Medical Journal vol.2 no.2 - Gundersen Health System

WILLIAM BEAUMONT
I
n 1822, while stationed at Fort Mackinac on
Mackinac Island, Michigan, army surgeon William
Beaumont first encountered Alexis St. Martin, the patient
whose unusual wound inspired his pioneering experiments in
gastric physiology. St. Martin, a 19-year-old French-Canadian
voyageur for the American Fur Company, had been accidentally
shot in the abdomen at close range. As described in the 1896
Anomalies and Curiosities of Medicine, a portion of St. Martin’s
lung “as large as a turkey’s egg” protruded through his wound.
Upon further examination, Beaumont discovered the portal
through which he would observe the mysteries of digestion:
Immediately below this [the protruding lung] 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. .
. . 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. 1
In 1825, Beaumont convinced St. Martin to join him at
Fort Niagara, situated at the mouth of the Niagara River
in western New York, so that he might employ St. Martin’s
unique aperture in a series of experiments. Then, between 1829
and 1832 while Beaumont was stationed at Fort Crawford
in Prairie du Chien, Wisconsin, St. Martin again joined him
in conducting an additional 56 experiments, bringing the
total number of experiments to 238. 2 The results of these
experiments were published in 1833 in Beaumont’s Experiments
and Observations on Gastric Juice and Physiology of Digestion,
widely recognized as a seminal work in gastric physiology.
Many schoolchildren will recall Beaumont’s experiments in
which he tied small pieces of food with a silk string and dangled
them through the hole in St. Martin’s stomach. He would then
pull out the string at intervals in order to determine the rate at
which different foods were digested. In the course of his research,
Beaumont conducted both in vivo and in vitro experiments and
observed the effects of numerous variables—among them,
temperature, humidity, and emotion—on digestion.
At the time Beaumont began his research, the means by
which food was transformed in the body had long been a subject
of endless speculation. One English doctor had finally cried,
“Some . . . will have it that the stomach is a mill, others that it
is a fermenting vat, others again that it is a stew pot.” 3 In the
introduction to his book, Beaumont first traced the contours of
the debate:
With respect to the agent of chymification, that
principle of life which converts the crude aliment into
chyme, and renders it fit for the action of the hepatic
William Beaumont
and pancreatic fluids, and final assimilation and
conversion into the fluids, and the various tissues of
the animal organism—no part of physiology has,
perhaps, so much engaged the attention of mankind,
and exercised the ingenuity of physiologists. It has
been a fruitful source of theoretical speculation, from
the father of medicine down to the present age. It
would be a waste of time to attempt to refute the
doctrines of the older writers on this subject. Suffice it
to say, that the theories of Concoction, Putrefaction,
Trituration, Fermentation and Maceration, have been
prostrated in the dust before the lights of science, and
the deductions of experiment. 4
He then laid the foundation for and asserted the validity of
his conclusions:
I had opportunities for the examination of the interior
of the stomach, and its secretions, which has never
before been so fully offered to any one. This most
important organ, its secretions and its operations, have
been submitted to my observation in a very
extraordinary manner, in a state of perfect health, and
for years in succession. I have availed myself of the
opportunity afforded by concurrence of circumstance
which probably can never again occur, with a zeal and
perseverance proceeding from motives which my
conscience approves; and I now submit the result
of my experiments to an enlightened public, who
I doubt not will duly appreciate the truths discovered,
and the confirmation of opinions which before rested
on conjecture.
I submit a body of facts which cannot be invalidated.
My opinions may be doubted, denied, or approved,
according as they conflict or agree with the opinions of
each individual who may read them; but their worth
will be best determined by the foundation on which
they rest—the incontrovertible facts. 4
Having marshaled his evidence, Beaumont presented his 51
conclusions, among them this excerpt describing the nature of
gastric juice:
I think I am warranted, from the result of all the
experiments, in saying, that the gastric juice, so far
from being “inert as water,” as some authors assert, is
the most general solvent in nature, of alimentary
matter—even the hardest bone cannot withstand its
action. It is capable, even out of the stomach, of effecting
perfect digestion, with the aid of due and uniform
degrees of heat, (100F/38C).
The fact that alimentary matter is transformed, in the
stomach, into chyme, is now pretty well conceded. . . .
Without pretending to explain the exact modus
Gundersen Lutheran Medical Journal • Volume 3, Number 2, December 2005 77

operandi of the gastric fluid, yet I am impelled by the
weight of evidence, afforded by the experiments,
deductions and opinions of the ablest physiologists,
but more by direct experiment, to conclude that the
change effected by it on aliment is purely chemical. We
must, I think, regard this fluid as a chemical agent, and
its operation as a chemical action.
The decay of the dead body is a chemical operation,
separating it into its elementary principles—and why
not the solution of aliment in the stomach, and its
ultimate assimilation into fibrine, gelatine and
albumen? Matter, in a natural sense, is indestructible.
It may be differently combined; and these
combinations are chemical changes. It is well known
that all organic bodies are composed of very few simple
principles, or substances, modified by excess or
diminution of some of their constituents.
The gastric juice appears to be secreted from numberless
vessels, distinct and separate from the mucous follicles.
These vessels, when examined with a microscope,
appear in the shape of small lucid points, or very fine
papillae, situated in the interstices of the follicles. They
discharge their fluid only when solicited to do so, by the
presence of aliment, or by mechanical irritation.
Pure gastric juice, when taken directly out of the stomach
of a healthy adult, unmixed with any other fluid, save a
portion of the mucus of the stomach with which it is
most commonly, and perhaps always combined, is a
clear, transparent fluid; inodorous; a little saltish; and
very perceptibly acid. Its taste, when applied to the
tongue, is similar to thin mucilaginous water, slightly
acidulated with muriatic acid. It is readily diffusible in
water, wine or spirits; slightly effervesces with alkalis; and
is an effectual solvent of the materia alimentaria. It
possesses the property of coagulating albumen, in an
eminent degree; is powerfully antiseptic, checking the
putrefaction of meat; and effectually restorative of
healthy action, when applied to old, fetid sores, and foul,
ulcerating surfaces. 4
Working in the most primitive of conditions and far from
the recognized centers of medical knowledge, Beaumont
nonetheless, through careful design, observation,
documentation, and analysis, resolved many of the questions
about the physiology of digestion.
REFERENCES
1. Gould GM, Pyle WL. Anomalies and Curiosities of Medicine: Being an
encyclopedic collection of rare and extraordinary cases, and of the most striking
instances of abnormality in all branches of medicine and surgery, derived from an
exhaustive research of medical literature from its origin to the present day,
abstracted, classified, annotated, and indexed. Philadelphia, Pa: WB Saunders;
1896; 631. Available at: http://etext.lib.virginia.edu/etcbin/toccernew2?id=GouAnom.sgm&images=images/modeng&data=/texts/english/mode
ng/parsed&tag=public&part=12&division=div1.
2. Katch FI. History makers. Available at http://www.sportsci.org/news/history/
beaumont/beaumont.html.
3. Quoted in Lienhard JH. Engines of our ingenuity, No. 774: William
Beaumont. Available at: http://www.uh.edu/engines/epi774.htm.
4 Beaumont W. Experiments and Observations on Gastric Juice and the Physiology
of Digestion. Plattsburgh, NY: FP Allen; 1833. In: Katch. I. History makers.
Available at: http://www.sportsci.org/news/history/beaumont/beaumont.html.
Author:
Cathy Mikkelson Inderberg, MA
Gundersen Lutheran
Medical Foundation
La Crosse, Wis
Address for correspondence:
Cathy Mikkelson Inderberg, MA
FB0-003
Gunderson Lutheran Medical
Foundation
1836 South Avenue
La Crosse, WI 54601
Telephone: (608) 775-6648
Fax: (608) 775-6601
Email: clinderb@gundluth.org
One-Footed Gull
Photograph by Gregory G. Fischer, MD
Gundersen Lutheran
78 Gundersen Lutheran Medical Journal • Volume 3, Number 2, December 2005