Neurologists have cited it as evidence in support their pet theories, and even creationists have been known to cite it as evidence that personality is not a product of brain function.Īccording to psychologist Malcolm Macmillan, however, many of the reports are inconsistent and unsubstantiated by the evidence. Despite this, the case of Phineas Gage has been used and abused ever since it first appeared. We actually know next to nothing about Gage's personality before the injury, so it is difficult to understand exactly how it changed afterward, and the story is further complicated by our incomplete knowledge of the extent of his injury. Some reports state that became violent and "uncontrollable", and even that he started to molest children. He is often reported as having permanently lost his inhibitions, so that he started to behave inappropriately in social situations. Similarly, most popular accounts of Phineas Gage describe him as having undergone profound personality changes because of his injury. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was "no longer Gage". 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 of advice when it conflicts with his desires, at times pertinaciously obstinent, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. His contractors, who regarded him as the most efficient and capable foreman in their employ previous to his injury, considered the change in his mind so marked that they could not give him his place again. Twenty years later, Harlow described the "mental manifestations" of Gage's injury in the Bulletin of the Massachusetts Medical Society: But those closest to him began to notice dramatic changes in his behaviour. Fearing the worst, his family prepared a coffin, but Gage soon recovered and by January 1849 was leading an apparently normal life. Several days later, one of the wounds became infected and he fell into a semi-comatose state. Back at Gage's nearby lodgings, Harlow removed small bone fragments from the wounds, replaced larger fragments that had been displaced by the passage of the tamping iron, and closed the large wound at the top of Gage's head with adhesive straps. Remarkably, Gage survived this horrific ordeal, and by all accounts was conscious and walking within minutes. entered the cranium, passing through the anterior left lobe of the cerebrum, and made its exit in the medial line, at the junction of the coronal and sagittal sutures, lacerating the longitudinal sinus, fracturing the parietal and frontal bones extensively, breaking up considerable portions of the brain, and protruding the globe of the left eye from its socket, by nearly half its diameter. He provides a detailed description of the "hitherto unparalleled case" in a letter to the editor of the Boston Medical and Surgical Journal, entitled "Passage of an Iron Rod Through the Head": John Harlow, the physician who attended to Gage at the scene, noted that the tamping iron was found some 10 metres away, "where it was afterward picked up by his men, smeared with blood and brain".
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