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Phineas Gage is currently a Biology and medicine good article nominee. Nominated by CurlyLoop (talk) at 18:55, 30 May 2013 (UTC) An editor has indicated a willingness to review the article in accordance with the good article criteria and will decide whether or not to list it as a good article. Comments are welcome from any editor who has not nominated or contributed significantly to this article. This review will be closed by the first reviewer. To add comments to this review, click discuss review and edit the page.

	Phineas Gage was one of the Natural sciences good articles, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones Date Process Result December 20, 2005 Good article nominee Listed June 14, 2007 Good article reassessment Delisted
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Current status: Delisted good article

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Archives

Archive #1, through January 2009 Archive #2, through March 2013

Using Gage or his case

Could someone please provide me an example of a person being used as idiom for their set of circumstances. I'm not trying to be obtuse, I'm American and have never heard of a persons name being used as a placeholder for their life experience. I've always seen "Aristotle's reasoning..." or "According to Blackburn..." More to the point, I'm not familiar with people "...using Aristotle" as opposed to "using Aristotle's reasoning". Maybe this is a British turn of phrase? Any input would be appreciated. Padillah (talk) 12:42, 17 September 2009 (UTC)

Abundant examples (British and American) will be found via submission of "look to Aristotle" to a Google search, quotation marks included; then try "use Aristotle to". If you prefer, substitute Marx or Smith or Freud according to doctrinal inclination -- good results in any case. Googlebooks yields higher-quality citations than does the regular Web search. EEng (talk) 20:38, 17 September 2009 (UTC)

Thank you for that. Not only did it give adequate examples of the usage above, it also lead to some rather nice logical reading. I must admit, I've not seen that particular usage outside of subject specific text but it's not incorrect so leave it. Padillah (talk) 16:57, 21 September 2009 (UTC)

I'm glad you didn't turn out to be one of those tiresome persons insisting on some ridiculous rule learned from Miss Snodgrass in the 7th grade. EEng (talk) 17:22, 21 September 2009 (UTC)

Fast review by User:Garrondo

<-- Comments indented to this point are my responses to Garrondo's comments. (Garrondo, as I keep saying this is going to take some time, and I'll have to do it in pieces. Since your points and mine, new and old, cross-reference one another, it might be the best use of your time if you wait until I say I'm done before you go over it. Really your "points 1-5" posted Feb. 15 are the most important thing, but I want to address your earlier points first.) EEng (talk) 03:26, 7 March 2010 (UTC)

Garrondo's comments and edits

First of all I want to congratulate EEng for his work. The article is very complete right now, with many citations and a well researched. However after a fast review I find several issues; specially with style: In general I found the tone most according to a novel, historic book or journal article, but not to an encyclopedia: style in an encyclopedia should be more "cold" with less adjetives and valuation expressions, even if they are in the original sources. Some examples are:

• Weighing 13–1/4 lb (6 kg), this "abrupt and intrusive visitor" (completely irrelevant)

I cannot agree that an article is supposed to be "cold," as you say. Factual, neutral, verifiable, etc. -- yes. But not cold. Quite the opposite: an article should be engaging and inviting, including details which, perhaps, don't have to be there, but which nonetheless increase the reader's understanding of the context, sometimes operating at different levels for different readers. So, for example, Boston Medical & Surgical Journal's reference to Gage's tamping iron as an "abrupt and intrusive visitor" to Gage's noggin is just a fun detail many, but to a sophisticated reader interested in the history of medicine, it conveys the sense of bemused wonderment found in writing about Gage at the time (foreshadowed in the lead -- "The case...calculated to excite our wonder...) and offers a window into the less stuffy and more stately, more literate style of medical wrioting of the time in contrast to today (one of delights of researching Gage, by the way). You won't find writing like that in New England Journal of Medicine -- which believe it or not is the modern title of Boston Med & Surg J!

• Despite Harlow's skillful care (Irrelevant and common sense: otherwise is clear to everybody he would have died)

See below.

• Harlow's 1868 presentation of the case is by far the most informative (An irrelevant valuation)
• A similar concern was expressed as far back as 1877 (better to say in 1877 since we can not know if there has been anybody saying it between him and McMillan)
• Aside from the question of why the very unpleasant changes usually attributed to Gage would inspire surgical imitation: that is quite irrelevant and highly journalistic. It could simply be eliminated.

Macmillan's paper on the (lack of any) relationship between Gage and lobotomy explains why this is relevant, and I've added a note on the subject to the article,

A second problem I find is the great overuse of verbatim citations. The importance of the longer ones is out of discussion. However sentences such as

By November 25 Gage was strong enough to return to his parents' home in Lebanon, N.H., where by late December he was "riding out, improving both mentally and physically." In April 1849 he returned to Cavendish and paid a visit to Harlow, who noted at that time loss of vision (and ptosis) of the left eye, a large scar on the forehead, and "upon the top of the head...a deep depression, two inches by one and one-half inches wide, beneath which the pulsations of the brain can be perceived. Partial paralysis of the left side of the face." Despite all this, "his physical health is good, and I am inclined to say he has recovered. Has no pain in head, but says it has a queer feeling which he is not able to describe."

are really tiring for the reader; when they could easily converted into prose My proposal in this case would be something similar to:

By November 25 Gage was strong enough to return to his parents' home in Lebanon, N.H., where by late December he was improving both mentally and physically. In April 1849 he returned to Cavendish and paid a visit to Harlow, who noted at that time loss of vision and ptosis of the left eye, a large scar on the forehead, and a skull depression of two inches by one and one-half inches wide. Despite all this Harlow considered that he was almost completely recovered.

Finally there is also an overuse of unneeded brackets and (I do not know the name in English), both quite tiring to reading: In addition to verbatim citations examples are:

• then compact ("tamp down") : Could simply be eliminated

People don't seem to know what a "tamping iron" so some explanation is needed. But I rewrote to eliminate the quotation.

• A "fungal" infection: Why not A fungal infection?

Because to Harlow a "fungus" was (OED) "spongy morbid growth or excrescence, such as exuberant granulation in a wound" i.e. the body's own reaction to the wound, not an infection (though this growth was itself clearly infected severely, probably by bacteria; see Macmillan 2000, p.61 for more). Putting "fungal" in quotes alerts the reader that the word is not being used in the usual sense. Even though I'll be reverting your change in this and many other cases, the exercise has been extremely helpful, because it shows where explanatory text (or a note) should be added (e.g for "fungus").

• consistent with a "social recovery" hypothesis: consistent with a social recovery hypothesis.

I'll try to propose further improvements (probably more important than the stylistic changes proposed) along this week. Bests.--Garrondo (talk) 08:09, 8 February 2010 (UTC)

Editing

I have the article according to some of the simplest of my above points. However other possible eliminations are more open to discussion. I am going to go ahead with some changes with the aim of simplifying language and structure of some sentences and eliminated not very relevant data. I will add here any sentences I eliminate and their rationale for elimination so if somebody does not agree it can be added back.--Garrondo (talk) 15:20, 9 February 2010 (UTC)

Gage's accident

• (via a laborious process which today might best be thought of as chiseling): Not really relevant to topic and complicate too much structure. Topic is Gage and his accident, not the method of drilling rock
• this "abrupt and intrusive visitor" was said to have landed some 80 feet (25 m) away.. Too much novelesque language but does not really add info (abrupt and intrusive). "Was said to have landed": As everything else in the article we base it in original and secondary sources. Unless there is a reason to doubt it it can be eliminated. Sentence changed to: it landed 80 feet (25 m) away.

It would be incorrect to say, "it landed X distance away" because reports of the distance varied, and since it's a quantitative statement it needs to be qualified as inexact. The only alternative to "...said to have landed..." would be to just say it landed "far" away and that's hardly helpful to the reader. (The distance does matter because it puts a limit on the speed as the bar left Gage's skullm yucky as that sounds).

• Despite Harlow's skillful care. Eliminated skillful: Do we have any indication that it was above what is expected for a physician of that time? Did he do anything unusual? It probably was an average care.

Harlow's management of the case was creative and well above the norm for the time. I've added cites to Macmillan's and Barker's discussion of this.

I will continue with other sections along the week.--Garrondo (talk) 15:20, 9 February 2010 (UTC)

Subsequent life and travels

• in New York City (the curious paying to see, presumably, both Gage and the instrument that injured him) although there is no independent confirmation of this. Recently however, evidence has surfaced supporting Harlow's... There is no confirmation for this but neither there is for almost everything... We base our knowledge on Gage in Harlow's, and there is no reason to doubt on its veracity, specially with the later sentence. Changed to: both Gage and the instrument that injured him). Evidence has surfaced supporting that Gage made public appearances in the larger New England towns For the second sentence a reference is needed.

Bests.--Garrondo (talk) 15:29, 9 February 2010 (UTC)

EEng's thougts on above

Garrondo, your careful attention is very much appreciated! And I want to mention that you (along with User:Delldot and others) did the really hard work of building the article from scratch long before I got involved two years ago. Many of your recent changes point out weaknesses (some of which I knew about and hadn't got around to ). But many show misunderstandings -- you don't seem to have absorbed the sources cited for the material you're changing, and often the statements in your edit summaries are factually incorrect. To avoid the article carrying misinformation too long, I'm going to revert some of those changes immediately, making the best explanation I can in the edit summaries; later (maybe over the weekend) adding further explanation here.

Beyond straight-out factual issues are your concerns about whether certain material is relevant, or whether material can be paraphrased, rather than quoted, without loss of meaning. Again, you really need to read the context of a given quote, as found in the cites, before paraphrasing it in a way which you assume to be equivalent, or which changes the meaning in "minor" ways which you assume are safe. Similarly, you can't assume that omitting this or that material won't damage the reader's understanding of the case it its context, unless you carefully check the cited material from which it came and secondary sources discussing it. Interpreting Gage -- particularly, making sense of the conflicting things written about him in the 19th century -- requires careful attention to the shifting medical and popular meanings of terms we take for granted as settled today. An example of how much less settled ideas about the brain were in Gage's time: it wasn't even generally recognized that injury to one side of the brain tends to affect movement or sensation on the opposite side of the body, much less did many mid-19c physicians accept that brain injury might affect "higher functions" such as language and behavior. So in saying a patient "recovered," he might -- depending on his training and doctrinal inclination -- only mean that movement and sensation are unimpaired, any behavioral changes being ascribed to something other than the brian injury, or simply ignored as not even medical issues in the first place. That's why the article quotes Harlow's and Bigelow's statements about Gage's "recovery" -- to acknowledge them as the two men's individual wordings, each needing individual interpretation according its source. (For example, Bigelow was hostile to phrenology, while Harlow was almost certainly influenced by it to some extent.) To simply write, by paraphrase, that Harlow said Gage was almost fully recovered, leads the reader to interpret the word recovered in its modern sense, comprehending the far wider range of functions for which we now believe the brain is responsible, compared to some (but not all) physicians 150 years ago. And to change Harlow's words, "His health is good, and I am inclined to say he has recovered," into a narration that Harlow considered that was almost completely recovered absolutely changes the meaning as a modern reader will interpret it, especially when one considers the question in light of everything else Harlow writes. These issues are extensively discussed in Barker, Macmillan 2000, Macmillan 2008, and other cited material.

You omitted Harlow's mention of Gage's hard-to-describe "queer feeling in the head." This is a phenomenon often associated with certain brain injuries -- see A.R. Luria's The Man with a Shattered World -- and tying Gage in to Luria's description 100 years later vividly ties Gage to the modern theory of brain-injury rehabilitation, for those with the background to recognize it. This is another example of text working at different levels for different readers, and should be retained.

Contrary to what you say, not every physician was a "doctor" at the time (and in fact for a long time in the UK, some classes of surgeons were styled Mr. not Dr.).

In other cases, you've made edits which, on simple grammar and punctuation alone, change the meaning into an incorrect or ambiguous one on its own face, having nothing to do with interpretation. Example: Harlow noted loss of vision (and ptosis) of the left eye makes it clear that the loss of vision, as well as the ptosis, affected the left eye only. Your text loss of vision and ptosis of the left eye is unclear as to whether of the left eye applies to loss of vision, or to ptosis only -- ambiguously suggesting that the loss of vision might have been in both eyes. The parentheses correct this. (Commas could be used instead, but in a sentence with many commas already, parentheses help subordinate this phrase to the larger structure. You seem to dislike parentheses for some reason, but they are completely acceptable in good writing, when used carefully. The same goes for dashes (—) as well, I might add.)

Another important point (I had meant my comments to be brief, but it's not working out that way...): Contrary to what you say, almost everything Harlow tells us about Gage's movements has been independently verified one way or another -- see Macmillan 2000, 2008 especially. That's why, for example, it's specially called out that the Barnum appearance is unverified (despite several ransackings of Barnum archives in locations throughout the US).

As I said, I'll make certain more urgent reversions now, others in time, and if the edit summaries don't satisfy you please start a list here, where we can continue discussion on individual points. In the meantime, please continue to make further changes you think are helpful. I'll either leave them alone (or build on them), revert with explanatory edit summaries, or (in many cases) revert while adding explanatory text so the text won't mislead future readers the way it has you. That seems the most efficient way to do this -- no need to discuss everything in advance (unless you feel the need) -- just be bold and we can revert-discuss as necessary. But please do more carefully review the cited sources before making further changes. Misplaced Pages Excelsior! EEng (talk) 22:13, 10 February 2010 (UTC)

(Later) Well, Garrondo, I'm sorry to say I ended up reverting almost all your changes. There's an explanation on each individual edit summary, though in a few places I'll add more explanation here on Talk, but that can't be for a few days. But (and I really mean this) this has really helped, because it showed how many places extra explanation is needed. You'll see one added note already (which I fear you might think frivolous, but it's really not -- the tenor of the times was important to the fate of the case in medical history) and I'll be adding at least two others, one on "fungus" and one on "drilling" -- probably a few more as well. Please do keep making proposed changes, frustrating as that may seem, because they really are helping me see the article in a new light. And please feel free to "push back" here on any of my reversions. EEng (talk) 02:31, 11 February 2010 (UTC)

I do not agree with most of your explanations and I believe that at least in most cases they are related to a conscious or most probably unconscious sense of ownership over the article. From now on I won't edit any more the article since I do not feel that collaboration is really welcome. Having said this I still hope that we could make a better article together. I will point out some comments, if I feel they are heard and addressed I will continue pointing more, if not I will simply leave you at your own. --Garrondo (talk) 09:48, 12 February 2010 (UTC)

Oh dear! I was afraid something like this might happen. I really don't want you to feel that way -- remember, I contacted you especially asking for your thoughts, and that was sincere. But look, the only way to work together to make the article better (and there's lots to be done) is to discuss our different points of view. I said I would annotate your original comments in the next few days, and I'll do that, and then we can discuss from there. I don't know any other way. In the meantime if some of my edit summaries don't satisfy you, list them here for discussion. Similarly, please annotate my reasoning above where you disagree. But you really, really have to read the sources cited (the secondary ones, I mean) to understand why many things are the way they are. EEng (talk) 12:38, 12 February 2010 (UTC)

More than offended I had the feeling of work being useless. Nevertheless I still want to try to work in the article because it is an article I am really interested and in general I believe you have done good work. However I would change to an approach which leaves to you all decisions regarding the article. I will only do peer review, commenting in the talk page. It will be up to you to decide on using it or not and it is there and then were you would have to prove how much open to change you are. Bests.--Garrondo (talk) 18:23, 12 February 2010 (UTC)

More comments from Garrondo

Some of my editions were intended to eliminate some quotation marks. I have counted more than 140 which makes 70 quotations. When I read the full article they make me really tired and they are far from improving prose. From my point of view the article will improve if many of the direct quotations are converted into prose. (More comments soon).--Garrondo (talk) 10:09, 12 February 2010 (UTC)

I did a quick check and only two or three of your changes involved dropping quotes, and in those cases they set off unusual terms with which most readers would be unfamiliar, such as "social recovery." If there's a Misplaced Pages article to link to, that would be better than quote marks, but I can't find one. As I write I realize some of these cases could use italics instead, and maybe that would be better. But I have to get to work now. Let's talk later. EEng (talk) 12:38, 12 February 2010 (UTC)

That is because I preferred to try what I thought that were going to be simpler editions to more complex ones. I would not use italics, since the problem is exactly the same and additionally the article will not be consistent. Solution should be to convert into prose. There are many places that using the exact same words as in the primary source is not at all a necessity. Some probable examples

• "a vainglorious tendency to show off his wound," an "utter lack of foresight: why not simply a tendency to vainglory from his wound and lack of foresight
• "up and down stairs, and about the house, into the piazza," and while Harlow was absent for a week, Gage was "in the street every day except Sunday," his desire to return to his family in New Hampshire being "uncontrollable by his friends...got wet feet and a chill." He soon developed a fever, but by mid-November he was "feeling better in every respect...walking about the house again; says he feels no pain in the head." Harlow's prognosis at this point: Gage "appears to be in a way of recovering, if he can be controlled." (There are 4 quatations in 3 sentences!!!) A possible alternative for the second part would be something similar to: He soon developed a fever, but by mid-November he had recovered from it, was walking again and had no pain in the head. At this point Harlow thought that he was going to get over his injury if he could be controlled. (I am really tired today; I have just given an speech in which curiosly I have talked about Phineas Gage; so I do not feel capable of thinking something for the first part of the sentence; and anyway these are only examples).
• "riding out, improving both mentally and physically.": is it really necessary to say the "riding out"? Does it add ANY information? Why not simply improving both mentally and physically and no quotes?
• "upon the top of the head...a deep depression, two inches by one and one-half inches wide, beneath which the pulsations of the brain can be perceived. Partial paralysis of the left side of the face." I think the part of the pulsations is probably much to gory and does not really add much. How about something like: and at the top of the skull a depression two inches by one and one-half inches wide which put in direct contact the scalp skin with the brain's surface. Gage also suffered from partial paralysis in the lef side of the face.

With rephrasings similar to the ones above we should be able to eliminate many of the messier quotations(I will point some more ones on Monday).--Garrondo (talk) 18:25, 12 February 2010 (UTC)

On the other side I agree completely with delldot on the article having a non-neutral, essay-like tone with the bullets section being the most clamorous example.--Garrondo (talk) 20:09, 12 February 2010 (UTC)

In a more general perspective the article from my point of view gives undue weight to the misuse of the case in comparison to the importance of the case: While in the lead it is commented that it has had great importance in the history of neuroscience nothing else is said but a line to Damasio's theory afterwards. I find the misuse section very interesting but it should come only after a whole section commenting at least some of the following points:

• 1-How has the case influenced the knowledge on the relationship between behavior and brain.
• 2-How has been used by different schools of thought (again only a line in the misuse of the case is said, while the fact that two different schools used it as an example on opposite theories is not really a misuse).
• 3-How it is in accordance with the knowledge on the functioning and damage consequences knowledge we have today on the frontal lobe
• 4-How it is still used as an example in many textbooks (lead should only be a summary of the text below, the line that it is said in it should be expanded in the text)
• 5-A more in-depth coverage of Damasio's theory.

Otherwise it is using a Non Neutral Point of View. The fact is that the consequences commented by Harlow are common in people with frontal lobe damage, so Harlow's description of Gage sequels is still today a valid one. The fact that there may be some factual incorrections in the description should not be given more importance. In this sense only one author (an important and fruitful one nevertheless) says that the description is not correct so the article would be greatly improved if this was shown.--Garrondo (talk) 11:37, 13 February 2010 (UTC)

Hey, Garrondo, I've started work on adding my comments and explanations to your comments above, but it's a big job and not nearly done (it's not really something that can be done piece by piece). But I have made some changes to the article which I hope address some of your concerns. Your points 1-5 above are good ones, and I'd much rather talk about them (substance of the article) and worry about use of quotes and other stylistic stuff later.

One particular thing I'm realizing is that you seem to think the article questions the accuracy of Harlow's description of Gage's behavior. It absolutely does not do that, and I've tried to make that even more clear. The issues with Harlow's description are these:

• it's unclear when the different things he says about Gage apply -- some may apply soon after the accident, others years later. And once you realize the possibility of Gage having made a substantial recovery over the years, it becomes really important to figure that out.
• Some of what he says comes second or third hand, and so must be taken with caution (in particular, such stuff may be incomplete)
• As discussed already in my comments further up, words like recovered are very tricky to interpret, depending on the medical training and background of the writer

I think it's also very important that you read up on the key secondary sources -- pardon my saying, but from some of your comments it's clear you haven't done that. And I can understand that -- there's a lot to go through. But the fact is you're the only person taking a substantial interest in the article, your concerns are quite sensible, and there's no way we can have a productive discussion on e.g. your POV concerns unless you have access to the cited materials. Here's what I consider essential reading: Macmillan 2000 (the book), Macmillan 2000 ("Restoring" paper), Macmillan 2008 (), Barker, Ratiu, plus and , and finally a Macmillan paper not cited, "Phineas Gage: A case for all reasons" . If you have trouble getting any of those I can help -- I'll even send you Macmillan 2000 if you really need it. It's that important to me that we be able to work together well. (I'd also like to know more about your talk on Gage.) EEng (talk) 15:28, 16 February 2010 (UTC)

The truth is I do not have neither access nor time to read the secondary sources that I have not red (Mostly McMillian). It is true that I have not red them, but I do not doubt on the conclusions you draw from them. In that sense I believe that the distortion and misuse is a section that clearly should be maintaineed. The problem is that what I do not see anywhere in the article (but a line in the lead which should be a summary of the article which is not right now) why the case has had such an impact. This missing section is probably the most important point in the article, since with out it the article would be a non-notable anecdote of a survivor. Moreover the misuse section does not make sense without a previous section where it is said how the case has been used since its occurrence until today. We should center our efforts to decide wether this section is a neccesity and what should include.--Garrondo (talk) 16:11, 16 February 2010 (UTC)

sexually molesting small children

An anon recently removed a claim that he was accused of "sexually molesting small children", which was using this as its source. It was added by EEng as an example of how "Gage" has been misused.

I'm wondering whether mentioning the course notes is a bit of original research, unless the source has been subject to criticism by other sources.

More importantly, was there ever an accusation of this kind? i.e. Are the course notes referring to real accusations made by others, or did the writer of the course notes invent this.

If it was not an invention of the course notes, it is unfair to point to the course notes as if they are the one who is misusing Gage; we should find the original accusations in order to put the course notes in perspective. OTOH, if it is an invention, can it not be excused as a form of pedagogy, especially as we are only seeing the printed course notes and we are not familiar with how it was presented to the students. John Vandenberg 03:30, 29 June 2010 (UTC)

Nothing relating to this should go in in any form whatsoever without a highly reputable source to back it up. Looie496 (talk) 03:50, 29 June 2010 (UTC)

I've added some specific cites on point, but I can see the OR concern -- give me a bit to address that. EEng (talk) 04:04, 30 June 2010 (UTC)

No worries. John Vandenberg 08:01, 30 June 2010 (UTC)

Great article!

I read the whole thing, was drawn in and was fascinated, really fantastic. It's appropriate for subject. Should be featured. Shame so many people don't recognize talented and quality work, commercial encyclopedia's would pay good money for this. The comments above about "cold" writing being required at Misplaced Pages is just lol. In fact Misplaced Pages is 95% awful writing (myself included) so when we see actual rare good work, the crowd can't stand it because it sets off the rest to look so bad and amateur. Anyway, don't take my word, look at the user reviews at the bottom of the page, and article view statistics. People love this article. Green Cardamom (talk) 03:38, 13 September 2011 (UTC)

Yes. A lot of that "professional" quality comes from the work of EEng in 2008-2010. This article was once rated a "Good Article" (in 2007), but was delisted in 2008, before EEng started working on it. It might be worth renominating -- however EEng has not edited since March of this year, so would probably not be available to deal with issues that arise. I could probably take care of minor stuff, but I'm definitely far from an expert on Gage. Looie496 (talk) 15:29, 13 September 2011 (UTC)

I'm sorry to say I just got out after six months in prison (they block Misplaced Pages) so it's comforting to find such friendly voices here on the outside. (Just kidding about being in prison -- you didn't really believe that, did you?) I can't deny I'm tickled by the praise for the article above and below. I did put a lot of work into it, but it's no false modesty when I say that it was others (Garrondo especially) that did the essential work of putting it together in the first place. If I'd started it on my own from scratch it wouldn't be nearly as good. EEng (talk) 01:09, 16 September 2011 (UTC)

Just stating for the record that it was me who missed the "just kidding" part. You are all, therefore, warned as to the competency of my editing! --Tryptofish (talk) 18:14, 14 March 2012 (UTC)

P.S. I'm amazed at how little (relatively) the article has changed while I've been gone, but of course I'm gonna look it all over now. Y'all please let me know if I you think I do something unwise. EEng (talk) 01:35, 16 September 2011 (UTC)

I echo the praise. Far too many Misplaced Pages articles are cold and sterile (if sometimes littered by the leftovers of earlier POV wars). The passion in this one makes it much more informative and interesting. Where such passion would get in the way of objectivity and NPOV, it of course would need to be toned down. And it's unrealistic to assume that all of our articles will ever get such treatment. But let's not tone it down in a search for anodyne consistency of style. I respect that there are a range of criteria for this, but as far as I am concerned, this is more deserving of being a Featured Article than many others we have. Martinp (talk) 17:10, 13 September 2011 (UTC)

Yes. Very interesting read about a very interesting man. The author(s) of this article certainly did him justice. By the way, does anyone else thing that Phineas Gage bears a striking resemblence to Christopher Reeve? Van Vidrine (talk) 19:17, 13 September 2011 (UTC)

The resemblance to Reeve is frequently commented on. Search for Reeve (see esp. the July 24 comment). EEng (talk) 01:09, 16 September 2011 (UTC)

Comments

I see this excellent article has been the subject of numerous comments already so I'll try and keep this relatively brief. I should also say at the start that I haven't consulted any of the secondary sources cited in the article so my comments should be read under the presumption of my own ignorance (I could probably get most of the articles cited but I'm less certain I could locate Macmillan's book-length treatment).

Coverage: As a reader, the one item I'm left dissatisfied about is the coverage of the manner in which the Gage case was used to advance or support theories relating to cerebral localisation or other aspects of psychology, behaviour and brain function. As it stands this is limited to a brief mention of a 19th century dispute in regard to localisation theories and Antonio Damasio's hypothesis linking the frontal lobes to emotions and decision making. Note D indicates that Harlow's (1868) account was, at least until 1974, the second most cited source in 20th century psychological texts. I would like a better sense of what theories or hypotheses Gage's case was used to illustrate or support, however erroneously.

Style: In regard to the writing style, I should preface my remarks by stating that it is excellent overall and I wouldn't favour changes that are likely to render it less engaging. However, I feel there is at times an overuse of both parentheses and dashes. I think, personally, these should be used somewhat more judiciously. Dashes are useful in lending a particularly emphasis to a section of text but retain that effect only when used sparingly. Parentheses, used to clarify a point or term, I'd really only include when absolutely necessary. Otherwise, if overused, both dashes and parentheses can lend something of juddering effect to the reading experience. In regard to the use of dashes, I think that this is most evident in the lead where in many instances I would advocate the use of commas instead. If say, you removed about half of the dashes, the text they are removed from may flow better whereas their effect where they are retained would be greatly enhanced. Similarly with the use of parentheses, some should probably be retained but many, I think, should not and the information would be more easily digested if commas were substituted for brackets or if new sentences were introduced. In fact, in some instances notes could be used.

Footnote 38 should follow the bracket, no?

Note C: I'd actually like to see some of this note integrated into the main text (esp. "The leading feature of this case is its improbability ... This is the sort of accident that happens in the pantomime at the theater, not elsewhere").

Note K: "Contrary to common reports" - assuming this observation is derived from Macmillan, why would it need a separate citation?

An excellent article overall. Will it be nominated for Good or Featured article status? FiachraByrne (talk)

van Horn

[The following is continued from elsewhere

Hello. You may have noticed that I have made repeated edits to the Phineas Gage page that you appear to moderate. Each time, you reverse the edits and remind me that the source I am using has been added to the further reading. I do not agree that this is sufficient representation of the findings. The Van Horn article is the only significant research of the Gage case in nearly ten years. The Warren Anatomical Museum has stated that they are the last group who will have had access to the famous skull, as it is becoming too fragile. The article has been featured in the Huffington Post, the Guardian, Discover Magazine, NPR, CNN, and various other news sites. Your reasoning seems to be that the findings are too technical, but I do believe that the difference between grey matter and white matter is simple enough for your readers (it ought to be, since you have pages for both that go quite in depth into the difference). I earnestly believe that the only study to ever examine the damage to white matter, the massive part of the brain underlying the thin coating of grey matter, deserves it's own sentence. Even if the study does not deserve a mention, I think the damage to the white matter is relevant to readers and at least the simple fact that damage to white matter occurred must be mentioned in the article even if you choose not to point out that this damage was far more widespread than the grey matter damage that you mention in dozens of citations. If you can explain to me why this small, one-sentence fact does not belong on the page, I will happily stop re-editing the article. Additionally, after viewing the talk page for the Phineas Gage page, I noticed that I am not the first user to have asked for the inclusion of this finding.

UCLA Lab of NeuroImaging —Preceding undated comment added 21:55, 13 March 2013 (UTC)

First of all, welcome -- sincerely -- to Misplaced Pages. The project can really use someone with your interests and expertise. I'm pinging another editor who is more broadly involved with medical topics (as far as medicine goes, my exclusive interest is Gage) to let him know you're here.

Some miscellaneous points:

• I'm not any kind of moderator or administrator. I'm just an editor like you.
• Misplaced Pages doesn't allow shared, institutional, or "role" accounts -- each account is to be used by exactly one person, so you'll need to stop signing as "UCLA Lab of Neuroimaging". See WP:ROLE, WP:NOSHARE.
• Please remember to sign your discussion posts with ~~~~.

Here's my response to your concerns. I hope it won't come across as a sledgehammer applied to a walnut, but I want you to understand that everything I did was for careful reasons:

• Our editing interactions:

• On March 6 you added this to the article:

Van Horn et al. (2012) created a 3D digital mask based on CT images of Gage's skull, and calculated 1.303×10³ viable rod trajectories. Their calculations uniquely take into account the reports that Mr. Gage was speaking at the time, and therefore would have had his jaw open. After morphing the T1 anatomical and diffusion images of 110 right-handed males, aged 25–36 into the digital mask, the researchers were able to calculate the likely cortical damage, as well as the white matter fiber networks likely to have been damaged or removed by the tamping iron. While the average percentage of total cortical grey matter volume affected was 3.97±0.29%, the amount of total white matter volume lost

Apart from being at far too technical, most of this text was taken word for word from the van Horn article, and that's a no-no. I therefore removed it .

• On March 7 you added to the lead a cite to van Horn for the statement that the accident had destroyed Gage's left frontal lobe. In general, statements in the lead aren't cited if they recapitulate material cited elsewhere in the article and (if truth be told) inserting this cite in the very first sentence gave me the impression of wanting to give special prominence to this particular source. This edit also inserted

Van Horn et al. (2012) demonstrated that the damage extended beyond the left frontal lobe into the left insular cortex and left temporal lobe, as well as into the underlying white matter

I believe this is mistaken, because what van Horn says is (underline added) "Regions whose connectvity affected included: left frontal lobe ... left insular cortex and the left temporal lobe." That the connectivity of certain regions was affected does not mean that those regions were themselves damaged, and in fact van Horn specifically states that the "injury is specific to left frontal lobe." (This is certainly outside my expertise so please correct me if I'm wrong.)

I removed that statement, but modified other text to reflect that van Horn confirms Ratiu and Harlow in believing that the right F.L. was undamaged.

• On March 8 you introduced a narrative of the accident offering certain details (sand omitted, speaking at moment of ignition) as if they are flat fact, when in fact they are merely the balance of probability. I realize that in doing so you were following van Horn, but where sources conflict we must make intelligent choices about what to say -- and here, without doubt, Macmillan 2000 is authoritative (as he is on just about everything). You also added that van Horn "discovered that these effects paled in comparison to the damage to the white matter fiber networks beneath the cortical areas" -- in a context in which it's impossible to tell what "these effects" refers to.

I removed these statements .

• On March 12 you added

Van Horn "et al." (2012) showed that the damage to white matter was far more extensive than the damage to the cerebral cortex, and probably had a greater influence on the reported behavioral changes.

which (partly because "showed" is way too strong given science's still-primitive knowledge of how damage X translates into behavior Y) I modified to

Van Horn et al. makes detailed estimates of damage to Gage's white matter, concluding that its role in Gage's mental changes may have been more significant than that of cerebral cortex damage.

(The main-text statement, that van Horn confirms left-only damage, remains as well.)

In summary, I did not "reverse" your edits, but in three cases made straightforward removal of copied, inaccurate, or unintelligible material, and in the fourth case rephrased.

• I disagree with your contention that van Horn is "the only significant research of the Gage case in nearly ten years". (I'm assuming you consider Ratiu outside this 10-yr range.) Almost everything published on Gage is derivative bullshit and it's good to see thoughtful work like van Horn once in a while. However, IMHO the most significant research on Gage of the last ten years (Ratiu included) is Bev and Jack Wilgus' "Face to Face with Phineas Gage" which, combined with the evaluation (related in Macmillan and Lena 2010) of Gage by a physician who knew him a few years befoe his death, puts the final nail in the coffin of the idea that Gage was anything like a drunken, brawling vagrant. All the scanning and computing in the world, attempting to relate damage to behavioral changes, is in vain if the behavioral changes aren't grounded in reality.

• You asked me to explain why "this small, one-sentence fact" (re white vs grey matter) doesn't belong in the article -- but it is in the article. (Search horn in .) The question is the level of detail and prominence it should be given.
  • The publicity doesn't matter. Every development on Gage gets the full-court press.
  • Historically, the debate over the extent of damage has been at the grosser level of left-only vs. bilateral. The Damasio study (with its unpardonable slanders against Gage) being now thoroughly defunct, that question is provisionally settled, and this is something the typical reader can understand. Thus I've left it in the main text.
  • But I've put the white-grey point in a footnote, and here's why. To a reader with some notion of what WM is, and where it is, it is obvious given even the crudest idea of the iron's path that a great deal of WM must have been destroyed -- much more, it is further obvious to such a reader, than the amount of GM destroyed. Thus the significance of van Horn is not that lots of WM was destroyed, but the list of specific WM circuitry likely zapped. On the other hand, to a reader who has no real understanding of what white matter is anyway, the information comparing WM vs GM damage isn't going to mean anything anyway.

• You misunderstand about "Further reading", which acts as the article's bibliography (I've changed it now to "Sources and further reading" to make this clearer). So to add full bibliographic information to the "Citations" section, as you kept doing, was redundant.

Thoughts? EEng (talk) 06:39, 17 March 2013 (UTC)

I think we just fundamentally disagree on the level of intelligence that wikipedia readers have. I find other parts of the article to be far more technical than the distinction between white and grey matter, which, again, is a distinction commonly referenced in other wikipedia articles and easy to link to for readers who have any questions. I tried to make the statement - that the white matter damage was more extensive - less "obvious," but you said that reporting any of the tracts affected were too technical. I guess my overall problem is that I don't see a lot of room in the middle of what you call too technical, and what is old news, and it seems as though the case is closed in your opinion (which is not the view of the case in the neuroscience research community). I also disagree that finding a picture of the man is more important research than the last group of researchers to ever have first-hand access to the skull and rod (as I pointed out, the museum no longer allows such access to the materials). That is the reason that I pointed you to the sources that have covered the article, not just to name-drop; the news sources point out that the damage to white matter has far more to do with the behavioral changes that your article cites than any of the cortical damage, and points out that Van Horn goes on to point out what modern day diseases and disorders are associated with deterioration of cells in the same areas (i.e. hypothesizes that because people with Alzheimer's have low function in the same areas of connection, Gage's memory-storing capabilities were likely affected). While you point out that this is speculative, it is no more speculative than any of the other studies you cite and far less speculative than the articles which are examine non-scientific observations from over 100 years ago. I disagree with your assertion that first-hand comments about his behavior are superior to scientific examination, as the page itself points out how ridiculously false some of the observations are (like the idea he beat his non-existent wife). I will cease to pointlessly edit the page and respect your authority to decide its content, but I will continue to look for avenues to get this information the more prominent place in the literature that other users have called for in the past. I am confident that, due to the large impact of the article at present, history will see it included in your page with or without my actions. — Preceding unsigned comment added by Loniucla (talk • contribs) 22:07, 18 March 2013 (UTC) ~~~~

Everyone wants you to continue to participate. I, at least, know very little about brain anatomy and could use your help in, for example, understanding the Van Horn results. Having said that... The kind of strident advocacy above is highly inappropriate in light of . While there's nothing wrong with an author citing his/her own publications in a Misplaced Pages article (I am myself cited here) our goal is to develop the article so as to best serve the reader's understanding of the subject, not to give your publication the "prominent place" it "deserves".

I had thought that "Loni" was your real-life name, but I see now that Loni = Laboratory Of Neuroimaging. As already explained, "institutional" names are not allowed. The best thing might be for you to start afresh under a new username (see WP:UNC). EEng (talk) 23:10, 22 March 2013 (UTC)

As I've taken pains to point out, this isn't "my" page, I don't have any special "authority to decide its content", and I hope we can work together to make the article as fine as possible. Some points:

• First: My ideas about how the WM-GM material should be treated have nothing to do with any preconception of the reader's intelligence (high or low -- and by the way, I believe the article overall manifests a very high level of respect for the reader). Rather, I was said that, depending on the reader's level of knowledge, the gross result re WM-GM damage (i.e. that more WM than GM was affected) will be either not news, or news whose implication will be unclear to the reader; and the conclusion of that reasoning is not that WM-GM shouldn't be in the article at all, but rather that it is more appropriately treated in a note, where for the moment it is, rather than the main text.
• Second: I can't understand what you mean about van Horn being "no more speculative that any of the other studies , and far less speculative than the articles which examine non-scientific observations from over 100 years ago". What are these speculative articles you're talking about? Your comments imply you've misunderstood something very fundamental, and that implies that the article has somehow misled you, so I'd like to understand that and improve the article's presentation of whatever it is.
• Third: The ridiculous things said about Gage (e.g. mistreating his non-existent family) do not, as you say, come from first-hand observations, but from distortions originating with people who never actually met Gage. And I didn't say that first-hand reports of Gage are "superior to scientific examination" (of his skull, I guess you mean), but rather that a clear understanding of his behavior is more fundamental that examination of his skull: if we had an accurate picture of his behavior but not his skull, Gage would still teach us a lot; on the other hand, if we knew nothing of his behavioral changes, then his scanning the skull and modeling the damage would be pointless, since there would be no behavior changes to explain.

Look, can you do two things for me? First, can you search the article for the string horn, to be sure you're seeing all the text related to van Horn currently in the article? (I made an adjustment just now, BTW.) And second, can you propose, here, for discussion, what you'd like to see added or changed? Then let's talk about it.

EEng (talk) 23:16, 18 March 2013 (UTC)

Comment with specific proposal to move forward

I do not intend to engage in a disscussion, but I do think I can give some second-opinion.

First of all I would want to ask both of you to 1-Try to be a bit more concise... It is quite painful to try to read all the paragraphs above; and 2-Try to instead of disccussing why the other is incorrect work towards a consensus.

In this sense, while I greatly admire EEng for his work in this article, which I believe it is a really good description of a lot of what is out there on Gage, it is true that when anybody works almost alone in an article for years (as is the case) develops some feeling of ownership. EEng, try to step back a bit to evaluate yourself and see if you are really trying to integrate a newcomer views with a reasonable understanding of Gage's cage, or simply defending your case.

LoniUcla; similarly, EEng has done an impressive work in this article, and you should really try to listen when he says that a proposal is probably too technichal for a lay reader. It is common in those who work in research or university teaching (as is my, and probably your case) to forget what truly a lay reader is.

Regarding specific proposals: (bolded specific proposal)

(Previous note: I have to say that I have not read the specific article)

I fully agree with EEng that initial proposals were faaaaaar too technical. I find that his refractoring of your initial posting into: Van Horn et al. makes detailed estimates of the locus and extent of damage to Gage's white matter, concluding that the role of white-matter damage in Gage's mental changes may have been more significant than that of cerebral cortex damage. is very appropiate. It is a good, understandable summary.

However, I also feel this comment is far more interesting and understandable for a lay-reader than to leave it in a footnote. I would move it to the main article. In this sense I disagree with EEng in his following comment:

But I've put the white-grey point in a footnote, and here's why. To a reader with some notion of what WM is, and where it is, it is obvious given even the crudest idea of the iron's path that a great deal of WM must have been destroyed -- much more, it is further obvious to such a reader, than the amount of GM destroyed. Thus the significance of van Horn is not that lots of WM was destroyed, but the list of specific WM circuitry likely zapped. On the other hand, to a reader who has no real understanding of what white matter is anyway, the information comparing WM vs GM damage isn't going to mean anything anyway..

I specifically think that you (EEng) are committing a fallacy by dividing knowledge of WM into a dichotomy of "a lot" vs "no knowledge". For example a pre-university student may know more or less why WM is important and what is it, and may find useful the info (and it will be easier to find in the main article).

From your comments above van Horn also talks a lot regarding connectivity damage (which is probably more technical than the direct white matter damage, but probably even more important).. I would include in the footnote some info on connectivity damage as an explanation of why van Horn feels that WM damage may account better for neuropsychological problems.

--Garrondo (talk) 08:05, 19 March 2013 (UTC)

Thanks, Garrondo! Overnight I was thinking I would ask you and Looie to join the discussion, and here you are -- maybe you read my mind. I've made a start on implementing your ideas (though definitely needs more work). More to say later, must run now. Loni, I hope Garrondo's contribution helps you feel more comfortable about staying involved. Please do! EEng (talk) 15:31, 19 March 2013 (UTC)

First of all sorry for spelling mistakes. As you know I am Spanish, and in talk pages I tend to writte a bit carelessly as a trade-off for speed; so EEng thanks for the corrections. Regarding the article I feel it has improved a lot. Lets see what LONIUCLA says. Nevertheless now I feel that the footnote on van Horn has gone from one side to the other and is filled with redundant details. It specifically says:

Um... what corrections are you talking about? EEng (talk) 01:56, 20 March 2013 (UTC)

Specifically, Van Horn et al. estimated that "the cortical regions most affected by the rod included: the left orbital sulcus, the left middle frontal sulcus, the horizontal ramus of the anterior segment of the lateral sulcus, the anterior segment of the circular sulcus of the insula, the orbital gyrus, the lateral orbital sulcus, the superior frontal sulcus, and the orbital part of the inferior frontal gyrus. While extensive damage occurred to left frontal, left temporal polar, and insular cortex, the best fit rod trajectory did not result in the iron crossing the midline as has been suggested by some authors" (such as H. Damasio). "Fiber pathway damage extended beyond the left frontal cortex to regions of the left temporal, partialparietal, and occipital cortices as well as to basal ganglia, brain stem, and cerebellum. Inter-hemispheric connections of the frontal and limbic lobes as well as basal ganglia were also affected." (Quotations abridged to remove quantitative estimates of extent of damage to individual loci.)

I would change it to:

Specifically, Van Horn et al. estimated that although extensive damage occurred to left frontal, left temporal polar, and insular cortex, the best fit rod trajectory did not result in the iron crossing the midline as has been suggested by some authors" (such as H. Damasio). "Fiber pathway damage extended beyond the left frontal cortex to regions of the left temporal, partialparietal, and occipital cortices as well as to basal ganglia, brain stem, and cerebellum. Inter-hemispheric connections of the frontal and limbic lobes as well as basal ganglia were also affected." (Quotations abridged to remove quantitative estimates of extent of damage to individual loci.)

Reason is that left frontal, left temporal polar, and insular cortex is more or less a summary of the first sentence with the detailed locations.

--Garrondo (talk) 20:56, 19 March 2013 (UTC)

You'll notice my edit summary was a start on van Horn specifics, but not perhaps a very good one -- I just copied in the whole pile, figuring one of you guys would come along and adjust it. I made the change you suggest, Garrondo, but Loni, please go ahead and adjust as you see fit. I don't know what all that hypochondriacal hippocampus spiro-gyro stuff means, anyway. EEng (talk) 01:56, 20 March 2013 (UTC)

I am not sure what you mean with hypochondriacal hippocampus spiro-gyro stuff.

On the other hand, after re-reading the paragraph it is not very clear if the sentence

"Fiber pathway damage extended beyond the left frontal cortex to regions of the left temporal, partialparietal, and occipital cortices as well as to basal ganglia, brain stem, and cerebellum. Inter-hemispheric connections of the frontal and limbic lobes as well as basal ganglia were also affected." is from van horn or from Damasio, or from van Horn citing Damasio. Do you know which one is the correct one?

Bests.--Garrondo (talk) 07:33, 20 March 2013 (UTC)

Hypochondriacal hippocampus spiro-gyro stuff is my way of making fun of the complicated terminology of brain anatomy, about which I know almost nothing. The quotes are all from Van Horn et al., and represent their conclusions, not H. Damasio's. (Damasio's 1992 analysis of the damage, while an interesting exercise, is now completely defunct, being fatally flawed by being based not on images of Gage's skull but a "Gage-like" skull.) EEng (talk) 15:26, 21 March 2013 (UTC)

I thought so, but I was not sure. To say that frontal, temporal, occipital cortices were damaged is more or less to say that there was some widespread damage to the whole brain, even if the wound was much more localized. On the other hand: I am quite sure that it should say parietal and not partial (no brain location called partial but there is a parietal lobe).

--Garrondo (talk) 15:42, 21 March 2013 (UTC)

Fiber pathway damage

You're wrong. There certainly is such a thing as a partial lobe. For example, after his accident Phineas Gage had a partial lobe.

I copy-pasted straight out of VH and now that I look at it, it really does read left temporal, partial, and occipital cortices, so it looks like some proofreader is going to be in trouble. I've fixed it in the article.

VH doesn't say literally that frontal, temporal, and occipital were damaged -- he says Fiber pathway damage extended beyond the left frontal cortex to regions of the ... . I won't pretend I understand more than 20% of VH but I believe what's being said is that there was damage to pathways serving (though not necessarily within or part of) these areas outside the frontal -- though if I'm right, this doesn't seem like a very clear way of saying it.

Elsewhere VH says, We observe that with the jaw opened, the best-fit rod trajectory satisfying all constraints does not intersect or cross the superior sagittal sulcus and the injury is specific to the left frontal lobe, and if specific to means something like limited to (again, I'm out of my depth here) then that supports my interpretation of the fiber pathway passage discussed in the previous paragraph. I hope Loni can help us with this.

EEng (talk) 09:59, 22 March 2013 (UTC)

Gage vomittng its brain

Maybe there is a better way to say that. As I'm probably having some kind of brain issue, I was highly impacted by the sudden way that this horrible scene appeared and I almost fainted here. Now the phrase doesn't affects me and I can re-read it without problems, but it's possible that more people interested in the case, coming to this article by hyperlinks from articles about other kinds of brain damage, be impacted in the same bad way.--MisterSanderson (talk) 06:04, 14 April 2013 (UTC)

We're talking about this passage, from the account of Dr. Williams:

I first noticed the wound upon the head before I alighted from my carriage, the pulsations of the brain being very distinct. Mr. Gage, during the time I was examining this wound, was relating the manner in which he was injured to the bystanders. I did not believe Mr. Gage's statement at that time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through his head .... Mr. G. got up and vomited; the effort of vomit­ing pressed out about half a teacupful of the brain, which fell upon the floor.

Bigelow gathered these testimonials, including their gory details, because given that Gage survived, people couldn't believe how serious his injury had been. Today we're used to people surviving amazing injuries, so to emphasize how precarious Gage's situation really was given the modest tools available to his 19th-century doctors, I juxtapose the doctor "alighting" from his carriage with the brain matter falling out of the very open wound. Also, this is a popular topic for kids about 10-14 (see e.g. John Fleischman's Phineas Gage: A Gruesome but True Story About Brain Science) and kids that age love this kind of stuff.

We all know WP:NOTCENSORED etc., but that doesn't make you feel any better about the reaction you experienced. So I'm not sure what to say. Other editors, please jump in. EEng (talk) 15:39, 14 April 2013 (UTC)

It seems to me very unlikely that this happened as described. There are no muscles that can compress the brain and make it squirt out, even after an injury such as Gage's. I also doubt that even a doctor could distinguish between brain tissue and other types of gore, such as semi-clotted blood, of which there would undoubtedly have been some. Still, there is no question that it would have been a grotesque wound, and that seems to be the main point to convey here. Looie496 (talk) 16:15, 14 April 2013 (UTC)

Dr. John Martyn Harlow created a clime in the report, saying first that "the picture presented was, to one unaccustomed to military surgery, truly ter­rif­ic", so anyone who was reading would not be surprised when saw that "the bed on which he was laid, were literally one gore of blood." (what is not so surprising as vomiting the brain). The reticences in the Dr. Edward H. Williams report means that a section was cut, right? This section doesn't help to create this clime of "I will say something really horrific ahead, don't be surprised"?--MisterSanderson (talk) 18:13, 14 April 2013 (UTC)

The omitted portions of W's statement detail the size and appearance of the exit wound, and his discovery of the cheek (entry) wound. We needn't imagine W is saying brain was "vomited" out by any kind of pressure or constriction; rather one imagines that shaking of the head and bodily spasms of retching knocked loose pulpified brain matter, clotted blood, or whatever. Bear in mind, however, that the injury opened a 1-inch hole connecting the mouth to the cranium, and from this hole to the exit was a path of destroyed tissue left by the iron's passage; Harlow was actually able to touch, or almost touch, the end of his finger inserted into the cheek wound to that of another finger inserted into the skull wound. So I suppose it's not impossible that the force of matter being ejected, from the stomach into the mouth, might be hydraulically or pneumatically (if you will) transmitted via this path through the brain to the wound at the top of the skull, and something thereby expelled. Think of a whale, I guess, but without the harpoon tamping iron.

Anyway, are we questioning the reliability of the text, or the way it's presented, or what? EEng (talk) 01:52, 15 April 2013 (UTC)

I questioned the way it was presented; Looie496 questioned the veracity of the information.--MisterSanderson (talk) 20:24, 15 April 2013 (UTC)

and I'm questioning what if anything is being proposed be done to improve the article. EEng (talk) 23:14, 15 April 2013 (UTC)

Well, you said that there is no way to improve the citation of the vomit episode by unfolding part of the omitted piece of the citation... So I can't figure another manner to do that.--MisterSanderson (talk) 01:25, 16 April 2013 (UTC)

While I am sorry for the discomfort caused you, I'm at a loss to know what might be done about it. The article begins by explaining that a large iron bar destroyed a substantial part of Mr. Gage's brain as it was driven through his head (the bar was driven through his head, that is -- his brain wasn't driven through his head), mentions that the iron returned to earth "smeared with blood and brain", has two graphic images of the iron passing through his head (prior to Williams' statement), plus Williams' statement begins by mentioning that he could distinctly see the pulsations of the brain within the head wound before he even got out of his carriage. If this hasn't prepared the reader for some further gory details, I don't what can. EEng (talk) 01:55, 18 April 2013 (UTC)

I was thinking how to point what caused the discomfort to me, when I realized that it's too personal/unconscious/irrational to be described. But it's basicaly because the accident didn't left time to Phineas feel pain or to be scared (the impact made him immediately uncounscious), while the vomit episode suscits that he was suffering, feeling really bad. Pictures of crushed corpses are irrelevant or even comical, but suffering (even minor sufferings) can be very scaring. Related info: recent movies that use slow-motion to show people shouting when falling make them comical and unrealistic, because they doesn't pass suffering to the viewers; <spoiler>Vertigo (film), in contrast, makes the viewer thinks not about the falling person (that didn't suffered, because the impact killed immediatly), but about what the hanging person (that was to be pulled by who fallen) is thinking, how scared it may be about falling too.</spoiler> But, as I said, I see now that this is very personal, so I really think now that there's no reason to change anything in the text, because there's no evidence that someone besides me will be affected too. So, forget about it, it's unecessary to change something.--MisterSanderson (talk) 17:49, 18 April 2013 (UTC)

Recategorization

I have recategorized the article from the "Category:People with severe brain damage" to "Category:People with brain injury". While the injury experienced by Gage was horrible, the former category seems populated with unfortunates who were in something like a vegetative state. Gage miraculously recovered consciousness, and was able to function (although badly). Reify-tech (talk) 20:34, 9 May 2013 (UTC)

I always admire the editors who do that grunt work on categories -- it would drive me crazy. Just for the record though, it turns out Gage did not function "badly", but actually quite well. See Phineas Gage#Social recovery. EEng (talk) 01:49, 10 May 2013 (UTC)

GAN, McMillian and Gage

First of all I want to say that I greatly admire the work done by EEng in this article, which has led it to probably become a great piece, with fine writting and really good documentation. However, I have stated several times that while McMillian is probably a great source, it is not a definitive one, and certainly there is no consensus with his position regarding the well-doing of Gage.

In the section above EEng said: Just for the record though, it turns out Gage did not function "badly", but actually quite well. This comment defines exactly the problem I find with several parts of the article, since it clearly overstates the importance of McMillian theories: it would certainly be more accurate to say that it has been proposed by an investigator that he did quite well, or that some evidence points towards him doing better than previously thought.

I find all sections till the "theoretical use and misuse" very balanced, but from it (included) to the end of the article I believe that some undue weight is given to McMillian, giving the impression that there is consensus on his theories. I find specially troublesome the "use of the case" section, where only a few lines are given on how the case has been used along the history of neurology. However, this section should probably be one of the most important ones in the article, since independently of how truly was the case of Gage he has been an icon used for over a 100 years to explain frontal lobe disorders. This section should explain how has he become such an icon, and it certainly should give minimal importance to McMillian. Moreover, the article should also make clear that many of the problems that at some point have been proposed that he suffered are consistent with frontal brain injuries and that the MRI and neurological knowledge on the prognosis of other similar cases point towards him certainly suffering some kind of cognitive problems for the remaining of his life.

EEng has stated several times that he only has basic knowledge on neurology and neuroanatomy, and he recently indicated in other article that he was involved in the preparation of one of McMillians works. While none of the two facts actually invalidate his huge acomplishments in this article, they may be hindering the advance of the article in what I think are the final stages towards GA and even FA and work with other editors is probably the only way of moving forward from this point.

In summary: I do not think right now the article is up to GA status although it is probably close, with only some (not huge) problems in balance of content along the full article (McMillians importance should be down-toned at some points) (criterium 3) and an (important) lack of content in another section (criterium 4).

I have been involved in the article, so my evaluation does not count as the requiered review for GAN, but I hope that nevertheless is taken into account.

--Garrondo (talk) 07:40, 31 May 2013 (UTC)

Soft hyphens

The following is copied from User talk:Bender235#Phineas Gage. The edit in question, by Bender235, changed the markup (a) &emdash;, (b) &endash;, and (c) ­ to (a) a literal em-dash(—), (b) a literal en-dash (–), and (c) a literal soft hyphen, which is nonprinting and invisible in the edit window.

What was the purpose of these changes? En- and em-dashes are hard to distinguish in the markup, and soft hyphens improve layout and appearance -- why did you remove them? EEng (talk) 01:52, 29 May 2013 (UTC)

Soft hypens are a bit too much Insp. Gadget for Misplaced Pages. If you look at the source of the article then, it is basically unreadable, which is something Misplaced Pages should always avoid. --bender235 (talk) 09:05, 29 May 2013 (UTC)

I see. And you changed the mdash/ndash markup to literal mdashes/ndashes because...? EEng (talk) 11:33, 29 May 2013 (UTC)

Because User:Cameltrader/Advisor suggested it. And I don't see any reason not to do it. --bender235 (talk) 18:07, 29 May 2013 (UTC)

I said why you shouldn't do it in my initial post here: the literal em- and en-dashes are very hard to distinguish in source. So in removing the soft hyphens you impaired the quality of what the reader sees (and summarily discarded a lot of someone's work) in the name of improving what the editor sees -- a tradeoff already made, in the opposite direction, by those who actually edit the article. Then you changed symbolic dashes to literal dashes, which does nothing at all except impair what the editor sees. Please don't make choices about what is or isn't convenient for the article's editors if you're not one of them. EEng (talk) 13:07, 30 May 2013 (UTC)

Okay, you better get off the high horse here. I've been editing Misplaced Pages long enough to have an educated opinion on what's convenient for editors and what is not. That soft hyphen overkill you (or whoever) introduced to that article is simply ridiculous. I mean, ...sec­ond, com­pen­sat­ing..., what the hell is that? Could you name any plausible scenario in which it would be necessary for the viewer's browser to break a single word three times? Is there anybody browsing Misplaced Pages with a 10px screen, or what? --bender235 (talk) 13:34, 30 May 2013 (UTC)

Brought this case to WP:MOS. And by the way, just because you contributed to a particular article more than I did does not make you its owner. --bender235 (talk) 13:54, 30 May 2013 (UTC)

I'm perfectly comfortable up here on my high horse, thank you.

• Multiple soft hyphens allow a word to be broken at the one best point among several choices. That you think they imply breaking a single word over several lines calls into question your claimed extensive experience.
• As it turns out your edits didn't even remove the soft hyphens -- what you actually did, using an automated tool you apparently don't understand, was to substitute a literal soft hyphen for each occurence of ­, similar to your substitution of — and – for — and –. But since literal soft hyphens are nonprinting (except at end-of-line), by doing so you have made it not only (as previously explained) very difficult to visually distinguish an en- from an em-dash in the edit window, you've now made it completely impossible to see where the soft hyphens are. Good work.
• This article is full of medical terms and majestic 19th-century quotations, making hyphenation very helpful in avoiding unsightly underfilled lines, particularly in narrow captions and multicolumn notes/references. Your argument that readability of source text (seen by less than one editor per day) trumps readability of formatted text (seen by thousands of readers per day) is nonsense.
• In any event this particular choice, in this particular article, was made (or accepted with no hint of objection) by editors actually working on (or at least monitoring) it. This has nothing to do with ownership -- if you showed any interest in substantive edits to the article that would be quite a different matter from what actually happened i.e. you dropped in to impose your personal ideas of what markup should look like, and moved on.
• When you gain consensus at MOS for regulations micromanaging soft hyphenation please let us know, assuming the universe has not run cold by then. In the meantime, since you apparently don't know how soft hyphens work, or what the automated tool you're using actually does, think twice before applying the word "ridiculous".

EEng (talk) 22:42, 1 June 2013 (UTC)

You're barking up the wrong tree. I'll give you a chance to reply at WP:MOS and explain what people there describe as a "joke edit" of yours, before I revert your edit. --bender235 (talk) 13:46, 2 June 2013 (UTC)

Please, no more metaphors -- so far you've got me "barking up the wrong tree" while on "the high horse".

• Your insistence that you are combatting "soft hyphen overkill" is ludicrous since, as already explained above, your edit did not remove the soft hyphens but merely changed them to a form making then impossible to see in the edit window. (That the soft hyphens are still there is easily seen via the hyphenated linebreaks in the live article e.g. in most image captions.) This makes no sense at all.
• Talk:MOS is for discussion of changes to MOS or of MOS interpretation, not forum-shopped editing disputes unrelated to anything in MOS.
• Soft hyphens are part of Misplaced Pages markup, and in the absence of guidelines to the contrary they exist to be used according to the consensus of editors of the article in question. I am copying this discussion to Talk:Phineas Gage#Soft hyphens so we can hear if any of them finds soft hyphens as objectionable as you do.

EEng (talk) 03:47, 4 June 2013 (UTC)

End of copied discussion

I would recommend that both of you take a deep breath... The tone of this conversation has not been really productive. Regarding hyphens... I agree with EEng that to change them with literal literal mdashes/ndashes is a bad idea with no positive effects. On the other hand the use of soft hyphens is a tradeoff between readibility of text and accesibility of editing, being the two of them important (this is the encyclopedia that anybody should be able to edit). I have to say that sometimes I have taken a look at the editing text and it does take quite a lot of effort to understand it, so Bender may have a point there. On the other hand in the absence of policy changes in format in an article should be first consensuated.

As a conclussion: I would rather not to use them unless in very specific cases since it is true that use is really extensive at several places of the article and they might be contributing to editors not being able to contribute in the article, while their positive effect is a matter of subjective aesthetic preference (I have for example no problems with spaces).

--Garrondo (talk) 06:57, 4 June 2013 (UTC)

I actually don't want to have this discussion here, but rather with a broader audience on WP:MOS, but let me just reply to this: "Your insistence that you are combatting "soft hyphen overkill" is ludicrous since, as already explained above, your edit did not remove the soft hyphens but merely changed them to a form making then impossible to see in the edit window. (That the soft hyphens are still there is easily seen via the hyphenated linebreaks in the live article e.g. in most image captions.) This makes no sense at all."

It makes perfect sense, because the problem with soft hyphens aren't the soft hyphens themselves, but the effect they have on the readability of source code. I mean, lines like inap­pro­priate sex­u­al behav­ior, ina­bil­ity or refus­al are practically unreadable to human eye. Imagine a new editor (or any, for that matter), spotting a typo in this line and wanting to fix it: he/she would most likely have no idea what to do with this mess.

Like I said, the problem aren't the soft hyphens themselves. What matters to me is keeping the source code readable. --bender235 (talk) 08:44, 4 June 2013 (UTC)

These &shys certainly make the code much harder for the editors. Is it worth this inconvenience in order to give the reader a better article? Sure but I don't agree that this is happening. You might be reducing the blank space at the end of lines but you do so at the expense of breaking words up. A word broken over two lines is harder to read. I could see a use for soft hyphens where the word is very long and/or the space is very narrow but this is not the case here. Also, I believe Bender's suggestion to take the discussion to WT:MOS is quite reasonable; the use (or misuse) of soft hyphens is not just an issue for this article but is relevant for most articles. JIMp _talk·cont 13:45, 7 June 2013 (UTC)

Undue weight of first quote

To have a long quote on the misuse of the case in the lead is in my opinion to give undue weight to such misuse. It certainly is not mentioned in most sources on Gage and is only a central point in McMillans theories. While I think the quote is a good one, I feel that it would better fit in the specific section within the article. I was going to be bold and move it but I have been unable due to the complex syntax used.--Garrondo (talk) 19:24, 9 June 2013 (UTC)

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