Wonderful Journey Research Articles

New doors to open...and so many!

New doors to open...and so many!

Frontal lobe function: Mr. Phineas Gage's famous injury.

T next article in our series is a case report written in 1848 by John M. Harlow, M.D., describing his care of Mr. Phineas Gage, who suffered an extreme injury to the frontal cortex. Mr. Gage was employed as a railroad worker in Vermont and fell victim to a freak accident that involved a long metal rod called a tamping iron. This rod was used to pack sand over an explosive charge, which was used to excavate rock for the building of railroad lines. In this instance the charge exploded unexpectedly and propelled the 3-foot-long rod through Mr. Gage’s head. The 13-pound rod entered the left cheek and exited the midline of the skull anterior to the bregma, resulting in severe injury to his left and, in all probability, his right prefrontal cortex. The Gage case, one of the most famous and influential in neuropsychiatry, played a crucial role in the discovery of behavioral syndromes resulting from frontal lobe dysfunction. Readers interested in detailed accounts of the case and its historical context can find excellent reviews by MacMillan and Barker. The case report was initially met with disbelief because it was thought to be impossible for a human to survive a brain injury of such magnitude. Beyond the astonishing fact of Mr. Gage’s survival was the description of his ability to walk immediately after the event, communicate sensibly, and remain lucid though most of the period following the injury. This fact attracted the attention of P. T. Barnum, who employed Mr. Gage for a short period following his recovery. Dr. Henry J. Bigelow, a prominent professor of surgery at Harvard Medical School, examined Mr. Gage after Harlow’s report and failed to note the changes in Gage’s behavior. He proclaimed that Gage had no demonstrable sequelae of the injury. Dr. Bigelow and others used the Gage case as a persuasive argument against the field of phrenology, which was the only prominent discipline at the time that considered the possibility of localization of brain function. Yet, as the reader will note, there are several suggestions in the original report that Mr. Gage’s behavior had changed. Dr. Harlow promised to report the mental manifestations of the injury in a subsequent communication. He did not produce this report until 20 years later, when he described a pervasive change in personality and character in the Journal of the Massachusetts Medical Society, a periodical with very limited circulation. In this report, Harlow described the following:

Biblical Hebrew: An Introductory Grammar

Comprehensive in scope, this carefully crafted introductory grammar of Hebrew offers easy-to-understand explanations, numerous biblical illustrations, and a wide range of imaginative, biblically based exercises. According to Page Kelley, his book is not so much for seasoned travelers as for those who are just starting out on a strange and wonderful journey. The book consists of thirty-one lessons arranged as follows: the nonverbal aspects of the language (lessons 1-10); the verb forms and their functions, with special attention to the strong verbs (lessons 11-20); the coordinate relationship of verbs, a topic alluded to but seldom developed in other grammars (lesson 21); and a comprehensive introduction to each of the ten classes of weak verbs (lessons 22-31). The grammar is accompanied by eleven complete verb charts, an extensive vocabulary list, a glossary of grammatical terms, and a subject index. Kelley employs a method that one reviewer has described as a cross between a straight presentation of grammatical principles and rules and a semi-inductive presentation of concepts through the exercises. Each lesson first presents new grammatical concepts, with biblical examples, and then provides reinforcing exercises that Kelley has judiciously selected from the biblical text (the exercises do not presuppose vocabulary and grammar not already covered). Deriving from the author's forty years of experience in teaching Hebrew to seminary students, and enthusiastically employed in its developing stages by instructors at a variety of colleges and seminaries, Kelley's Biblical Hebrew: An Introductory Grammar promises to be an excellent teaching tool with high potential as a textbook. Kelly has designed it for use in either a one-semester or a two-semester course.

A wonderful journey through skull and brains: The travels of Mr. Gage's tamping iron

Phineas Gage was injured by his tamping iron nearly 140 years ago, and only one similar case has been reported since then. In this paper, the contemporary popular and medical responses to the news of Gage's accident are summarized. An attempt is made to evaluate the contribution of Harlow's treatment of Gage as well as the successive bearings which the case was thought to have on analyses of brain function, aphasia, and frontal lobe function.

Societies and Academies

LONDON Royal Geographical Society, May 12.—Major-General Sir II. C. Rawlinson, K.C.B, president, in the chair.—The paper read was “Journey tlsrough Western Mongolia,” by Mr. Ney Ehias. The distance travelled over was 2,000 miles, acconsplished between July 1872 and January 1873. The route from Kalgan (the starting-point in crossing the desert of Gobi by the usual route viâ Urga to Kiachta) was westerly to the Chinese frontier town of Kwei-hua, thence north-westerly to the river Onghin, and afterwards again westerly, along the foot of the Khangai Range, to the city of Uliassutai, which his observations showed to be 5,700 ft. above the sea-level. His furthor journey was impeded by the bands of Mahommedan Mongol rebels, the so-called Dungans, who, although badly armed, struck terror into the Chinese garrisons of the towns, and carried fire and slaughter wherever they went. He narrowly escaped the band, which a few days before his arrival destroyed the city of Kobdo, west of Uliassutai; arriving there, he saw the charred remains of the outer town and the unburied bodies of slaughtered people scattered over the streets. The Chinese garrison still occupied the fort, and received him and his party with kindness. All his endeavours, however, to obtain assistance for his further journey southward and westward to Kuldja were met by steady opposition, and he finally had to cross the frontier to the Russian town of Büsk. The president informed the meeting that Mr. Elias had not only accomplished a wonderful journey over a tract of Central Asia never visited by a European sincc the times of Marco Polo, but had executed, unaided, a survey of the whole route travelled. His very numerous observations for longitude and latitude had been computed by Mr. Ellis, of the Greenwich Observatory, and those for heights above the sea-level by Mr. Strachan, of the Meteorological Office. For this great service rendered to geographical science, the Council of tlse Society has just awarded him the Founder's Gold Medal for 1873.