Phineas P. Gage
Phineas Gage's death mask
Born	1823
Died	May 21, 1860
Occupation	railroad worker

Phineas P. Gage (1823 – May 21, 1860) was a railroad construction foreman who suffered a traumatic brain injury when a tamping iron accidentally passed through his skull, damaging the frontal lobes of his brain. This injury is supposed to have negatively affected his emotional, social and personal traits—leaving him in a temperamental and unsociable state, so much so that his friends said he was "no longer Gage". 1823 was a common year starting on Wednesday (see link for calendar). ... is the 141st day of the year (142nd in leap years) in the Gregorian calendar. ... 1860 is the leap year starting on Sunday. ... Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ... The frontal lobe is an area in the brain of mammals. ... In psychology and common terminology, emotion is the language of a persons internal state of being, normally based in or tied to their internal (physical) and external (social) sensory feeling. ... Social refers to human society or its organization. ... Personality psychology is a branch of psychology which studies personality and individual differences. ...

At the time of its report to the scientific community, Gage's condition led to changes in the scientific perception of the function and compartmentalisation of the brain with regards to emotion and personality. Gage's case is cited as among the first evidence suggesting that damage to the frontal lobes could alter aspects of personality and affect socially appropriate interaction. Before this time the frontal lobes were largely thought to have little role in behavior.

Gage's injury

On September 13, 1848, Phineas P. Gage was working outside the small town of Cavendish, Vermont on the construction of a railroad track where he was employed as a foreman. One of his duties involved filling the hole with gunpowder, adding a fuse, and then packing in sand with the aid of a large tamping iron. Gage was momentarily distracted and forgot to pour the sand into one hole. Thus, when he went to tamp the sand down, the tamping iron sparked against the rock and ignited the gunpowder, causing the iron to be blown through Gage's head with such force that it landed almost thirty yards (27 meters) behind him. Image File history File links No higher resolution available. ... is the 256th day of the year (257th in leap years) in the Gregorian calendar. ... Year 1848 (MDCCCXLVIII) was a leap year starting on Saturday (link will display the full calendar) of the Gregorian Calendar (or a leap year starting on Monday of the 12-day slower Julian calendar). ... Cavendish, Vermont Cavendish is a town located in Windsor County, Vermont. ... This is the top-level page of WikiProject trains Rail tracks Rail transport refers to the land transport of passengers and goods along railways or railroads. ... Smokeless powder Gunpowder is a pyrotechnic composition, an explosive mixture of sulfur, charcoal and potassium nitrate that burns rapidly, producing volumes of hot gas which can be used as a propellant in firearms and fireworks. ...

The three foot (1 m) long tamping iron with a diameter of 1.25 inches (3.2 cm) weighing thirteen and a half pounds (6.12 kg) entered his skull below his left cheek bone and exited after passing through the anterior frontal cortex and white matter. Whether the lesion involved both frontal lobes, or was limited only to the left side, remains a matter of controversy. Remarkably, after such a traumatic accident, Gage regained consciousness within a few minutes, was able to speak, and survived a 45-minute ride back to his boarding house while sitting in a cart. For other uses, see Cortex. ... White matter is one of the two main solid components of the central nervous system. ... The frontal lobe is an area in the brain of mammals. ...

As the doctor arrived, he was reportedly conscious, and had a regular pulse of about 60 beats per minute; however, he was getting exhausted from the hemorrhage, which was very profuse.

His left pupil was still reacting to direct light (and stayed that way for the following 10 days), which indicates that the left optic and oculomotor nerves were still functioning, supporting the hypothesis that the tamping iron must have passed laterally to the left optic nerve. After a seemingly complete recovery from such a serious injury, Gage was soon back at work.

While studies by Hanna Damasio and colleagues suggested a bilateral damage to the medial frontal lobes,^[1] a recent study by Ratiu and colleagues based on a CT scan of Gage's skull suggests that the extent of Gage's brain injury must have been more limited than previously thought.^[2] The frontal lobe is an area in the brain of mammals. ...

In the view of modern medical science, a bilateral damage of the frontal brain by a projectile measuring 1.25 inches in diameter and weighing thirteen pounds, would unlikely be compatible with survival, since this would imply an extensive damage to vital vascular structures, such as the superior sagittal sinus (however, the rod did not emerge exactly in the midline, and may have missed the sinus by passing beneath it). Nevertheless, Gage survived the traumatic event and complications by a fungal infection and over-exercise. Gage later reportedly developed personality changes. The superior sagittal sinus lies within the superior border of the falx cerebri, a two-layered dural structure separating the two cerebral hemispheres. ...

Effect on Gage

Wikisource has original text related to this article:

Passage of an Iron Rod Through the Head

Diagram appearing in 1868 journal article, described as: "Front and lateral view of the cranium, representing the direction in which the iron traversed its cavity; the present appearance of the line of fracture, and also the large anterior fragment of the frontal bone, which was entirely detached, replaced and partially re-united."

Gage had complications from a fungal infection which left him in a "semi-comatose state" from September 23rd to October 3rd, "seldom speaking unless spoken to, and then only answering in monosyllables." From October 4th onwards, he began improving, and took his first step on October 7th.^[3] On October 20th, Harlow described Gage as "very childish" and stated that Gage "wishes to go home to Lebanon [New Hampshire]". When Harlow left for a week, Gage left the house every day except Sunday, and was making plans to go home to Lebanon, being "uncontrollable by his friends". He subsequently became sick with a fever, and recovered from that by November 17th, at which time he reported no pain in the head. Harlow's final remarks include the statement that "he appears to be in a way of recovering, if he can be controlled".^[3] Image File history File links Wikisource-logo. ... The original Wikisource logo. ... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ...

According to Gage's doctor, Dr. J.M. Harlow, whereas previously he had been hard-working, responsible, and popular with the men in his charge, his personality seemed to have been radically altered after the accident. In 1868, his doctor reported that:

Some months after the accident, probably in about the middle of 1849, Phineas felt strong enough to resume work. But because his personality had changed so much, the contractors who had employed him would not give him his place again.

When he was well enough again in or around 1850, he spent about a year as a sideshow attraction and at P. T. Barnum's New York museum, putting his injury, and the tamping iron which caused it, on display to anybody willing to pay for the show. He then worked as an assistant in New Hampshire and, for nearly seven years, as a coach driver in Chile. When his health started to fail in 1859, he returned to San Francisco, where he lived with his mother and, for some months before his death, was employed as a farm worker. In 1860, he began to have epileptic seizures and died a few months later. Phineas Taylor Barnum Phineas Taylor Barnum by Mathew Brady 1856 newspaper advertisement for Barnums American Museum Parody of Jenny Linds first American tour for P.T. Barnum, New York City, October 1850 Wikiquote has a collection of quotations related to: P. T. Barnum Phineas Taylor Barnum (July 5...

Significance for neuroscience

This computer generated graphic, based on data from a "standard human skull", shows how the tamping rod may have penetrated Phineas Gage's skull, crossing the midline and damaging both frontal lobes, according to Damasio et al.

Gage's case is cited as among the first evidence suggesting that damage to the frontal lobes could alter aspects of personality and affect socially appropriate interaction. Before this time the frontal lobes were largely thought to have little role in behavior. Neurologist Antonio Damasio has written extensively on Gage, as well as on various patients he has studied which, in his personal view, had similar brain injuries. In a theory he calls the somatic marker hypothesis, Damasio suggests a link between the frontal lobes, emotion and practical decision making. He sees Gage's case as playing a crucial role in the history of neuroscience, arguing that Gage's story "was the historical beginnings of the study of the biological basis of behavior".^{[5][page # needed]} CGI image of rod piercing Phineas Gages skull taken from NINDS public domain page at http://www. ... CGI image of rod piercing Phineas Gages skull taken from NINDS public domain page at http://www. ... The seawater creature in The Abyss marked CGIs acceptance in the visual effects industry. ... The frontal lobe is an area in the brain of mammals. ... António C. R. Damásio (IPA: //) (b. ... The word theory has a number of distinct meanings in different fields of knowledge, depending on their methodologies and the context of discussion. ... The somatic-marker hypothesis (SMH)[1][2] proposes a mechanism by which emotional processes can guide (or bias) behavior, particularly decision-making. ...

It is occasionally suggested that Gage's case inspired the development of frontal lobotomy, a now-obsolete psychosurgical procedure that leads to a blunted emotional response and personality changes. However, historical analysis does not seem to support this claim. It seems that consideration of Gage's injury had little influence on the development of this practice.^[6] Look up Lobotomy in Wiktionary, the free dictionary. ... Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain, and thus effect changes in cognition, with the intent to treat or alleviate severe mental illness. ...

Criticism of popular story

There is no doubt that Gage suffered the accident, and that it had a dramatic impact on his life. However, in his book An Odd Kind of Fame: Stories of Phineas Gage, Australian psychologist Malcolm Macmillan casts serious doubts on the accuracy of the account that entered both scientific and popular discourse. First, very little is known about Gage's personality and habits before the accident; second, the post-traumatic psychological changes reported while Gage was still alive were much less dramatic than later reports assert.

Within twenty four hours of the accident, a first report was (anonymously) printed in the Ludlow, Vermont Free Soil Union. Having described the accident, the paper reports that "the most singular circumstance connected with this melancholy affair is, that he was alive at two o'clock this afternoon, and in full possession of his reason, and free from pain." Gage was popularly supposed to have later died in some way due to the damage in the frontal lobe, but the true cause of his death so many years later remains unclear.

Harlow mentioned very few psychological changes in his initial report of 1848. Henry Bigelow, Professor of Surgery at Harvard University, wrote in 1850 that Gage was "quite recovered in faculties of body and mind." It was Harlow's account from 1868, eight years after Gage's death, that introduced the now-textbook changes.^{[citation needed]} Later writers began to embellish even more,^{[attribution needed]} adding drunkenness, braggadocio, a vainglorious tendency to show off his wound as part of Barnum's Traveling Exhibition and an utter lack of foresight^[7] — all unmentioned by Harlow.^[8][4][3] Harvard redirects here. ...

Physical remains and legacy

Gage kept the rod which damaged him as a souvenir throughout his life, and it was buried with him in death. In 1867, when his skeleton was exhumed, the original rod was thus available with it. There is an inscription on the rod that reads, "[t]his is the bar that was shot through the head of Mr. Phineas P. Gage at Cavendish, Vermont, Sept. 14, 1848." But someone got the date wrong; the accident was on September 13, not 14. He fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard University. Phineas P. Gage Lebanon Grafton Cy N-H Jan 6 1850. ^[9] Gage's skull, as well as the rod that pierced it, is currently part of the permanent exhibition at Harvard Medical School's Warren Anatomical Museum in Boston, Massachusetts. The University of Wisconsin-Madison replicated the Phineas Gage skull at half scale ^[10] Harvard Medical School (HMS) is one of the graduate schools of Harvard University. ... The Warren Anatomical Museum, located at Harvard Medical School in Boston, was founded in 1847 by Dr. John Collins Warren, a professor at the university and a collector of unusual anatomical and pathological specimens. ... Nickname: City on the Hill, Beantown, The Hub (of the Universe)1, Athens of America, The Cradle of Revolution, Puritan City, Americas Walking City Location in Massachusetts, USA Counties Suffolk County Mayor Thomas M. Menino(D) Area    - City 232. ... This article is about the U.S. state. ...

See also

• Cognitive neuropsychology
• HM (patient)
• Clive Wearing
• Michael Hill
• Ahad Israfil

== ISABEL IS COOL AND SHE LOVES COGNITIVE NEUROPSYCHOLOGY!!!!!!!!! == Cognitive neuropsychology is a branch of neuropsychology that aims to understand how the structure and function of the brain relates to specific psychological processes. ... HM (also known as H.M. and Henry M., born 1926 in Connecticut) is an anonymous memory-impaired patient who has been widely studied since the late 1950s and has been very important in the development of theories that explain the link between brain function and memory, and in the... Clive Wearing (born 1938) is a British musicologist, conductor, and keyboardist suffering from an acute and long lasting case of anterograde amnesia. ... Michael Hill is notable for having survived an attack on April 25, 1998, when an anonymous person brutally stabbed him in the skull. ... Ahad Israfil is a gunshot victim from Dayton, Ohio, famous for his remarkable recovery from an injury that led to the loss of almost half his brain (one cerebral hemisphere). ...

References

1. ^ Damasio H., Grabowski T,. Frank R., Galaburda AM., Damasio AR. (1994). "The return of Phineas Gage: clues about the brain from the skull of a famous patient.". Science 264 (5162): 1102-5.
2. ^ Ratiu P, Talos IF, Haker S, Lieberman S, Everett P (2004). "The tale of Phineas Gage, digitally remastered". Journal of Neurotrauma 21 (5): 637-43.
3. ^ ^{a b c} Harlow, J.M. (1848). "Passage of an iron rod through the head". Boston Medical and Surgical Journal 39: 389-393. (Republished in Journal of Neuropsychiatry and Clinical Neuroscience., 11, 281-283)
4. ^ ^{a b} Harlow, J.M. (1868). "Recovery from a Passage of an Iron Bar through the Head". Publications of the Massachusetts Medical Society 2: 327-347.
5. ^ Antonio R. Damasio (1995) Descartes' Error: Emotion, Reason, and the Human Brain. ISBN 0-380-72647-5.
6. ^ Macmillian, M.. Analysis of Gage's influence on psychosurgery. Retrieved on 2007-06-02.
7. ^ Macmillian, M.. Phineas Gage's Story. Retrieved on 2007-06-06.
8. ^ Bigelow, H.J. (1850). "Dr Harlow's case of Recovery from the passage of an Iron Bar through the Head.". The American Journal of the Medical Sciences 20: 13-22.
9. ^ Macmillan, M. Corrections to An odd kind of fame. Retrieved on June 2, 2007.
10. ^ Kelley, D. Creating Physical 3D Stereolithograph Models of Brain and Skull. Retrieved on November 1, 2007.

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 153rd day of the year (154th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 157th day of the year (158th in leap years) in the Gregorian calendar. ... The American Journal of the Medical Sciences is an American general medical journal. ... is the 153rd day of the year (154th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 305th day of the year (306th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ...

Further reading

• Antonio R. Damasio (1995) Descartes' Error: Emotion, Reason, and the Human Brain. ISBN 0-380-72647-5.
• J. Fleischman (2002) Phineas Gage: A Gruesome but True Story About Brain Science. ISBN 0-618-05252-6
• M. Macmillan (1986) "A wonderful journey through skull and brains: The travels of Mr. Gage's tamping iron" Brain and Cognition 5(1): 67-107 doi:10.1016/0278-2626(86)90062-X
• M. Macmillan (2000), "Restoring Phineas Gage: A 150th retrospective," Journal of the History of the Neurosciences, 9(1): 42-62. DOI 10.1076/0964-704X(200004)9:1;1-2;FT046
• M. Macmillan (2002) An odd kind of fame: Stories of Phineas Gage. ISBN 0-262-63259-4.
• Kelley DJ, Farhoud M, Meyerand ME, Nelson DL, Ramirez LF, et al. (2007) Creating Physical 3D Stereolithograph Models of Brain and Skull. PLoS ONE 2(10): e1119. doi:10.1371/journal.pone.0001119

Antonio R. Damasio, GOSE (IPA: ) (b. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

• Malcolm Macmillan, The Phineas Gage Information page, School of Psychology, Deakin University. Victoria. Australia
• Phineas Gage roadside memorial
• Fact sheets on brain injury and personal stories from survivors
• House for Phineas Gage, sculpture
• Phineas Gage's injury digitally remastered at Google video.
• Phineas Gage Skull Replication

Deakin University is a large Australian public university with around 32,000 students studying Bachelor, Masters, Doctoral and Professional programs as of 2004. ... Google Video logo Google Video is a free video sharing and video search engine service from Google that allows anyone to upload video clips to Googles web servers as well as make their own media available free of charge; some videos are also offered for sale through the Google...

In popular culture

• UK band Phineas Gauge located in Los Angeles sings Irish drinking songs, is named after him.