In 1912, Dr. William Osler, a renowned internist and the co-founder of Johns Hopkins Hospital, wrote an essay titled “Backwoods Physiologist,” in which he described Dr. William Beaumont as “the pioneer physiologist of the United States and the first to make a contribution of enduring value.” Dr. Osler wrote that Dr. Beaumont’s “work remains a model of patient, persevering research.” But like that of many founding figures in our nation’s history, including Dr. Osler himself, Dr. Beaumont’s legacy is complicated by ethical questions related to his medical research and informed consent that persist in medicine today.
Dr. Beaumont was born in Connecticut on November 21, 1785. After turning 21, he spent several years as a teacher in New York, then moved to Vermont for an apprenticeship with a physician, during which he was reported to have spent more time observing patients than reading books. He passed an examination, was licensed to practice medicine by the state of Vermont and went on to serve as an assistant Army surgeon in the War of 1812.
By 1820, Dr. Beaumont was stationed at Fort Mackinac, on Lake Huron’s Mackinac Island, in what was then the Michigan territory. John Jacob Astor’s American Fur Company operated in this area, and two years after his arrival, Dr. Beaumont had a fateful encounter with one of its employees.
A Miraculous Recovery
On June 6, 1822, someone accidentally fired a shotgun loaded with duck shot inside the company store. Alexis St. Martin, a French Canadian, thought to be about 18 years old, stood less than three feet from the muzzle and took the blast on his left side, just under the nipple. A messenger went to the fort to get a doctor, and within 30 minutes, Dr. Beaumont—the only doctor on the island—arrived.
When Dr. Beaumont arrived at the store, Mr. St. Martin was still alive, but his most recent meal was pouring out of the gaping wound. As he examined the young man, Dr. Beaumont found a fractured rib and pieces of a lung and the stomach protruding from the wound. He applied a carbonated fermenting poultice and kept the area moist with a lotion of muriate of ammonia and vinegar.
After this initial care, Mr. St. Martin underwent bloodletting (about 20 ounces) and was given an emetic. For two weeks, he received his meals by enema.
Treatment continued and weeks became months. Dr. Beaumont changed the wound dressing frequently, and stomach contents would flow based on Mr. St. Martin’s diet. The external wound was 12 inches in circumference and the fistula was in the middle, 2 inches below the nipple.
By April 1823, Mr. St. Martin had recovered enough to walk around and do light work. His appetite was good. He remained a ward of the county for many months, and Dr. Beaumont was reimbursed for providing care and medicine. By that summer, this aid had ceased because as a Canadian, Mr. St. Martin was not eligible for government support. Deeming a return to Canada unsafe given his patient’s condition, Dr. Beaumont invited Mr. St. Martin to move into his home as his servant.
At this point, the injured flesh around the fistula had firm scarring. The doctor taped a compress to the patient’s abdomen so he could retain food and drink. For months, pus seeped from the wound as portions of the injured lung and stomach sloughed off. An abscess formed just below the wound that was painful and produced violent fever.
While Dr. Beaumont reported that it was impossible to close the fistula, others have found this argument dubious and potentially obscured by the doctor’s ambitions to benefit from experimentation. It is also possible that Dr. Beaumont, despite his apprenticeship in Vermont and medical experience in the army, lacked the surgical skill required for this unusual wound.
A Scientific Opportunity
In March 1825, almost three years after the gunshot wound that nearly ended Mr. St. Martin’s young life, Dr. Beaumont began recording experiments in his casebook. These efforts involved the suspension of raw and roasted meat and other foods into Mr. St. Martin’s stomach on a string, to determine digestion times. By August, Dr. Beaumont had conducted hundreds of such tests with foods and drinks, taking temperature readings and withdrawing gastric juices with elastic catheters. These efforts continued even after Dr. Beaumont was transferred to Fort Niagara, New York, and Mr. St. Martin accompanied him. Some of the experiments were suggested by U.S. Surgeon General Joseph Lovell, with whom Dr. Beaumont corresponded about his work.
Dr. Beaumont recorded digestion in relation to Mr. St. Martin’s exercise and emotions. By studying food dropped into the extracted gastric juice, Dr. Beaumont confirmed the theory that a chemical process, not just stomach movement, was involved in digestion.
Repeated insertion of the thermometer bulb and extraction of quantities of gastric juice often caused pain and discomfort to Mr. St. Martin. Sometimes Dr. Beaumont would relent temporarily; on other occasions, he would not.
In addition to often being an unwilling subject, at times Mr. St. Martin would disappear. Dr. Beaumont took the servant with him on a trip to Plattsburgh, New York, in August 1825. Close to home, Mr. St. Martin headed north to his native Canada, where he married, fathered two children, and worked as a voyageur, or boatman, for the Hudson Bay Fur Company in the Indian territory.
In his book, Dr. Beaumont noted the patient had left his care “without obtaining my consent.” In letters to Dr. Lovell, he declared that he did not understand why Mr. St. Martin would show such ingratitude since, in his view, the experiments were not painful.
Dr. Beaumont did not see Mr. St. Martin again for four years, until 1829, when Dr. Beaumont was stationed at Fort Crawford in present-day Wisconsin. Dr. Beaumont asked the American Fur Company to contact and hire Mr. St. Martin for him. Between experiments, Mr. St. Martin “performed all the duties of a common servant,” Dr. Beaumont wrote. He chopped wood, carried loads, and did other chores “with little or no suffering or inconvenience from his wound.”
In the spring of 1831, with Dr. Beaumont’s knowledge, Mr. St. Martin returned home, where he remained until the next fall, when the two men entered into a contract in which Dr. Beaumont paid Mr. St. Martin $150 annually plus supplied food, drink, laundry services, clothes, and lodging. Dr. Beaumont, then stationed in Plattsburgh, New York, persuaded Mr. St. Martin to enlist in the army for five years and spend the first six months as his private assistant. Mr. St. Martin’s family remained in Canada.
Plaudits and Publication
Jurisprudence regarding medical malpractice and informed consent was nonexistent in antebellum America, and Dr. Beaumont’s experiments raised few ethical concerns at the time. Defending his work in the preface of his book, Dr. Beaumont insisted that his research derived from “motives which my conscience approves.”
In 1834, he petitioned Congress for reimbursement of expenses incurred since 1822, which he estimated at $5,000, owed to him for his endeavor to advance science and thus benefit mankind. He asked for less than the full sum, $3,148.75, neglecting to mention help he had received from various sources. However, Congress twice refused his petition. During this period of American history, federal support for any scientific or philanthropic endeavor was viewed by many as unconstitutional.
Most of Dr. Beaumont’s peers in medicine and journalism considered the experiments a public good and praised the doctor. Little concern was expressed for Mr. St. Martin or about Dr. Beaumont’s failure to close a fistula because the knowledge gained from it could benefit humanity. Many physicians and others of the period felt an ethical duty to perform experiments that enhanced medical understanding.
Physicians across the country clamored to collaborate with Dr. Beaumont. Vegetarian researchers wanted access, as did many foreign scientists, some of whom suggested importing Mr. St. Martin to their countries. During this period, Dr. Beaumont studied medical literature and dined and worked alongside local physicians, some of whom encouraged him to publish his research. In March 1833, Columbian College, now George Washington University, awarded him an honorary MD degree.
Despite his lack of formal training in chemistry and medicine, Dr. Beaumont impressed experts in various fields and paved the way for a positive reception for his book. In August 1833, Dr. Beaumont printed a book prospectus, which resulted in orders and publicity because magazines such as the Boston Medical and Surgical Journal, now The New England Journal of Medicine, and newspapers began to publish articles about his remarkable case and experiments.
Dr. Beaumont’s Experiments and Observations on the Gastric Juice and the Physiology of Digestion was published in December 1833, describing his initial and subsequent treatment of the wound; his 10-year relationship with the patient; and the methods, results, and conclusions of his experiments.
By the time of its publication, Dr. Beaumont’s research had garnered momentum in the American medical community and began to be noted in Europe. A translation of his book was published in Germany, in 1834. By 1845, articles and books in France, Britain, and Germany cited his work or noted its influence.
A Lack of Closure
Before publication of his book in late 1833, Dr. Beaumont and Mr. St. Martin, who reportedly could not read, had signed a new contract in which Mr. St Martin would be paid $200 a year for two years of experiments. Dr. Beaumont gave him money to return to his family in Canada on the condition he would return for experiments six times between 1834 and 1852. However, something, such as weather, family, or shortage of funds always prevented his trip.
Dr. Beaumont continued offering Mr. St. Martin more money to induce him to return and submit to further study, as medical journals and institutions sought reports of more experimentation into gastric function. But the two men would never see each other again.
The voluminous correspondence between these men indicates that Mr. St. Martin was grateful for Dr. Beaumont’s payments, if not his contribution to medical science.
Two Trials
In 1839, Dr. Beaumont resigned from the army, where he had been stationed at Jefferson Barracks near St. Louis. He did not want to be transferred to Florida, where the Seminole War was underway. He remained in the city and set up a practice with Dr. Stephen Adreon, helping to create the Medical Society of Missouri.
In 1840, a St. Louis newspaper publisher was brutally beaten with a cane by a politician who had been maligned in the newspaper, and Dr. Beaumont was among several doctors called in to assist. The doctors performed a trepanning procedure to relieve cranial pressure, but the publisher died, and the politician was charged with murder. During the trial, the politician’s attorneys used Dr. Beaumont’s notoriety to argue that the doctor drilled the hole simply to see what was side, just as he’d left an opening in Mr. St. Martin’s abdomen. The politician was convicted but received no jail time and instead was given a $500 fine.
This case would not be the last time Dr. Beaumont’s name would come up in a courtroom. Mary Dugan was a 55-year-old white woman, who was destitute and in poor health. Dr. Adreon saw her several times about a suspected right groin tumor. He consulted with Dr. Beaumont and a third doctor, and all of them diagnosed her with an enlarged inguinal gland. Dr. Adreon operated, and Ms. Dugan seemed pleased with the result until a minister visited her and called in Dr. Thomas White, a medical society enemy of Drs. Beaumont and Adreon.
Dr. White persuaded Ms. Dugan to bring a lawsuit against Drs. Beaumont and Adreon in October 1844. The trial took place over two weeks in February 1846. Ms. Dugan claimed she was disabled and requested $10,000 in damages. Drs. Beaumont and Adreon were acquitted, but Dr. Beaumont’s relationship with the medical community was changed forever.
The case received publicity not only in the local press, but in the pages of the St. Louis Medical and Surgical Journal. The journal called the recent trial “unfortunate” but also acknowledged Ms. Dugan’s attorneys’ claims: The treatment she received at the hands of presumed professionals was incompetent. From 1844 until 1846, the pages of the Journal were filled with debate about Ms. Dugan’s diagnosis—was it a hernia or not? Infighting became fierce, and the schism in Missouri’s medical society persisted for many years.
Dr. Beaumont was not even present at the surgery, but the case had a profound effect on him. He had long promoted professional education and standards in medicine but refused an invitation to New York in 1846 to attend the organizational meeting of the American Medical Association, still bitter about the criticism he had endured from fellow physicians.
In 1853, Dr. Beaumont slipped on icy steps after visiting a patient and hit his head. He died a month later.
A Complicated Legacy
Dr. Beaumont’s work often is described as the first American scientific contribution to medicine. He made clear, concise descriptions of his experiments, and although he knew nothing at the time of pancreatic or intestinal digestion, most of his observations held up for decades. He closed his book with 51 conclusions, almost all new at the time. In 1824, Englishman William Prout had demonstrated that stomach contents contained hydrochloric acid, but Dr. Beaumont’s efforts confirmed that work and discovered what was later identified as pepsin.
Mr. St. Martin died on June 24, 1880, finally freed from the hordes of researchers and their ambitions of experimenting on him. Dr. Osler offered to purchase his stomach for the Army Medical Museum, in Washington, but the patient’s family chose to let the remains decompose in a sunny open field before burying him in an unmarked grave.
In 1962, the Canadian Physiological Society contacted the St. Martin family in the hope of finally marking his grave, at which time the society learned that Mr. St. Martin was 28—not 18—when he was shot. Dr. Beaumont may have learned a long list of facts about his patient, from how long it took him to digest oysters to the effect emotions had on his gastric juices, but he never knew his patient’s true age.
—A.J. Wright, MLS, and Katie Prince
Suggested Reading
- Beaumont W. Experiments and Observations on the Gastric Juice and the Physiology of Digestion. Maclachlan & Stewart; 1833.
- Gale A. Dr. William Beaumont: founding father of gastroenterology. Mo Med. 2021;118(6):518-519.
- Edwards L. The gruesome medical breakthrough of Dr. William Beaumont on Mackinac Island. Mynorth.com. Published May 18, 2017. Accessed Feb. 27, 2025. https://mynorth.com/2017/ 05/ the-gruesome-medical-breakthrough-of-dr-william-beaumont-on-mackinac-island/
- Eschner K. This man’s gunshot wound gave scientists a window into digestion. Smithsonianmag.org. Published June 6, 2017. Accessed Feb. 27, 2025. https://www.smithsonianmag.com/smart-news/ grisly-story-human-guinea-pig-alexis-st-martin-180963520/
- Martin DB. Doctor William Beaumont: His life in Mackinac and Wisconsin, 1820-1834. The Wisconsin Magazine of History. 1921; 4(3):263-280.
- Myer J. Life and Letters of Dr. William Beaumont. University Microfilms, 1967.
- Numbers RL. William Beaumont and the ethics of human experimentation. J Hist Biol. 1979 ;12(1):113-135.
- Numbers RL, Orr WJ Jr. William Beaumont’s reception at home and abroad. Isis. 1981;72:590-612.
- Roberts CS. William Beaumont, the man and the opportunity. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Butterworths; 1990.
This article is from the April 2025 print issue.