A photo of Phineas Gage in 1850, holding the tamping iron that caused his brain injury. He was a construction foreman (in charge of blasting) on the railroad, age 27, when an accidental early explosion occurred. The explosion drove a tamping iron (large iron rod, 1.25 inches in diameter) into his head. A large part of his left frontal lobe was destroyed.

After the accident, with the bar still in his head, it is reported that he sat up, talked, and walked to a wagon. Sitting in the wagon for the 3/4 mile ride into town, he was seen by a doctor. The doctor said:

"When I drove up he said, "Doctor, here is business enough for you." I first noticed the wound upon the head before I alighted from my carriage, the pulsations of the brain being very distinct. The top of the head appeared somewhat like an inverted funnel, as if some wedge-shaped body had passed from below upward. Mr. Gage, during the time I was examining this wound, was relating the manner in which he was injured to the bystanders. I did not believe Mr. Gage's statement at that time, but thought he was deceived. Mr. Gage persisted in saying that the bar went through his head. Mr. G. got up and vomited; the effort of vomiting pressed out about half a teacupful of the brain [through the exit hole at the top of the skull], which fell upon the floor."

The doctor removed some coagulated blood, some of the protruding brain, and some skull (bone) fragments, then bandaged his head and cheek.

Gage survived but his personality and temperament were changed. Later in his life, some social skills and personal skills returned and he worked as a stagecoach driver in Chile and later as a farmworker in Santa Clara County, California.

He died of an epileptic seizure (which was being treated by bleeding) in San Francisco, CA on May 21, 1860 at age 37.