, and that

"through his affliction he served all humanity."

*St. Martin "was accidentally wounded by a discharge from a musket. The contents of the weapon, consisting of powder and duck-shot, entered his left side from a distance of not more than a yard off. The charge was directed obliquely forward and inward, literally blowing off the integument and muscles for a space about the size of a man's hand, carrying away the anterior half of the 6th rib, fracturing the 5th rib, lacerating the lower portion of the lowest lobe of the left lung, and perforating the diaphragm and the stomach. The whole mass of the discharge together with fragments of clothing were driven into the muscles and cavity of the chest. When first seen by Dr. Beaumont about a half hour after the accident, a portion of the lung, as large as a turkey's egg was found protruding through the external wound. The protruding lung was lacerated and burnt. Immediately below this was another protrusion, which proved to be a portion of the stomach, lacerated through all its coats. Through an orifice, large enough to admit a fore-finger, oozed the remnants of the food he had taken for breakfast. His injuries were dressed; extensive sloughing commenced, and the wound became considerably enlarged. Portions of the lung, cartilages, ribs, and of the ensiform process of the sternum came away. In a year from the time of the accident, the wound, with the exception of a fistulous aperture of the stomach and side, had completely cicatrized. This aperture was about 2 1/2 inches in circumference, and through it food and drink constantly extruded unless prevented by a tent-compress and bandage." [From Anomalies and Curiosities of Medicine by George M. Gould and Walter L. Pyle (Philadelphia, 1896)]