A HOLE IN THE HEAD

 

I suppose there are a hundred measures by which to assess the history of Phineas P. Gage. The most unlikely might be the field of phrenology, which held that just as a lifetime of muscular exertion leaves evidence on the leg and arm bones, mental endeavors - personality, intelligence and emotions - leave tell-tale imprints on the top of the skull: or so the theory went. 

Practitioners, like the American Orsen Squire Fowler (above), would run their fingers over the bumps on your head and divine your occupation, your character flaws, even why you were having trouble sleeping. 

But as profitable as the business was, even Fowler acknowledged, "....phrenology is either fundamentally true or else untrue..." - a statement which, standing alone,  is undoubtedly true. The ultimate disproof of phrenology would be provided by the words Pheneas P. Gage.

Phineas was originally an Egyptian title, meaning a dark or bronze skinned oracle. He first appears in the Old Testament  (Numbers 25, verses 7-8), as a priest's son who spies the Hebrew prince Zimri entering the Tabernacle with a Midianite woman. In a fit of offended religious passion, Phineas runs them both through with a spear. For this double murder, Moses rewards Phineas. His namesake may have paid the price for that excess of zeal.

His family name was English, which actually means it came from the French spoken in Normandy in 1066.  This Old French was mostly based on the everyday language spoken by Roman soldiers. In their Vulgate Latin a "jalle" was a measure of liquid, equal to our gallon, and a "jalgium" was the stick or rod inserted into the amphora to measure how much wine was left. Over centuries the pronunciation became a "gaunger" later shortened to "gauge". Thus a gauge is a standard of measurement. And by a happy coincidence, that describes Phineas Gage perfectly - an oracle of measurement.

In 1823 Phineas P. Gage was born in the southern New Hampshire village of Lebanon. He grew into a strikingly handsome young man, and a natural leader.  The doctor for the Burlington and Rutland Railroad,  physician John Martlyn Harlow, described Phineas as "...a perfectly healthy, strong active young man, 25 years of age...5 feet 6 inches tall...150 pounds...having had scarcely a day's illness...." 

Navies were members of the work teams - inland navigators -  who laid out the path of railroads crossing the land. The weak steam engines of the day could climb or descend no more than a 1 1/2 % grade, or rise 18 inches for every foot forward.  Any obstacles to this would have to be blasted out of the way.  But it was worth the effort because of the money that could be made from transporting resources by rail.

In 1825 Englishman George Stephenson's locomotive "The Rocket" (above) took less than two hours to haul 36 wagons of loaded with coal, nine miles from the mine to the docks on the River Tees. His steam locomotive was not only a revolution in speed, but also reduced transportation costs by two thirds. 

Competitors literally followed in Stephenson's tracks. George had set his new rails four feet eight and one-half inches apart because that was the "gauge" of the old rails used when the wagons were pulled by horses. And by decree of the royal commission of 1845, that would be the "Standard Gauge" for Britain, and eventually most of the rest of the world.

Just three years later, on Wednesday, 13 September, 1848 a Rutland and Burlington Railroad construction crew, headed by the 25 year-old foreman Phineas P. Gage, was preparing a road bed outside of the little mill town of Cavendish, Vermont. Each member had a simple job, which is to say their collective task was a technically complicated jigsaw puzzle of mundane occupations, which when combined in a specific order, changed the world. 

In this case, an engineer would determine where rock was to be removed. Team members would then pound a drill into the rock, creating a hole.  As foreman, Phineas Gage would then pour a measure of black powder into the hole. Then he would pour a measure of sand on top of the powder. Then Phineas would insert a fuse through the sand and into the powder. 

Then he would drop a 35 pound, three and a-half foot long iron tamping rod (above), sharpened at one end,  into the hole to compact the charge and sand. Finally, Phineas would light the fuse.

After the resulting explosion (above), other workers with shovels and carts would remove the broken rock while the foreman engineer would determine where the next charge should be placed.

Toward the end of a had day's work, the team had just about finished clearing a curved cut through a granite outcrop (above). At just about 4:30pm, Phineas ordered his weary drilling team to take cover yet again.  

Again Phineas poured black powder into the drill hole. But this time, in his haste or wearyness,  he forgot to add enough sand. So when he shoved down the iron tamping rod down the hole, it sparked against the granite. And without the insulating sand, that set off the black powder.

There was a bright flash and a sharp loud crack. 

In something less than one second, the 35 pound rod was driven out of the hole, penetrating just below Gage's left cheek bone, destroying his left eye, plowing through his brain and blasting out the top of his skull. 

The tamping rod landed 80 feet away, smeared in blood and brain matter..

As the smoke cleared, the startled crew rushed to Phineas' assistance. They found him awake and alert, but in great pain. 

With assistance Phineas was loaded aboard an ox cart, and suffered a jarring forty-five minute long, three quarters of a mile ride back to the Adams Hotel in Cavendish. During the ride Phineas called for his work book and made notes concerning the days progress. Once back at the hotel, Phineas was was placed in a chair on the front porch.

An hour local doctor, Edward Williams,  arrived. "I first noticed the wound," wrote the good doctor, "before I alighted from my carriage, the pulsations of the brain being very distinct."  The doctor recorded that his patient had a pulse of 60, was breathing regularly and his pupils were reactive. He reported no pain. "Mr. Gage...was relating the manner in which he was injured to the bystanders," wrote Dr. Williams, ".(and then) got up and vomited; the effort...pressed out about half a teacup full of the brain, which fell upon the floor."

The tamping rod had performed a frontal lobotomy on Phineas Gage's brain, disconnecting that part of his mind which dealt with "....future consequences... chooses between good and bad actions... (and) override(s) and suppress unacceptable social responses..." (Wikapedia - "Frontal Lobe"). 

Severing the neural connections with the frontal lobe causes patients to  "...not respond to imaginary situations, rules, or plans for the future..." and who tend to be  "...unusually aggressive ".  And in the case of Phineas Gage, he tended to ".. use puns a lot." In other words, Phineas Gage was a new gauge of the human brain.

About 6:00 pm a company doctor, John Martyn Harlow (above) arrived and took over treatment of the unusual young patient.

http://www.psywww.com/intropsych/ch02_human_nervous_system/lobotomy_effects.html

To no one's surprise, the company doctor decided the young man with the hole in his head could be quickly released from care. And despite several setbacks, Dr. Harlow deemed Phineas able to travel the thirty miles to his mother's home, in Lebanon, New Hampshire for Christmas in 1848.  

He returned to Cavendish in April of 1849, and Dr. John Harlow noted "his physical health is good, and I am inclined to say he has recovered. Has no pain in (his) head, but says it has a queer feeling which he is not able to describe."

Phineas never worked as a "navvie" again. Briefly he tried selling his story via public speaking engagements, and displaying the very rod (above) which had passed through his brain. 

But handsome though he still was, that career never suited him. Despite rumors that he appeared in P.T. Barnum's museum in New York, there is no evidence he ever did. Instead, in 1851, he found a job at the Hannover Inn in Dartmouth, New Hampshire, as a stable hand and coach driver.  Perhaps he found animals a better gauge of Gage than humans. 

Then in 1854 he moved to driving for another stage line , this time in Valparaiso, Chile (above). He took with him his "constant companion", that iron tamping rod. 

Phineas held down his new job for seven years, driving the 70 miles up and down the steep mountain roads (above) between Valparaiso, and Santiago. That would seem to me to be a far longer than you would expect from an unpredictable violent man, as Phineas was described in later medical texts. But I suspect those are just inventions based on old wives' tales. But one of the occasional side effects of a frontal lobotomy are seizures caused by scar tissue within the brain. And those now began to plague Phineas.

In 1859 Phineas rejoined his mother, sister and her husband, who were now living in California. He got a job as a farm hand in Santa Clara County (above), at the southern end of San Francisco Bay. But the seizures got worse, and on 21 May, 1860,  Phineas Gauge died of what the doctors called complications of epilepsy, six months short of twelve years after he forgot to load enough sand atop the black powder.

Phineas Gage died just as the American Civil War was exploding. Over the next four years the number of survivors with similar brain injuries multiplied. 

Doctors now had patients and skulls aplenty to examine, and upon reflection they reached several conclusions. First, it was clear that the bumps on the top of the head had no connection to anything going on inside the skull. Phrenology was bunk. But the disabilities of various head wound survivors (above) was proof that different sections of the brain did perform different functions.

And third, the old adage that medicine is the search for profit after death, was confirmed when in 1866, the ex-company Doctor John Harlow convinced (paid?) Phineas' sister and brother-in-law to disinter Phineas just long enough to chop off his head and ship the skull and the infamous tamping rod back to Boston. 

There Doctor Harlow used the skull as an exhibit in his second (and more colorful) paper on his most famous patient.  It was this paper which enlarged on the stories of his post accident temper and use of profanities. But there can also be no doubt that even after his death Phineas reset the gauge for our understanding of brain injuries.

A 2012 study by Harvard University determined the iron rode had "...destroyed approximately 11% of the white matter in Gage's frontal lobe and 4% of his cerebral cortex".  However, this study did our hero no good whatsoever. The story of Phineas P. Gage can thus serve as a parable of the dangers in being in the forefront of medical science.

- 30 -

THE GREAT KLUTZ

I can't make up my mind about William Huskinson. “Tall, slouching, and ignoble-looking”, he was

considered one of the best economic brains in England, a Tory (conservative) member of Parliament.  At the same time he also agitated for liberal issues, like equal rights for Catholics and Jews and election reform. But it wasn't William's contrariety in politics that confuses me, it was the way he kept falling over and off things. 

While on his honeymoon in April of 1799, a horse fell on him. Two years later he dislocated an ankle. He had broken his right arm so many times it was almost useless.  But was this genial scarecrow just a klutz, or did his bumbling rise to the exalted level of ironic? 

It was certainly ironic that the Liverpool and Manchester Railway was built only because of the enthusiastic intervention of the sixty year old MP from Liverpool, but it was also the L and M which was responsible for William's brutal demise. When, I wonder, does unfortunate become ironic?

William was effective in English politics because he was almost universally liked. His official biography described him as “extremely agreeable...generally cheerful, with a great deal of humor, information, and anecdote...As a speaker in the House of Commons...he had no pretensions to eloquence; his voice was feeble, and his manner ungraceful.” Still, because of his brains and his sense of humor, people tended to like him - important people, like Granville Leveson-Gower (above), the richest man in England. 

In Scotland, Granville, aka the Duke of Sutherland , aka the Marquess of Stafford, was reviled for his wholesale evictions of highland farmers, but in England he was respected because....well, because he was the richest man in England, because of the two things he had inherited from his in-laws - his talent for “absorbing heiresses” (he outlived three wives) and what he had inherited from his third' wife's uncle, the first “true canal” in England, the Bridgewater.

After its opening in 1761 the 39 mile long Blackwater Canal (above) had cut the price of coal powering the linen mills in Manchester by half, while making the first Earl of Bridgewater very wealthy. In 1776 a connection was cut to the river Mersey which allowed the finished Manchester fabrics to be inexpensively shipped out of the port of Liverpool, the transport taking only 30 hours, and thus making the Earl even richer. 

So it was no surprise that Granville, who inherited the canal in 1803, was not anxious to see Manchester wool merchants build a railroad and cut into his profits. Even with the canal, it cost as much to move the finish garments from Manchester to Liverpool as it had cost to ship the raw cotton from America. Granville successfully fought the railroad for years, until the Liverpool MP,  William Huskinson, suggested to his fiend that it might be more profitable joining the Manchester merchants rather then fighting them. 

With Wilkinson’s adroit assistance, a deal was struck. Granville became a partner in the railroad. And on Wednesday 15 September, 1830, a gala grand opening was staged for the 35 mile long Liverpool to Manchester Railroad, including a “whistle stop” visit (the very first in history) from the man who had beaten Napoleon, the Prime Minister, one time friend and ex-political ally of William Huskinson, Arthur Wellesley, the Duke of Wellington.

As a politician the Duke (above) was the perfect model of modern major General. He gave ground where it cost him little, as when he urged the repeal of laws restricting Catholics. But he dug in against repeal of the infamous Corn Laws. These slapped taxes on any grain exports from England, and just made things worse for the Irish starving from the potato famine. But the “Iron Duke” was a landowner and willing to defend the Corn Laws to the last breath of the last Irishman.

William Huskinson grew so frustrated with the Duke over the corn laws, he resigned from the government. However his resignation had not driven the Duke to back down, and William was hoping the ceremonies around the opening of the railroad would give him a chance to repair his relationship with his old friend Wellesley.

The Manchester and Liverpool railroad was the invention of George Stephenson, who had even manufactured a prototype locomotive – the Rocket - for the system. Stephenson had insisted on two tracks, one westbound from Manchester to Liverpool, and the other eastbound, so the line could safely carry twice as many trains. It was a good idea, but doubled the cost of construction. So Stephenson had saved money by placing all four of the rails equal distance apart.

His rational was that this not only eliminated an enormous amount of grading, but should a train have to carry anything wider than eight feet, it could simply shift to the two center rails, providing more elbow room on either side. What Stephenson could not know was that as speeds increased in the future, passing carriages would create a lower air pressure between them which, which would suck the carriages toward each other. That was one of the things experience would teach railroad engineers like Stephenson. And what happened this opening day, would teach them a few other things.

There were eight separate inaugural passenger trains which left Liverpool beginning at eleven that morning, The Duke's train was first on the eastbound tracks, pulled by the 14 horse power engine named the Northumberland, and made up of a car carrying a band (above), followed by six carriages carrying 12 to 24 passengers each.  In the carriage just in front of the Duke's sat William Huskinson with his wife Emily, and several other important politicians. 

The other seven trains, with about 60 passengers per car, traveled eastward on the westbound tracks, leap frogging the Duke's train, to provide numerous opportunities for all the celebrants to cheer and laugh and stare at the victor of Waterloo as the trains climbed their way the 35 miles uphill toward Manchester.

The trains all paused at Parkside station, an hour out of Liverpool and about halfway to Manchester.

At Parkside (above) the Duke's train stopped, while the Phoenix and the North Star trains passed ("like the whizzing of a cannon ball", said the Duke) with many shouts and cheers. Then it waited a few hundred yards beyond the station. As the water tank of the engine Northumberland was slowly refilled, about 50 men disembarked and walked between the rails to stretch their legs and probably unload their personal water  tanks, in a light drizzle.

William Holmes, the Chief Tory Whip suggested this would be a prime opportunity for William Huskinson to renew his bonds with the Prime Minister,  The two men walked the few yards back to the Duke's carriage where William extended a hand. The Duke, happy at seeing his old friend again, grasped William's hand firmly. They were about to speak when a shout went out, “An engine is approaching, take care gentlemen!”  In future decades this would be shortened to either "Look Out!" or "Heads Up!"

It was the Rocket (above), Stephenson's prototype, pulling another train of passenger cars. The driver, Joseph Locke, saw the men on the tracks about 80 feet ahead of him. There was plenty of time to stop, except the Rocket had no brakes. And no whistle to warn anyone on the tracks.  Nobody had thought of such safety devices.  Locke threw the little engine into reverse. There was still ample time to avoid injury, unless you were a major klutz –  like guess who. 

All the other men in the way managed to easily escape, either being pulled into the Duke's car, or running the ten feet or so across the tracks. But William Huskinson could not make up his mind. Initially the Duke tried to lift the scarecrow into his car, but William yanked free and started to dash across the tracks. Then, abruptly he changed his mind and returned to the car's side. The Duke shouted, “"For God's sake, Mr Huskisson, be firm!" and grabbed for him again. But William dodged rescue and bolted as if to cross the tracks yet again. 

Some one threw open the door of the Duke's car suddenly, and William reversed course a third time,  and jumped for the open door. He grabbed onto it just as the Rocket smashed it to smithereens. Huskinson, said eyewitness Harriet Arbuthnot, “was... thrown down and the engine passed over his leg and thigh, crushing it in a most frightful way. It is impossible to give an idea...of the piercing shrieks of his unfortunate wife, who was in the car (ahead).”

They dumped the band, because their car was the only one with a flat bottom, and carrying the right Honorable Huskinson on a door ripped off a track side shack, placed him gently aboard. The rest of the cars were then detached, Stephenson opened the throttles full, and the engine, the coal car, the wounded man and two doctors headed for Manchester at 40 miles an hour. 

Crowds cheered as the speeding machine raced past them. It was perhaps the fastest humans had ever traveled, except for the few unfortunates fired from a catapult. At this rate they would have made it to Manchester in less than half an hour, except ….except the clouds opened up and a storm broke upon the desperate mission.  The engine was forced to slow as it was felt the wet tracks could not afford traction.  

As they approached the little village of Eccles, less than four miles from Manchester, the conditions forced them to stop, supported by Huskinson who said he had a good friend in the village, the Reverend Thomas Blackburne. 

They managed to lug William up the steep slope to the village, dropping William a couple of times before depositing him on a couch in the vicarage. The Reverend Blackburne was not there, of course. He was in Manchester, waiting with the crowds to welcome the triumphant voyagers. Mrs. Blackburne, who was home, served tea.

“Blackwood's Edinburgh Magazine" noted that back at Parkside station, after much discussion, “The final decision being in favor of advancing, seats were resumed, and we moved on; but ...the whole now wore the somber aspect of a funeral procession. The military band was left to return as it could; I saw them, crest-fallen, picking their way homeward through the mud and mire...” At about nine that night William Huskinson died in a generous laudanum haze - generally considered the first man ever killed by a railroad locomotive.  An inquest was opened the very next morning, but the instant the jury seemed to show an interest in any failure by railroad staff or or it's line's design, it was pulled up by the coroner. Within a few hours, the verdict was “accidental death”. It does not seem Emily Huskinson agreed.

Half the population of Liverpool, about 69,000 people, attended William Huskinson''s funeral on Friday 24 September,  1830. Emily did not. She never returned to Liverpool again, and died in 1856, never having traveled on a train again. Would you?

Meanwhile the publicity surrounding the accident attracted passengers to the new rail line. In the next year half a million people rode the Liverpool and Manchester line at 7 shillings for the two hour round trip. All future locomotives built by George Stephenson were fitted with hand brakes and steam whistles. And Stephenson never again built a two track line with so little room for error between the rails. 

But the question remains unanswered to this day - was William Huskinson's death merely a  tragedy, or was it ironic? He was, after all, run over by the railroad he had done so much to get built.

                                                           - 30 -