The Warren Medical聽Museum in Boston is a fascinating place, named after Dr. John Collins Warren who performed the first surgery under ether anesthesia in 1846. On view is the actual flask that housed the ether used during the surgery. Also on display is the famous meter long rod that聽聽passed completely through the skull of railroad company聽worker聽Phineas Gage in 1848 without killing him.聽It did, however, dramatically alter his personality.聽聽
The unfortunate event turned out to be a landmark in the history of neurology, demonstrating that different parts of the brain had different functions.聽Apparently, catastrophic injury to the frontal lobes of the brain could be sustained without causing significant neurological deficits, but not without affecting behaviour.聽聽To this day, a memorial plaque marks the spot where the spectacular accident occurred on聽September 13, 1848聽in聽Cavendish, Vermont.聽聽
Phineas聽Gage was employed as a foreman by a railroad company, in charge of a crew laying new track.聽One of his tasks was to blast apart huge rocks that were in the way with gunpowder.聽This involved boring a hole into the rock and filling it with gunpowder using a long iron tamping rod.聽One fateful day, a spark ignited the powder prematurally, propelling the five kilogram iron rod through Gage鈥檚 left cheek and out the top of his head, landing some distance away.聽Miraculously he survived, in spite of having lost a significant portion of his brain.聽Not only did Gage survive, within minutes he was walking and conversing normally.聽The only immediate consequence was loss of vision in the left eye which apparently did not prevent him from sitting down and recording the event in his notebook.聽
Gage鈥檚 luck, however, did not last long, as he developed an infection that left him comatose for a month.聽 During this time he was carefully looked after by Dr. John Harlow, who skillfully covered the head wound and later recorded the fascinating case in the Boston Medical Surgery Journal.聽In his account Harlow described how the physical injury had altered the victim鈥檚 personality to an extent that he was 鈥渘o longer Gage.鈥澛燗lthough his memory was not altered, the formerly mild-mannered Gage now became capricious and obstinate, often peppering his words with obscenities.聽He lost his job and for a while exhibited himself with the famous iron rod at P.T. Barnum鈥檚 circus.聽聽
Gage鈥檚 most unusual adventure stimulated Scottish neurologist聽David Ferrier to investigate the role of the prefrontal lobes in brain function.聽 Ferrier removed the lobes in monkeys and noted that there were no great physiological changes but the animals鈥� character and behaviour were altered.聽Today, it is well understood that the prefrontal cortex of the brain controls the organization of behaviour including emotions and inhibitions.聽Phineas Gage died twelve years after the celebrated accident of epilepsy, leaving behind a fascinating legacy, and altering our understanding of the relation between the mind and the brain.聽Gage鈥檚 skull has become a relic and is on display along with the famous iron rod at the Warren Anatomical Museum in Boston.聽One could say that Gage needed the job with the railway company like he needed a hole in the head.
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