Warren Anatomical Museum (WAM)
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The Phineas Gage Case
story of Phineas Gage illustrates some of the first medical knowledge
gained on the relationship between personality and the functioning of
the brain's frontal lobe. A well-liked and successful construction
foreman, Phineas Gage was contracted to work on the bed preparation for
the Rutland & Burlington Railroad in Cavendish, Vermont in late
1840’s. On the 13th of September 1848, while preparing the railroad
bed, an accidental explosion of a charge he had set blew a 13-pound
tamping iron straight through Gage’s head, landing many yards away.
all accounts, the front part of the left side of his brain was
destroyed. Incredibly, almost immediately after the accident, Gage was
conscious and able to talk, and insisted on walking to the cart that
would take him into town to be treated. Despite his torn scalp and
fractured skull, Gage remained lucid and rational during the ride and
was able to speak with his attending physician, Dr. John Martyn Harlow.
Dr. Harlow, a young physician in Cavendish, noted that although the
tamping iron appeared to have gone directly through Gage’s frontal
lobes, Gage was still able to speak rationally and answer questions
about the injury. Gage was treated by Harlow and returned home to
Lebanon, New Hampshire 10 weeks later.
Gage’s recovery was not a complete success. The once friendly and
well-liked man became "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." Those who knew him before the
accident said he was "no longer Gage."
Phineas Gage Skull & Life Cast, 2010
00949 & 00950
Warren Anatomical Museum
Francis A. Countway Library of Medicine
never worked at the level of a foreman again. The undesirable changes
in his personality ensured that the contractors who had previously
employed him would never hire him again. After the accident Gage had
several odd jobs: exhibiting himself at Barnum’s American Museum in New
York, working in the livery stable of the Dartmouth Inn (Hanover, NH),
and driving coaches in Chile. In 1859, after his health began to fail,
Gage moved to San Francisco to live with his mother. In February 1860,
he began to experience the epileptic seizures that would lead to his
death on May 21, 1860.
1867 Gage’s body was exhumed, and his skull, along with the tamping
iron, was sent to Dr. Harlow, then in Woburn, Massachusetts. In 1868
Dr. Harlow authored a report on the Gage medical case, which appeared
in the Publications of the Massachusetts Medical Society (v. 2 (1868):
327-347). Harlow eventually donated the skull and tamping iron to the
Warren Anatomical Museum, which already housed a plaster head cast of Gage taken by physician Henry Jacob Bigelow in 1850. The skull, life cast and tamping iron are currently on display in the Warren
Museum Exhibition Gallery at the Countway Library of Medicine.
More on Phineas Gage
Harlow, John M. "Passage of an iron rod through the head." Boston medical and surgical journal, v. 39, no. 20 (November 1848): 389-393.
Bigelow, Henry J. "Dr. Harlow's case of recovery from the passage of an iron bar through the head." American journal of the medical sciences, n.s. v.20 (July 1850): 13-22.
Harlow, John M. "Recovery from the passage of an iron bar through the head." Publications of the Massachusetts Medical Society, v.2 (1868): 327-347.
Macmillan, Malcolm. An odd kind of fame: stories of Phineas Gage.
(Cambridge: MIT Press, 2000).
Macmillan, Malcolm. "The Phineas Gage Information Page." Deakin University