Sometimes the bigger mysteries in life are solved by asking big, complex questions.
Sometimes it’s done by asking “hey, can I poke at that open wound in your side for, idk, a decade?”
Today in a Moment of Science… Alexis St. Martin’s holy stomach.
We were a bit fuzzy on the finer details of how digestion worked two hundred years ago. At the time there were some who believed in vitalism, the ‘life force energy’ medicine of its day. Their proponents would say you couldn’t describe digestion chemically or mechanically. Those who were more anatomically minded suggested some combination of grinding, body heat, or even fermentation were used. In the absence of scanning equipment and immunoassays, the main way we learned about anatomy was by cutting into it, often during autopsy. Since digestion is a process that takes hours to truly observe, it remained largely a mystery until a bullet intended for a duck accidentally split open Alexis St. Martin.
A Canadian voyageur and fur trapper whose name was to be lost to the history books, St. Martin has been described as a “ne’er do well” and having a reputation for drinking too much. Which is only known about him today because, in 1822 in Michigan, he was shot in the stomach.
Dr. William Beaumont, an American army surgeon, was summoned to help. Beaumont’s first reaction was “oh shit son, you’re gonna die.” At that point medical school was more like medical one year apprenticeship before you were shipped out the door to pretend you knew fuck all about saving lives. And to be fair, even an experienced doctor would have looked at this idiot fur trapper who was shot from mere feet away and thought “Canada is not sending their best.” His lung and bits of his breakfast were visibly emerging out of his side. Trigger discipline, man.
Beaumont thought he wouldn’t live thirty-six hours, but did what he could to treat St. Martin. Surgeries were primitive and without antiseptic or anesthesia, but he patched a growingly cantankerous man up. Food fell out the hole in his side when he ate, so they fed him… rectally. “Nutritious enemas.”
Y’all, they did this on South Park, I could not make this up if I tried. The 1800s were lit.
So here’s where things take a turn for the weird.
I mean, weirder. We’re already at rectal feeding.
The hole in St. Martin’s side never fully closed. Even with multiple surgeries, his stomach adhered itself to his abdominal wall, keeping a peephole into his digestive system open. Perhaps he could have opted for surgery to patch this gastric fistula up, but have you heard how bad they were at medicine in the 1820s? Rectal feeding bad.
Amazingly, his stomach acid did quite the efficient job of keeping it clean and infection free. But given the state of his health after this ordeal, he couldn’t go back to the Canadian wilderness. And Beaumont couldn’t just let this live peek inside the human anatomy walk away. He took St. Martin on as a handyman… and a specimen.
Beaumont started recording his observations on St. Martin’s stomach. He would put a piece of food on a string, lowering it into the stomach, pulling it back out after some hours to record observations. He noted foods being digested at different rates. The gastric system slowed when St. Martin had a fever, likely marking the first time a doctor linked digestion with disease. He took samples of digestive juices and sent them for analysis. This is mainly composed of hydrochloric acid, giving your stomach an overall pH of about 1.5-3.5.
Pivotally, Beaumont put pieces of food into cups with the sampled digestive juices. Observing food breaking down in the absence of mechanical processing was a revelation; digestion was now shown to be mostly a chemical process.
Beaumont published his seminal work in 1833, Experiments and Observations on the Gastric Juice, and the Physiology of Digestion, a brief history of St. Martin’s stomach.
This is where we have a long overdue discussion about medical ethics. From all accounts, the men were locked into a toxic codependent relationship. Beaumont on St. Martin as a unique source of research, and St. Martin on Beaumont as the person who saved his life. Beaumont couldn’t stand his drinking and St. Martin was tired of being his lab rat. After a few attempted breakups, their corporeal collaboration ended for good in 1834.
This has been your daily Moment of Science, and a reminder that research subjects are best found the old fashioned way: desperate randos applying on craigslist.
> rectally
I recall with a shudder reading long ago that that route is also the fastest way to absorb alcohol, if getting drunk is the goal.