The strange yet instructive case of Mr Phineas Gage

Phineas Gage

Phineas Gage, above, was clearing rocks for the US railroad in 1848 when dynamite he’d just placed in a hole was accidentally fired. The heavy metal pole he’s seen holding rocketed through his skull leaving a two-inch tunnel diagonally through his head, tearing away his pre-frontal lobe. Amazingly he not only lived, he sat up beside the buggy driver who took him to the nearest doctor, chatting away. Despite the severity and extent of his injuries he seemed to make an almost complete physical recovery, though it was soon evident that mentally he had changed, significantly. More than 100 years passed before scientists realised that Phineas Gage had been living proof that brain and mind are connected but are not single separate entities. Instead they’re made of several different compartments all with distinct and separate functions.

Or, so it seemed. But nothing to do with the brain is ever simple
. Or uncontroversial.

That summer Mr Phineas Gage was a young man of 25 years, a popular gang boss working on the Rutland and Burlington railway of Boston. He was fit, energetic, strong, a model employee, a pillar of his community. Then he suffered an accident so traumatic it is a miracle he survived yet he survived almost unchanged. Almost, but not quite.

Phineas Gage’s survival was a boon to what was the then unknown, barely even nascent science of neurology. From Mr Gage scientists learned perhaps their single most important insight ever into the workings of the human brain.

At the time of the accident the railroad faced a stubborn outcrop of rock blocking its planned path. Mr Gage’s job was to break these rocks with strategically placed explosives. In this task he employed a straight cylindrical metal pole three and a half feet in length, one and one half inches thick, ground to a needle-sharp point and weighing 13 and a half pounds. With this implement in hand Mr Gage would first make a deep hole, fill it one third with gunpowder, attach a fuse, top this with sand, damping down the sand to form a tight seal. Then, from a safe distance, he and his assistant would light the fuse to detonate the charge and clear the rock.

On the day in question Mr Gage was going about his business when his attention was distracted by a call from behind. He failed to realise that the sand had not been applied and began damping down heavily onto the exposed gunpowder with his metal bar. This created a spark that ignited the powder causing a large explosion. The metal bar, his damping iron, rocketed skyward with the force of an exploding missile.

Between this rocketing metal spear and the freedom of the sky there stood Phineas Gage. Upon exiting its silo the missile missed his body but entered his jawbone just left of his chin. Without slowing it rocketed upwards though his brain, blasting away the prefrontal lobe to exit through a two inch gaping, mushroom-shaped hole at the top of his skull. The metal spear landed some 50 feet from the scene. Phineas Gage was knocked clean off his feet and assumed by all watching to be instantly killed. Not so. Incredibly he rose mere seconds after the explosion and walked unaided to a nearby bench, shaken, bleeding but seemingly otherwise little the worse. All including Gage himself at first assumed that the missile had hit him only a glancing blow.

This was not so, though even when the scale of injury was realized Gage refused to lie down. A coach and pair came to convey him four miles to the local doctor. He sat upright beside the driver the entire way.

The local doctor, James Harlow, promptly examined the patient and found a remarkable clear, clean wound. ‘The patient’, Dr Harlow later wrote, ‘bore his sufferings with the most heroic firmness. He recognized me at once, and said he hoped he was not much hurt. He seemed to be perfectly conscious, but was getting exhausted from the hemorrhage. His person, and the bed on which he was laid, were literally one gore of blood.’

Gage appeared normal, speaking and behaving merely as if slightly shaken, though he had a near perfect two inch hole right through his head from below his chin to the top of his skull. Yet he seemed coherent, alert and in little pain. Harlow’s assistant Dr Williams wrote later that he could see the man’s brain pulsating clearly through the gaping, funnel-shaped hole in his skull. Gage talked all the time while Williams was examining him. Crude chemical disinfection was recognized as important even then and the wound was vigorously if rather roughly cleaned. Gage later suffered from abscesses, but survived not just that day, but for 13 more years.’

The point of such a bizarre tale is simple. What Phileas Gage had shown was that the mind has many distinct compartments each responsible for different parts of what, collectively, adds up to our mind, to ‘us’.

Phineas Gage was healed and appeared unchanged. Physically, remarkably, he was. He rapidly regained outward health and strength. Save for losing the sight in his left eye he could touch, see and hear as before. His sense of smell was unchanged. He could walk purposefully upright, use his hands dexterously as before yet those who knew him noticed powerful, seemingly permanent change to his character and personality.

Dr Harlow described him as follows. ‘The intellectual balance between his human faculties and animal propensities has been destroyed.’ Gage started to swear foul oaths and gross profanities, something foreign to him before the accident.  He became irreverent, irritable, inconstant, a drunkard and a brawler. Women were counselled to avoid his company for fear of offence or worse. Indeed so radical was the change in personality that people who had known him before could scarcely recognise the man. It became clear: Phineas Gage was no longer Phineas Gage.

Though intensely documented, the real lessons from the strange case of Phineas Gage were not realised for 100 years, before it was appreciated that Gage’s experience shows that by altering or removing a small and specific portion of the brain, the mind can be so changed as to alter someone’s personality out of all recognition. Phineas Gage’s accident shows us that the human mind in its home the brain has many compartments and that damage in one area need not noticeably affect all or even any of the other areas.

Recently though this version of Mr Gage’s story has been challenged. Two photographs of Gage and a physician’s report of his physical and mental condition late in life were published in 2009 and 2010, detailing new evidence that suggests Gage’s most serious mental changes may have been temporary, so that in later life he was far more functional, and socially far better adjusted, than was previously assumed.

Perhaps, over time, his brain regained some of its former functions. It is of course a remarkable thing, the human brain. However, a noted psychologist has commented, ‘Phineas’s story is [primarily] worth remembering because it illustrates how easily a small stock of facts becomes transformed into popular and scientific myth.’

It’s a good story though. And true, for sure.

Joe Louis knocks out Max Schmeling, 22nd June 1938

This breathless transcript from a radio broadcast paints a powerful picture. It’s included because it packs so much action into so few words. In a previous fight Schmeling had beaten Louis, an achievement the recently elected Nazi party took as a symbol of German supremacy over non-Aryans. Just before this fight in Madison Square Gardens New York, Adolf Hitler apparently wrote to Max Schmeling reminding him of his nation’s expectations, leaving the boxer in no doubt that this was one fight he had to win. The controversy sold a lot of tickets, adding hugely to the pre-fight hype.

Joe Louis Max Schmeling

‘Listen to this, buddy, for it comes from a guy whose palms are still wet, whose throat is still dry, and whose jaw is still agape from the utter shock of watching Joe Louis knock out Max Schmeling.

‘It was a shocking thing, that knockout – short, sharp, merciless, complete. Louis was like this.

‘He was a big lean copper spring, tightened and retightened through weeks of training until he was one pregnant package of coiled venom.

‘Schmeling hit that spring with a whistling, right-handed punch in the first minute of that fight and the spring, tormented with tension, suddenly burst with one brazen spang of activity. Hard brown arms, propelling two unerring fists, blurred beneath the hot white candelabra of the ring lights. And Schmeling was in the path of them, a man caught and mangled in the whirring claws of a mad and feverish machine.

‘There were four steps to Schmeling’s knockout…’

From Bob Considine’s ringside commentary, reported in The New York Times.

Joe Louis 2

 

The gorilla

In the 1860s Africa was still the dark continent. Though it’s shocking to us now to read of our ancestors stumbling around the jungle blasting at pretty much everything that moved, it’s easy to forget that these were different times with different values and priorities. Still this account of the killing of a great ape is shocking. It comes in the final page of a Herculean work of natural history compiled from submissions by the leading naturalists and explorers of the day. It is added as a single last entry, almost as if it’s a STOP PRESS late discovery. In reproducing it here we have tried to keep as close as possible to the layout and style of the original which, though in two columns, has no paragraph breaks.
Gorilla5

From A History of the Earth and Animated Nature, Part 1, by Oliver Goldsmith et al, published by W G Blackie & Co, Glasgow, 1867.

The interest excited in the natural history of the Gorilla, or Great Chimpanzee, while the latter pages of this work are passing through the press, by the publication of M Du Chaillu’s Exploration and Adventures in Equatorial Africa, will justify the occupation of a spare corner, by a brief notice of that formidable species of the simial tribe. The Troglodytes gorilla has long been known to naturalists, although it was not till the year 1848 that Professor Owen gave to the world a correct description of the animal, specimens of the skeleton of which had been obtained from the Gaboon river, and which much exceeded in size, and was found to be specifically distinct from the previously known T. niger, the Chimpanzee, or Black Orang, known in its young state also by the name of Jocko. Fresh specimens of the gorilla having been brought to this country by M. Du Chaillu, professor Owen has been able to determine still more satisfactorily the distinctive characters of this huge man-like ape. M. Du Chaillu’s account of the habits of the animal has been subjected to considerable freedom of criticism, and the accuracy of his observations has been discredited by several naturalists; ·but his descriptions can hardly fail to interest the general reader. During his African researches he had long been in quest of the gorilla, and had endured many disappointments, when at length he made the acquaintance of the animal under the following circumstances: – ‘Suddenly,’ he says,  ‘I was startled by a strange, discordant, half-human, devilish cry, and beheld four young gorillas running toward the deep forests. We fired, but hit nothing. Then we rushed on in pursuit, but they knew the woods better than we. Once I caught a glimpse of one of the animals again, but an intervening tree spoiled my mark, and I did not fire. We ran till we were exhausted, but in vain. The alert beasts made good their escape. I protest I felt almost like a murderer when I saw the gorillas this first time. As they ran on their hind legs, they looked fearfully like hairy men; their heads down, their bodies inclined forward their whole appearance like men running for their lives. Take with this their awful cry, which, fierce and animal as it is, has yet something human in its discordance, and you will cease to wonder that the natives have the wildest superstitions about those ‘wild men of the woods.’ A closer acquaintance speedily followed. The traveller thus describes the exciting incidents of that occasion: ‘The underbrush swayed rapidly just ahead, and presently before us stood an immense male gorilla. He had gone through the jungle on his all-fours, but when he saw our party, he erected himself, and looked us boldly in the face. He stood about a dozen yards from us, and was a sight I think I shall never forget. Nearly six feet high (he proved four inches shorter), with immense body, chest, and great muscular arms, with fiercely glaring large deep gray eyes, and a hellish expression of face, which seemed to me like some nightmare vision; thus stood before us this king of the African forest. He was not afraid of us. He stood there, and beat his breast with his huge fists, till it resounded like an immense bass-drum, which is their mode of offering defiance, meantime giving vent to roar after roar. The roar of the gorilla is the most singular and awful noise heard in these African woods. It begins with a sharp bark, like an angry dog, then glides into a deep bass roll, which literally and closely resembles the roll of distant thunder along the sky, for which I have sometimes been tempted to take it where I did not see the animal. His eyes began to flash fiercer fire as we stood motionless on the defensive, and the crest of short hair which stands on his forehead began to twitch rapidly up and down, while his powerful fangs were shown as he again sent forth a thunderous roar. And now truly he reminded me of nothing but some hellish dream creature  – a being of that hideous order, half-man, half-beast, which we find pictured by old artists in some representations of the infernal regions. He advanced a few steps, then stopped to utter that hideous roar again, advanced again, and finally stopped when at a distance of about six yards from us. And here, just as he began another of his roars, beating his breast in rage, we fired, and killed him. With a groan which had something terribly human in it, and yet was full of brutishness, he fell forward on his face. The body shook convulsively for a few minutes, the limbs moved about in a struggling way, and then all was quiet-death had done its work, and I had leisure to examine the huge body. It proved to be five feet eight inches high, and the muscular development of the arms and breasts showed what immense strength it had possessed.’ M. Du Chaillu also describes how one of the negroes of his escort was killed by a gorilla: ‘He said that he had met the gorilla suddenly, and face to face, and that it had not attempted to escape. It was, he said, a huge male, and seemed very savage. He said he took good aim, and fired when the beast was only about eight yards off. The ball merely wounded it in the side. It at once began beating its breasts, and with the greatest rage advanced upon him.’ The negro reloaded his gun, but the animal sprang upon him, dashed the gun out of his hands, and striking him with its immense paw, lacerated the abdomen, and laid bare the intestines. As the man sank bleeding to the ground, the monster seized the gun, and flattened the barrel between his jaws. When the party came upon the ground, the dying man was alone, the gorilla having fled.

The Gorilla
 

A salamander, 1505.

Salamander
by Benvenuto Cellini.

This story recounts a curious incident in the life of a great man, though it was written when he was a child. I’ve included it because of the curious way the father ensures that his child learns from a singular experience.

Benvenuto Cellini (1500–1571) was a sculptor, painter, soldier and musician. Perhaps his most famous artwork is the statue of Perseus with the Head of Medusa which stands in the Loggia dei Lanzi gallery on the edge of the Piazza della Signoria in Florence;

When I was about five years old my father happened to be in a basement chamber of our house, where they had been washing, and where a good fire of oak logs was still burning; he had a viol in his hand, and was playing and singing alone beside the fire. The weather was very cold. Happening to look into the fire, he spied in the middle of those most burning flames a little creature like a lizard, which was sporting in the core of the intensest coals.

Becoming instantly aware of what the thing was, he had my sister and me called, and pointing it out to us children, gave me a great box on the ears, which caused me to howl and weep with all my might. Then he pacified me good-humouredly, and spoke as follows: ‘My dear little boy, I am not striking you for any wrong that you have done, but only to make you remember that that lizard which you see in the fire is a salamander, a creature which has never been seen before by anyone of whom we have credible information.’ So saying, he kissed me and gave me some pieces of money.