Medicine: Through a Stomach Hole

The summer of 1822 Fort Mackinac, Michigan Army and fur-trading post, was a rough, brawling, drunken community of about 5,000 Indians, French-Canadians and half-breeds spending the proceeds of their winter fur catches. Only doctor within a 300-mi. radius was William Beaumont, an Army surgeon who meticulously recorded in a diary every medical tittle and jot he performed. For June 6, 1822, the entry, now a precious incunabulum in the history of U. S. Medicine, reads:

"St. Martin, a Canadian lad, about 19 yrs. old, hardy, robust and healthy, was accidentally shot by the unlucky discharge of a gun. . . . The whole charge, consisting of powder and duck shot, was received in the left side at not more than two or three feet distance from the muzzle of the piece, . . . carrying away by its force the integuments more than the size of the palm of a man's hand; blowing off and fracturing the sixth rib . . . , fracturing the fifth, rupturing the lower portion of the left lobe of the lung and lacerating the stomach by a spicule of the rib that was blown through its coat; landing the charge, wadding, fire in among the fractured ribs and lacerated muscles and integuments and burning the clothing and flesh to a crisp. I was called to him immediately after the accident. Found a portion of the lung as large as a turkey's egg protruding through the external wound, lacerated and burnt, and below this another protrusion resembling a portion of the stomach, what at first view I could not believe possible to be that organ in that situation with the subject surviving, but on closer observation, I found it to be actually the stomach with a puncture in the protruding portion large enough to receive my forefinger, and through which a portion of the food he had taken for breakfast had come out and lodged among his apparel.

"In this dilemma I considered any attempt to save his life entirely useless. But as I had ever considered it a duty to use every means in my power to preserve life when called to administer relief, I proceeded to cleanse the wound, give it a superficial dressing, not believing it possible for him to survive 20 minutes. On attempting to reduce the protruding portions, I found that the lung was prevented from returning by the sharp point of the fractured rib, over which its membrane had caught fast, but by raising up the lung with the forefinger of my left hand I clipped off, with my penknife in my right hand, the sharp point of the rib, which enabled me to return the lung into the cavity of the thorax, but could not retain it there on the least effort of the patient to cough, which was frequent."

This was before germs, antisepsis and chloroform anesthesia were discovered. Doctors were often obliged to steal or buy corpses for anatomical studies. They had very little precise knowledge of what goes on within the body of the living man. Organic chemistry was just blossoming out of alchemy, with only 49 of the 92 elements recognized. Surgeon Beaumont had little beyond simple Nature to help him treat Alexis St. Martin.