Phineas Gage
Information about Phineas Gage
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".
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.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.
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]
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.
Effect on Gage
Gage had complications from a fungal infection which left him in a "semi-comatose state" from September 23 - 3 October, "seldom speaking unless spoken to, and then only answering in monosyllables." From 4 October onwards, he began improving, and took his first step on 7 October.[3] On 20 October, 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 17 November, 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]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. His doctor reported that:
Insert the text of the quote here, without quotation marks.
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.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".[4]
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.[5]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. Later writers began to embellish even more, adding drunkenness, braggadocio, a vainglorious tendency to show off his wound as part of Barnum's Traveling Exhibition and an utter lack of foresight[6] — all unmentioned by Harlow.<ref name"bigelot_phineas">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.[6][3]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. 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. [7] 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, MassachusettsSee also
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. ^ 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. ^ Antonio R. Damasio (1995) Descartes' Error: Emotion, Reason, and the Human Brain. ISBN 0-380-72647-5.
5. ^ Macmillian, M.. Analysis of Gage's influence on psychosurgery. Retrieved on 2007-06-02.
6. ^ Macmillian, M.. Phineas Gage's Story. Retrieved on 2007-06-06.
7. ^ Macmillan, M. Corrections to An odd kind of fame. Retrieved on June 2, 2007.
Further reading
- Antonio R. Damasio (1995) . 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.
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.
In popular culture
- UK band Phineas Gauge located in Los Angeles sings Irish drinking songs, is named after him.
Neuropsychology is an interdisciplinary branch of psychology and neuroscience that aims to understand how the structure and function of the brain relate to specific psychological processes and overt behaviors.
..... Click the link for more information.A brain-computer interface (BCI), sometimes called a direct neural interface or a brain-machine interface, is a direct communication pathway between a human or animal brain (or brain cell culture) and an external device.
..... Click the link for more information.Brain damage or brain injury is the destruction or degeneration of brain cells.
Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis.
..... Click the link for more information.Clinical neuropsychology is a sub-specialty of clinical psychology that specialises in the diagnostic assessment and treatment of patients with brain injury or neurocognitive deficits.
..... Click the link for more information.Cognitive neuroscience is an academic field concerned with the scientific study of biological mechanisms underlying cognition, with a specific focus on the neural substrates of mental processes and their behavioral manifestations.
..... Click the link for more information.The human brain controls the central nervous system (CNS), by way of the cranial nerves and spinal cord, the peripheral nervous system (PNS) and regulates virtually all human activity.
..... Click the link for more information.Neuroanatomy is the branch of anatomy that studies the anatomical organization of the nervous system. In vertebrate animals, the routes that the myriad nerves take from the brain to the rest of the body (or "periphery"), and the internal structure of the brain in particular, are
..... Click the link for more information.Neurophysiology is a part of physiology. Neurophysiology is the study of nervous system function. Primarily, it is connected with neurophysiology and also to with neurobiology, psychology, neurology, clinical neurophysiology, electrophysiology, ethology, neuroanatomy, cognitive
..... Click the link for more information.Phrenology (from Greek: φρήν, phrēn, "mind"; and λόγος, logos, "knowledge") is a theory which claims to be able to determine character, personality traits and criminality on the basis of the shape of the head (i.e.
..... Click the link for more information.Wikipedia articles related to Brain Function
- Visual system
- Auditory system
- Olfactory system
- Gustatory system
- Somatosensory system
- Visual perception
- Motor cortex
- Broca's area (aka Language Area)
- Lateralization of brain function
..... Click the link for more information.Arousal is a physiological and psychological state of being awake. It involves the activation of the reticular activating system in the brain stem, the autonomic nervous system and the endocrine system, leading to increased heart rate and blood pressure and a condition of
..... Click the link for more information.Attention is the cognitive process of selectively concentrating on one aspect of the environment while ignoring other things. Examples include listening carefully to what someone is saying while ignoring other conversations in the room (the cocktail party effect) or listening to a
..... Click the link for more information.Attention is the cognitive process of selectively concentrating on one aspect of the environment while ignoring other things. Examples include listening carefully to what someone is saying while ignoring other conversations in the room (the cocktail party effect) or listening to a
..... Click the link for more information.Consciousness is a characteristic of the mind generally regarded to comprise qualities such as subjectivity, self-awareness, sentience, sapience, and the ability to perceive the relationship between oneself and one's environment.
..... Click the link for more information.Decision making is the cognitive process leading to the selection of a course of action among variations. Every decision making process produces a final choice. It can be an action or an opinion. It begins when we need to do something but know not what.
..... Click the link for more information.Executive functions is a term synonymous with cognitive control, and used by psychologists and neuroscientists to describe a loosely defined collection of brain processes whose role is to guide thought and behaviour in accordance with internally generated goals or plans.
..... Click the link for more information.In the philosophy of language, a natural language (or ordinary language) is a language that is spoken, written, or signed (visually or tactilely) by humans for general-purpose communication, as distinguished from formal languages (such as computer-programming
..... Click the link for more information.Learning is the acquisition and development of memories and behaviors, including skills, knowledge, understanding, values, and wisdom. It is the goal of education, and the product of experience.
..... Click the link for more information.In psychology, memory is an organism's ability to store, retain, and subsequently retrieve information. Traditional studies of memory began in the realms of philosophy, including techniques of artificially enhancing the memory.
..... Click the link for more information.Gross motor coordination addresses the gross motor skills: walking, running, climbing, jumping, crawling, lifting one's head, sitting up, etc.
Fine motor coordination
..... Click the link for more information.perception is the process of acquiring, interpreting, selecting, and organizing sensory information. It is a task far more complex than was imagined in the 1950s and 1960s, when it was proclaimed that building perceiving machines would take about a decade, but, needless to say,
..... Click the link for more information.>For planning in AI, see .
Planning is both the organizational process of creating and maintaining a plan; and the psychological process of thinking about the activities required to create a desired future on some scale.
..... Click the link for more information.Problem solving forms part of thinking. Considered the most complex of all intellectual functions, problem solving has been defined as higher-order cognitive process that requires the modulation and control of more routine or fundamental skills (Goldstein & Levin, 1987).
..... Click the link for more information.Thought or thinking is a mental process which allows beings to model the world, and so to deal with it effectively according to their goals, plans, ends and desires.
..... Click the link for more information.Arthur Lester Benton, Ph.D., (October 16, 1909 - December 27, 2006) was a neuropsychologist and Emeritus Professor of Neurology and Psychology at the University of Iowa.
He received his A.B. from Oberlin College in 1931, his A.M.
..... Click the link for more information.Kenneth M. Heilman is an American behavioral neurologist.Biography
Early Life and Career
Kenneth Heilman was born and raised in Brooklyn, New York. He attended and graduated from medical school at the University of Virginia in 1963.
..... Click the link for more information.Norman Geschwind can be considered the father of modern behavioral neurology in America. He was mentor to the cadre of behavioral neurologists who would shape the subspecialty for the 20th and early 21st centuries.
Dr.
..... Click the link for more information.Elkhonon Goldberg (1946) is a neuropsychologist and cognitive neuroscientist.Biography
Elkhonon Golderg was born in Riga, Latvia in 1946, studied at Moscow State University with the great neuropsychologist Alexander Luria and moved to the United States in 1974.
..... Click the link for more information.Donald Olding Hebb (July 22, 1904 – August 20, 1985) was a psychologist who was influential in the area of neuropsychology, where he sought to understand how the function of neurons contributed to psychological processes such as learning.
..... Click the link for more information.Alexander Romanovich Luria Александр Романович Лурия
..... Click the link for more information.
)
This article is copied from an article on Wikipedia.org - the free encyclopedia created and edited by online user community. The text was not checked or edited by anyone on our staff. Although the vast majority of the wikipedia encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article. This article is distributed under the terms of GNU Free Documentation License.