University of Michigan
Dr. Joel D. Howell
The first event took place in 1822 at Fort Mackinac, which today is known as Mackinac Island on northern Lake Huron in Michigan. Alexis St. Martin, a French-Canadian fur trapper, was standing outside of the general store when a shotgun blast accidentally struck him in the stomach. Ordinarily, this would have been a fatal wound, but St. Martin miraculously survived--but with a gastric fistula that permanently exposed the interior of his stomach.
William Beaumont, the post surgeon at Fort Mackinac, engaged in a series of experiments – purportedly 238 – to study human digestion. In one experiment, Dr. Beaumont would pull food in and out of the stomach to study digestion. In another, he would withdraw fluid from the stomach to observe digestion outside of the body. The experiments caused St. Martin considerable discomfort. He eventually returned to Canada, but returned later when the U.S. Army agreed to compensate him for some of his expenses. Today, the experiments would be called into question as having crossed ethical boundaries. Dr. Beaumont published the results from his experiments in a book that established the fundamental basics of our current beliefs about digestion. The experiments arguably mark the first example of gastrointestinal research in the United States.
The second historical event – the invention of the fiber-optic endoscope – also occurred in Michigan. At the University of Michigan, Basil Hirschowitz, MD, invented a flexible, fiber-optic instrument that could be used to look into the stomach, and perhaps even the duodenum. He first tried the invention on himself, and in 1957, he demonstrated it at the national meeting of the American Gastroscopic Society by reading a telephone directory through the new device.
The instrument was soon adopted for clinical use by physicians. Whether the fiber-optic machine was superior for visualizing the stomach was hotly debated, but what was very clear was that the fiber-optic tool was more comfortable for patients. By the mid-1960s, the fiber-optic invention had become the instrument of choice for gastrointestinal endoscopy. Many advances have since been made to the original instrument.
Dr. Howell is the Elizabeth Farrand Professor and a professor of internal medicine, history, and health management and policy at the University of Michigan, Ann Arbor. He has no financial disclosures.
