3.4 Essay Phineas Gage

The Accident Phineas

Gage was an American railroad construction foreman born in 1823. On September 13th, 1848, when Gage was 25 years old, he was working in Cavendish in Vermont, leading a crew which were preparing the Rutland and Burlington Railroad by blasting rocks to make a roadbed.

This was done by using an iron tamping rod to pack the explosive powder into a hole. Whilst Gage was doing this however, the powder detonated and the tamping iron he was using launched from the hole and entered the left side of Gage’s face from the bottom up.

The iron rod (which was 43 inches long and 1.24 inches in diameter) penetrated Gage’s left cheek, travelling behind his left eye and entered through his left side brain and exited his skull, landing 80 feet away.

After the incident, Gage was thrown onto his back from the force of the iron rod and had some brief convulsion of the arms and legs. Within a few minutes however, Gage was able to get himself up, speak and walk with small assistance to a nearby cart so he could travel into town.

A physician called Dr Edward H. Williams attended to Gage and reported that he could see ‘the pulsations of the brain being very distinct. The top of the head appeared somewhat like an inverted funnel. Williams claimed that Gage was recounting his injuries to bystanders and he did not initially believe the story, thinking that Gage was ‘deceived’. Apparently, Gage had greeted Williams by angling his head at him and saying, ‘Here’s business enough for you.’

Williams recalled that Gage vomited which lead to about a teacupful of his brain to fall upon the floor from the hole at the top of his skull.

After the Accident

Dr John Martyn Harlow took over the case of Gage soon after. Harlow (1848) reported that Gage was fully conscious and recognized Harlow at once but was tired from the bleeding.

In the next couple of days, Harlow observed that Gage spoke with some difficulty but could name his friends and the bleeding ceased. Gage then spent September 23rd to October 3rd in a semi-comatose state but then was able to take steps out of bed by October 7th.

By October 11th, Harlow claimed Gage’s intellectual functioning began to improve, he recognized how much time had passed since the accident and could describe the accident clearly.

Four years after his injury, Gage moved to Chile and worked in taking care of horses and being a stagecoach driver. In 1860, he moved to San Francisco, California where his mother and sister lived and was suffering from an illness, of which Harlow did not know the nature of.

On May 21st, 1861, twelve years after his accident, Gage died after having a series of repeated epileptic convulsions. Seven years after Gage’s death, his body was unearthed and his skull and the iron rod were given to Harlow and to this day, both are on display at the Harvard School of Medicine.

Phineas Gage’s Personality Change

From Harlow’s 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 ‘efficient and capable’ before the accident, could no longer offer him work due to considerable changes in Gage’s 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 (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." (Harlow, 1868).

"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 ‘no longer Gage." (Harlow, 1868).

Through Harlow’s reports, it can be suggested that Gage’s personality changed due to the accident he endured. The accounts imply that the injury lead to a loss of social inhibition, meaning that Gage would behave in ways which were considered inappropriate.

Conclusion

All studies investigating the brain damage suffered by Gage is essentially all speculation as we cannot know for certain the extent of the accident’s effects. We know that some brain tissue got destroyed, but any infections Gage may have suffered after the accident may have further destroyed more brain tissue.

We also cannot determine the exact location that the iron rod entered Gage’s skull to the millimeter. As brain structure varies from person to person, researchers cannot ever know for certain what areas of Gage’s brain were destroyed.