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—— ON THIS DAY ——
SEPTEMBER 13, 1848
Cavendish, Vermont, USA
178 years ago
Phineas Gage, the railway construction foreman who survived an iron rod passing through his skull on September 13, 1848, and became the most studied patient in the history of neuroscience.
On the afternoon of September 13, 1848, a twenty-five-year-old construction foreman named Phineas Gage was preparing a blasting charge on a railway cut near Cavendish, Vermont. He was using a tamping iron, a rod more than a metre long and about three centimetres thick, to pack sand over explosive powder in a drilled hole. Something sparked, and the charge went off. The rod was driven upward through his left cheek, behind his left eye, through the front of his brain, and out of the top of his skull, landing some distance away.
Gage did not die. He may not even have lost consciousness. Within minutes he was sitting upright in an ox cart on the way to his lodgings, and he greeted the physician who arrived, John Martyn Harlow, with a remark about the accident. Harlow cleaned and dressed the wound and treated him through weeks of infection and delirium. Within about ten weeks Gage was walking around and, by the standards of 1848 medicine, recovered.
—— MARQUEE EVENT ——
The frontal lobe of the brain, the region damaged in Gage's injury, now understood to be central to planning, judgement, impulse control, and social behaviour.
What made the case famous was not the survival but the reported change in personality. Harlow wrote that Gage, previously regarded as capable, well balanced, and shrewd in business, had become impatient, profane, unreliable, and unable to hold to a plan. Those who knew him, Harlow recorded, said he was no longer Gage. In an era when many scientists doubted that mental faculties could be localized to particular regions of the brain, here was evidence that damage to a specific area could alter judgement and behaviour while leaving speech, memory, and movement intact.
The case has also been badly distorted in retelling. Gage was frequently described in later accounts as a hopeless, brutish drifter, an exaggeration that grew with each retelling and that the primary sources do not support. In fact he worked with horses in New Hampshire, then spent several years in Chile as a stagecoach driver on the route between Valparaíso and Santiago, a demanding job requiring skill and reliability. Some researchers now argue his case is better read as evidence of substantial recovery and adaptation than of permanent ruin.
Gage's later years were troubled. He returned to the United States in 1859 in poor health, worked on a farm in California, and began having seizures. He died in May 1860, twelve years after the accident, aged thirty-six. His skull and the tamping iron were later recovered by Harlow and given to the Warren Anatomical Museum at Harvard, where they remain on display. Modern imaging studies have used the skull to reconstruct which pathways the rod is likely to have severed, and Gage continues to appear in neuroscience and psychology textbooks well over a century and a half after his death.
—— WHY THIS MATTERS ——
It provided early evidence that specific brain regions govern specific functions. At a time when localization of mental faculties was disputed, a man whose speech, memory, and movement survived intact while his judgement and temperament changed was powerful evidence that the frontal lobes do particular work.
It laid groundwork for the study of personality and the brain. The case became the reference point for later research into how frontal damage affects planning, impulse control, and social behaviour, and it still appears in introductory neuroscience courses.
It is a lesson in how case histories get distorted. The popular version of Gage as a ruined brute grew far beyond the evidence, and the correction of that record has become a standard example of how scientific stories drift from their sources over time.
—— THE TAKEAWAY ——
On September 13, 1848, an explosion sent an iron rod through Phineas Gage's skull and out the top of his head. He was talking within minutes and walking within weeks. What changed was his judgement and temperament, and that change made his the most studied brain injury in history, even as the story told about him drifted further from the facts.
—— QUOTE OF THE DAY ——
“He is no longer Gage.”
— John Martyn Harlow, reporting what those who knew Phineas Gage said of him after the accident
—— OUR QUIZ OF THE DAY ——
How much do you know about Phineas Gage, the accident at Cavendish, what his case revealed about the frontal lobes, and how his story was later exaggerated?
