The traumatic brain injury case of Phinias Gage in 1848 helped doctors begin to understand the way the brain works.
In 1848, Phinias Gage, a hard-working man and a pillar of the community, was working in Cavendish, Vt., laying down railroad tracks. He was using a 13-pound, 3-foot-long metal bar called a tamping iron as part of the process.
Gunpowder was also being used. The tamping iron apparently hit a rock causing a spark that ignited the gunpowder and the tamping iron flew into the air. Unfortunately for Gage, the flying iron entered his head, going in under his left eye and exiting at the top of his skull. The tamping iron damaged mainly the frontal lobes of Gage's brain.
Amazingly, Gage survived this traumatic episode but not without some serious consequences. His personality underwent a great transformation. His behavior changed from being a sedate and reasoned gentleman to a person whose behavior became inappropriate.
Prior to the accident he got along with everybody. After it, he could not get along with anyone. He also used excessive profanity, something he never did previously.
Physicians were astonished by the dramatic change in his behavior.
Since the frontal lobes were damaged by this unusual accident, the doctors concluded that the brain's frontal lobes were associated with behavior and personality.
Present-day MRI scans have subsequently shown that the frontal lobes of the brain are the most common areas injured following traumatic brain injuries because of their size and location.
Modern-day researchers have determined that frontal-lobe damage is associated with excessive risk-taking, difficulty solving problems, poor impulse control, memory loss, poor judgment, and abnormal social and sexual behavior.
The frontal lobe has been described as the body's emotional and personality control center.
This year, almost 60 years later, Harvard researchers have uncovered the frontal lobe neurons that are responsible for these various functions.
However, Gage and the physicians who cared for him didn't have to go to Harvard to find out what happens when the frontal lobes are damaged. Gage was living proof of the behavior changes that take place.
Dr. Murray Feingold is the physician in chief of the National Birth Defects Center, medical editor of WBZ-TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.