September 13: A Case Study for Neuroscientists

On 13 September 1848, while clearing rocks for a new railroad track, Phineas Gage survived an accident that caused a more than three foot eight inch metal tamping iron to go through his head and brain. The tamping iron entered just below the left cheek bone and exited through the top of Gage’s skull. Although Gage survived, he went through significant personality changes as the result of the injury to his brain. His was one of the first documented cases of brain injury recorded by the then emerging field of neuroscience.

Gage was 25 years at the time of the accident and worked as the foreman of a railroad crew. To excavate rocks, a hole was first drilled in a boulder. Using a tamping iron, the hole was filled with dynamite and then plugged with sand. When the dynamite exploded, the energy was released into the boulder causing it to smash into smaller rocks which could then be hauled away.

An earlier method for clearing rock had been developed in China when the Dujiangyan (都江堰) project caused the Min River to be rerouted through Mount Yulei; a project begun in 256 BCE. Because gunpowder had not yet been invented, the rock face of Mount Yulei was heated and then cold water was applied which caused the hot rock to crack.

Had Gage been using the earlier method, he would not have been injured in the same way. The problem for Gage was that a spark caused the explosive powder he was using to explode. The tamping iron flew out of the hole and through his skull. However, it was not the fact that Gage survived the traumatic injury that makes his case significant. Instead, as the author of “The Incredible Case of Phineas Gage” explains, “Gage is the index case of an individual who suffered major personality changes after brain trauma. As such, he is a legend in the annals of neurology, which is largely based on the study of brain-damaged patients.”

    –Steven L. Berg, PhD

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Photo Caption: Daguerreotype of Phineas Gage holding the tamping iron that went through his head. Image from the Smithsonian Institution article “Phineas Gage: Neuroscience’s Most Famous Patient.”

Posted on by stevenlberg
Categories: American History: Nineteenth Century, World History: Ancient
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5 Responses

  1. Crystal says:
    14 September 2012 at 5:27 am

    IN my PSYCH 201 course, we talked about this guy Phienas Gage in a chapter that delt with multiple personalities. Though we never discused how the accident actually occurred but the fact that Phineas was the first to be studied in the neuroscience field (Neurology) And Gage has been said to be the first individule to have brought attention the particular field of Neurology.

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  2. Jenna Elwell says:
    16 September 2012 at 1:57 pm

    The case of Phineas Gage was the first case to suggest a link between brain trauma and personality change. A set of recent studies from the UK found that traumatic brain injury, or TBI, sufferers show a much higher prevalence of some specific problems in emotional processing. Unfortunately, TBI is increasing, especially in the military. Nearly six out of ten causalities entering the military hospital at the Walter Reed Medical Center in Washington DC have been diagnosed with some degree of a TBI, putting into perspective the relevancy of the problems in Iraq and Afghanistan. Without Phineas Gage’s accident on September 13, 1848, the understanding of the changes in personality after a traumatic event to the frontal lobes and the understanding of TBI in soldiers wouldn’t be as advanced as it is today.

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  3. Crystal Heidler says:
    17 September 2012 at 10:23 am

    Phineas Gage was the first to be studied in the Neuroscience Field (Neurology) and Gage has been said to be the first individule to have brought attention to the field of Neurology. On the day the the incident gage lost a large section of his brain and lost sight in his left eye. Shockingly, he was actually to tell the doctor what had happened. Gage suffered massive seizures and wasn’t expected to survive, but did. Today brain injured patients can receive many treatments to help prevent seizures, blood clots, mood disorders and depression. Brain injuries are one of the major causes of physical, cognitive, social, emotional, and behavioral effects, and outcome can range from complete recovery to permanent disability or death. A case in October 1991 shows how severe a blow to the head really is. A 17 year old football player was tackled on the last day of the season and who’s head hit the ground. Not telling his coach that he was feeling ill, continued to play and received several routine blows to his helmet during blocks and tackles, he soon collapsed on the field and was transported to the nearest center. A CT was performed withe the results showing severe swelling and subdural hematoma (collection the blood on the surface of the brain). Unable to control the effects, he was dead within 4 days.

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  4. Justin Shureb says:
    17 September 2012 at 5:29 pm

    In time, Gage became the most famous patient in the annals of neuroscience because his case has the first to suggest a link between brain trauma and personality changes. Gage was kind of a celebrity at this time because he had this tragedy happen to him but survived. After he got through everything and was ready to work again he tried to go back to the railroad company, but they would not take him back. He ended up going to New Hampshire and working at a stable. He died in 1860, at the age of 36, after a series of seizures. Seven years went by,Gage was dug out of his grave and now both his skull and the tamping iron are both on display at the Harvard Medical School.

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  5. Christopher Nichol says:
    13 November 2012 at 4:39 am

    Like Crystal, I too had a PSYCH 201 course a couple semesters ago and we talked about Phineas Gage. The accident wasn’t discussed, but it was really fascinating finding out how he lived through everything. Almost makes you question a lot of things in life, and how one can survive such trauma. It’s interesting to note that Gage’s headless remains were moved to Cypress Lawn Cemetery due to the arranged relocation of San Francisco’s dead to new burial places outside of the city limits.

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