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Friday, September 4, 2015

Phineas Gage

During the mid 1800's a man by the name of Phineas P. Gage worked as the Foreman of a The Rutland and Burlington Railroad, near Cavendish, Vermont.  Phineas had a well earned reputation of having a very methodical mind, and was well respected for having a mind as "sharp as a tack" for both business and in supervising his crew. 

On Wednesdday, September 13, 1848, Phineas and his crew had prepared to ignite an explosive charge at the bottom of a borehole, as part of every day work in preparing a railbed,  by using a tamping iron.  

A tamping iron is a long, straight, metal rod, which is often described as being similar to a crowbar but without a curve or crook in it. More accurately, its appearance is like a javelin, being long and tapering down from 1 and 1/4 inches thick to a diameter of about 1/4 inch of solid iron.  It weighed about 13 and 1/2 pounds!

Actual tamping iron and skull of Phineas Gage
On that day, the tamping iron bore a hole 3 feet and 7 inches.  An unexpected spark caused an explosion - and the tamping iron was blown from the borehold - straight through Phineas' skull.  The tamping iron entered under the bone of his left cheek, passed behind his left eye and exited through the top of his head.  The iron was said to have landed some 80 or 90 feet away!  

"Gage "was thrown upon his back by the explosion, and gave a few convulsive motions of the extremities, but spoke in a few minutes", walked with little assistance, and sat upright in an oxcart for the 3⁄4-mile ride to his lodgings in town. About thirty minutes after the accident Dr. Edward H. Williams, finding Gage sitting in a chair outside the hotel, was greeted with "one of the great understatements of medical history"" -wiki

Dr. Edward H. Williams documented this statement::

"When I drove up he said, "Doctor, here is business enough for you." I first noticed the wound upon the head before I alighted from my carriage, the pulsations of the brain being very distinct. The top of the head appeared somewhat like an inverted funnel, as if some wedge-shaped body had passed from below upward. Mr. Gage, during the time I was examining this wound, was relating the manner in which he was injured to the bystanders. I did not believe Mr. Gage's statement at that time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through his head. Mr. G. got up and vomited; the effort of vomiting pressed out about half a teacupful of the brain, which fell upon the floor."

Dr. John Martin Harlow, a physician from Cavendish, then attended Phineas Gage for 3 months until Gage returned home to Lebanon, New Hampshire.  Dr. J.M. Harlow found this to be a unique opportunity to study neuroscience, and to document the affects of an individual having survived such severe brain damage and subsequently the profound personality changes as the result of such an accident.  

Dr. J. M. Harlow
Harlow published a medical report in 1848, contributing to modern neurology, but it was largly unpopular among his peers.  During this time, science of the brain was in its infancy and many important written medical contributions were being made by other's in the field of neuroscience, psycho-pathology, and psychology.  The case of Phineas Gage, regained popularity when Harlow published another medical report in 1868, this time citing the profound personality changes which connected neuroscience to specific traits of behavior.  

Today there exists few facts and one may have difficulty separating fact from fiction, but what is known, is that Phineas Gage was brought back to work as foreman, but he was forever changed.  The once steadfast, serious man had returned as a shadow of himself.  It is reported that he took to swearing and cussing, and could not perform his regular duties.  According to his most accounts from his family and friends, he was "No longer Gage".

Phineas Gage, with famous tamping iron
So, Phineas took odd jobs to include traveling through New England and Europe with his tamping iron in order to earn money, and it is said that he appeared in the Barnum American Museum in New York. This is not 100% verified. 

He worked briefly at a livery stable in New Hampshire and then spent seven years as a stagecoach driver in Chile. He eventually moved to San Francisco to live with his mother as his health deteriorated. After suffering a series of epileptic seizures, Gage died on May 20, 1860, almost 13 years after his accident.

Seven years after his death, Gage's body was exhumed from San Francisco's Lone Mountain Cemetery.  His skull and the tamping rod were taken to Dr. Harlow, and later donated to the Warren Museum at Harvard University's School of Medicine, where they remain on display.

"The case created a good deal of interest in both medical and lay circles at the time and which continues to this day. Gage had survived a horrendous injury; his case began to have an influence on the science of localization of brain function. For nearly twenty years knowledge of the profound personality change was not widely disseminated. It was true that he was physically unchanged except for obvious scars, and that his mental capacity was unchanged."

"But, without knowledge of the personality difference, most people thought he had survived totally unchanged. His case was therefore used as evidence against the doctrine that any functions were localized in the brain, especially against the phrenological version of it. Later it was also used as negative evidence in the medical debates regarding aphasia and frontal lobe function. The real story was published after 1868 by David Ferrier, the notable English doctor and physiological research worker. Even today, the case continues to generate controversy." - virtualvermont.com

Photo Credits: All photos and images found on Google Images