How Did Phineas Gage Survive the Horrifying Brain Injury?

Phineas Gage was Neuroscience’s Most Famous Patient. Gage was an American construction foreman, known for his involuntary contribution in the field of Neuroscience. His injuries have helped scientists gain more perspective about the brain and human behaviour.

In 1848, Gage was working on Burlington Railroad in Vermont, USA. Workers often used dynamite to blast away rocks and clear path for railways. He was using a tamping iron (a long hollow cylinder of iron weighing 6 kilos) to compact explosive powder into the rock for a blast. The iron rod struck the rock, creating a spark which accidentally ignited the explosives. The rod drove through Gage’s skull, entering his left cheekbone and exiting through the top of his head.


                                                      Depiction of Gage’s case 

Despite the injury Gage was sitting up in a cart, very conscious, recounting what had happened. Dr Harlow cleaned and dressed his wounds, placing fragments of skull around the exit wound caused by the rod back in their positions and made sure no shard of bone remained in the brain by feeling inside Gage’s head with his fingers.

Gage’s wound however, became infected and he consequently fell into a semi-coma state. Later that year he recovered and returned to his parents home.

Physically, Gage made a remarkable recovery, but his injury made a permanent impact on his mental condition. His character altered dramatically after the accident and he started behaving very inappropriately in social places. Some reported that he became very violent and uncontrollable and that he even went as far as molesting children. His friends said that he was no longer the Gage they knew!

Around 4% of the cerebral cortex and about 11% of white matter in the frontal lobe was destroyed. The damage to the frontal cortex caused by the iron rod resulted in the loss of social inhibitions. Gage’s condition was evidence to neurologists’ theories at a time when they were just beginning to realize that the frontal cortex was associated with decision making, social cognition, personality and behaviour.  Female Frontal Lobe - Anatomy Brain

                                                                  Frontal Cortex

Gage’s survival was miraculous and has sparked tremendous scientific research. The continuing research into Gage’s condition encourages us to believe that scientists will one day unravel more mysteries of the brain.

Edited by : keerthana Suresh 


Big Picture. (2018). Retrieved from

Costandi, M. (2018). Phineas Gage and the effect on personality of an iron bar through the head. Retrieved from

Dahlitz, M. (2018). Prefrontal Cortex | The Neuropsychotherapist – The Neuroscience of Psychotherapy. Retrieved from



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