Phineas Gage's Story
Phineas Gage is probably the most famous person 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, 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 American Museum in New York City, worked in the livery stable of the Dartmouth Hotel (Hanover, NH),
and drove coaches and cared for horses in Valparaiso, 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 was anxious to work and found it on a farm in
Santa Clara County, 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 was buried on 23rd May 1860. (Although Harlow
gives the year as 1861, the records show conclusively that it was 1860. Here, as elsewhere I have silently corrected
Harlow's dates).
Here is the iron (with the inscription corrected since my book).
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 American Museum in New York City 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 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. No one notices that his mother said he was anxious to work after he recovered his health in 1859.
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
patients undergoing radical brain surgery, 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 uncovered by Dr. Fred Barker, Matthew L. Lena, and
myself, little has been added to what Harlow told us about Gage. What Harlow says may not be completely accurate.
It is clearly influenced by his medical and phrenological ideas and is not specific about the period of Phineas' postaccident life to which it is meant to apply. But it is virtually all that we have. The story Harlow tells is tragic enough:
it has no need for these modern undocumented and contradictory fabrications. What it does need is filling out with
descriptions by people who actually saw Phineas and described what he did and how he behaved. Most families and
genealogists have old documents such as letters and diaries written by great-great-great grandparents and other
ancestors and it is these that will contain such descriptions. The 'Questions' page has a list of things for which
answers are needed about Phineas when he lived in New England, Chile, and San Francisco.