lae2 at lae2 at
Sat Aug 17 11:59:08 EST 1996

In Article<32128d1a.43394859 at>, <cogito at>  
> >lori jones wrote:
> >> 
> >> Can anyone give me info/details on the guy in the 19C who survived a 
> >> spike through the brain?  What was his name and where can I find out 
> >> about his case?  You can email me directly if you want to.  Thanks
> >
> >
> >Lori,
> >
> >Science carried an article on the reconstruction of his brain 
> >lesion from his exhumed skull and the preserved iron bar.  This 

> Phineas's injuries clearly demonstrate something termed, "frontal
> disinhibition."  A term that encompases the dysfunction apparent in
> individuals with frontal lobe injuries (e.g., attention and
> concentration px., orienting response px., apparent lack of societal
> inhibition, planning difficulties, etc.).
> The article Bill refers to above was written by the Damasios, and
> involved the MRI recostruction of Phineas's skull (which, I believe is
> housed at Harvard Med. School Library).  By extrapolating the injury
> site, the Damasios were better able to pin-point the brain injury
> Phineas suffered.  I believe the main point of injury was the left
> orbitofrontal region, the "seat of volitional control" or as my
> advisor coins, "the place where the little man drives the bus."
> J.Browndyke
Yet another significance of Gage's case in the history of 
clinical/scientific thinking was the fact the he survived regardless of 
any personality changes.  Despite the attention given to the heart, the 
prevailing belief was that the brain was vital to life.  In fact, the 
personality changes and other deleterious effects of Gage's lesion tended 
to be ignored (except for the phrenologists setting up shop in 
Philadelphia).  Some have speculated/known that Gage suffered 
increasingly severe epileptic episodes up to the time of his death in San 

The fact that Gage survived his injury paved the road leading up to 
psychosurgery.  The findings of Kluver Bucy established the "End of 
Construction" sign.  For better or worse, a new mode of personality 
therapy involving surgical interventions and the brain was established.

Of course, there are other interpretations as to the significance of 
Gage's injury.  Regardless, the injury and the wave it stirred within the 
personality/clinical world are fascinating.  The original records of the 
event are worth reading.

I suspect that the Jefferson Medical College library would have a wealth 
of information on the history and significance of the incidence.

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