Boston : A. Williams and company, 1870.
Description : front., xii, 759 pp. ; 1 pl., 23 cm.
Photograph: frontispiece is an albumen, montage of four images.
Photographer: S. Webster Wyman.
Subject: Anatomical museum catalogs.
Cited: Burns, Early Medical Photography in America,
p 1233:
Although itself containing only one composite photograph (fig. 3), the book is important in photographic history in that it documents early medical photography in America
Nor would the profession forgive me if I forgot to mention the admirable museum of pathological anatomy, created almost entirely by the hands of Dr. John Barnard Swett Jackson, and illustrated by his own printed descriptive catalogue, justly spoken of by a distinguished professor in the University of Pennsylvania as the most important contribution which had ever been made in this country to the branch to which it relates 1. — O. W. Holmes.
The most valuable specimen that has ever been added to the Museum, and probably ever will be, was given two years ago by Dr. John M. Harlow, of Woburn. It was the skull of the man through whose head a large iron bar passed, and who essentially recovered from the accident. For the professional zeal and the energy that Dr. H. showed, in getting possession of this remarkable specimen, he deserves the warmest thanks of the profession, and still more, from the College, for his donation. Unfortunately, and notwithstanding the evidence that Dr. H. has furnished, the case seems, generally, to those who have not seen the skull, too much for human belief. — preface.
The very small amount of attention that has been given to the above wonderful case, by the profession in this country, as well as in Europe, can only be explained by the fact that it far transcends any case of recovery from injury of the head that can be found in the records of surgery. It was too monstrous for belief, and yet Dr. Harlow has at last furnished evidence that leaves no question in regard to it. — page 149.
The frontispiece is a photomontage showing three views of the skull of Phineas Gage. A fourth view shows the skull next to a 3 ½ foot iron bar that passed through his head when an explosive charge that he was tamping down detonated prematurely. Gage survived, living another 12 ½ years. His attending physician was Dr. John Martyn Harlow of Woburn, Vermont who wrote two papers on this extraordinary case, the first one appearing in the Boston Medical and Surgical Journal 2 three months after the accident.
Recognizing the case for its importance in the study of brain function, Dr. Henry Jacob Bigelow of Harvard summoned Phineas Gage to Boston, incurring the travel expenses and gratuities himself. He took a cast of Gage's head, and wrote his own paper on the case which was published in the American Journal of Medical Sciences. 3 The Bigelow and Harlow papers are in opposition over the conclusions they draw from Gage's injury. Bigelow found Gage to be wholly recovered and this was proof enough to refute Gall's idea of any localisation to brain function. Harlow was not so sure and continued to study Gage, eventually providing incontrovertible evidence of behavioral changes which included a permanent loss of Gage's ability to plan for the future. Harlow pioneered in the difficult science of mapping brain function and his 1868 paper is still cogent for contemporary neurobiologists. In 1994, Dr. Hanna Damasio led a team of scientists to trace the exact injury caused by the projectory of Gage's tamping iron. Her lab at the University of Iowa ran computer analysis of Gage's skull and demonstrated a probable injury to the prefrontal cortices. A fascinating account of her work can be found in Descartes' Error 5 written by her husband and partner Dr. Antonio Damasio, providing comparative examples of his patients with Phineas Gage disorder.
It should be noted with curiosity that Harlow donated his specimens to the Warren Museum, choosing this repository over that of the Thomas Dent Mütter Cabinet associated with the Jefferson Medical College where he took his degree in 1844. Harlow would have studied under Mütter who assumed the chair of surgery in 1841 and although not much is known what Mütter thought of Gall and the science of phrenology, it is known that Jefferson College provided course work on the subject and it was at Jefferson that Harlow took up the discipline. John Collins Warren also advocated phrenology and his pathological cabinet began with the purchase of the Spurzheim collection of skulls. Both Warren's and Mütter's cabinets were established in 1847 but it was not until 1874, with the purchase of Hyrtl's collection of skulls, that the Mütter had a phrenological archive of any importance. Harlow probably chose the Warren over the Mütter because of the authenticity of its phrenological collection as it was Johann Gaspar Spurzheim who assumed the mantle of Gall. Furthermore, it was Dr.Warren who arranged for Spurzheim's sensational trip to America in 1832, who introduced him to Boston's medical elite and who found a home for Spurzheim's skull in his cabinet after he died a few months later. Lastly, it was probably significant for Harlow that the Warren cabinet held several other specimens of head injuries which were important for the study cerebral function including a remarkably similar case of a man who recovered after a length of pipe pierced his skull in a gas explosion. The iron pipe and a cast of the man's skull (specimens 952 and 3107 ) were presented to the museum by Dr. Bigelow in 1868, the same year that saw the publication of Harlow's second monumental treatise 4 on Phineas Gage and the year this most famous of skulls was nested in the Warren Museum.
The following link will bring up Jackson's transcription of Harlow's notes on the Phineas Gage case including a description of Gage's skull which Harlow donated to the museum and is listed as specimen #949 »». There are also descriptions of the iron bar (specimen #3106), a plaster cast of Gage's head made by Dr. Bigelow (specimen #960) and a skull model Bigelow made to demonstrate the angle of the path taken by the iron bar (specimen #951).
The following link will bring up Jackson's transcription of Bigelow's notes to another case remarkably similar to that of Phineas Gage; a man whose head was pierced by a gas pipe not that dimensionally different than Gage's custom forged tamping iron: Specimens #952 and 3107 »». Bigelow comments on the aphasia he found in his subject, but he makes no mention of damage to Broca's region of the brain which could have caused this debility. A brilliant surgeon, Bigelow would have known of Pierre Paul Broca's 1861 work6 which placed the speech function to the inferior side of the left frontal lobe. By omitting this reference Bigelow seems to be making a point of his skepticism of regional brain function, a point he emphasizes by observing that his patient suffered no paralysis — Broca's subject did suffer a hemiparalysis from brain lesion. To be fair to Bigelow, the gas-pipe probably missed Broca's region and damaged instead both the motor and auditory cortices although bone fragment could have been pushed into the left prefrontal lobe. Unfortunately a chance for an important autopsy was missed when Bigelow's patient returned to Ohio and presumably died there.
1. Holmes, Oliver Wendell, 1809-1894. Medical essays, 1842-1882 ;
Boston, Houghton, Mifflin, 1883.
2. Harlow, John Martyn, Passage of an iron rod through the head ;
Boston Medical and Surgical Journal, 39, pp 389-393 (also issued as an
offprint, vide Cordasco, 60-0808), 1848.
3. H. J. Bigelow, Dr. Harlow’s case of recovery from the passage of
an iron bar through the head ; American Journal of the Medical
Sciences, 19, pp 13-22, 1850.
4. Harlow, John Martyn, Recovery from the passage of an iron bar
through the head. (Paper read before the Massachusetts Medical Society) ;
Publications of the Massachusetts Medical Society, 2, pp. 327-347, 1868.
5. Damasio, Antonio R., Descartes’ error : emotion, reason, and the
human brain ; New York : G.P. Putnam, c1994.
6. Broca M. P., Perte de la parole, ramollissement chronique et
desstruction partielle du lob antérieur gauche de cerveau ; Bulletins
de la Société d'Antrhopologie, 62:235-238, 1861.
7. Broca M. P., Remarques sur le siége de la faculté du langage articulé,
suivies d'une observation d'aphemie (Perte de la Parole) ; Bulletins et
memoires de la Societe Anatomique de Paris 36:330-357, 1861.
