The Curious Case of Mr. Phineas P. Gage

Mr. Phineas P. Gage (1823-1860) was a railroad construction foreman in Cavendish, Vt., who, because of a particularly gross injury to the frontal lobes of his brain, contributed vital knowledge to the annuals of neuroscience. Mr.Gage's case was one of the first to reveal the possible functions of the frontal lobes regarding brain and behavior.

In September 1848, the then twenty-five year old Gage was engaged in blasting, in order to remove boulders for the Rutland to Burlington railroad track. This involved drilling holes with 3 1/2 ft. tampering irons. Inadvertently, a blast projected a tampering iron through Phineas' left cheekbone and left orbital cavity and out of the top of his head. The blast was so violent that the iron landed some 80 ft. away.

Remarkably, Mr. Gage walked away from the scene, engaging in conversation with his fellows and appearing rather calm as they sought to find the nearest doctor. Apparently, the iron missed major blood vessels, and so bleeding was not as profuse as would be expected. Dr. John Harlow, the first physician to attend Gage, was amazed at Phineas' consciousness and chattiness in light of such extreme injury.

In the coming weeks Mr. Gage did suffer from fungal infection and was comatose and bedridden for a period of time. Dr. Harlow literally had to reposition chunks of Gage's anterior skull. It was expected that Phineas would not live. However, Gage eventually 'recovered,' and by January 1849 was able to resume everyday life. Though Gage did not return to his former position, he did work.

People closest to Phineas, however, noted dramatic personality changes, mostly in the areas of social inhibitions, and forethought and planning. Mr. Gage, in comparison to his former self, was 'fitful, irreverent, and prone to gross profanity.' Also, given that he was formerly a railroad foreman, Gage no longer seemed to possess his previous organizational abilities. To sum up, though language and other neurological functions remained intact, 'Gage was no longer Gage.'

Phineas P. Gage died 12 years later of seizures related to his injury, in San Francisco, under the care of his mother and sister. Eventually, Phineas' skull and tampering iron ended up on display at Harvard Medical School's Warren Anatomical Museum, where it remains today.

Despite Phineas' eventual grim outcome, a recent daguerreotype discovered of him suggests another light. In the photo, Phineas Gage is depicted as a handsome and stalwart man, proudly clutching the tampering iron which some years earlier had projected through his skull.

In fact, folklore has it that Gage even tried to make money selling his incredible story, and was an attraction at the P.T. Barnum's American Museum in New York. Though these stories are unconfirmed, perhaps the daguerreotype does tell the story. Mr. Phineas P. Gage, posing with his 'bar,' was a man that had lost all reason.

*for more articles on this amazing case, click here.