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What Part Of Phineas Gage’s Brain Was Damaged

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The Damage To Phineas Gage’s Brain

This can damage your personality | Phineas Gage story

Within weeks of Phineas Gage’s accident differences of opinion emerged among those who examined him about the extent and location of the damage to his skull and brain. Over time these differences increased. There are two problems: first, can the path of the tamping iron be estimated accurately from the damage to his skull, and, second, can the damage to his brain be inferred from that path?

Differences over the damage to 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 3.5 inches long and 2 inches wide. 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.

Differences over the passage of the tamping iron

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 0.5 inches in front of the junction and 1 inch to the left of the mid line.

Jack Van Horn and his colleagues have since verified that the damage was left-sided.

Differences over the damage to the brain

What to make of the differences?

Extent Of Brain Damage

It is regretted that an autopsy could not have been had, so that the precise condition of the encephalon at the time of his death might have been known.

Video reconstruction of tamping iron passing through Gage’s skull

Debate about whether the trauma and subsequent infection had damaged Gage’s left and right frontal lobes, or only the left, began almost immediately after his accident. The 1994 conclusion of Hanna Damasio et al., that the tamping iron did physical damage to both lobes, was drawn not from Gage’s skull but from a cadaver skull digitally deformed to match the dimensions of Gage’s:829-30:1103-4and made a priori assumptions about the location of Gage’s internal injuries and the exit wound which in some cases contradict Harlow’s observations.:77-82 Using CT scans of Gage’s actual skull, Ratiu et al.:638 and Van Horn et al.:4-5,22 both rejected that conclusion, agreeing with Harlow’s beliefbased on probing Gage’s wounds with his fingersthat only the left frontal lobe had been damaged.

In addition, Ratiu et al. noted that the hole in the base of the cranium has a diameter about half that of the iron itself combining this with the hairline fracture beginning behind the exit region and running down the front of the skull, they concluded that the skull “hinged” open as the iron entered from below, then was pulled closed by the resilience of soft tissues once the iron had exited through the top of the head.:640:830

How Did Phineas Gage’s Personality Change

How did Phineas Gage’s personality change?

From Harlowâs written account, Gage was considered to be fully recovered and felt fit enough to reapply for his previous role as a foreman.

However, his contractors, who had regarded Gage as âefficient and capableâ before the accident, could no longer offer him work due to considerable changes in Gageâs personality. Marlow described him as follows:

“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 , 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, though untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart business man, 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 âno longer Gage.” .

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Damaged Connections In Phineas Gage’s Brain: Famous 1848 Case Of Man Who Survived Accident Has Modern Parallel

Date:
University of California, Los Angeles , Health Sciences
Summary:
In 1848, Phineas Gage survived an accident that drove an iron rod through his head. Researchers, for the first time, used images of Gages skull combined with modern-day brain images to suggest there was extensive damage to the white matter pathways that connected various regions of his brain.

Poor Phineas Gage. In 1848, the supervisor for the Rutland and Burlington Railroad in Vermont was using a 13-pound, 3-foot-7-inch rod to pack blasting powder into a rock when he triggered an explosion that drove the rod through his left cheek and out of the top of his head. As reported at the time, the rod was later found, “smeared with blood and brains.”

Miraculously, Gage lived, becoming the most famous case in the history of neuroscience — not only because he survived a horrific accident that led to the destruction of much of his left frontal lobe but also because of the injury’s reported effects on his personality and behavior, which were said to be profound. Gage went from being an affable 25-year-old to one that was fitful, irreverent and profane. His friends and acquaintances said he was “no longer Gage.”

Van Horn found that nearly 11 percent of Gage’s white matter was damaged, along with 4 percent of the cortex.

Van Horn noted a modern parallel.

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What Phineas Gages Injury Taught Us About Frontal Lobes

my psychology journal: Phineas Gage

In 1848, Phineas Gage, a 25 year old railroad worker, unwittingly became a benchmark of modern neuroscience. Gage was using a tamping iron to pack explosives when a spark ignited the explosive charge, propelling the iron rod through his cheek, behind his eye socket, then upwards through his brain, finally exiting the top of his skull, and landing some distance away. Gage survived, despite the fact that the tamping iron had destroyed much of his left frontal lobe.

While it is reported that Gage never lost consciousness following the accident, his once even-tempered personality changed dramatically thereafter, as noted by John Martyn Harlow, the physician who treated him. Gages case became a text book example of how an injury to the brain can produce a change in personality. However, it was also reported that the personality change was temporary and that Gage was able to resume working and normal activity until his death in 1860, 12 years post-injury, as a result of a seizure.

Gages case has been studied ever since his death. Most recently, in 2012, researchers combined CT scans of Gages skull with MRI scans of typical brains to study how Gages brain function could have been affected by the injury he suffered.

Phineas Gage is proof positive that someone can sustain a traumatic brain injury, despite not losing consciousness.

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Phineas Gage’s Impact On Psychology

Gage’s case had a tremendous influence on early neurology. The specific changes observed in his behavior pointed to emerging theories about the localization of brain function, or the idea that certain functions are associated with specific areas of the brain.

In those years, neurology was in its infancy. So, Gage’s extraordinary story served as one of the first sources of evidence that the frontal lobe was involved in personality.

Today, scientists better understand the role that the frontal cortex has to play in important higher-order functions such as reasoning, language, and social cognition.

News Of Gages Accident

The above news clipping appeared in the Boston Post on September 21, 1848.

The article states:

Horrible Accident As Phineas P. Gage, a foreman on the railroad in Cavendish, was yesterday engaged in tamping for a blast, the powder exploded, carrying an instrument through his head an inch in length, which he was using at the time. The iron entered on the side of his face, shattering the upper jaw, and passing back of the left eye, and out at the top of the head.

The most singular circumstance connected with this melancholy affair is, that he was alive at two oclock this afternoon, and in full possession of his reason, and free from pain.

The piece contains a few inaccuracies, including suggesting that Gages jaw was shattered and understating the dimensions of the projectile. His attending doctor, John Martyn Harlow, kept notes on the case as it progressed, which he later published. While he described Gage as conscious and rational in the immediate aftermath of the accident, the man was certainly not free from pain as the above article suggested. In the days and weeks that followed, Gage would lapse into a state of delirium, followed by a semi-comatose state brought on by an infection.

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Living With Half A Brain: Phineas Gage

The Warren Medical Museum in Boston is a fascinating place, named after Dr. John Collins Warren who performed the first surgery under ether anesthesia in 1846. On view is the actual flask that housed the ether used during the surgery. Also on display is the famous meter long rod that passed completely through the skull of railroad company worker Phineas Gage in 1848 without killing him. It did, however, dramatically alter his personality.

The unfortunate event turned out to be a landmark in the history of neurology, demonstrating that different parts of the brain had different functions. Apparently, catastrophic injury to the frontal lobes of the brain could be sustained without causing significant neurological deficits, but not without affecting behaviour. To this day, a memorial plaque marks the spot where the spectacular accident occurred on September 13, 1848 in Cavendish, Vermont.

After Phineas P Gage Took An Iron Tamping Rod Through His Skull In 1848 His Personality Changed Drastically In A Baffling Case That Helped Give Birth To Modern Neuroscience

Lessons of the brain: the Phineas Gage case

Wikimedia Commons Phineas Gage after his accident.

On September 13, 1848, Phineas Gage was working on the side of a railroad, outside Cavendish, Vermont.

He was part of a crew blasting rock out of the way for new tracks to be laid down. His job, specifically, was to pack the rock full of blasting powder and then use a tamping iron, a three-foot-long, 1 1/4 inch wide iron bar, to tamp it down.

Around 4:30 PM, Gages attention was momentarily pulled from his work by the men working behind him. As he leaned forward and looked over his left shoulder to speak to them, the tamping iron sparked against the rock, exploding the powder in the hole.

The tamping iron flew out of the hole, into Gages left cheek, through the roof of his mouth, into his brain, and out through the top of his head.

Gage was thrown to the ground, twitching.

After a few minutes though, miraculously, Gage started speaking. Then, he started walking and eventually was able to sit upright in his oxcart for the three-quarter mile journey back to his hotel.

The doctor who was called about 30 minutes after the accident, Edward H. Williams, was slow to believe the tale of Gages incredulous mishap.

However, when he found Gage sitting upright in a chair outside of his hotel, talking to those around him while his brain was visibly pulsing through the open wound in his head.

Williams found he no longer needed much convincing.

Wikimedia CommonsPhineas Gages skull on display after his death.

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Phineas Gage Life Mask

Prior to the 2009 and 2010 discovery of photographs of Phineas Gage, the only existing depiction that existed was a life mask made of his face and skull. The life mask was made for Henry Jacob Bigelow sometime around 1849 or 1850. Bigelow was a surgeon and professor at Harvard who published an article in American Journal of the Medical Sciences on Gages case, which helped generate considerable attention. Today, the life mask can be seen at the Warren Anatomical Museum at the Harvard University School of Medicine.

What Happened To Phineas Gage

After the accident, Gage was unable to continue his previous job. According to Harlow, Gage spent some time traveling through New England and Europe with his tamping iron to earn money, supposedly even appearing in the Barnum American Museum in New York.

He also 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 a series of epileptic seizures, Gage died on May 21, 1860, almost 12 years after his accident. Seven years later, Gage’s body was exhumed and his brother gave his skull and the tamping rod to Dr. Harlow who subsequently donated them to the Harvard University School of Medicinewhere they are still exhibited in its museum today.

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Phineas Gage: The Man With A Hole In His Head

BBC World Service

“Phineas Gage had a hole in his head, and ev’ryone knew that he oughta be dead. Was it fate or blind luck, though it never came clear, kept keepin’ on year after year⦔

That song by banjo man Dan Lindner probably sounds like an outlandish myth, an old wives’ tale passed around a small town.

But incredibly, his jaunty tune about Phineas Gage is true.

He did have a hole in his head, and against all the conceivable odds, he should have been dead. But instead, his remarkable story changed the study of neuroscience forever.

A railway worker in Vermont, US, Phineas was responsible for clearing away rocks in order for railway tracks to be laid down.

For the biggest rocks, he would drill a hole and use an iron rod to tamp down explosives into the middle before lighting the fuse.

But on 13 September 1848, this relatively simple procedure took a vicious twist. Phineas’ iron rod apparently scraped the side of the rock, creating a spark which set off the gunpowder early.

It sent the iron – about 1m long and 3cm in diameter – straight up into his skull, driving through just under his left eye, and out of the top of his head, landing some 30m away.

Phineas was unconscious for a few moments before getting up and riding an oxcart into town with, the old banjo song continues, “a big bleedin’ hole in his head”.

The Influence Of Phineas Gage

Pin on Neuroscience

Gageâs case is important in the field of neuroscience. The reported changes in his behavior post-accident is strong evidence for the localisation of brain function, meaning that specific areas of the brain are associated with certain functions.

Neuroscientists have a better understanding today about the function of the frontal cortex. They understand that the frontal cortex is associated with functions of language, decision making, intelligence, and reasoning. Gageâs case became one of the first pieces of evidence suggesting that the frontal lobe was directly involved in personality.

It was believed that brain lesions caused permanents deficits to a person. However, Gage was proven to have recovered remarkably and live a mostly normal life despite his injury. It was even suggested by a psychologist called Malcolm Macmillan that Gage may have relearnt lost skills.

People with damage to their frontal lobes tend to have trouble completing tasks, get easily distracted and have trouble planning. Despite this damage to his frontal lobe, Gage was reported to have worked as a coach driver which would have involved Gage being focused and having a routine, as well as knowing his routes and multitasking.

Macmillan therefore suggests that Gageâs damage to the frontal lobe could have somewhat repaired itself and recovered lost functions. The ability for the brain to change in this way is called brain plasticity.

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Neuroscience Education Begins With Good Science: Communication About Phineas Gage One Of Neurologys Most

  • Faculty of Behavioral and Social Sciences, Theory and History of Psychology, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands

Phineas Gage is one of the most famous neurological patients. His case is still described in psychology textbooks and in scientific journal articles. A controversy has been going on about the possible consequences of his accident, destroying part of his prefrontal cortex, particularly with respect to behavioral and personality changes. Earlier studies investigated the accuracy of descriptions in psychology textbooks. This is, to my knowledge, the first analysis of journal articles in this respect. These were investigated with regard to four criteria: Description of personality changes, psychopathy-like behavior, alternative explanations besides the immediate brain damage, and Gages recovery. 92% of articles described personality changes, 52% of a psychopathy-like kind only 4% mentioned alternative explanations and 16% described Gages recovery. The results are discussed in the light of the available historical evidence. The article closes with several suggestions on improving science communication about the famous case.

Limitations Of Our Study

We have worked to provide a detailed, accurate, and comprehensive picture of the extent of damage from this famous brain injury patient and its effect on network connectivity. While the approach used here to model the tamping iron’s trajectory is precise and the computation of average volume lost across our population of subjects is reflective of the acute level of damage, we acknowledge that there was likely more damage than that caused by its presence alone. The iron likely propelled unrecovered bone fragments through the brain. The resulting hemorrhage from the wound was also considerable. Subsequent infection and a large abscess took further toll. Consequently, more GM and WM tissue may have been lost than estimated here. Like Damasio et al. and Ratiu et al., we make the assumption that Gage’s brain and its position within the skull can be estimated from the structure of the skull itself, and that its sub-regions, WM, and connective anatomy can be localized through population averaging. Such a supposition may have its limitations and could be open to debate. Nevertheless, ours represents the best current estimation as to the extent of brain damage likely to have occurred at the level of both cortex and WM fiber pathways. We also have no way of assessing the biochemical cascade of changes to biomarker proteins measureable post-injury in modern TBI patients which may also have influenced the trajectory of Mr. Gage’s recovery.

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