The Hawaiian gazette., 1868-11-04

A REMARKABLE SURGICAL CAsE.-At
recent meeting of the Massachusetts Medi-
cal Society, DR.. John NJ. Harlow. physi-
clan and surgeon, Of Woburn, but formerly
of Cavendish, Vermont, read a paper con-
tanning the history of most interesting
case Of injury to the head, and presented
to the meeting the veritable skull which
sustained the injury.
The case occurred some twenty years
ago in Cayendish, Vermont, and was des-
sribed in the Traveller few days later.
On the 18th Of September, 1913, Phineas
p. Gage, foreman Of gang of men engag-
ed in blasting deep cut in the Rutland
and Burlington road, had a tamping-iron
blown through his brains, and recovered
within sixty days, living twelve years after.
The tampingiron was three and half
feet long, one and quarter inches thick,
pointed at one end, the taper being seven
inches long and the diameter Of the point
a quarter of an inch. 1t weighed thirteen
pounds. The point was upward, and the
iron smooth.
The missile entered the cheek outside
the teeth, and under the cheek bone, went
inside an inch behind the eye. and out of
the top of the head in the centre, two
inches back of the line where the forehead
and hair meet.
Gage was a perfectly healthy, strong
and active young man, twenty-five years
of age, of nervo-bilious temperament, five
and half feet in height, average weight
one hundred and fifty pounds, possessing
an iron will as well as an iron frame, muscu-
lar system remarkably well developed, hav-
ing had scarcely day illness from child
hood up.
One piece of the skull had been broken
out in fragments T; another piece was raised
and thrown back, like door, the scalp
serving as hinge; and on the opposite
side of the wound there was another
fracture and an elevation. The globe Of
the left eye was partially protruded from
its orbit, the left side of the face was more
prominent than the right, The opening
in the skull was two inches wide by three
and half long, and the brain was hang
ing in shreds on the hair. The pulsation
of the brain could be distinctly seen, and
the doctor passed his finger in its whole
length without the patient saying he felt
pain.
In ffty-nine days the patient was abroad.
On the third day there was an inflammation
and some delirium; and during several
weeks there was occasional delirium for
two weeks of the time the patient lay in
stupid condition. ana his death was ex-
pected and his grave clothes prepared.
On the 25th of November he went in
close carriage thirty miles to his home in
Lebanon.
The subsequent history of the case is
interesting. Gage came back to Caven-
dish in April, in fair health and strength
having his tamping-iron with him, and he
carried it with him till the day of his death
twelve years after. The effect of the In
jury appears to have been the destruction
of the equilibrium between the intellectual
faculties and the animal propensities. He
was now capricious, fitful, irreyerent, i'm
patient of restraint, vacillating-a youth
in intellectual capacity and manifestations,
man in physical system ard passions.
His physical recovery was complete, but
those who once knew him as a shrewd,
smart, energetic, persistent business man,
recognised the change in his mental char
acter. The balance of his mind was gone.
He went to various places, being en-
gagged here and there; he was year and
half in charge of horses at livery stable;
he was exhibited at Barnums Museum,
New York; and in August. 1852, four
years after his injury, left New England
forever, and went to Valparaiso with a
man who was going to establish line of
coaches. Here he lived eight years, oc-
casionally driving six-horse coach, and
enduring many hardships. In 1859 his
health began to fail. In 1860 he had
long illness, the nature Of which cannot
now be ascertained.
He now left Chill, and Dr. Harlow lost
oil trace Of him for some years, but finally
found out that he had mother and sister
in San francisco, wrote to them and as
certained that Gage had got there in 1860;
worked with farmer in Santa Clara, and
in February, 1861, was taken with epilep-
tic fits, afterward he worked in several
places and finally in May, 1861, had q q
succession of fits which lasted couple of
days and carried him of.