An Odd Kind of Fame: Stories of Phineas Gage

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In 1848 a railway construction worker named Phineas Gage suffered an accident that made him a major curiosity of medicine and a significant figure in psychology and neuroscience: an explosion caused a tamping iron to be blown completely through his head, destroying the left frontal lobe of his brain. Gage survived the accident and remained in reasonable physical health for another eleven years. But his behavior changed markedly after the injury, and his case is considered to be the first to reveal the relation between the brain and complex personality characteristics. Yet almost nothing is known about him, and most of what is written is seriously in error.In this book Malcolm Macmillan, a leading authority on Gage, covers all aspects of this fascinating story. He describes Gage's family and personal background, the context of his work and the accident, and Gage's subsequent history. He analyzes contemporary medical and newspaper reports of the accident and its consequences, and evaluates the treatment Gage received from Dr.

John Martyn Harlow. He also looks at Harlow's own life and work. Macmillan examines Gage's place in the history of how functions came to be localized in the brain. He explores the many ways that Gage's tale has been represented and misrepresented through the years in popular, fictional, and scientific works. One of Macmillan's primary aims is to rescue the case from the predominantly fantastic accounts so that its real contribution to modern neuroscience can be understood. Partly for this reason, the appendices include facsimiles of Harlow's 1848 and 1868 reports, the primary sources about Gage, and previously unpublished CT scans of Gage's skull made in 1982.

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Editorial Reviews

From the Publisher
"...a historical tour de force." Daniel Tranel, Ph.D. The New England Journal of Medicine

"The book's success lies in... Macmillan's skill as a writer... and his passion for collecting and presenting evidence." Ian Glynn Nature

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Product Details

  • ISBN-13: 9780262632591
  • Publisher: MIT Press
  • Publication date: 8/7/2002
  • Edition description: New Edition
  • Pages: 576
  • Sales rank: 1,004,809
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.25 (d)

Meet the Author

Malcolm Macmillan is Adjunct Professor in the School of Psychology at Deakin University, Australia.

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Table of Contents

1 Introduction
The Structure of the Book
Construction and Fabrication
2 Background to Fame
The Case of Phineas Gage
The Farming Background
Working on the Railroad
"Tamkin" and the Accident
3 Early Receptions: Popular and Medical
Newspapers from September 1848 to March 1849
Henry Jacob Bigelow and the Medical Skeptics
The Tamping Iron and the Museum
4 The Implications of Harlow's Treatment
Harlow's Treatment
Antiphlogistic and Other Therapies
Harlow's Treatment Compared with Others
Acknowledgments of Harlow's Experience
Injury and Resistance
Gage the Standard
5 The Wonderful Journey
The Damage to Gage's Skull
The Damage to Gage's Brain
6 The Damage to Gage's Psyche
Psychological Change
Subsequent History
What Harlow Most Desired to See
The Reception Given Harlow's History
Additions to the History
A Kind of Conclusion
7 Localization: The Background
Early Clinical and Experimental Findings
Early Brain Anatomy
Ventricular Physiology and Clinical Observations
Psychological Function and Ventricular Physiology
8 Localization: The Beginnings
Functions for the Brain
Functions in the Roots of the Spinal Nerves
Sensory-Motor Physiology
Bain's Sensory-Motor Psychology
9 Localization in the Brain
Sensory-Motor Processes in the Brain
Language and the Brain
Sensory-Motor Processes and the Localization of Language
10 Gage and Surgery for the Brain
Aphasia, Localization, and Brain Surgery
Sensory-MotorPhysiology and Brain Surgery
Ferrier, Frontal Localization, and Gage
The Criticisms of Frontal Localization
Starr's Cases Reconsidered
Gage as Exemplar
11 Gage and Surgery for the Psyche
Surgery for Insanity
Radical Resection as a Basis for Psychosurgery
Animal Experiments on Frontal Ablation
Moniz and Frontal Surgery for Psychoses
The Histories of Psychosurgery
12 Gage, Inhibition, and Thought
Inhibition in Physiology
Inhibition in Psychology
The Fate of Ferrier's Inhibitory Thesis
A Digression on Bain, Ferrier, and Freud
Phineas Gage and Sigmund Freud
13 The Popular Stories
Gage in the Lore of the Williams Family
Folklore and Popular Culture
Newspaper Stories
Science, Newspapers, and the Warren
14 The Scientific Stories
Gage in the Physiological Literature
Gage in Early Textbooks of Psychology
Gage in the Contemporary Literature
Functions for Interpreting Gage
The Bases of the Errors
Harlow as Frontal Lobe Theoretician
15 The Hidden Portrait
The Harlow Family
Life in Woburn
The Obscure Country Physician
16 A Realistic Conclusion
Gage Achieves Fame
Phineas Gage 150 Years On
Appendix A: Facsimiles of the Gage Papers
Appendix B: A Collation of Notes and Other Material on the Case
Appendix C: The Statement of Walton A. Green
Appendix D: Ferrier's Letters to Bowditch about Gage
Appendix E: The CT Scans of Phineas Gage's Skull
Appendix F: Harlow's Presentations to the Middlesex East District
Medical Society
Appendix G: Lineages of Phineas Gage and John Martyn Harlow
Appendix H: The Sources Searched
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