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Doctors Of The Frontier
Underschooled and ill-equipped, the men who attended the pioneers practiced a rugged brand of medicine—but they made some major advances all the same
April 1963 | Volume 14, Issue 3
If the physician was prepared to give up, however, the patient was not. All the wild vigor of St. Martin’s young body rallied to his defense. The man simply refused to die. For a long time he lingered, then slowly he gained strength and began to recover. But the abdominal wound would not close. Dr. Beaumont kept it covered with compresses so that when St. Martin ate, the food would not leak out through the hole in his stomach. At the end of a year the patient was on his feet again, weak and crippled but hobbling about. His stomach cavity was still not sealed, and never would be again, but his body had effected a rough repair. Overlapping layers of skin had grown over the wound, creating a valve which could be opened by lifting a flap.
Dr. Beaumont slowly recognized in St. Martin a remarkable opportunity to advance medical science. Medicine at that period had almost no knowledge of the vital chemical action which transforms food into the fuel of life. There were theories about it—dozens of theories—but very few facts. With grave excitement the doctor confided to his notebook: “The case provides an excellent opportunity for [experiment] … I can look directly into the cavity of the Stomach, observe its motion, and almost see the process of digestion. I can pour in water with a funnel, or put in food with a spoon, and draw them out again with a syphon. … It would give no pain nor cause the least uneasiness.”
Dr. Beaumont was not trained for such exacting research; he had picked up his knowledge of medicine by rolling pills and mixing powders for another doctor and had never set foot in a medical school. But he saw the opportunity and pursued it, and his very ignorance may have been an advantage. Knowing little about the learned disputes on the digestive process, he was never tempted to distort his findings in defense of established views. He was imbued, moreover, with the show-me attitude of the typical frontiersman. Once, for instance, he siphoned off samples of the gastric juices and sent them to some of the world’s leading chemists for analysis. The reports that came back indicated hydrochloric acid. Dr. Beaumont put it to the test. Filling one vial with gastric juices, and another with hydrochloric and acetic acid, he placed some well-chewed boiled beef in each. The beef in the gastric juice was completely dissolved, while a jelly-like residue remained in the vial of acid. Three years later, pepsin was isolated as an important factor in digestion.
If Beaumont was enterprising and persistent, other aspects of his personality were not so admirable. He was overbearing, proud of the status conferred by his rank and profession, and he insisted on treating St. Martin as a menial servant. The voyageur sometimes retaliated by refusing to let his stomach be probed. The two often quarrelled bitterly. But Dr. Beaumont turned even this to scientific advantage; he noted that violent anger produced some quite interesting changes in the patient’s digestive chemistry. When St. Martin got drunk, which he quite frequently did, Dr. Beaumont would turn to the notebook and record his observations on the effects of alcohol in the stomach.
Several times St. Martin decamped for the wilderness, swearing that he would never let the doctor lay hands on him again. He found, however, that he was no longer fit for the old wild, free life, and after a while he would come trudging back, offering to resume the experiments in exchange for his board and keep. Over the years, this cost the doctor more and more, for St. Martin progressively acquired a wife and four children. Dr. Beaumont was by now a family man himself; he railed at the vexatious demands on his slender purse, but in the end he always agreed to pay. He was a man obsessed. Whatever the cost, he had to find out what was going on in that stomach.
The curious association continued for nearly ten years. Finally there was a last, angry, irreconcilable quarrel. St. Martin packed up his family and returned to Canada, leaving Dr. Beaumont to sputter over the “villainous obstinacy” of his unwilling partner. But by then, Dr. Beaumont had completed more than two hundred experiments, learning nearly all that could be learned by the methods then available. He had contributed an exact description of the stomach’s action, providing detailed information which was not materially expanded until X-ray procedures came into use. He had discovered almost singlehandedly what digestion is, and how it works. When his findings were published, he received world-wide medical acclaim.
Along with such epic figures as Dr. McDowell and Dr. Beaumont, frontier medicine produced dozens of lesser but still brilliant men. Most were surgeons. They performed the first cholecystotomies, laryngotomies, and nephrectomies in pioneer country, the first heart sutures and skull perforations. Their names and achievements are scattered through the footnotes of medical histories, and they make dull reading. But the events behind the footnotes were far from dull.
Take what was probably the first successful Caesarean section in the American West, performed in 1827 by Dr. Jonn Richmond at a farmhouse near Newton, Ohio. The operation at that time was fatal to three women out of four, even when done under the best of circumstances. Dr. Richmond accomplished it at night, by the uncertain light of flickering candles, in a primitive setting typical of frontier surgery. He did it, moreover, despite his own grave doubts that he was equal to such a challenge.