What Happened to Phineas Gage?

Computer reconstruction of the skull of Phineas Gage illustrating the projection of the tamping rod through the brain.  Reprinted with permission from Damasio H.Grawboski, Frank R. Galaburda AM, Damasio AR; The return of Phineas Gage:  Clues about the brain from a famous patient.

Due to an accident while he was working, Phineas Gage made a contribution to the under-standing of how the brain works. In 1848, 25-year old Phineas Gage worked for the Rutland and Burlington Railroad Company laying railroad tracks across Vermont. Before railroad track could be laid, however, the uneven ground needed to be leveled. Gage and coworkers had to drill holes in the stone, put explosive in the holes, cover the explosive with sand, and then use a fuse and tamping iron to trigger an explosion.

 One day, an accident occurred that changed Gage’s life forever. The explosive went off early sending the tamping iron, which was 1.25 inches in diameter and 43 inches long, shooting into Gage’s face, through his skull and brain, and out the top of his head. The tamping iron landed about 25 yards away. Gage regained consciousness within a few minutes. Amazingly, he not only survived the blast, but he was able to talk and to walk! His coworkers took him to the doctor who cleaned and bandaged the wounds, the standard medical treatment at the time.

Although Gage survived the physical injuries from the blast, he was a changed man. He appeared to be just as intelligent as before the accident, and he did not have any impairment in movement, speech, or memory. But, something was different. Prior to the accident, he was a responsible, intelligent and likeable person. After the accident, he was irresponsible, used profanity extensively, and demonstrated no respect for social customs. His friends commented that “Gage was no longer Gage.” He could not hold the responsible jobs that he had prior to the accident and apparently wandered for the next several years. Phineas Gage ended up in San Francisco in the custody of his family where he died approximately 12 years after the accident.

Twenty years after the accident, the physician who treated Gage correlated the behavioral changes with damage to the frontal region of the brain. At the time, the brain was thought to control language and movement, but the suggestion that the brain functioned to process emotions and social behavior was new. In addition, scientists at the time believed the brain lacked localized functions. Unknowingly, Phineas Gage contributed to our understanding of how the brain processes information.

In the 1990s, scientists used their improved understanding of brain function, computer modeling techniques, and new data from Gage’s skull. Based on this information, they found that the accident damaged both hemispheres of the frontal lobe, which is the part of the brain that influences social behavior. Today, physicians see patients with damage to the frontal lobe that has occurred through motor vehicle accidents, gun accidents, or major falls. These individuals, like Phineas Gage, often have dramatic changes in their emotional and decision-making abilities.

If you haven't heard of Phineas Gage before then you should find it very interesting.  He contributed to our understanding of how the brain processes information.   

1.  How did Phineas Gage change after the accident? 

     After  the accident Gage's personaility changed.  He was no longer the  likeable and responsible person he was prior to the accident.  Instead, he was irresponsible and used profanity. 

2.  How did Phineas Gage's accident change scientists understanding of the brain?

    Scientists  learn  that  the  brain contains  more than control language   and   movement.   It   also  controls   emotions  and social  behaviors.  qually   important,  scientists   learned  that   the   brain    processes   information  for  specific funtions in specific brain areas.

Significance for Neuroscience

This computer generated graphic, based on data from a "standard human skull", shows how the tamping rod may have penetrated Phineas Gage's skull, crossing the midline and damaging both frontal lobes, according to Damasio et al.Gage's case is cited as among the first evidence suggesting that damage to the frontal lobes could alter aspects of personality and affect socially appropriate interaction. Before this time the frontal lobes were largely thought to have little role in behavior.

Neurologist Antonio Damasio has written extensively on Gage, as well as on various patients he has studied which, in his personal view, had similar brain injuries. In a theory he calls the 'somatic marker hypothesis', Damasio suggests a link between the frontal lobes, emotion and practical decision making. He sees Gage's case as playing a crucial role in the history of neuroscience, arguing that Gage's story "was the historical beginnings of the study of the biological basis of behavior".

It is occasionally suggested that Gage's case inspired the development of frontal lobotomy, a now-obsolete psychosurgical procedure that leads to a blunted emotional response and personality changes. However, historical analysis does not seem to support this claim. It seems that consideration of Gage's injury had little influence on the development of this practice.

Gage kept the rod which damaged him throughout his life as a souvenir, and it was buried with him in death. In 1867, when his skeleton was exhumed, the original rod was thus available with it. There is an inscription on the rod that reads, "[t]his is the bar that was shot through the head of M. Phineas P. Gage at Cavendish, Vermont on September 14, 1848.

He fully recovered from the injuries and deposited this bar in the Museum of the Medical College of Harvard University."Gage's skull, as well as the rod that pierced it, is currently part of the permanent exhibition at Harvard Medical School's Warren Anatomical Museum in Boston, Massachusetts.

References: (1)  The  Brain:   Understanding  Neurobiology  Through  The Study of Addiction; Lesson 1 The Brain: What's Going In  There?  (NIDA 2004)
                    (2)  Damasio   H.,  Grabowski  T,.   Frank  R.,   Galaburda  AM., Damasio AR. (1994).  "The return of Phineas Gage: clues  about  the  brain   from  the  skull  of  a  famous  patient." Science 264 (5162):  1102-5.

Compiled & Edited By: Deborah  Shrira       Dated: Jan 3, 2007

Asst. Editor: Dee Black                                         Updated: March 26, 2012