The Tamping Iron That Taught Us About the Frontal Lobe

At 4:30 in the afternoon on September 13, 1848, a 25-year-old foreman named Phineas Gage was packing blasting powder into a hole he had drilled near Cavendish, Vermont, for the Rutland and Burlington Railroad. The powder ignited early. The tamping rod he was using — a custom iron bar 1.1 meters long, 6 millimeters thick at the tip, weighing about 6 kilograms — shot upward through his left cheek, behind his eye, and out the top of his skull. It landed about 25 meters away.

Gage did not lose consciousness. He spoke to his men a few minutes later, sat upright in the ox cart that took him to the boarding house, and reportedly told the local doctor: "Here is business enough for you." Dr. John Martyn Harlow cleaned the wound, picked bone fragments out of the cavity, and waited.

Gage survived. He survived a fungal infection that left him semi-comatose for weeks. He survived seizures, weight loss, and the open hole the iron had punched through his orbital and frontal bone. Within a year he was walking and talking and looking, in any photograph, like a slightly wary working man.

But the people who knew him said he was different. Harlow, in a follow-up paper years later, recorded that the previously "shrewd, smart" foreman had become impatient, profane, and unable to stick to plans. His employers would not rehire him. "No longer Gage," his friends said.

That single sentence, more than the hole in his head, is why neurology students still learn his name. Before Gage, the frontal lobes were thought to do nothing in particular. His case became the first concrete argument that personality, judgment, and self-control live in the front of the brain. He died of seizures in 1860, twelve years after the accident. The iron and his skull are still at Harvard.