Recovery from the passage of an iron bar through the head
|Recovery from the Passage of an Iron Bar Through the Head
|Published 1868 in Bulletin of the Massachusetts Medical Society. Reprinted in History of Psychiatry, Vol. 4, No. 14, 274-281 (1993) 10.1177/0957154X9300401407
The title of this work is often mistakenly cited as "Recovery from the Passage of an Iron Rod Through the Head" (because of confusion with Harlow's 1848 paper which was entitled simply "Passage of an Iron Rod Through the Head"). The first page of the article's text carries the headline "Recovery after Severe Injury to the Head."
The text given here is a series of excerpts. See Talk page for concern about reliability of this text, as it stands now, versus the original paper.
This case has been cited as one of complete recovery...
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He has no pain in the head, but says he has a queer feeling (in his head) which he is not able to describe. 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. The equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. 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 obstinate, 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. .. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart business man, very energetic and persistent in executing all his plans of operation. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage.”
...was accustomed to entertain his nephews and nieces with the most fabulous recitals of his wonderful feats and hair-breadth escapes without any foundation except his fancy. He conceived a great fondness for pets and souvenirs, especially for children, horses and dogs, only exceeded by his attachment for his tamping iron, which was his constant companion during the remainder of his life.
Remembers passing and past events correctly, as well as before the injury. Intellectual manifestations feeble, being exceedingly capricious and childish, but with a will as indominate as ever; is particularly obstinate; will not yield to restraint when it conflicts with his desires.
The iron ... entered the left cerebrum at the fissure of Sylvius, possible puncturing the cornu of the left lateral ventricle, and in its passage and exit must have produced serious legion of the brain substance-the anterior and middle lobes of the cerebrum-disintegrating and pulpifying it, drawing out a considerable quantity of it at the opening in the top of the head, and lacerating unquestionable the upper aspect of the falx major and the superiar longitudinal sinus.
Mentally the recovery was only partial, his intellectual faculties being decidedly impaired, but not totally lost; nothing like dementia, but they were enfeebled in their manifestations, his mental operations being perfect in kind, but not in degree or quantity.