Phineas Gage Articulo

2000, Vol. 9, No. 1, pp. 46–66 © Swets & Zeitlinger
Restoring Phineas Gage: A 150th Retrospective*
Malcolm Macmillan
ABSTRACT
September 13 1998 marked the 150th anniversary of the accident to Phineas Gage, one of the most famous
cases of survival after massive injury to the brain, and certainly the most famous case of personality change
after brain damage. For this article a sample ofthe current literature about Gage was examined. It was
found that although his case is mentioned in about 60% of introductory textbooks in psychology, there is
a good deal of inaccuracy in what has been written about him. Similar inaccuracy was found in a smaller
sampling of the psychiatric, medical, physiological, linguistic, and general neuroscientific literature. The
main basis of theinaccuracies is an ignorance or disregard of what is contained in the primary sources
about Gage, coupled with a tendency to attribute to him characteristics that belong to other cases of frontal
damage. The errors and their bases are discussed in an endeavour to restore the picture of Gage to its original
state. The paper includes an Appendix of verbatim quotations from the primary sources that canbe
compared with the later, inaccurate renditions.
Keywords: brain injury, personality change
A moral man, Phineas Gage,
Tamping powder down holes for his wage,
Blew the last of his probes
Through his two frontal lobes;
Now he drinks, swears, and flies in a rage.
Author unknown
Phineas Gage is probably the most famous case
of survival after massive injury to the brain, and
certainly themost famous case of personality
change after brain damage. Although much written
about, a good deal of what has been written
is strikingly at variance with what little is known
about him; in fact it is about as accurate as the
summation in the above limerick. On this 150th
anniversary of the accident, it is my intention to
restore our picture of Phineas Gage to its original
state.
Mytitle is based on the analogy of restoring
an old painting that has become so changed by
centuries of grime and amateurish attempts at
restoration that it is sometimes impossible to
discern the underlying original. I do not have
that disadvantage. The primary documents,
mainly the reports of John Martyn Harlow the
physician who treated Gage and followed up his
case, show us what we have totake as the original
portrait. Of course, we do not know how acRESTORING
PHINEAS GAGE 47
curate Harlow’s rendering is, but that is irrelevant
to my point. It the only picture of Gage that
we have.
THE ORIGINAL PICTURE
Phineas Gage suffered his accident at 4.30 p.m.
on Wednesday 13th September, 1848, just outside
Cavendish, Vermont. Employed by the contractors
who were preparing the bed forthe
Rutland and Burlington Railroad, he and the
men of the gang of which he was foreman were
putting a cutting through a large rocky outcrop
about three quarters of a mile south east of the
town. It was his job to place the explosive powder
and fuse into the holes drilled in the rock,
pack it or ‘tamp’ it down, and then tamp sand or
some other inert material on top of the charge.
Forthis purpose he used a specially made tamping
iron, a small crowbar-like tool weighing
thirteen and a quarter pounds and three feet
seven inches long. At its wider end, the tamping
iron was one and a quarter inches in diameter
but, over about a foot, it tapered to a diameter of
one quarter of an inch at the other. As the consequence
of an accidental explosion, the tamping
iron was blowncompletely through Gage’s
head. It entered pointed end first, under the left
zygomatic arch, came out the top of his head
mainly left of the midline at about the junction
of the coronal and saggital sutures, and landed
some 25 to 30 yards behind him.
Gage, who may not have lost consciousness,
was then helped by his men to an oxcart, in
which he rode unsupported to the inn or tavern
in...