A gunshot wound reveals the mystery of the appetite

  Before the 19th century, humans knew very little about their own digestive functions. In the early 19th century, scientists realized that the stomach is the key to digestion, but no one can tell what is the way it processes food, is it chemical action or physical grinding? Is gastric juice a chemical solvent? It was not until 1822 that American military doctor William Beaumont encountered a once-in-a-lifetime “experimental subject” and conducted an eight-year experiment, and finally obtained a breakthrough understanding of gastric juice and digestion.
  William Beaumont, who was born in a peasant family, had never received formal medical training. To a large extent, he was self-taught. He had been an apprentice with general practitioner Benjamin Chandler for two years before obtaining a medical license. This way of studying medicine was very common in the United States at that time.
  The military doctor Beaumont was assigned to a remote town in northern Michigan, which is located in the virgin forest on the border between the United States and Canada. In 1822, a young Canadian, Alex Pydagan St. Martin, was engaged in the fur trade here, but was accidentally shot in the abdomen by a hunter’s Mauser.
  Saint Martin was seriously injured, his stomach was shot through, leaving a hole, and food for breakfast flowed out of the hole. Under the conditions of diagnosis and treatment at the time, St. Martin’s probability of survival was very small, but perhaps by fate, he miraculously survived under Beaumont’s diagnosis and treatment, but the hole in his stomach never healed. This hole changed his life and also changed the course of medicine.
  When St. Martin’s wound healed, the stomach and abdominal wall healed together, leaving a finger-sized hole in the abdomen, leading directly to the stomach, which is called a “gastric fistula.” When he eats, he needs to press the hole with a cloth to prevent the food from escaping. Because of this gastric fistula, Saint Martin lost his ability to work, and Beaumont took him home to take care of him, and later hired him as a handyman. By chance, from a certain angle, Beaumont saw the digestion of food in Saint Martin’s stomach through a gastric fistula.
  ”This is simply a miracle!” No one has ever been able to observe the digestive conditions in a living human body in real time. Beaumont discovered this opportunity and seized it. He persuaded Saint Martin to cooperate with him in the stomach digestion experiment.
  The conditions under which Beaumont did the experiment were rather rudimentary. Wang Zhijun, a well-known digestive physiologist in China, once wrote in an article: “Beaumont has neither the opportunity to study in the laboratory nor the mastery of any experimental methods. The town where he is located is deserted for hundreds of miles, as if living in an isolated one. The world is cut off from the scientific society, and there is no other doctor to exchange views with him. As for the experimental equipment, let alone the thermometer, test tube, funnel, and casserole, only relying on his own facial features.”
  Beaumont put beef , Oysters, bread, vegetables and other foods are tied to the rope, put into St. Martin’s stomach through the fistula, taken out after a fixed time, and observe its digestion; he observes the stomach in different weather and when St. Martin’s emotions are different. Status; he observes the effects of coffee, tea, alcohol, etc. on the stomach; he observes gastric disorders caused by improper diet; sometimes, he draws out the gastric juice and puts it in a test tube to compare and observe the digestion of food in the test tube; he The gastric juice was also sent to a chemist for analysis, which confirmed the presence of free gastric acid in the stomach.
  From 1825 to 1833, Beaumont conducted about 238 experiments on Saint Martin. In 1825, he published the first paper related to the above experiment-“A Case of Stomach Injury Patient” in the “Philadelphia Medical Yearbook”. In 1833, Beaumont published the work “Experiments and Observations of Gastric Juice and Digestive Physiology”. This 300-page work discussed 51 inferences, describing the movement, secretion and digestion of the stomach. In addition to proving the presence of hydrochloric acid in gastric juice, Beaumont also recognized that other substances are involved in the digestion process, which laid the foundation for the discovery of pepsin and lipase in the future.
  At that time when experimental medicine was very backward, Beaumont’s discovery was quite close to today’s view. As a result, Beaumont’s medical status was established, and he was called the “father of digestive physiology.” After the results of Beaumont’s experiments were spread to Europe, they inspired scientists to build animal organ fistula models and promoted the study of the digestive system. In 1889, Pavlov used the famous “dog sham feeding” experiment to prove that the nervous system stimulates the secretion of gastric juice.
  Although Beaumont’s experimental discoveries promoted the advancement of medicine, its ethics is still criticized. In Beaumont’s eyes, is Saint Martin a patient, a servant, or a medical “guinea mouse” available for use? In Saint Martin’s mind, is Beaumont his lifesaver, his employer, or a scientific maniac who restricts his personal freedom? We may not be able to look at the experiments more than 100 years ago with today’s eyes. After all, at the time, there was no normative constraint on research behavior, and the rights and interests of the subjects were not discussed.
  Perhaps because he could not stand the experiment, Saint Martin left Beaumont, returned to Canada, married a wife and had children. Beaumont retrieved Saint Martin again and paid Saint Martin to sign a contract with him, promising to cooperate with his own research. It wasn’t until 1933 that after Saint Martin left again, the requested fee exceeded Beaumont’s ability to pay, and the two have since parted ways.
  Saint Martin lived to be 83 years old. After his death, his family was afraid that curious doctors would come to dig the grave for his stomach. The place of the tomb was strictly kept secret, and there were no tombstones.
  In 1962, the Canadian Physiological Society believed that although Saint Martin was passively participating in the experiment, it did make an indelible contribution to the study of digestive physiology, so through his descendants he found the cemetery and erected a tombstone, writing: He experienced pain, but served Mankind.