Phineas Gage and the Iron Rod

The Accident

On September 13, 1848, the 25 year old Phineas Gage was working as a foreman in a railroad project near Cavendish Vermont. His crew was clearing the path of the railroad by using explosives to remove the masses of land and rock. They were making holes in the area and poured explosive powder on it. Gage was tamping the powder in one of the holes by the use of an iron rod when unfortunately, it exploded. The 43 inch long and 1.25 inch in diameter iron rod hurtled upward penetrating the left cheek of Gage and passing through his skull damaging his frontal lobe (brain). The iron rod reportedly found about 80 feet away from the site of the accident.

courtesy of  Jack and Beverly Wilgus

Right before the accident, it was surprising that Gage managed to walk to a nearby cart and asked help from his crew. They took Gage in the town to be seen by a doctor. The first doctor to look at Gage was Dr. Edward H. Williams. The physician remarked;

"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. Gage got up and vomited, the effort of vomiting pressed out about half a teacupful of the brain, which fell upon the floor."

Another Doctor that examined Gage was D. John Martyn Harlow. Dr. Harlow said;

"You will excuse me for remarking here, that the picture presented was, to one unaccustomed to military surgery, truly terrific; but the patient bore his sufferings with the most heroic firmness. He recognized me at once, and said he hoped he was not much hurt. He seemed to be perfectly conscious, but was getting exhausted from the hemorrhage. His person, and the bed on which he was laid, were literally one gore of blood."

After the Accident

Dr. John Martyn Harlow reported that Gage had developed an infection and went through a semi comatose state from September 23 until October 3 of the same year. Fortunately, Gage recovered from the comatose and began to improve his physical and intellectual functioning. Gage returned to his parents' house in New Hampshire the following months. When he got fully recovered he worked as a stagecoach driver in Chile. He also held a work in a livery stable and a farm.

But the most shocking thing is not the "gore bloody accident" of Gage. It was his "change in personality" after recovery, and it was not just a mere shift in attitude but as if he was no longer Phineas Gage! Dr. Harlow accounted;

"The equilibrium or balance, so to speak, between his intellectual faculties and animal propensities, seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity, manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinacious obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, although untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was no longer Gage."
 

Psychological Explanation

courtesy of J.B.S. Jackson MD.

So what was the reason why Phineas Gage had a personality different from who he was before the accident? Psychologists believed that the reason behind the phenomena is due to damaged frontal lobe of Gage brought by the accident. According to them, the frontal lobe of the brain is responsible for our personality formation. Gage’s personality was distorted when his frontal lobe was damaged.

Phineas Gage’s Death

Gage had several epileptic seizures beginning in February of 1860. On May 20 at his mother’s house, Gage had a severe convulsion and on succeeding day, May 21 he died. He was buried in San Francisco’s Lone Mountain Cemetery. Seven years later his skull were exhumed by Dr. Harlow with the permission of Gage’s family. The iron rod was also in the possession of Harlow by the time. Today, Gage’s skull and iron rod is now displayed at the Medical Museum of Harvard University.