After Phineas regained his health he was anxious to work and found it on a farm in Santa Clara County, south of San Francisco. In February , he began to have epileptic seizures and, as we know from the Funeral Director's and cemetery interment records, he was buried on 23rd May Although Harlow gives the year as , the records show conclusively that it was Here, as elsewhere I have silently corrected Harlow's dates. This is the bar that was shot through the head of Mr.
Phinehas P. Gage at Cavendish, Vermont, Sept. Warren Anatomical Museum records discovered by Dominic Hall of the Countway Library since my book was published show that Phineas himself originally deposited the tamping iron in the Harvard Medical School Museum and asked for it to be returned in It also means that the tamping iron could not have been, as Dr. What I have summarised is almost all of what Harlow tells us about Phineas Gage.
The slightness of what he tells us seems to have encouraged the attribution to Gage of all sorts of fabulous psychological characteristics and an equally fabulous post-accident history. This is not surprising given that neither the Proceedings of the Massachusetts Medical Society nor Harlow's pamphlet version of his address are held in many of the world's libraries. Most of the accounts of Gage's life after are strange mixtures of slight fact, considerable fancy and downright fabrication.
These remarks are frequently elaborated into a Gage who drifts around aimlessly and is not interested in working or, if interested, is incapable of holding a job. Harlow replaced both flaps; the parietal rear reuniting so successfully that it is actually difficult to see from outside the skull. In summary, the main injury to Gage's skull was at the exit, where the tamping iron created an irregular area of damage about 3.
The main problem in estimating the trajectory of the iron is to know exactly through which part of each of these areas the iron passed. It is a problem that is most acute for the exit area on the top of the skull. John Martin Harlow and Edward Higginson Williams, the two physicians who saw Gage on the day of the accident, said nothing specific about the entry under the zygomatic arch or the damage at the base, but Harlow was definite that the tamping iron had emerged at the junction of the coronal and sagittal sutures, and in the midline.
Phelps, who examined Gage six weeks later, thought the point was about 0. Henry Jacob Bigelow apparently drew no conclusions from his examination of Gage late in , about a year after the accident, but when he drilled holes through a demonstration skull to show that the passage was possible, he may have arbitrarily placed the centre of the hole in the base 1 inch from its midline, and that of the exit to the front of the junction and to the right of the midline.
The differences were not resolved when Gage's skull was brought to Massachusetts in Harlow placed the entrance in the base of the skull 1. He was now rather less certain about where it emerged saying only that it was to the front of the junction and in the midline. Eugene Dupuy, in criticising the concept that different functions were localised in different parts of the brain, used John Barnard Swets Jackson's description, and possibly the photographs, from the Catalogue of the Warren Museum to conclude it had emerged frontally and to the left of the midline.
After later seeing the skull itself, he seemed to maintain the left sided point of emergence but now moved it to behind the junction. In developing his reply to Dupuy's criticism of his work on localisation, David Ferrier first judged Bigelow's placement of the entry in the base to be too far the left of the midline, and the exit too frontal and too far to the right. In an important later discussion he omitted mentioning an exit point; it was almost as if he had given up trying to determine one.
Stanley Cobb prepared a sketch in on the basis of a visual examination of the skull. He implied that the exit was between the frontal bones and that some right-sided damage had been caused.
Rick and Ken Tyler concluded from their CT study that all that could be specified was a range within which the tamping iron could have emerged. As can be seen on their scan below d , it included the area of total destruction so that the small area to the right of the midline marked one extreme limit of that range. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights.
Measure content performance. Develop and improve products. List of Partners vendors. Phineas Gage is often referred to as one of the most famous patients in neuroscience. He experienced a traumatic brain injury when an iron rod was driven through his entire skull, destroying much of his frontal lobe.
Gage miraculously survived the accident. However, his personality and behavior were so changed as a result that many of his friends described him as an almost different person entirely. On September 13, , the thenyear-old Gage was working as the foreman of a crew preparing a railroad bed near Cavendish, Vermont. He was using an iron tamping rod to pack explosive powder into a hole.
Unfortunately, the powder detonated, sending the inch-long and 1. The rod penetrated Gage's left cheek, tore through his brain, and exited his skull before landing 80 feet away. Gage not only survived the initial injury but was able to speak and walk to a nearby cart so he could be taken into town to be seen by a doctor. He was still conscious later that evening and was able to recount the names of his co-workers.
Gage even suggested that he didn't wish to see his friends since he would be back to work in "a day or two" anyway. Descriptions of Gage's injury and mental changes were made by Dr. John Martyn Harlow. Much of what researchers know about the case is based on Harlow's observations. After developing an infection, Gage then spent September 23 to October 3 in a semi-comatose state. On October 7, he took his first steps out of bed and by October 11 his intellectual functioning began to improve.
Harlow noted that Gage knew how much time had passed since the accident and remembered clearly how the accident occurred, but had difficulty estimating size and amounts of money. Within a month, Gage was well enough to leave the house. In the months that followed, Gage returned to his parents' home in New Hampshire to recuperate. How many midth-century men with a mangled eye and scarred forehead had their portrait taken holding a metal tool?
A tool with an inscription on it? The Wilguses had never noticed the inscription; after all, the daguerreotype measures only 2. Phinehas P. Harvard has not officially declared that the daguerreotype is of Gage, but Macmillan, whom the Wilguses contacted next, is quite certain.
Steve Twomey is based in New Jersey. He wrote about map and document thieves for the April issue of Smithsonian.
From the collection of Jack and Beverly Wilgus Image laterally reversed to show the features in the correct position since daguerreotype is a mirror image Jack and Beverly Wilgus, collectors of vintage photographs, no longer recall how they came by the 19th-century daguerreotype of a disfigured yet still-handsome man.
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