Cavendish Semiquincentennial: Phineas Gage

On Sunday, July 17, there will be a presentation about Phineas Gage, his importance to the understanding of traumatic brain injury, neuroscience and why he continues to be of interest, at the Cavendish Historical Society Museum at 2 pm in Cavendish. The presentation will be followed by a walking tour of historic spots associated with Gage. FMI: 226-7807 or margoc@tds.net

On September 13, 1848 Phineas Gage, a foreman, was working with his crew excavating rocks in preparing the bed for the Rutland and Burlington Railroad in Cavendish. An accidental explosion of a charge he had set blew his tamping iron through his head. It entered under the left cheek bone and exited through the top of the head. The rod, covered with brains and blood, was found approximately 30 yards from the site of the accident.

Sitting on the back of an ox cart, Gage was brought to the boarding house where he was staying on Main Street in Cavendish. Dr. John Harlow treated his wounds, along with Dr. Edward H. Williams. The large wound at the top of his head was closed with adhesive straps and a wet compress covered the opening. No surgery was involved.

Within days of the accident, an infection developed and Gage lapsed into a semi comatose state. Fearing that he was about to die, a local carpenter prepared a coffin for him. Two weeks after the accident, Harlow released 8 fluid ounces of pus from an abscess under Gage’s scalp. By January 1, 1849 (approximately 4 months) Gage was functional.

It is remarkable that Gage survived this accident, let alone lived for almost 12 more years. Fortunately Dr. Harlow and Dr. Henry J. Bigelow, a professor of surgery at Harvard University, tracked Gage as much possible, thereby documenting one of the first cases of traumatic brain injury in medical science. It was also the first understanding that different parts of the brain have different functions. With this knowledge, the first brain tumor removal operation became possible in 1885.

According to Gage’s family and friends, his behavior was significantly altered by the accident. In 1868, Harlow wrote in the “Bulletin of the Massachusetts Medical Society” His contractors, who regarded him as the most efficient and capable foreman in their employ previous to his injury, considered the change in his mind so marked that they could not give him his place again. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint of advice when it conflicts with his desires, at times pertinaciously obstinent, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage.”

Not able to work as a foreman, Gage held a variety of jobs. He worked in the livery stable at what is now known as the Hanover Inn in New Hampshire. He drove coaches and cared for horses in Valparaiso, Chile. Around 1859, after his health began to fail he went to San Francisco to live with his mother. While there, he worked on a farm in Santa Clara County. In February 1860, he began to have epileptic seizures and ultimately died May 21, 1860.

Rumors circulated that Gage appeared at Barnum’s American Museum in New York. It would take another Cavendish doctor, Dr. Gene Bont, almost 160 years later to find proof that Gage did in fact promote himself as a curiosity. Bont found a poster advertising Gage’s appearance at Rumford Hall.

One of the least talked about people connected with the Gage accident is Dr. Williams. He was an engineer, who went to medical school when ill health kept him from working outside. Since he did not have a busy medical practice, Williams spent considerable time in various forms of engineering. In fact, he knew Gage prior to his accident. He was the first doctor on the scene but would have differed to Dr. Harlow as he was a surgeon. Not long after the incident, Williams returned to engineering full time and started the oldest engineering society in the United States, Tau Beta Pi.