Wednesday, 4 September 2013

The Curious Case of Phineas Gage and the Rod That Pierced His Skull

On the morning of September 13th 1848, Phineas Gage, a railway worker was involved in a mishap. One that would change his life and personality as well as the fields of neurology and psychology.

Gage was involved in blasting rock at the time which involved boring a hole into the rock, adding blasting powder, a fuse, sand and finally compacting this all down the hole using a tamping iron, a long iron rod.

It is believed that Gage neglected to put sand in one bore hole and when tamping down the lack of sand allowed for the creation of sparks.

So ignited explosives + long iron bar come together and poor Phineas had his head right in the trajectory. The rod passed through the right side of his face, behind the eye and out the top of his head. The 32 mm diameter, 1 metre long rod was recovered 25 metres away and looking quite gruesome.

Despite the injury, he seemed to have small convulsions and then proceeded to talk normally. He then sat in the back of a cart and was transported to the nearest doctor.
Doctor Edward H. Williams noted:

"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."

Gauge's physical injuries healed over time, but people close to him noticed a distinct change in personality. Doctor John Martyn Herlow studied Phineas over a period of decades afterwards and reported:

"The equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifest­ing but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was "no longer Gage"."

In February 1860 Gage started to suffer seizures and died in May of that year, 12 years after his initial injury.


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