Phineas Gage Information
Psychology
An Odd Kind of Fame: Stories of Phineas Gage was published by MIT Press in September, 2000. It is one of a very small number of works devoted to Phineas Gage and the only book ever written about him. I believe it makes an important contribution to our understanding of how we came to attribute psychological functions to the brain as well as to our understanding of Phineas Gage himself.
In February 2001 An Odd Kind of Fame gained MIT Press the year 2000 excellence award in the History of Science and Technology section from the Professional and Scholarly Division of the Association of American Publishers. In June 2002 the International Society for the History of the Neurosciences awarded it its inaugural prize for the book making the most outstanding and original contribution to the history of the neurosciences in the period between 1999 and 2001. A paper back edition was published in August 2002.
Extracts from all the reviews of An Odd Kind of Fame that have appeared to September 2005 can be reached through the 'More puzzles' link.
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The Odd Kind of Fame of the title is meant to convey the fact that we know almost no more about Phineas and the changes in his behaviour than is contained in the few hundred words John Martyn Harlow devoted to him. Despite that, he is still famous enough, some 150 years after his accident, to appear in almost 60% of all textbooks of psychology, neuropsychology, and the neurosciences. The subtitle, Stories of Phineas Gage, is meant to convey that there are as many different and mostly grossly inaccurate stories about Phineas Gage in the scientific as in the popular literature. Establishing the real significance of Gage's case required correcting these erroneous and often tendentious representations. |
The background to Phineas Gage, the accident, and the news about him
In the first four chapters, I place Phineas in the New England farming community in which he was born and grew up, set out what can be inferred about his education and how he acquired his work skills, describe the kind of work he was undertaking when he was injured, and document the location and circumstances of his accident. Maps, photographs, documents, newspaper reports, and an (almost) eyewitness account are used as illustrations and to correct the date of his death. I give particular consideration to Gage's status as a foreman that may give meaning to Harlow's otherwise odd phrase that Gage was "a shrewd, smart, business man.".
I trace how the news of Phineas' accident and Harlow's treatment of him was received in the popular and medical press and how Gage's injury and treatment became a standard for comparing others.
The physical and psychological damage suffered by Phineas
Chapters 5 and 6 are devoted to the physical and psychological damage Gage suffered. I summarise and bring out the bases of the nineteenth century disputes over the passage of the tamping iron -- how far to the right of the mid-line and how far to the front of the coronal and sagittal sutures it passed -- and the consequent disputes over the site and extent of the damage to Gage's brain. Twentieth century attempts to resolve the differences of opinion, including the 1982 CT scan study by the Tylers (included in an Appendix), and the 1994 computer based reconstruction by Hanna Damasio and her colleagues, are evaluated critically. (See also the 'damage' section).
I set out the little that is known about Gage's psychological and behavioural characteristics before and after the accident, most of which comes from Harlow. From my extensive but unsuccessful searches for more information about Phineas, I believe that, at the time it occurred, his case was regarded in popular and medical circles as little more than a sensational story. Only later, and in limited medical circles, did Gage himself become important.
Phineas Gage and the localisation of psychological functions in the brain
My somewhat complex treatment of the history of localisation, covered in Chapters 7, 8, and 9, begins with the organology ('phrenology') founded by Franz Joseph Gall. I show that a complex interaction between philosophical stance, the role given the ventricles, and methods of dissection and related techniques delayed understanding of the anatomy of the brain and of its functions until the early nineteenth century when Gall's work began. Although fundamentally flawed, Gall's work forced an appreciation of the fact that the brain had structures other than the ventricles and psychological functions other than the very general ones postulated by the cell psychology associated with the ventricles.
I then bring out three important aspects of the development of sensory motor physiology and psychology that replaced Gall's system: Bain's associationist psychological theory, the clinical observations that some kinds of frontal lobe damage caused language impairment, and Ferrier's hypothesis that an inhibitory-motor function was localised frontally. I show that the changes and presumed changes in Phineas Gage were a not unimportant factor in resolving the debates over the localisation of motor and language functions.
Phineas Gage in relation to brain surgery and lobotomy
References to Phineas Gage in the literature on the development of brain surgery proper are infrequent. However, in Chapter 6 I show how David Ferrier's description of the alterations produced when the frontal lobes of his monkeys were removed set the stage for surgery for the removal of tumours from the frontal lobes. However, sensory-motor psychology gave such limited explanations of these symptoms, and there were such discrepancies about what counted as a 'symptom' that Gage disappeared from the brain surgery literature at about the time the twentieth century began. (See also the 'brain surgery' section).
As compared with his absence from the literature on brain surgery, Phineas Gage is often cited as a direct precursor of operations for the cure or amelioration of psychiatric disorders -- especially for lobotomy. The original psychiatric and neurological literature reveals no evidence for any such role. (See also the 'lobotomy' section).
Phineas Gage and theories of thinking
According to the theory of Alexander Bain and David Ferrier, rational thinking and choice depended on the inhibition of all but one of a set of competing thoughts or ideas. I examine the parallels between the Bain-Ferrier theory of thinking and that of Sigmund Freud, and conclude that Freud knew enough about their theory, and about Phineas Gage, to use that knowledge in formulating his own inhibitory theory.
The popular and scientific stories about Phineas Gage
Chapters 13 and 14 are devoted to the popular and scientific stories about Phineas Gage. Almost all share the defect of departing from what we actually know about Gage. They exaggerate the changes caused by his accident, making him more personally unstable and less settled in his employment than may have been the case. Many of the scientific stories are no more accurate than the popular ones. Some errors are due to their tellers not reading the original documents and others to authors fitting what little they know of Gage into an existing framework, usually their own. A simple instance is the frequent portrayal of Phineas as a Barnum or other circus freak, when the place where Harlow says Phineas appeared is Barnum's (stationary) Museum in New York. More serious are the errors that attribute to Phineas the characteristics of typical lobotomy patients or other well-known cases of frontal damage.
John Martyn Harlow and the truth about Phineas Gage
Finally I turn to Harlow himself and the question of the truth about Phineas Gage, and emphasise that practically all we know about Phineas Gage comes from him. Although what he tells us is not free of having been filtered by his phrenological and other beliefs, it is the basis for all the stories about Phineas. It therefore serves as the truth about him. Alternative descriptions of Phineas are therefore not merely equivalent discourses told in a different language -- they are simply not true.
Ordering An Odd Kind of Fame
An Odd Kind of Fame: Stories of Phineas Gage was published on 11 August, 2000 in hardcover [ISBN: 0262133636, List Price: US$50.00/£39.95] and in August 2002 as a paperback [ISBN 0-262-63259-4, List Price US$24.95/£16.95].
Ordering information may be found on the MIT Press site http://www.mitpress.mit.edu
A useful comparison of prices may be obtained from http://www.bestbookdeal.com Note that once you click on the page of particular store you may not be able to get back to this page, as you otherwise can, by successive use of the 'Back' button on your browser.
Corrections to An Odd Kind of Fame
p. xi, last para: Preface should be dated January 2000
p. 47, para 1: The inscription actually reads 'This is the bar that was shot through the head of Mr. Phinehas P. Gage at Cavendish, Vermont, Sept. 14, 1848. He fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard University. Phinehas P. Gage Lebanon Grafton Cy N-H Jan 6 1850'
p. 108, para 2: The year of Gage's death is 1860, but the only other date on the records is 23rd. May for the funeral/interment, and only
Gray's Funeral Record gives 'epilepsy' as the cause of death (ouch!).
p. 298, para 1: Huban should be Hugan
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