Continuing upward outside the upper jaw and possibly fracturing the cheekbone, it passed behind the left eye, through the left side of the brain, then completely out the top of the skull through the frontal bone. Rocketed from the hole, the tamping iron- 1 + 1⁄ 4 inches (3.2 cm) in diameter, three feet seven inches (1.1 m) long, and weighing 13 + 1⁄ 4 pounds (6.0 kg)-entered the left side of Gage's face in an upward direction, just forward of the angle of the lower jaw. Looking over his right shoulder, and inadvertently bringing his head into line with the blast hole and tamping iron, Gage opened his mouth to speak in that same instant the tamping iron sparked against the rock and (possibly because the sand had been omitted) the powder exploded. Panel from Bring Me the Head of Phineas Gage, a portrayal of Gage in popular culture Īs Gage was doing this around 4:30 p.m., his attention was attracted by his men working behind him. a shrewd, smart business man, very energetic and persistent in executing all his plans of operation", : 13-4 he had even commissioned a custom-made tamping iron-a large iron rod-for use in setting explosive charges. : 18-22,32n9 His employers' "most efficient and capable foreman . : 17-8 In July 1848 he was employed on construction of the Hudson River Railroad near Cortlandt Town, New York, : 643 and by September he was a blasting foreman (possibly an independent contractor) on railway construction projects. Gage may have first worked with explosives on farms as a youth, or in nearby mines and quarries. : 4 (In the pseudoscience of phrenology, which was then just ending its vogue, nervo-bilious denoted an unusual combination of "excitable and active mental powers" with "energy and strength mind and body possible the endurance of great mental and physical labor".) : 346-7 : 6 Physician John Martyn Harlow, who knew Gage before his accident, described him as "a perfectly healthy, strong and active young man, twenty-five years of age, nervo-bilious temperament, five feet six inches in height, average weight one hundred and fifty pounds, possessing an iron will as well as an iron frame muscular system unusually well developed-having had scarcely a day's illness from his childhood to the date of injury". Little is known about his upbringing and education beyond that he was literate. Gage was the first of five children born to Jesse Eaton Gage and Hannah Trussell (Swetland) Gage of Grafton County, New Hampshire. A social recovery hypothesis suggests that his work as a stagecoach driver in Chile fostered this recovery by providing daily structure that allowed him to regain lost social and personal skills.Ĭavendish, Vermont, 20 years after Gage's accident: (a) Region of the accident site (t) Gage's lodgings, to which he was taken after his injury (h) Harlow's home and surgery. Historically, published accounts of Gage (including scientific ones) have almost always severely exaggerated and distorted his behavioral changes, frequently contradicting the known facts.Ī report of Gage's physical and mental condition shortly before his death implies that his most serious mental changes were temporary, so that in later life he was far more functional, and socially far better adapted, than in the years immediately following his accident. Despite this celebrity, the body of established fact about Gage and what he was like (whether before or after his injury) is small, which has allowed "the fitting of almost any theory to the small number of facts we have" : 290 -Gage acting as a " Rorschach inkblot" in which proponents of various conflicting theories of the brain all saw support for their views. Gage is a fixture in the curricula of neurology, psychology, and neuroscience, : 149 one of "the great medical curiosities of all time" and "a living part of the medical folklore" : 637 frequently mentioned in books and scientific papers : ch14 he even has a minor place in popular culture. Long known as the "American Crowbar Case"-once termed "the case which more than all others is calculated to excite our wonder, impair the value of prognosis, and even to subvert our physiological doctrines" -Phineas Gage influenced 19th-century discussion about the mind and brain, particularly debate on cerebral localization, : ch7-9 and was perhaps the first case to suggest the brain's role in determining personality, and that damage to specific parts of the brain might induce specific mental changes.
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