One of the most amazing studies ever conducted on brain function occurred after an industrial accident. The subject of this study was a 25 year-old foreman, Phineas Gage, who had been working at a railroad construction site in Vermont. On September 13, 1848, Gage was tamping explosive powder into a hole in a rock in order to blast it. His tamping iron accidentally hit the rock and ignited the powder. The tamping rod, which was 3 feet 7 inches long and weighed 13 1/2 pounds, went through Gage's head just below his left eye and passed through his left frontal lobe, exiting the skull at the top of his head. This terrible accident was documented by Dr. John Harlow in an article entitled “Passage of an iron rod through the head.”(1) Amazingly, Gage was able to sit up during the ride to a nearby hotel and walked up the stairs to see Dr. Harlow. This accident had destroyed a considerable portion of the frontal lobes on both sides. Even more incredibly, Gage recovered in a month and lived another 12 years after the accident. Dr. Harlow kept in touch with Gage and wrote another article 20 years later describing his life after the accident. Gage's personality had drastically and permanently changed. Harlow described him as follows (2):
“He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, ... His mind was radically changed, so decidedly that his friends and acquaintances said he was no longer Gage.”(3)
The damage to his frontal lobes caused Gage to behave like an ill-tempered child.
Another source of information on brain function is derived from the follow-up studies of patients who have had a portion of the brain removed. Frontal lobotomy is the term used for the surgical removal of the frontal lobe in patients with emotional disorders.(4) It may be difficult today to imagine that an invasive procedure like destroying a large portion of the brain can be employed as a therapeutic approach. Yet, in 1949 the Nobel Prize in medicine was awarded to Dr. Egas Moniz for his development of the frontal lobotomy technique. (Strange enough, Moniz himself was shot in the spine and partially paralyzed by a lobotomized patient.) Tens of thousands of people were lobotomized following World War II.
A variety of techniques were used to produce lesions on the frontal lobes. In the techniques shown in Figure 2, a knife was inserted through the thin bone at the top of the orbit of the eye. The handle was then swung medially and laterally to destroy the frontal brain areas. Thousands of people were lobotomized with this technique, sometimes called “ice pick psychosurgery.” This operation benefited patients with a number of psychological disorders and provided them with relief from anxiety and a means of escape from thoughts that were unendurable. Although frontal lobotomy did not significantly alter the patient's IQ or memory functions, some other profound side effects emerged.
The information presented above exemplify the two main sources of information for our understanding of brain function; accidents that lesion the brain, as in the case of Phineas Gage, and surgical interventions on patients with various psychological disorders or epilepsy. In both cases, certain brain functions become impaired and thereby provide evidence as to which brain functions the destroyed areas are involved with. It is now believed by neuroscientists that although there are only one or two types of information that each brain center is specialized to process, there is extensive communication and information sharing between these areas. The frontal lobe is one of the integrative areas where neural information from many other centers converges. It is a highly developed area where an advanced level of information processing takes place. In light of the scientific data presented above, one cannot help but think that the wisdom that lies behind a number of verses in the Holy Qur'an that refer to the forehead and forelock may be related to the function of the frontal portion of the brain in decision making and its function in the formation of ethical values. In the Qur'an, God says:
Let him beware! If he desist not, We will drag him by the forelock, a lying, sinful forelock. (Alaq 96:15-16)
The Arabic word nasiyah here can also be translated as forehead or face. Abdullah Yusuf Ali, who translates this word as forelock, in his comments on these verses says that the forelock is located on the forehead, and is thus symbolic of the summit and crown of the human power or dignity. To be dragged by this is to suffer the greatest humiliation.(5)
We also find a reference in the Qur'an to the sinners being seized by their nawasi, the plural of forelock:
(For) the sinners will be known by their marks: and they will be seized by their forelocks (nawasi) and their feet. (Rahman 55:41)
Another reference in the Qur'an is found where the forehead (jabha) is mentioned as a body part that will be punished:
On the Day when heat will be produced out of that (wealth) in the fire of Hell, and with it will be branded their foreheads (jabha), their flanks, and their backs. “This is the (treasure) which you buried for yourselves. Taste, then, the (treasures) you buried!” (Tawba 9:35)
Here the Arabic word jabha literally means the forehead of a person.
Can these verses be indicating the importance of the frontal area of the brain in decision-making and the formation of ethical values? The decision-making that we call “freewill” raises the human being above all other beings and puts on their shoulders the “trust” of their Creator. This is the “trust” by which the human being becomes responsible for understanding the divine purpose in life and conducting their life accordingly as a dignified vicegerent of his Lord on Earth. It is also very interesting to note that the frontal lobes are much smaller in other animals that are lower in the phylogenetic scale. It is the human being that has the largest frontal lobes, larger even than that of the great apes. The Author of the Book knows best, yet, it is the responsibility of humanity, as those who have been bestowed with intelligence and reason, to contemplate and reflect . . .
1 Harlow, J.,M., “Passage of an iron rod through the head,” Boston Medical and Surgical Journal, (1848) 39:389-393.
2 Harlow, J.,M., “Recovery from the passage of an iron bar through the head,” Publication of Massachusetts Medical Society, (1868) 2:329-347.
3 Damasio, H., Grabowski, T., Frank, R., Galaburda, A.,M., Damasio, A.,R., “The return of Phineas Gage: clues about the brain from the skull of a famous patient,” Science, (1994) 264:1102-1105, pp. 339-340.
4 Bear, M., F., Connors, B., W., Paradiso, M., A., “Neuroscience: Exploring the Brain,” second edition, Lippincott Williams&Wilkins, Baltimore, Maryland: 2001.
5 Yusuf Ali, A., The Meaning of The Holy Qur'an, Tenth edition, Amana Publications, Maryland: 1999.