GASTRIC JUICE. 



233 



eighteen years of age, of good constitution and perfectly healthy, was wounded in the 

 left side by the accidental discharge of a gun loaded with duck-shot. The wound was 

 received on the 6th of June, 1822, and the muzzle of the gun was not more than a yard 

 distant from the body. The contents of the gun entered posteriorly, carrying away 

 integument and muscles from a space the size of the hand, with the anterior half of the 

 sixth rib, fracturing the fifth rib, lacerating the lower portion of the left lobe of the 

 lung and the diaphragm, and perforating the stomach. The patient was seen by Dr. 

 Beaumont twenty -five or thirty minutes after the accident, when the above facts were 

 noted, and an opening into the stomach was discovered large enough to admit the fore- 

 finger. Extensive sloughing took place, and for seventeen days every thing that was 

 swallowed passed out at the wound, and nourishment was administered by the rectum. 

 In the spring of 1824, the wound had cicatrized, and the patient had perfectly recovered 

 his health ; but, in the process of cure, seven pieces of cartilage had come away, and three 

 or four inches of the sixth rib, with about half of the lower edge of the fifth rib, had been 

 removed by an operation. The perforation into the stomach was irregularly-circular in 

 form and about two and a half inches in circumference. This opening was closed by a 

 protrusion of the mucous membrane of the stomach in the form of a valve, which could 

 readily be depressed by the finger so as to expose the interior of the organ. This valve 

 effectually prevented the discharge of the contents of the stomach, which had annoyed 

 the patient previous to the winter of 1823-'24. 



A, A, A, B, 



FIG. 61. Gastric fistu lain Hie ease of St. Martin. (Beaumont.) 



IB ui ihe opening into the stomach ; C, left nipple ; D, chest ; E, cicatrices from the wound made 

 for the removal of a piece of cartilage; F, F, F, cicatrices of the original wound. 



From May, 1825 until August of the same year, St. Martin was under the observation 

 of Dr. Beaumont and submitted to numerous experiments. At the end of that time, he 

 returned to Canada and was lost sight of for four years, during which time he married 

 and became the father of two children, " worked hard to support his family, and enjoyed 

 robust health and strength." He then came again under the observation of Dr. Beau- 

 mont and continued in his service, doing the work of a common servant, until March, 

 1831. After this he was under observation from time to time until 1836 ; all this time 

 enjoying perfect health, with good digestion, and having become the father of several 

 more children. The la?t published observations made upon this case were in 1856. 



The following was the method employed by Dr. Beaumont in extracting the juice : 



