Open Wound: The Tragic Obsession of Dr. William Beaumont

by Jason Karlawish

  One hour later, Alexis lay upon his back in the customary position, and Beaumont withdrew the string, taking care to minimize the discomfort as the articles passed over the tender cuticle. He laid the length of string out carefully on a towel. The cabbage and bread were half digested. The pieces of meat slightly were gray but otherwise unchanged. He returned the food parts into the stomach.

  He recorded his observations, and beneath them he made notes. The facts were opposite to his expectations. The cabbage should be digested last, but it was digesting first. The beef should digest first, but it remained essentially undigested.

  When the clock struck two, he withdrew the string again. The cabbage, bread, pork and boiled beef were all gone from the string. The high-seasoned beef and raw salted lean beef remained very little affected by the digestion. He returned them into the stomach. His observations upset the conventional expectations. Did I chop the cabbage too finely? he wrote. He took up his copy of Antiquel's history, opened it without care and tried to read as he waited for the third hour.

  “Doctor, I am not well.”

  Alexis stood before Beaumont. His face was pale, and he held his right hand over his stomach.

  “I am sick at the stomach and the head.”

  Beaumont snapped the book closed.

  “On to your cot.”

  “I feel sick.”

  “Just lie down as usual.”

  The two pieces of beef were nearly in the same condition as when he had last examined them. He leaned closer to the gastric cavity and sniffed. He sniffed again. The odor was rancid and sharp, and the surface of the gastric tissue bore a few tiny white papules. He measured Alexis's pulse. Regular but bounding. He ran the back of his hand over his forehead and the skin of his chest. Warm and dry. The phenomena of fever, but he was not feverish.

  “How do you feel now?”

  Alexis shook his head.

  “How's your stomach?”

  Alexis grimaced and shook his head again. “Not good,” he muttered.

  “Don't fret. It's minor venous congestion.”

  Alexis moaned as he drew his skinny legs up to his chest. Beaumont sat back on his chair and observed the lad. The bottoms of his feet were dark and calloused. He looked down at the two pieces of undigested beef. The facts made no sense. To be sure, the multiple items of aliment had led to indigestion, but the pace and order of digestion was not as he had expected. He had suspended beef, raw and cooked, into the cavity many times before, and they were always digested within two hours. He had sampled meals of meat and vegetable with a siphon and seen the slow pace of vegetable matter.

  “How are you?”

  Alexis did not open his eyes.

  “Alexis?”

  “My head.”

  “Yes?”

  “My stomach.”

  Beaumont measured Alexis's pulse. Without change.

  “Just rest there as you are. You'll mend soon.”

  “I could puke.”

  “Don't try. There's nothing there.”

  Beaumont stepped into the kitchen and gazed at his notebook wherein he simply wrote, beef remains undigested, complains of distress at stomach and head & costiveness, and then he shut the notebook.

  “What am I doing?”

  IN THE EVENING, a whitish coating had developed over Alexis's tongue, his pulse was depressed, and Beaumont found numerous pustules spread over the stomach's surface. The water Alexis passed was dark and foul smelling. After Beaumont emptied the chamber pot in the bucket beside the shed, he stood for some time in his yard, gazing at the night sky. How odd that a man like Ramsay Crooks wished to make a study of the stars when there was so much to discover here on earth. He whistled for Rex, but the dog did not come. He had not seen the dog for several days. Weeks even.

  He considered the experiment again and yet again. Perhaps he had demonstrated that a stomach filled with multiple items of aliment will exhaust itself, and some items will be retained and ferment. The bread was stale and so porous as to readily admit the gastric juice and fall off the string. The cabbage was chopped too fine. But why the meat, and only some of the meat, why did it resist the powers of the gastric juice?

  When he returned inside, Deborah was seated at her dressing table brushing out her hair. “What's wrong with Alexis?”

  “Some distress at his stomach and head. It'll mend.”

  She continued brushing her hair.

  “Is he ill?”

  Beaumont shook his head. “Simply recovering from too much variety of food. Cabbage, bread, beef boiled, à la mode and raw, and salted fat pork.”

  “That's quite a supper, even for a laborer.”

  Beaumont explained the day's experiment to his wife while she completed her toilet. When he finished, they were lying side by side in the darkness. She yawned. Washing day exhausted her. She did not speak for some time, and when she did, her voice was small and soft, like drizzle on leaves.

  “What will you report to Dr. Lovell?”

  He considered her question. “Honestly, I think my results are important from the pathologic point of view. They confirm the common opinion that undigested aliment retained in the stomach produces all the phenomena of fever. It's clear evidence of the danger of excess in aliment.”

  “I suppose then you can write him about that and see what he has to surmise.”

  “Perhaps. But I think it wise to try some other experiments prior to sending a report. That was just the first, and tentative as well. It raises as many questions as it answers. But I have written to Lovell to request a transfer and review of my rank. We've been here now five years. It's high time I have my choice of another fort and promotion to surgeon.”

  “Yes,” she said. Her voice was thick and heavy with sleep.

  “As soon as next spring, perhaps Fort Howard. Or even Plattsburgh. Or St. Louis. Wouldn't that be grand?”

  It would be grand. Any of those places would be grand. But as he was talking about their hope for the future, he was thinking about his past, about his apprentice years when he slept in a low-ceilinged loft above the kitchen while Dr. Chandler lay beside his golden-haired wife in a room of their own. Beaumont rose early, before the rest of the household. He sat on the edge of a milking stool, his thin frame curled close over the low pine table that was wedged beside his narrow and lonely bed. A circle of candle-light illuminated his medical text's soft pages, and the sand on the kitchen floor glowed pale like the lonely moonscape. He copied passages into notebooks, recorded cases, recited treatments. His cold fingers were stained with ink and his nails bitten to their bloody quick. He worked hard with the belief that his labor would one day free him of poverty and his humble origins. And now, some fifteen years later, he was back at that table.

  TWENTY-THREE

  THE NEXT MORNING, ALEXIS STILL LAY with his legs curled up to his chest and complained about his stomach and head. Beaumont inserted a half a dozen calomel pills directly into the gastric cavity. Within three hours, these induced a brisk, cathartic response, and by the afternoon, Alexis had recovered. Following a supper of cold beef, potatoes and pudding, he performed his usual chores.

  In the days following the first experiment, a keen energy possessed Beaumont. He rose early. He retired late. He kept reaching for his notebook to jot an idea, or if the notebook was not handy, any odd scrap of paper. He was planning to prove the chemical nature of digestion. The stomach was not a grinding machine or a fermenting vat. Gastric juice was not inert. He'd tasted its acrid, sharp flavor many times. He'd even put a few drops on a cut along his forearm and felt its sting. It was a chemical. What he needed was to prove it through a series of experiments varying the articles of aliment and the conditions of digestion.

  The necessary test was to isolate the action of the juice upon aliment in conditions without the grinding and churning and the possibility of fermentation. The solution came to him as he stood outside the blacksmith's shop watching the sweating man heft a stone jar of molten iron from a fire kept red
and furious by his two sons' rhythmic pumping of the bellows.

  The solution was heat. The chemicals he had tasted in the juice required heat to react. He knew that proper temperature from previous observations of Alexis's stomach. One hundred degrees on his Fahrenheit thermometer. But how to make the heat steady and general around the vial of juice so as to mimic the stomach's surrounding warmth? This question the blacksmith answered. A sand bath.

  Beaumont was pleased with himself. A silk thread he'd divined from watching soldiers feed a length of it to a goat, then slowly pull it out. The gum elastic tube to extract gastric liquor he'd discovered while watching a child drink sweetened tea. And now a blacksmith's sand bath. He had solved his heat problem. He would nestle the vial into a basin filled with dry sand of constant and regular granularity and place that basin upon a fire. The caloric action would travel uniformly through the sand and surround the vial like the warm flesh of a man's innards.

  LATE ONE SUNDAY MORNING following the Reverend James's service, Beaumont excused himself from conversation with Abigail and Theodore Mathews and hurried home to set up his sand bath and wait for Alexis's return from Father Didier's chapel among the tents along the beachfront. Didier had a strange burlesque ritual that ended with serving wine and bread he claimed to transform into Jesus Christ's blood and body, but only to those who had fasted. A small amount of wine and bread would rapidly digest. The cavity would be entirely empty and prepared for his experiment.

  And it was.

  “Very simple plan here, Alexis. I want to take the measure of temperature in here and then draw off some of the liquor. I'll give you a piece of cooked beef, a small piece, and suspend it as I have done before. You should digest that within an hour or two, and then we'll have dinner.”

  “May I walk about?”

  “Just here in the house.”

  Alexis folded his arms behind his head and stared up at the ceiling as Beaumont took up his Fahrenheit thermometer from its felt-lined case. He wiped the length of it with a cotton cloth he kept expressly for this purpose, then slowly inserted the thermometer into the cavity. He marked the top of the column with ink, and then he withdrew it and placed it upon the ruler. The ink mark read one hundred degrees. He wiped the column carefully, set it into its case and took up his gum elastic tube.

  “Now then, onto your left side.” He guided Alexis with his hands. “There now. The elastic tube.”

  Alexis let out a small whimper.

  “Tell me if the sinking feeling happens.”

  Beaumont carefully inserted the tube, taking care not to rub the tender cuticle of the hole's margin.

  “Really, Alexis, this is minor,” he remarked. “Remember that first autumn after the shooting? When the wound started expelling pieces of shot and clothing? You once coughed up a button.”

  Alexis nodded.

  Within two minutes the slow trickle of juice began to flow. Beaumont gently moved the tube back and forth, in and out, as the trickle continued. After a few minutes Alexis moaned. He told the lad to bear with him, and in another minute he withdrew the tube. The vial contained some three ounces of clear gastric juice.

  “Stay please, lad.”

  Beaumont stepped quickly to the kitchen hearth. He set a piece of boiled and recently salted beef into the vial, corked the vial tight and nestled it into the sand bath as far as the cork. Then he returned to Alexis, who lay with one leg flexed and rocking slowly to and fro, the other stretched out.

  “Now then,” Beaumont said, and he straightened out Alexis's leg. He eased his forefinger into the cavity, then followed this with a piece cut from the same beef, precisely the same size and shape, tied neatly as a gift box with a piece of silk thread. As before, he let the piece fall into the cavity, let the flap of tissue close and wrapped the length of string outside the cavity around the curved mahogany piece.

  “That's all. Why don't you put on your shirt, and we can have look in about an hour? Alexis?”

  “Maybe I just lie here.”

  He patted Alexis's thigh. “Whatever you wish. I shall be out in the kitchen.”

  He checked the vial in the sand bath regularly. It was evident after forty minutes that digestion had commenced over the surface of the beef. After ten more minutes the fluid had become quite opaque and cloudy. He had to uncork the vial to inspect the beef. Its surface was quite loose.

  When Beaumont returned to inspect the gastric digestion of the beef, he found Alexis lying upon his side running his index finger slowly along the seams of the wall. Beaumont ordered him onto his back and withdrew the string. The beef was as much affected by digestion as that in the vial. He leaned close to the aperture and sniffed. The smell was clean. Not putrid. The tissue of the gastric lining was pink and glistening. He returned the beef to the cavity.

  One hour later, the muscular fibers of the beef in the vial were reduced to small, loose, unconnected shreds. He took a few fibers into the palm of his hand: they were tender and soft. He returned them to the vial and corked it.

  When Beaumont withdrew the string from Alexis's cavity, all that remained were the two loops that had once held the beef snug like some queer hangman's double noose.

  These were glorious proofs that the process of digestion was not simply grinding and certainly not fermentation or putrefaction. It was chemical. And boiled beef was just the first test. There were other foods: salted beef, beef à la mode, roasted beef, chicken, both boiled and roasted, venison, salted cod and a variety of vegetables as well. Milk and eggs. Certainly spirituous liquors too.

  TWENTY-FOUR

  HE WOULD HAVE DONE MORE EXPERIMENTS. He had sketched out detailed plans to observe the temperature of the stomach and regularly sample the chyme and its temperature. But in that first week of June he received a letter announcing that an inspector from the surgeons' corps was making the rounds of the Northern territories. Dr. Lyman Foote would arrive within the month.

  Elias and he prepared the hospital. They used pine tar to caulk the seams and replaced several rotting floorboards. Beaumont convinced the quartermaster to give him two new cots to replace those that were broken beyond repair. They inventoried their supplies, swept out all the cabinets, dusted all their bottles and jars and used this occasion to prepare a fresh set of medicinals from the garden.

  Dr. Lyman Foote arrived midday aboard the regal steamship Saratoga. Surgeon in the U.S. Army, Fellow of the College of Physicians of Philadelphia, and Correspondent of the Lyceum of Natural History, New York, he was nearing the end of his four-month tour inspecting the garrison hospitals of the Northern territories. Authorized by Congress and appointed by his friend and Harvard classmate Surgeon General Joseph Lovell, he traveled with an aide, a deferential corporal, pox marked and with crooked yellowed teeth, who lugged along a much-used lap desk.

  ON THE EVENING OF FOOTE'S ARRIVAL, Captain Pearce hosted a dinner in his honor. The officers, officials of the company, village leaders and Foote assembled in the officers' mess. Soldiers butlered platters of drinks and savories. When the room grew noisy and hot, the windows were flung open, and more bottles were decanted. Moths fluttered across the ceiling, and a full moon illuminated the room. The fort glowed like a phosphorescent castle.

  After more than an hour of conversation fueled by drinks and food, the men were garrulous and at ease in conversation and laughter. It took several minutes to get them to settle at the long table. Once seated, order was briefly restored when Captain Pearce tapped his knife blade gently upon his claret glass.

  “Reverend James,” he intoned.

  The reverend scratched his arms and placed his thin hands together. Every man bowed his head.

  “Dear Lord, bless this gathering of your humble servants and the journey of our guest, Dr. Foote.”

  When the reverend finished, Pearce snapped his chin up, thanked the reverend briskly and raised his claret glass.

  “Gentlemen, let me commence with the first toast of the evening. To the United States Army and to our distingu
ished guest, Surgeon Hyman Flute.”

  Some swilled. Others sipped carefully.

  There were courses of meats, fishes and vegetables. A fresh-slaughtered steer in a wild mushroom gravy, roasted guinea fowl glazed with citrus and molasses, varieties of squash baked with honey and butter, white potatoes mashed with chestnuts, cabbages, three kinds of wine and lake trout caught that very afternoon in Mackinac harbor.

  Several of the guests queried Foote about steamship travel. Others joined in with their opinions on the future of transport in America. One wondered if there were any new inventions to create. Still another said he had heard of steamships that could travel on land.