Thursday, May 16, 2013

Phineas Gage Walking Tour

On Sept ember 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 11 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. In 1852, he boarded a boat in Boston and sailed to Valparaiso, Chile.  While he was there for approximately seven years, and was thought to have driven coaches and cared for horses, little is know about what he did there. According to his mother, many ill turns while in Valparaiso, especially during the last year, and suffered much from hardship and exposure.”

Around 1859, in failing health he went to San Francisco to live with his family.  He worked on a farm in  Santa Clara County but returned to his family when he started having seizures. He died May 21, 1860 from epilepsy.

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.

Start tour at the Phineas Gage Memorial  on the Cavendish Town Green (High Street & 131)

Location of Accident: While a precise location is not known, the alleged site of the accident took place 0.75 miles south of Cavendish along the track of the Old Rutland and Burlington Rail Road. Take Mill Street, by Mack Molding,  the first left from the Town Green, heading west on Route 131. Go through the underpass and take an immediate left on to the Cavendish Gulf Rd. When you come to the marked railroad track crossing, approximately 200 yards, look to the right along the tracks from the crossing, and you will notice a major cut in the rocks. The approximate site of the accident is somewhere between this cut and the “lime kiln” area. Please stay off the track. This is an active railroad. Continuing on the Cavendish Gulf Road, approximately 300 yards from the white house just past (east) the railroad crossing. On the right hand side, is a small driveway that crosses the tracks. There is a 21.7 marker on tracks, which can be seen from the road. If you look across the tracks, you will see the remains of a limekiln. In 1936, Walton H. Green relayed information given to him 30 years prior by Christopher Goodrich, the ox-cart driver who drove Gage to his boarding house. Goodrich was 82 at the time. Green said, “The accident took place at the second cut south of Cavendish …near where Roswell Downer built his lime kiln later.”  Please stay off the railroad tracks.

Boarding House: From the Town Green, walk west on Main Street. Standing by the War Memorial in front of the CHS Museum, the building was located across the street from the Memorial.

Carpenter’s House: Immediately after the Museum, same side of the street, is the area where the Carpenter’s shop would have been located. It currently is the Town Garage.

Dr. Harlow’s House and Surgery: Dr. Harlow’s house, on Main Street but east of the town green, was located next to the Stone Church. All that remains is the cellar hole.

Dr. William’s House: Dr. William 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. His home was located on Depot Street in Proctorsville. The house would have been on the right hand side of the road, as you head from Route 131 to Route 103,  just after crossing the railroad tracks. 

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