Título: Phineas Gage
Seção: Convalescence
Background: Phineas P. Gage (1823-1860) was an American railroad construction foreman remembered for his improbable[B1]:19 survival of an accident in which a large iron rod was driven completely through his head, destroying much of his brain's left frontal lobe, and for that injury's reported effects on his personality and behavior over the remaining 12 years of his life--effects sufficiently profound (for a time at least) that friends saw him as "no longer Gage". [H]:14 Long known as the "American Crowbar Case"--once termed "the case which more than all others is calculated to excite our wonder, impair the value of prognosis, and even to subvert our physiological doctrines" --Phineas Gage influenced 19th-century discussion about the mind and brain, particularly debate on cerebral localization,  [M]:ch7-9[B] and was perhaps the first case to suggest the brain's role in determining personality, and that damage to specific parts of the brain might induce specific personality changes.  [M]:1,378[M2]:C  :1347  :56

Conteúdo: Despite his own optimism, Gage's convalescence was long, difficult, and uneven. Though recognizing his mother and uncle (summoned from Lebanon, New Hampshire, 30 miles away)[H]:12[M]:30 on the morning after the accident, on the second day he "lost control of his mind, and became decidedly delirious". By the fourth day, he was again "rational ... knows his friends", and after a week's further improvement Harlow entertained, for the first time, the thought "that it was possible for Gage to recover ... This improvement, however, was of short duration."  Beginning 12 days after the accident,[M]:53 Gage was semi-comatose, "seldom speaking unless spoken to, and then answering only in monosyllables", and on the 13th day Harlow noted, "Failing strength ... coma deepened; the globe of the left eye became more protuberant, with ["fungus"--deteriorated, infected tissue][M]:61,283 pushing out rapidly from the internal canthus [as well as] from the wounded brain, and coming out at the top of the head." By the 14th day, "The exhalations from the mouth and head [are] horribly fetid. Comatose, but will answer in monosyllables if aroused. Will not take nourishment unless strongly urged. The friends and attendants are in hourly expectancy of his death, and have his coffin and clothes in readiness."  Galvanized, Harlow "cut off the fungi which were sprouting out from the top of the brain and filling the opening, and made free application of caustic [i.e. crystalline silver nitrate][M]:54[H1]:39

user: What was his recovery like?

assistant: Gage's convalescence was long, difficult, and uneven.

user: Did he fully recover?

assistant: walking about the house again". Harlow's prognosis at this point: Gage "appears to be in a way of recovering, if he can be controlled".

user: What happened to him next?

assistant: on the second day he "lost control of his mind, and became decidedly delirious".

user: What other symptoms or problems did he experience?

assistant: Beginning 12 days after the accident,[M]:53 Gage was semi-comatose, "seldom speaking unless spoken to,

user: How long was his recovery?

assistant: CANNOTANSWER

user: Any other odd behavior from Gage?

assistant: the morning after the accident, on the second day he "lost control of his mind, and became decidedly delirious".