The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1886-08-01
THE GREAT AMERICAN CASE.
Interesting Discussion on the Subject of Brain
Troubles and the Effects of Injuries.

Troubles and the Effects of Injuries.
In the course Of paper on the localization OF
cerebral disease before the County Medical So
ciety, at the last meeting DIR. Frank Morrison
gave some account of the most notable injury to
the brain, with recovery, on record. English
surgeons called this the "Great American Case"
for along time, not believing such extensive de-
struct,on of the skull and brain possible without
death. But the case is well attested by the emf
nent surgeon, DR.. Bigelow of Boston, and is de-
tailed in nearly all modern works on surgery
and physiology.
Tho subject of this remarkable lesion was
Phineas P. Gage, aged twenty-five. who was
tamping a blasting charge in New Hampshire
quarry with pointed iron bar, three and half
feet long, one and quarter inch thick, and
weighing over thirteen pounds, when the charge
exploded, and the bar, point frat passed clean
through his head, entering at the left angle OF
the jaw, going behind the left eye, and coming
out just about where the soft spot is in an In
fants skull. At this point piece of the skull
bone, the size of the palm, was
raised, as on hinge. giving egress
to the bar which was picked up at some dis
lance covered with sblood and brains" The
patient was for tae moment stunned, but rode
homo on an OK cart, and after an hour walked
up long fight of stairs to his bed and was able
to give the surgeon straight account OF his In,
jury. His life was dispaired of, but he lived
twelve years thereafter, finally dying In Cali
fornia of epileptic commissions. No post
norton was made, but the skull was
afterwards exhumed and, with the crow
bar, Is preserved in Howard Medical Museum.
The case is generally quoted as one in which the
man was no worse off in body or mind, put this
is false. for, as his friends said, he was ''no
longer Gage Before he had well-balanced
mind; afterwards he was fitful, irreverent,
grossly profane, obstinate, capricious and vacil-
lating. He became a child in intellectual capac-
ity and manifestations, with the animal passions
of strong man. So marked was the change,
his contractors, who had thought him their most
capable foreman, would not employ him. Dr.
Morrison here made diagram Of the skull
and of the course Of the bar through
the brain, showing that the entire
injury in the american Crowbar Case" was in
the prafrontal lobe, and stated that destruction
of these lobes in monkeys for the purpose of ex-
pertinent, caused no paralysis of motion or SEN
sation, and electrical irritation of them causes
no motor reaction. SO the great American case
does not, after ali, contradict the results OF ex-
pertinent as to the function of the anterio-
frontal region of the brain. Vision was lost in
the left eye as to smell nothing is known. The
result OF the injury, was, on the whole, loss OF
balance, 80 to speak, between the intellectual
IacultleS ana the amman prOpeusltleS
DR.. Morrison's paper and diagrams were IL
Illustrated by two cases of paralysis from his own
practice, in which there was evident relation be-
tween brain injury and the paralysis of certain
portions of the skin and groups OF muscles which
were dependent for sensation and motion upon
the lobes of the brain injured
There seems to be a localzation of special
sensory aud motor regions in the human brain.
There is great deal of interest in this matter,
and some few facts seem established as the re-
sale @f nj nd nh nal avid
Many things have been learned of cerebral To-
calization by the study of pathology and the
phenomena of disease.
Mr.. Hughlings jackson, of London. has with
in the last month cut down TO the cerebral Gen.
ter" that controls the muscles of the thumb,
where he found a tumor, removed it, and,
presto, the paralysis was gone This is drawing
it very fine. Probably, as DR.. Wooden said, this
kind of study and experiment. along which the
line of DR.. Morrisons paper lay, as also one by
DIR. Houghton on an allied subject the week pre-
vious, had not been given attention because the
pnrenologists and bumpologists had brought it
into disrepute man with plaster cast and
a chronological chart hires hall; he may not
know the inside of a brain from the inside of
pumpkin, but he deceives the people and gets
their money. The extremists, like Gall and
Spurzheim, did good work. but they went
further than honest observation and experiment
carried them.
Some members of the society were very SAN
gune that in decade they should be able, when
there was paralysis of sensation motion, to
outright down to the tumor or the blood-clot
that caused the trouble; Others thought that such
wisdom might come in a thousand years!
The sudden cessation for several hours or
even days, of mental action, as the result of
shock and conclusion, when, for the time, the
man is mechanical automaton, acting the
lower plane Of sensation or instinct was graphic
ally brought out by cases reported by DR..
Kitchen and Coroner Rocker. In each case,
after four days, the person awoke as
from momentary abstraction, one
asking for his overcoat, aud the other
ordering the engineer to 'sslack ahead little"
showing that the mind began again just where
ii left off. The whole tenor of these researches
and cases is to prove that medical men are far
ahead of those of fifty years ago. before the
functions of even the spinal cord were known,
and infinitely beyond the time Of the French
naturalist Button, who regarded 'sbrains as
mucous substance OF very little Importance
Moreover, there is tendency for every doctor
to study his own cases of nervous dis
ease. as more positive knowledge is attained,
rather than to turn them over to specialists.
Nearly all diseases have nervous phase or ee-
ment in them to which the doctor must and does
give attention, and he who studies and masters
this part of it for himself is pretty sure to get
along we'll, and is working in the line of the
great master minds who have established the
basis of facts upon which mental physiology and
nervous affections depend.