Phineas Gage Information
Psychology
This page of the site is really for topics that are to be added in the future. In the meantime, compare your evaluation of An Odd Kind Of Fame: Stories of Phineas Gage with these extracts from the reviews which had appeared up to September, 2005. You can also judge which of the pictures best represents what Phineas looked like.
Reviews
John Marshall, Science, 2000, 290(5492), 718:
Macmillan sets [his] interpretations against a changing background of
the
development of sensory-motor psychology, the emergence of the practice
of
modern brain surgery, and a variety of theories of the localization of
brain
functions. Macmillan’s book provides one of those rare occasions on
which
one can truly say that further research is not necessary ... [It] is
the
definitive account … a welcome wake-up call … to read the original
sources, and
it will interest the more rational exponents of the social construction
of
science.
A. R. Davis, Johns Hopkins, Choice: Current Reviews for Academic
Libraries, 2001, 38, January
Evaluation of Gage’s physical, emotional, and psychologic behavior
before
and after the accident is a major focus ... Macmillan ... explored
every
related area: psychiatry, neuroscience, medicine, written records, and
personal
interviews to shed new light and provide an authentic account of Gage’s
accident and subsequent life, a story unparalleled in medical
history.
Highly recommended for physicians, medical historians, and students at
all
levels.
Randolf W. Evans, Journal of the American Medical Association,
2001, 285,
215-216:
[W]ell-written, entertaining … meticulous research … nicely reviews the
history
of cerebral localization … discusses value of Gage’s case in the
origins
of … neurosurgery … demonstrates that [it] did not contribute directly
to …
lobotomy … I highly recommend [it] to anyone interested in the history
of
neuroscience
Daniel Tranel, New England Journal of Medicine, 2001, 344,
312:
[A]xe-grinding style … lacks new insights … engaging as a history
lesson …
thinly disguised vendetta against other Gage experts and the frequent
aspersions cast on their scholarship … [and] motives … make the
narrative
rather unsavory …. The best parts of this book were written by
Harlow and
Bigelow.
Ian Glynn, Nature, 2001, 409, 561-562:
Macmillan’s enthusiasm is as infectious as his knowledge of detail is
prodigious …. The book’s success lies in the combination of [his] skill
as a writer, his familiarity with the labyrinthine development of
nineteenth
century ideas about brain and his passion for collecting and presenting
evidence, whether scientific or historical … only rarely is one
seriously
worried about his conclusions.
Paul Crichton, The Lancet, 2001, 357, 566:
Some books encompass the whole of the universe (Hegel’s Phenomenology
of Mind) or a whole society (Tolstoy’s War and Peace);
others
have a much narrower focus (in Ulysses James Joyce describes
one day in
the life of Leopold Bloom). An Odd Kind of Fame combines
both
perspectives .... What Macmillan’s fastidious archaeological removal of
the layers of legend surrounding Phineas Gage convincingly demonstrates
is how
the varying theories of brain function shaped the formation of this
legend over
time and vice versa. Macmillan’s conclusions are refreshingly
deflationary ...
John Pickard, British Journal of Neurosurgery, 2001, 15,
81:
Macmillan is to be congratulated on a comprehensive and scholarly
account of
Phineas Gage. A detailed history of the location and
circumstances of the
accident are provided together with Dr. Harlow’s treatment .... most of
the book is devoted to a general discussion of localization of function
...
Overall, the book makes fascinating reading and the price is unusually
reasonable.
Bruce Ammons, Psychological Reports, 2001, 88, 319
[A] remarkable work of scholarship....much of what we've mistaken as
trustworthy facts was actually...misquoting, imagination,
misinterpretation,
fame-seeking attempts to force precious few facts into ... Procrustean
theoretical
beds... This book should be in every history and systems
psychology class
and deserves reading by anyone interested in the workings of science
and
history, developing views of the localisation of brain function, the
development of neurosurgical procedures, or a first rate example of
carefully
done historical work. The CT scans ... are alone worth the price
of
admission.
Roy Porter, Times Literary Supplement, 18th. May, 2001:
[T]his giant book is ... something of a curiosity - do we really need
six pages
on the construction of the Rutland
and Burlington Railroad? ... inordinate detail [on] the lives and work
of
scores of leading ... brain investigators, the great majority of whom
never
recorded a single thought about Gage .... Macmillan evidently hoped his
would
be a definitive story .... In reality, what he found was ... a dearth
of truly
solid, cast-iron historical facts ... as many “Gage’s” as
there are neuroscientists who evoke him .... it is rather a relief that
Gage
retains his mystery ...
Barbara Wilson, Neuropsychological Rehabilitation, 2001, 11,
188-190:
[T]he author of this extraordinary book ... almost certainly knows more
about
Phineas Gage than anybody else. There is passionate criticism
about many
of the accounts of Gage, including many from well-known
neuropsychologists. Most include errors of fact or
interpretation.... The
book concludes with a collection of papers and notes on Phineas Gage
.... Given
the difficulty of obtaining the original articles, these Appendices
provide a useful
resource. I have never read a book quite like this before.
It is a
passionate, scholarly, detailed, and fascinating account ... I
thoroughly
recommend it ...
Samuel Greenblatt, Journal of Neurosurgery, 94,
850-851:
An Odd Kind of Fame is a thorough antidote to its author’s
problem
of the paucity of material on Gage. Macmillan’s ingenuity and
energy in tracking down sources are truly awesome... Some of
[his]
insights [into localization] are quite penetrating, but sometimes
digress
rather far from the main theme.... [A]ll efforts to localize the
damage
to Gage’s brain by reconstructing the path of the tamping iron from the
localization of the skull defects are doomed to insufficiency.
Macmillan
draws this important conclusion plainly and without emphasis, but it
deserves
to be emphasized.
Has Pols, Journal of the History of Medicine and Allied Sciences,
2001, 56, 192-194:
[The tamping iron exited] ... slightly to the right of center... Gage
traveled
around quite a bit and held a number of odd jobs before he died twelve
years
later .... Macmillan’s research is painstakingly thorough and accurate,
and obviously driven by the desire to find out what actually happened
to Gage
and what role the Gage case played in the history of medicine, brain
physiology,
and psychology.... [h]e concludes that most accounts of Gage’s life are
mistaken [and] that Gage played a neglible role. These
conclusions are
interesting and convincingly supported ...[but leave] the reader
feeling rather
empty-handed. The author’s attack on a social constructionist
view
of history that allegedly disregards facts seem misplaced and
irrelevant...
John Hodges, Journal of Neurology, Neurosurgery, and Psychiatry,
2001, 71, 136-137:
[S]uperbly written ... fantastic reference source across a wide range
of
topics. The first few chapters describe, in detail, the events
surrounding the fateful afternoon... There are many revelations in this
part of
the book. The second section is in many ways the most fascinating
... a
scholarly account of the origins of the concept of cognitive
localisation ...
the contribution, or otherwise, of Gage’s story to psychosurgery ... a
great deal of overlooked early literature ... on the surgical treatment
of
insanity .... I can thoroughly recommend this book to anyone interested
in the
history of neuroscience, neuropsychology, or neuropsychiatry. It
is also
amazing value at just under Stg 25.
Sally-Ann Price, StudentBMJ, 2001, 9, 213:
While the choice of subject is laudable, the book itself is rather
dry. There
is a great deal of historical detail...undoubtedly a fine piece of
research
clarifying precisely what we do and do not know about Gage’s
story. .... difficult to see a niche for this book ...
Perhaps we
have been spoilt by ... Sacks and Ramachandran and their easy to read
style. ... other books (such as basic neuroanatomy texts) ... give
you a
greater understanding of functional anatomy. Read it if you are
fascinated by Gage or have an interest in historical detail, but for
most
people, the book gives far more detail than you require...
Tilli Tansey, Endeavour, 2001, 25, 83:
In this enormously detailed book (sometimes too detailed...) Macmillan
tackles
several themes, including...the biographies of the principal
participants...the
impact of the accident on...theories of localization... Macmillan
explores
both popular and scientific accounts ... provides facsimiles of the
original
case reports and concantenates a wide range of material
... [D]espite many
efforts to elucidate, extend and enhance Harlow’s report, Gage’s
genuine contributions to neurological knowledge remain a
mystery.. Gage
differs profoundly from Alexis St. Martin ... In contrast Gage’s
‘odd sort of fame’ remains just that.
James Beebe, http://www.mentalhelp.net/books/books.php?type=de&id=707,
August, 2001
[A]n impressive achievement...the definitive history of one of the most
widely
discussed cases in the history of neuroscience and
psychology. ....the
first and only comprehensive study of Gage’s injury and its influence
on
the history of medicine, neuroscience and psychology. ... not
light
reading [it] is a remarkable piece of historical research ....
Macmillan
has cleared up much misinformation... It will be recognized as an
authoritative and valuable resource for many years to come.
Samuel Greenblatt, Bulletin of the History of Medicine,
2001, 75,
798-799.
Macmillan shows convincingly that all other reports either derive from Harlow ,
or are inaccurate to the extent that they do not. ...it is
impossible to
localize the extent of his frontal lobe damage by simply reconstructing
the
path of the tamping iron from the location of the skull defects.
Macmillan states this conclusion clearly but too modestly. It
invalidates
all retrospective attempts at the precise localization ... even with
modern
imaging.. Macmillan has done a yeoman's job [and] has probably
added to
Gage’s fame, no matter how odd it may seem.
James Stone, Journal of the History of the Neurosciences,
2001, 10,
353-355.
In a highly readable yet extraordinarily well-referenced fashion, we
come to
realize Gage’s influence on the development of biological thought
including cerebral localization, neurosurgery, neurology, behavioral
neurology,
and neuropsychology ... to this reviewer, Harlow ’s
surgical capability and intuition were extraordinary. ....
Macmillan shows
much originality in the manner in which he presents [the development of
localization] .... gives a carefully measured analysis of pivotal
models
used ... in the past ... to explain behavior and the frontal
lobe. ... [A]
very well-written book which ... serves as a fairly extensive
reference
source on a number of areas relating to the development of
neuroscience ... I would highly recommend this volume to anyone in
the
allied neurological fields seriously interested in the history of their
discipline.
Jonathon Erlen, Quarterly Review of Biology, 2001, 76,
521:
The author presents at times excessive details of Gage’s accident,
recovery, later life, and death....What emerges is a pattern of
inaccurate
facts and exaggerations that has seriously distorted the place of
Gage’s
health conditions in medical history....[W]hen Macmillan leaves Gage’s
story to present an overview of brain localization theory [t]hese
chapters add
little.... Despite the unnecessary chapters and the author’s overuse of
minute details, this is a significant contribution to the history of
neuroscience.
Michael Saling, Australian and New
Zealand Journal of
Psychiatry, 2001, 35, 862.
The nature of [Gage’s] personality change has been elaborated
possibly distorted) into a prototype par excellence of the
frontal lobe syndrome. Yet the only link
between us and the clinical reality of the post-injury Gage is a
handful of
scattered notes and recollections ... In Macmillan’s hands
this becomes a study of the mutations that creep into the
historicoclinical
record in medicine, and an exercise in ‘recovering the
truth’, not only about Gage, but about Harlow as well. ...
Ultimately, the empirical status of Harlow ’s
account is the issue that still needs to be resolved. After Macmillan’s exhaustive account
one wonders if there is anything left to be uncovered.
The book is immensely detailed, locating the case in a rich historical,
social, and scientific context. It is
certainly a major document in the field of neuropsychology and I think
that
time will tell that this is the definitive work on Phineas Gage.
Kieran O'Driscoll, Isis, 2002, 93,
138.
[T]he definitive work on this fascinating subject ... Having
discharged his duty in relation to the sparse facts...and the lasting
importance of the event, Macmillan could have left it there. We are fortunate that he
didn’t ... [F]rom painstaking research [he] has taken us on a
fascinating journey through nearly two hundred years of neuroscientific
thinking on the functions of the frontal lobes ... I would
strongly
recommend this book to those interested in the history of medicine, to
the
clinical neuroscientist, and to the nonspecialist with an interest in
the
bizarre.
Rhodri Hayward, British Journal for the History of
Science, 2002, 35, 479-481.
It is the transformation of Gage from ordinary foreman to
neuropsychological exemplar which provides the structure and focus for
Macmillan’s book. Over the
course of four hundred pages of argument and a hundred pages of
appendices,
Macmillan provides an absolutely exhaustive interrogation of the
historical
bases of Gage’s story, his treatment, and its subsequent scientific
reconstructions. As a piece of
historical detective work it demonstrates a scholarly commitment which
borders
on the obsessional.
Despite the daunting amount of detail included .. the narrative
is leavened by Macmillan’s lightness of touch and his genuine
enthusiasm for the subject. Moreover the
level of detail .. serves to emphasize (by way of contrast) just
how
little is known about Gage, his injury, or the subsequent personality
change.
Although Macmillan is keen to distance himself from social
constructivist
arguments and makes extensive claims for a realist epistemology, it is
difficult to see how his method conflicts with those employed by
radical
sociologists of knowledge ... It is the difficulty of
disentangling
the social from the neurological that makes Macmillan’s account ..
so entertaining. ... Gage .. does at least provide a
stunning example of the ideological use of case histories and their
mythological reconstruction.
Fatah B. Nahab, Journal of Neurosurgery, 2003,
99, 1109.
Macmillan has done an excellent job of writing a multifaceted scholarly
work to satisfy different readers in different ways...Although the
medical
jargon is limited to allow a broader readership, the depth of
neuroanatomical
localization is highly accurate and descriptive, and the author does
not dilute
the essence of this medical case report and its ramifications. At a list price of $24.95, this book is a
highly recommended addition to any library.
T. R. Morley, Canadian Bulletin of Medical History,
2003, 20, 195-197.
...a thoroughly readable treatise not only on all aspects of the Gage
legend, but much more. The author
uses
Gage as the peg from which he hangs the history of the evolving
understanding
of brain function...Chapter 14 reviews the case reports that appeared
in the
medical journals; the authors sometimes got it right but as often got
it
wrong-a happy note to bring up the rear of a stunningly researched,
ordered,
and written history.
Paul Eling, Contemporary Psychology, 2003,
48, 289-291.
In essence more than an analysis of the Phineas Gage case,
Macmillan’s study is a colorful picture of how scientists (and
subsequently all kinds of people in society) used a particular case to
convince
others of their own theories.
[A]t this point [of Gages’s recovery and subsequent activities]
that [Macmillan’s] enterprise becomes relevant to current
scientists. That is not to say that his
unprecedented detective work...brought nothing new.
On the contrary: fact and fancy can
now be separated
clearly.
Macmillan...reveals how other authors picked up bits and pieces [of
Harlow’s 1868 paper] and reformulated them into a code that best fit
their own purposes ... In Chapter 6, Macmillan presents a sobering
overview
of the “post-Harlow fables” as well as their echoes in the
recent accounts...
Macmillan collected practically every piece of information about
Gage...Moreover, he analyzed all that material almost on a word-by-word
basis. The reader might think that this
would result in a rather boring report.
In fact, the book is a real pleasure to read, thanks to the
author’s writing style. He is
very precise, careful in his wording, and modest in his conclusions....
What can we learn...with respect to case studies in general?...Gage
might
be considered an interesting case study for the philosophy of science,
or for
the history of science. Macmillan,
however, does not give much attention to these aspects.
Georg Goldenberg, Cortex, 2004, 40, 552-555.
The main theme of the book is the confrontation between the many stories of Gage and the limited evidence of his real life. As to the evidence, Macmillan has obstinately searched all possible sources. It seems very unlikely that anyone else could find a relevant piece not considered. ...Macmillan’s writing style is not one of easy going story telling. Sometimes this makes reading a bit hard for readers who are not familiar with history of neurosciences, but the occasional use of rather bulky sentences...is compensated by the tongue in cheek humour of Macmillan’s comments... Macmillan’s book...does not strain the reader’s credulity. It is a sober and meticulous inquiry of facts and circumstances, but it is at least as exciting as any of the stories of Phineas Gage.
Representations
Which representation of Phineas is the most accurate? Try to identify where each comes from. The answers are at the bottom of the page.
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Answers:
(a) Very, very wrong. True, it is a skull with a tamping iron in it, but it is not even Gage’s. It is the ‘common’ skull Henry Jacob Bigelow drilled in 1849 or 1850 to show that the tamping iron could have passed through Gage’s. It is described as Gage’s in many textbooks of psychology, medicine, and the neurosciences.
(b) Reasonable but wrong. Although this is the woodcut of Gage’s skull made for John Martyn Harlow in 1868, the regrowth of bone in the 11 1/2 years after Gage’s accident would have prevented the tamping iron being passed through it as shown.
(c) Good. This is Gage’s actual skull, photographed for Harlow in Woburn in 1868.
(d) Plausible but very wrong. This is a drawing made in 1921 by Russell Windsor for her husband’s book on phrenology. Not only is it not known who the model was -- he probably does not resemble Gage -- but no one could have lived with the iron so embedded in their skull and brain.
(e) Very good. This is Phineas Gage’s life mask and was made for Henry Jacob Bigelow in 1849 or 1850. Add bonus points if you said ‘life mask’ -- it is often described as Gage’s death mask.
(f) Very wrong. This is a right to left reversal printing of (b), often also found in textbooks.
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