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"Anomalies and Curiosities of Medicine"

The blow was a very glancing one and did not
produce unconsciousness, and probably, as in the case of the
negro, because it did not strike with sufficient directness."
Head Injuries with Loss of Cerebral Substance.--The brain and its
membranes may be severely wounded, portions of the cranium or
cerebral substance destroyed or lost, and yet recovery ensue.
Possibly the most noted injury of this class was that reported by
Harlow and commonly known as "Bigelow's Case" or the "American
Crow-bar Case." Phineas P. Gage, aged twenty-five, a foreman on
the Rutland and Burlington Railroad, was employed September 13,
1847, in charging a hole with powder preparatory to blasting. A
premature explosion drove a tamping-iron, three feet seven inches
long, 1 1/4 inches in diameter, weighing 13 1/4 pounds,
completely through the man's head. The iron was round and
comparatively smooth; the pointed end entered first. The iron
struck against the left side of the face, immediately anterior to
the inferior maxillary and passed under the zygomatic arch,
fracturing portions of the spheroid bone and the floor of the
left orbit; it then passed through the left anterior lobe of the
cerebrum, and, in the median line, made its exit at the junction
of the coronal and sagittal sutures, lacerating the longitudinal
sinus, fracturing the parietal and frontal bones, and breaking up
considerable of the brain; the globe of the left eye protruded
nearly one-half of its diameter.


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