This reminds us of the power of one carefully documented case study.
This is a nice bit of historical research now been seen in
perspective that informs us of its importance. In the same way,
recent survival of CPR assisted heart attack victims are now changing
all our protocols for that particular event.
Both inform doctors to not give up quite so quickly, however
tempting.
I suspect that the stomach wall finally grew back together over time
and actually closed of the wound as he made it into old age and heavy
work.
Man With Hole in
Stomach Revolutionized Medicine
By Tia Ghose,
LiveScience, Wed, 24 Apr, 2013
A man whose gunshot
wound created a window into his stomach enabled scientists to
understand digestion.
But the patient, a fur
trapper named Alexis St. Martin, also transformed how physiologists
studied the body, new research suggests.
People "realized
this was a revolutionary approach to doing physiology and medicine.
You collect data on the clinical patient and then come to your
conclusions," said study co-author Richard Rogers, a
neuroscientist at the Pennington Biomedical Research Institute in
Baton Rouge, La.
Prior to that, doctors
typically decided what was wrong with a patient or how a bodily
function worked — often based on 1,600-year old medical ideas of
Galen — before ever setting eyes on them, Rogers said.
The findings were
presented Tuesday (April 23) at the Experimental Biology 2013
conference in Boston, Mass.
Gory wound
Physiologist
William Beaumont, an army doctor, was stationed in Fort Mackinac in
Mackinac Island, Mich., on June 6, 1822, when a fur trapper's gun
discharged and accidentally shot 19-year-old trapper Alexis St.
Martin in the stomach.
The wound was gory and
St. Martin wasn't expected to live out the night.
"He had lung
hanging out of his wound," Rogers told LiveScience.
Yet amazingly,
Beaumont performed several antiseptic- and anesthesia-free
surgeries on St. Martin over several months, and St. Martin
eventually recovered.
Window into digestion
St. Martin became fed
up with surgery and was left with a fistula, a hole in his stomach
through the abdominal wall, which left it open to view. (The
strong stomach acid essentially disinfected the wound from the inside
out, making it safe to not sew it up.)
Because St. Martin
couldn't work as a fur trapper anymore, Beaumont hired him as
handyman. The daily task of cleaning the fistula gave Beaumont an
idea: perhaps he could watch the process of digestion at work.
So for the next
several years, Beaumont recorded everything that went into St.
Martin's stomach, then painstakingly described what went on inside.
He also took samples of gastric secretions and sent them to chemists
of the day for analysis — an unheard of task at the time.
His precise
observations led him to conclude that the stomach's strong
hydrochloric acid, along with a little movement, played key roles in
digestion, rather than the stomach grinding food up as some
physiologists of the day believed.
"He was the first
one to observe digestive processes going on in real time,"
Rogers said.
He was also the first
to notice that St. Martin's digestion slowed when he was feverish,
making the first link between digestive processes and disease, Rogers
said.
Revolutionary approach
The findings paved the
way for modern physiology, where observations guided conclusions, not
vice versa, Rogers said.
The study also ushered
in some of the first controlled animal experiments by
physiologists who realized they could make faster headway by
performing fistula operations in animals.
For instance,
Beaumont's experiments inspired the famous Russian physiologist Ivan
Pavlov to conduct fistula operations in dogs. It was this window into
digestion that spurred Pavlov to make his famous conclusions that
classical conditioning could spur dogs to salivate on cue, Rogers
said.
St. Martin, meanwhile,
lived to the ripe old age of 83, going back to fur trapping for a
while and eventually becoming a farmer.
"This guy was in
superb condition," Rogers said.
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