Field of medicine: History of medicine.

Audience: Physicians, historians, and the general public.

Purpose: Many schoolchildren and most physicians and scientists know that Alexis St. Martin, a Canadian voyageur, had an opening in his abdomen that exposed the inside of his stomach, allowing his physician, William Beaumont, to conduct experiments on the function of the stomach. Reginald Horsman, Emeritus Professor of history at the University of Wisconsin, Milwaukee, now provides the definitive biography of Beaumont.

Content: Beaumont learned medicine from a physician preceptor in St. Albans, Vermont. He did not attend a university, nor was he trained in the scientific method. He enlisted in the U.S. Army as surgeon's mate during the War of 1812. When St. Martin was accidentally shot in the stomach while on isolated Mackinac Island, Beaumont managed his wound, which formed a gastric fistula as it healed. He conducted many experiments on St. Martin, determining the time course for digestion of various food-stuffs by the stomach, comparing the digestion of food in vivo to that in vitro, and measuring the effect of temperature on digestion. He noted that the presence of bile in gastric juice facilitated the digestion of oil and that St. Martin's drinking binges damaged his gastric mucosa. Surgeon General Robert Lovell arranged for Beaumont to correspond and meet with eminent scientists about his research. These scientists wanted to experiment on St. Martin, but Beaumont did not want to share his impending fame, and he limited their involvement to analyzing samples of gastric juice. Beaumont received international recognition after publishing reports on his experiments in 1833. Thereafter, Lovell assigned Beaumont to a post in St. Louis and gave him permission to develop a private practice. The lucrative practice became his life, and a new surgeon general forced him to resign from the Army. He made several half-hearted attempts to reunite with St. Martin, who had returned to Canada with his family, but he did not conduct any experiments after his book was published. He enjoyed a thriving practice until he died in 1853 at the age of 68.

Highlights: Although Beaumont's scientific contributions are fully elucidated, Horsman focuses primarily on Beaumont's life on the frontier in the first half of the 19th century. He vividly portrays the ravages of disease, in the absence of therapy, on individual persons and communities. Beaumont's personality is especially well elucidated. Horsman provides ample information about his sources, explaining that Beaumont's letters and other materials are available in several university libraries. The book is carefully referenced.

Limitations: A map showing the places in which Beaumont lived and worked would have been helpful.

Context: Most history is written by authors whose writing skills were honed on dry research papers. Here, we have a great story told by a historian who knows how to write. Physicians and scientists will appreciate Horsman's scholarship: Digging out the information in this book must have been an enormous job. The result is a definitive, scholarly work that will be of interest to the general public.

Reviewer: David L. Nahrwold, MD, Northwestern University Medical School, Chicago, Illinois.