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Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990.

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Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.

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William Beaumont, the Man and the Opportunity

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Born in 1785 in Lebanon, Connecticut, William Beaumont was the son of a thriving farmer and veteran of the Revolutionary War. After declining an offer by his father of a nearby farm, Beaumont left home in 1806 at age 22 with a horse and sleigh, a barrel of cider, and $100. He settled in Champlain, New York, near the Canadian border, and taught school for 3 years. In 1810, at age 25, Beaumont entered a preceptorship under Benjamin Chandler in St. Albans, Vermont, living in Chandler's home for 2 years as an apprentice. He learned medicine primarily through observation of patients rather than through study of books, and recorded cases and his thoughts in notebooks, a habit he continued throughout his life. At the outbreak of the War of 1812, Beaumont left Chandler with a medical license from Vermont and crossed Lake Champlain to Plattsburgh, New York, where he entered the army as a surgeon's mate. Over the next 3 years he gained experience treating soldiers and performed numerous autopsies. He participated in the capture of York in 1813 and the Battle of Plattsburgh in 1814, and resigned when the Treaty of Ghent ended the war in 1815.

After 4 years of private practice in Plattsburgh, Beaumont reenlisted in the army in 1819 at age 35 and was ordered to Fort Michilimackinac in the Michigan territory. Built by the British in 1780 on an island, Fort Mackinac was adjacent to a village inhabited by about 500 French Canadians and Indians employed by the American Fur Company. In June and July, however, Mackinac swelled with 5000 traders bearing their winter catch. Osler memorialized Fort Mackinac in a beautiful essay on Beaumont that begins:

Come with me for a few moments on a lovely June day in 1822, to what were then far-off northern wilds, to the Island of Michilimackinac, where the waters of Lake Michigan and Lake Huron unite and where stands Fort Mackinac, rich in the memories of Indian and voyageur, one of the four important posts on the upper lakes in the days when the rose and fleur-de-lys strove for the mastery of the western world. (Osler, 1902)

Beaumont was the only physician on the island in June 1822 when Alexis St. Martin, a 19-year-old French Canadian, was accidentally shot by a gun in the store of the American Fur Company. Beaumont's record of the event follows:

I was called to him immediately after the accident. Found a portion of the Lungs 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 examination I found it to be actually the Stomach, with a puncture in the protruding portion large enough to receive my fore-finger, and through which a portion of his food that he had taken for breakfast had come out and lodged among his apparel. In this dilemma I considered my attempt to save his life entirely useless. (Myers, 1912)

Under Beaumont's care, St. Martin survived the immediate effects of the wound but acquired a gastrocutaneous fistula, where the wounded stomach adhered to intercostal muscles. St. Martin remained debilitated and destitute after 10 months, so Beaumont took him into his own home and sustained him.

After 2 years of treating St. Martin, Beaumont published a letter describing "A Case of Wounded Stomach" in the Philadelphia Medical Recorder in January 1825. His scientific curiosity was increasing at the same time, and he wrote in his journal:

This case affords an excellent opportunity for experimenting upon the gastric fluids and process of digestion. It would give no pain, nor cause the least uneasiness, to extract a gill of fluid every two or three days, for it frequently flows out spontaneously in considerable quantities. Various kinds of digestible substances might be introduced into the stomach and then easily examined during the process of digestion. I may, therefore, be able hereafter to give some interesting experiments on these subjects. (Myers, 1912)

He began those experiments in May 1825 at Fort Mackinac and completed the last in 1833 at Plattsburgh. In 1833, at age 48, Beaumont published his Experiments and Observations on the Gastric Juice and the Physiology of Digestion, a 280-page book divided into two sections. The first contains general observations on various topics in gastroenterology. The second contains a description of the 238 experiments, concluding with 51 inferences. Osler (1902) considered the following to be the important contributions of Beaumont: (1) a more accurate and complete description of gastric juice; (2) confirmation of the previous observation that hydrochloric acid was the important acid of gastric juice; (3) recognition that gastric juice and mucus were separate secretions; (4) establishment of the influence of mental disturbance on secretion of gastric juice and digestion; (5) a more accurate and fuller comparison of the action of gastric juice inside and outside the stomach; (6) refutation of many erroneous opinions; (7) the first comprehensive study of motions of the stomach; and (8) a table of the digestibility of different articles of diet.

St. Martin left Beaumont forever in 1834. A year later, at age 50, Beaumont was ordered to St. Louis, where he lived the rest of his life and engaged in a lucrative private practice. When Captain Robert E. Lee and his family were stationed at St. Louis, they dined often at the Beaumont home. When he was ordered to Florida after 4 years in St. Louis, Beaumont submitted a conditional resignation, which was accepted in 1840, ending 25 years of military service. He died in 1853 at age 68 but will be remembered for an extraordinary 9-year period of his life, from 1825 to 1833, during which his 238 experiments on St. Martin were conducted. As Osler said, "The man and the opportunity had met."

References

  1. Myers JS. Life and letters of Dr. William Beaumont. St. Louis: C. V. Mosby, 1912.
  2. Osler W. William Beaumont. A pioneer American physiologist. JAMA. 1902;39:1223–31.
Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.
Bookshelf ID: NBK459PMID: 21250277
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