Phineas Gage

This post is also available in Dutch.

Very often great discoveries in neuroscience have their origin in unfortunate accidents. A known example is the case of Phineas Gage, a young man whose tragic accident was the beginning to understanding the relation between the frontal lobe and personality.

Phiineas

 Engraving of Phineas Gage skull and tamping iron, Bigelow, Henry J. American Journal of the Medical Sciences, n.s. v.20 (July 1850): 13-22

It was a hot afternoon in Vermont, in 1848, when 26-year-old Phineas Gage was about to have an accident that would change his life. Phineas worked for Rutland & Burlington, a railroad company, where he and his fellow workers would lay down tracks. One of Phineas’ tasks was to prepare detonations: he would drill a hole in the bedrock, fill it with explosive powder, insert a fuse, cover it with sand, and pound it down with an iron rod. On this unfortunate day, distracted by another worker, Phineas forgot to cover the explosive powder with sand. Consequently, a direct, single pound of the iron rod onto the powder lead to an immediate explosion.  This caused a roughly one-meter long iron rod (3cm in diameter) to enter Phineas’ left cheek, travel through the front of his brain, and exit at the top of his head. The explosion threw Phineas to the ground but he remained conscious.

A miraculous recovery?
After the accident, a town physician that examined Phineas reported that he was able to walk and talk, and remained coherent despite a large wound to his head. Within 2 months, Phineas completely recovered from his injury, yet something was different about him. Even though his language skills and cognitive abilities remained intact, his personality had changed. He seemed to be unable to set goals, plan or care about his future. He did not follow a set of morals or ethics, became impatient and started to use foul language to the extent that women were advised to avoid his company. His physical recovery was complete, but he was not the same Phineas Gage as before. This horrible accident, forever changed this young man’s life, but it also revealed an amazing fact regarding the human brain: the existence of a brain system responsible for reasoning and social behaviour.

What do we know today?
No autopsy was performed when Phineas Gage died. However, modern techniques allowed us to reconstruct the injury of Phinaes and conclude that the most severe damage was within the left frontal lobe. According to the reconstruction of the accident, Phineas had damaged the ventromedial prefrontal region (bottom of the frontal lobe). Today we know that this region plays a critical role in planning and decision making. As the lateral areas (toward the side and back) of Phineas’ prefrontal lobe did not suffer from injury, neither did the abilities involved this region – his capacity to perform calculations, use language, and attention remained intact. Despite his misfortune, the story of Phinaes Gage provided a beginning to the understanding of where and how decision-making processed take place in the brain.

More information

Descartes Error: Emotion, Reason en the Human brain. Anthony Damasio

This blog was written by Kasia

Edited by Marpessa

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