Phineas Gage's Story
Malcom Macmillan, http://www.deakin.edu.au/hbs/GAGEPAGE/
4/20/05 10:31 AM
Phineas Gage’s Story
Phineas Gage is probably the most famous patient to have survived severe damage to the brain. He is also the
first patient from whom we learned something about the relation between personality and the function of the
front parts of the brain.
As the first newspaper account of the accident, that appearing in the Free Soil Union (Ludlow, Vermont) the
day after the accident, and here reproduced as it appeared in the Boston Post, reported, Phineas Gage was the
foreman of a railway construction gang working for the contractors preparing the bed for the Rutland and
Burlington Rail Road near Cavendish, Vermont. On 13th. September 1848, an accidental explosion of a
charge he had set blew his tamping iron through his head.
The tamping iron was 3 feet 7
inches long and weighed 13 1/
2 pounds. It was 1 1/4 inches
in diameter at one end
(not circumference as in the
newspaper report) and tapered
over a distance of about 1-foot
to a diameter of 1/4 inch at the
other. The tamping iron went
in point first under his left
cheek bone and completely out
through the top of his head,
landing about 25 to 30 yards
behind him. Phineas was
knocked over but may not
have lost consciousness even
though most of the front part of
the left side of his brain was
destroyed. Dr. John Martyn
Harlow, the young physician
of Cavendish, treated him with
such success that he returned
home to Lebanon, New
Hampshire 10 weeks later.
Some months after the accident, probably in about the middle of 1849, Phineas felt strong enough to resume
work. But because his personality had changed so much, the contractors who had employed him would not
give him his place again. Before the accident he had been their most capable and efficient foreman, one with a
well-balanced mind, and who was looked on as a shrewd smart business man. He was now fitful, irreverent,
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and grossly profane, showing little deference for his fellows. He was also impatient and obstinate, yet
capricious and vacillating, unable to settle on any of the plans he devised for future action. His friends said he
was “No longer Gage.”
As far as we know Phineas never worked at the level of a foreman again. According to Dr. Harlow, Phineas
appeared at Barnum’s Museum in New York, worked in the livery stable of the Dartmouth Inn (Hanover,
NH), and drove coaches and cared for horses in Chile. In about 1859, after his health began to fail he went to
San Francisco to live with his mother. After he regained his health he worked on a farm south of San
Francisco. In February 1860, he began to have epileptic seizures and, as we know from the Funeral Director’s
and cemetery interment records, he died on 21st. May 1860 (not in 1861 as Harlow reported).
No studies of Phineas Gage’s brain were made post mortem. Late in 1867 his body was exhumed, and his
skull and the tamping iron sent to Dr. Harlow, then in Woburn (MA). Harlow reported his findings, including
his estimate of the brain damage, in 1868. He then gave the skull and tamping iron to what became the
Warren Museum of the Medical School of Harvard University where they were much studied. They are now
on display at Harvard’s Countway Library of Medicine.
This is the bar that was shot through the head of Mr. Phinehas P. Gage at Cavendish, Vermont, Sept. 14, 1848. He
fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard
University.
Phinehas P. Gage Lebanon Grafton Cy N-H Jan 6 1850 *
Henry Jacob Bigelow, Professor of Surgery at Harvard University’s Medical School, seems to be responsible
for the inscription and the errors in it over the spelling of Phineas’ first name and the date.
What I have summarised above is almost all of what Harlow tells us about Phineas Gage. Although it is
almost all we know, the slightness of what he tells us has not prevented the attribution to Gage of all sorts of
fabulous psychological characteristics and an equally fabulous post-accident history. Evidently most of those
who have written about Gage have not read Harlow’s 1868 report in which what little we know of Gage’s last
11 1/2 years are set out. This is not surprising given that neither the Proceedings of the Massachusetts Medical
Society nor Harlow’s 1869 pamphlet version of his address are held in many of the world’s libraries.
Most of the accounts of Gage’s life after 1848 are strange mixtures of slight fact, considerable fancy, and
downright fabrication. Harlow says, for example, that Phineas exhibited himself in the larger New England
towns and was with Barnum’s in New York for a time. These remarks are frequently elaborated into a Gage
who drifts around aimlessly and is not interested in working or, if interested, is incapable of holding a job.
During the same period, Phineas is often pictured as exhibiting himself, usually as a freak, in circuses or
fairgrounds around the country. Part of this fancy comes from Barnum now most often being remembered as
the proprietor of a circus rather than the owner of the New York Museum to which Harlow unmistakably
refers. Similarly, these stories turn Gage into a fairground freak because it is in such places that freaks are or
were once seen.
In fact, from early in 1851 until just before he died nine years later, Gage seems to have worked at the one
occupation, although in two places: in Currier’s livery stable and coach business for 1 1/2 years, and in Chile
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in a similar capacity for nearly seven more. There he clearly drove coaches, probably stage coaches. We
know he was barely well enough to do a full day’s work on his parent’s farm until June of 1849, just well
enough to travel to Boston in November of that year, and was still described in 1850 as failing in bodily
powers. The maximum time he could have travelled around New England or been with Barnum’s Museum
would seem to have been about a year. We know nothing about the quality of his work for Currier or when
he was in Chile, or to what extent he was able to support himself. This has not prevented the fabrication of
employment histories somewhat at variance with one another: for example, in one he is totally aimless, in
another he makes a lot of money from exhibiting himself but dies penniless in an institution.
Similarly, Gage’s mother told Harlow that he used to make up stories of his adventures to entertain his small
nephews and nieces. This fact, together with the attribution to him of behaviours actually shown by some of
the 1930’s radical resection patients, seems to be the basis for transforming Gage into an untruthful, shorttempered, psychopathic, braggart. What was written about some of the lobotomised patients is undeniably the
source of the descriptions of Gage as careless or unreliable and slovenly in his personal habits, or as having
less sexual drive but fewer inhibitions in talking about sex. Harlow mentions neither Gage’s sexual behaviour
nor his drinking; nor is any documentation provided by any of those who have written on the matters. The
prize for these kinds of fabrications must surely be shared between those accounts that endow him with sexual
activity and those that turn him into a drunkard who dies in careless dissipation.
With the exception of a very small stock of additional facts about Gage uncovered by Dr. Fred Barker and
myself, little can be added to what Harlow told us. Now, what Harlow says may not be completely accurate,
and it is clearly influenced by his medical and phrenological ideas, but it is virtually all that we have. The
story Harlow tells is tragic enough. It does not need the modern undocumented and contradictory fabrications.
Further reading:
Macmillan, M. B. (2000). Restoring Phineas Gage: A 150th retrospective. Journal of the History of the
Neurosciences, 9, 42-62.
* I was able to inspect the tamping iron properly only as late as July, 2000. This version of the inscription is
correct and more complete than those appearing anywhere else, including the one in my book.
The Phineas Gage Information Page is hosted by the Faculty of Health and Behavioural Sciences, Deakin University Australia
http://www.deakin.edu.au/hbs/GAGEPAGE/Pgstory.htm
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