How a Hole in the Stomach of Alexis St. Martin Revolutionized Medicine

The history of medicine isn't pretty. It's full of grisly accidents, inhumane behavior, and ambiguous ethics. The story of Alexis St. Martin and Dr. William Beaumont hits all of those low points, but it completely changed the way we do medicine. Dr. Beaumont studied human digestion through an open hole in St. Martin's stomach.

You Came In Like A Musket Ball

In 1822, Alexis St. Martin was working as a voyageur — a boatman who shipped furs from port to port — for the American Fur Company. The 28-year-old French Canadian was standing in the company store on Mackinac Island in Michigan when a shotgun misfired, hitting St. Martin in his lower ribs on the left side. It was a gruesome scene, leaving a gaping hole where fractured rib bones, burnt bits of lung, and stomach tissue protruded. The wound was so bad that his breakfast couldn't even stay in his stomach; it came out of the hole with everything else.

His fellow workers dressed his wound and called Dr. William Beaumont to the scene. Beaumont treated St. Martin but predicted the man wouldn't survive more than 36 hours. Miraculously, he did. St. Martin got better with every subsequent doctor's visit, and in about 10 months, the wound was healed — mostly. Despite multiple surgeries, the hole wouldn't close. Instead, the tissue healed back on itself to form a fistula. That made it difficult for St. Martin to eat since food easily escaped from his stomach.

But for Beaumont, that hole presented a window into human digestion. At the time, there were two competing theories about how digestion worked. On one side, you had those who believed digestion was mechanical, that food was literally ground up in the stomach. On the other, you had those who believed it was chemical, or that food was dissolved in the stomach with some sort of gastric juice.

To find out, Beaumont used St. Martin as a human guinea pig. He spooned food into the hole, left it there for a while, then siphoned it out again. He tied bits of meat to pieces of string and dangled them in the stomach like a fishing lure, pulling them out after various periods of time to see how the meat changed. He kept careful records of everything that went into and came out of St. Martin's stomach, and even sent samples of his gastric secretions for analysis — a task that sounds routine these days, but was unheard of at the time. In the end, Beaumont was able to prove that digestion was chemical, due to gastric juices made up primarily of hydrochloric acid.

An Ethical Gray Area

While examining a patient and recording observations is routine in medicine today, it was uncommon during Beaumont's time. Doctors would often diagnose patients before ever laying eyes on them, even basing some of their diagnoses on the 1,600-year-old ideas of the ancient Greek physician Galen.

As reported in LiveScience, people "realized this was a revolutionary approach to doing physiology and medicine," said Pennington Biomedical Research Institute neuroscientist Richard Rogers, who presented a study on Beaumont in 2013. "You collect data on the clinical patient and then come to your conclusions."

But this story wasn't all sunshine and rainbows. It's questionable how much consent St. Martin really gave Beaumont to experiment on his body. Beaumont kept him in his own home for years, feeding and clothing him, but also preventing him from leaving to visit his wife and children. Beaumont took several actions to keep St. Martin by his side, hiring him as a chore boy at one point and enlisting him in the army at another. By 1834, St. Martin had successfully extricated himself from the doctor, despite Beaumont's numerous attempts to lure him back.

Beaumont died in 1853. Against all odds, St. Martin outlived the doctor by 27 years, going back to work as a voyageur and a farmer before passing away at the ripe old age of 83.

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For more about the gruesome history of medicine, check out "The Butchering Art: Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine" by Lindsey Fitzharris. We handpick reading recommendations we think you may like. If you choose to make a purchase through that link, Curiosity will get a share of the sale.

Written by Ashley Hamer December 19, 2017

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