People & Places

Then Again: Phineas Gage cheated death after his ‘Horrible Accident!’

In 2009, a researcher discovered a daguerreotype of Phineas Gage holding the tamping iron that almost killed him. Wikimedia Commons

Add this to the titles of books you don’t want written about you: “Recovery from the Passage of an Iron Bar through the Head.” The title, which comes from a booklet written in 1869 by Dr. John Harlow, pretty much sums up the best-known episode in the life of Phineas Gage and explains why the railroad construction foreman is still famous today.

Immediately after the freakish accident, Gage’s fate rested in Dr. Harlow’s hands. Today, it rests in the hands of the staff at the Warren Anatomical Museum at Harvard, where Gage remains a presence — or at least his skull does. That skull is proof of what many at first doubted. Gage had survived an almost unimaginably gruesome injury. 

On Sept. 13, 1848, Gage was directing the blasting of ledge in Cavendish for the Rutland & Burlington Railroad, which was laying tracks through the town. Blasting involved creating an explosive charge by pouring powder into a drilled hole, dropping in a fuse, tamping it (gently!) with a heavy metal rod. Then pouring sand into the hole and tamping more vigorously to form a plug that would direct the force of the eventual explosion down into the rock.

It was an exceedingly dangerous business. Writing with extreme understatement, one Gage researcher observed that: “Where the material being drilled is of a kind that the impact of an iron bar upon it is likely to generate a spark and the explosive charge is susceptible to being so ignited, the use of a crowbar is somewhat imprudent” — as Gage was to learn.

The tamping iron in Gage’s hand was 3 and a half feet long, more than an inch in diameter and weighed 13 pounds. The accident occurred when he either dropped the bar or, believing the sand had already been added, plunged it too hard into the hole. The resulting explosion shot the heavy rod upward like a bullet. An instant before the explosion, Gage had turned his head to watch his men working in a pit behind him. That turn saved his life, but shattered it too.

The rod shot through his left cheek, passed behind his left eye and out through the top of his head, landing nearly 100 feet away. The impact knocked Gage to the ground, where he lay convulsing. His men crowded around and a few minutes later he began to speak to them.

Stunned that Gage was still alive, they decided to haul him by ox cart to the local tavern to see if anything could be done for him. Gage insisted on walking to the cart. And when it reached town, he climbed down and walked to the tavern’s veranda to await the doctor who had been summoned.

The first doctor to arrive, a Dr. Williams from Proctorsville, examined the wound at the top of Gage’s head, which he said resembled “an inverted funnel.” But he didn’t believe Gage’s story that a rod had shot through his head until Gage pointed to the small slit in his cheek. Supporting Gage’s version of events was the rod itself, which was found smeared with blood and brains.

Next to arrive was Dr. Harlow, who took over his case. He cleaned the wound, picking out the smaller bone shards and leaving the larger ones to stitch themselves back together. When, in the next days, Gage refused to take Harlow’s orders to remain in bed, the doctor laid him low with doses of “calomel, rhubarb and castor oil.” Harlow credited Gage’s recovery to the body’s own resilience (which he called by the Latin term “vis conservatrix”) and to God. 

“For what surgeon, the most skilful, with all the blandishments of his art, has the world ever known, who could presume to take one of his fellows who has had so formidable a missile hurled through his brain, with a crash,” he wrote, “and bring him, without the aid of this vis conservatrix, so that, on the fifty-sixth day thereafter, he would have been walking in the streets again?”

Dr. John Harlow treated Phineas Gage after his horrific accident, and two decades later wrote about this most unusual case. Wikimedia Commons

Harlow’s treatment probably saved Gage’s life, according to Malcolm Macmillan of Monash University in Australia, who is the leading expert on the incident. Macmillan wrote exhaustively of Gage’s case in his 2000 book, “An Odd Kind of Fame,” as well as in an article for the medical journal Brain and Cognition titled “A Wonderful Journey through Skull and Brains: The Travels of Mr. Gage’s Tamping Iron.” Both are interesting reads, though neither lends itself to reading on a full stomach.

News of the accident reached the general public about a week later. Two Boston newspapers reported the incident under the headline “Horrible Accident.” Two days later, the Vermont Mercury of Woodstock ran the headline “Wonderful Accident,” apparently focusing on the wonder that Gage had survived so long, though the paper assumed Gage had little chance of living much longer.

An A. Angier of Cavendish wrote the Boston Christian Reflector and Christian Watchman about the astonishing incident: “We live in an eventful era, but if a man can have thirteen pounds of iron in the shape of a pointed bar, thrown through his head, carrying with it a quantity of the brain, and yet live and have his senses, we may well exclaim, What next?”

The excitement over Gage’s recovery, however, was overblown. In many ways, he died the instant the tamping iron struck his brain. Before the accident, Gage had been known for his level-headedness and hard work. Afterwards, Harlow wrote, Gage “was no longer Gage.” Even casual acquaintances could see he had changed. 

Gage tried to return to work with the railroad, but proved unreliable and was let go. He became combative and irresponsible. People reported seeing him walking around in shirtsleeves on cold, rainy days. 

Gage’s erratic behavior after the accident has since led researchers to understand that different areas of the brain control different functions. The frontal lobes, to which Gage suffered grievous injury, regulate personality. But scientists were slow to come to that conclusion. At the time, it was unthinkable that something as abhorrent as immoral behavior could be linked to a physical cause. 

Gage worked for a year and a half for a stable in Hanover, New Hampshire, near where he had grown up. Then he began to ramble. Gage wandered through New England’s larger cities and towns and eventually found his way to New York, where he became a living part of P.T. Barnum’s museum. His freakish accident had made him a freak.

He drifted to Chile, where his life took on some form of stability. For years he tended horses for a stagecoach company. 

His final journey was to San Francisco, where his mother and sister had moved. For a time, he worked on farms outside the city, then his health began to slip. He started to have seizures. He eventually died from one in May 1860, 11-and-a-half years after his accident.

When Dr. Harlow learned of the death several years later, he made an unusual request of Gage’s mother. He wanted Phineas’ body. Actually, just the head. For science. The rest could remain buried in San Francisco. Gage’s mother consented.

An 1860s sketch shows the path of a three-and-a-half-foot-long tamping iron through the head of railroad worker Phineas Gage. Courtesy of the Vermont Historical Society

Harlow wanted something else too: the tamping iron. After the accident, Gage kept the rod. Perhaps he viewed it as tangible proof of his extreme good fortune, or his stupendous bad luck. At some point, someone engraved the iron with the words: “This is the bar that was shot through the head of Mr. Phinehas P. Gage.” Whoever did the engraving, it wasn’t Gage, since his first name was misspelled.

Gage donated the bar to the Warren museum at Harvard, then changed his mind and asked for it back. Unconfirmed reports claim that he was buried with it. Today, the skull and rod are on display together at Harvard, where it is part of the museum’s teaching collection. 

For decades, the only record the world had of what Gage looked like was a life mask taken of him shortly after the accident. The mask bears a C-shaped crease where the bar exited Gage’s head. 

But in 2009, a researcher noticed a striking image on the photo-sharing website Flickr. It shows a daguerreotype of a handsome man with a scarred brow and closed left eye. In his hands is what appears to be a tamping iron. The next year a second image emerged of the same man. He is holding the iron in this photo too. Researchers are confident the man is Gage. So we can now see the man who cheated death, and suffered greatly as a result.

Mark Bushnell

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