Phineas Gage case study

case study: an in-depth investigation of

a single individual, family, event, or
other entity. Multiple types of data
(psychological, physiological,
biographical, environmental) are
assembled, for example, to understand
an individual's background,
relationships, and behavior.

Phineas Gage is often referred to as the "man who began neuroscience."1 He experienced a traumatic brain injury
when an iron rod was driven through his skull, destroying much of his frontal lobe. Gage miraculously survived the
accident. However, his personality and behaviour were so changed as a result of the frontal lobe damage that
many of his friends described him as an almost different person entirely. The impact that the accident had has
helped us better understand what the frontal lobe does, especially in relation to personality.

Phineas Gage's Accident

In 1848, 25-year-old Gage was working as the foreman of a crew preparing a railroad in Vermont. He was using an
iron tamping rod to pack explosive powder into a hole. The powder detonated, sending the 43-inch-long, 1.25-
inch-diameter rod hurling upward. The rod penetrated Gage's left cheek, tore through his brain, and exited his
skull before landing 80 feet away.2 Gage not only survived the initial injury but was able to speak and walk to a
nearby cart so he could be taken into town to be seen by a doctor. He was still conscious later that evening and
able to recount the names of his co-workers. Gage even suggested that he didn't wish to see his friends since he
would be back to work in "a day or two" anyway.3

The Recovery Process

After developing an infection, Gage spent September 23 to October 3 in a semi-comatose state. On October 7, he
took his first steps out of bed, and, by October 11, his intellectual functioning began to improve. 4 Descriptions of
Gage's injury and mental changes were made by Dr. John Martyn Harlow. Much of what researchers know about
the case is based on Harlow's observations.

Harlow noted that Gage knew how much time had passed since the accident and remembered clearly how the
accident occurred but had difficulty estimating the size and amounts of money. Within a month, Gage was well
enough to leave the house.3 In the months that followed, Gage returned to his parent's home in New Hampshire
to recuperate. When Harlow saw Gage again the following year, the doctor noted that while Gage had lost vision
in his eye and was left with obvious scars from the accident, he was in good physical health and appeared
recovered.

Theories About Gage's Survival and Recovery

The type of injury sustained by Phineas Gage could have easily been fatal. While it cannot be said with certainty
why Gage was able to survive the accident, let alone recover from the injury and still function, several theories
exist. They include:
  The rod's path. Some researchers suggest that the rod's path likely played a role in Gage's survival in that
if it had penetrated other areas of the head, Gage may have bled to death.5
 The brain's selective recruitment. In a 2022 study of another individual who also had an iron rod go
through his skull—whom the researchers referred to as a "modern-day Phineas Gage"—it was found that
the brain is able to selectively recruit non-injured areas to help perform functions previously assigned to
the injured portion.6
 Work structure. Others theorize that Gage's work provided him structure, positively contributing to his
recovery and aiding in his rehabilitation.7

The Effects of Gage's Injury

Popular reports of Gage often depict him as a hardworking, pleasant man prior to the accident. Post-accident,
these reports describe him as a changed man, suggesting that the injury had transformed him into a
surly, aggressive heavy drinker who was unable to hold down a job.8 Harlow presented the first account of the
changes in Gage's behaviour following the accident. Where Gage had been described as energetic, motivated, and
shrewd prior to the accident, many of his acquaintances explained that after the injury he was "no longer Gage." 3

Since there is little direct evidence of the exact extent of Gage's injuries aside from Harlow's report, it is difficult to
know exactly how severely his brain was damaged. Harlow's accounts suggest that the injury did lead to a loss of
social inhibition, leading Gage to behave in ways that were seen as inappropriate. Some evidence suggests that
many of the supposed effects of the accident may have been exaggerated and that Gage was actually far more
functional than previously reported.9

Severity of Gage's Brain Damage

In a 1994 study, researchers utilized neuroimaging techniques to reconstruct Phineas Gage's skull and determine
the exact placement of the injury. Their findings indicate that he suffered injuries to both the left and right
prefrontal cortices, which would result in problems with emotional processing and rational decision-making.10

Another study conducted in 2004 used three-dimensional, computer-aided reconstruction to analyze the extent
of Gage's injury. It found that the effects were limited to the left frontal lobe. 11 In 2012, new research estimated
that the iron rod destroyed approximately 11% of the white matter in Gage's frontal lobe and 4% of his cerebral
cortex.12

Phineas Gage's Impact on Psychology

Gage's case had a tremendous influence on early neurology. The specific changes observed in his behaviour
pointed to emerging theories about the localization of brain function, or the idea that certain functions are
associated with specific areas of the brain.13

In those years, neurology was in its infancy. Gage's extraordinary story served as one of the first sources of
evidence that the frontal lobe was involved in personality.8 Today, scientists better understand the role that the
frontal cortex has to play in important higher-order functions such as reasoning, language, and social cognition.

What Happened to Phineas Gage?

After the accident, Gage was unable to continue his previous job. According to Harlow, Gage spent some time
traveling through New England and Europe with his tamping iron to earn money, supposedly even appearing in
the Barnum American Museum in New York.3

He also worked briefly at a livery stable in New Hampshire and then spent seven years as a stagecoach driver in
Chile. He eventually moved to San Francisco to live with his mother as his health deteriorated.

After a series of epileptic seizures, Gage died on May 21, 1860, almost 12 years after his accident. 9 Seven years
after his death, Gage's body was exhumed. His brother gave his skull and the tamping rod to Dr. Harlow, who
 subsequently donated them to the Harvard University School of Medicine. They are still exhibited in its museum
today.1

Phineas Gage Summary

In 1948, Phineas Gage had a workplace accident in which an iron tamping rod entered and exited his skull. He
survived but it is said that his personality changed as a result, leading to a greater understanding of the brain
regions involved in personality, namely the frontal lobe.

Gage's accident and subsequent experiences serve as a historical example of how case studies can be used to look
at unique situations that could not be replicated in a lab. What researchers learned from Phineas Gage's skull and
brain injury played an important role in the early days of neurology and helped scientists gain a better
understanding of the human brain and the impact that damage could have on both functioning and behaviour.

Strengths of casestudies
 Provides detailed (rich qualitative) information.
 Provides insight for further research.
 Permitting investigation of otherwise impractical (or unethical) situations.
 Case studies can help us generate new ideas (that might be tested by other methods). They are an important
way of illustrating theories and can help show how different aspects of a person's life are related to each other.
 The method is therefore important for psychologists who adopt a holistic point of view (i.e. humanistic
psychologists).

Weaknesses of the study

 Lacking scientific rigour and providing little basis for generalisation of results to the wider population.
 Researchers' own subjective feeling may influence the case study (researcher bias).
 Difficult to replicate.
 A case study deals with only one person/event/group we can never be sure if the case study investigated is
representative of the wider body of "similar" instances. This means the conclusions drawn from a particular case
may not be transferable to other settings.
 Information about the change in Gage’s personality were gleaned from details written more than a century ago,
meaning its accuracy is questionable.
 All studies investigating the brain damage suffered by Gage is essentially all speculation as we cannot know for
certain the extent of the accident’s effects. We know that some brain tissue got destroyed, but any infections
Gage may have suffered after the accident may have further destroyed more brain tissue.
 We also cannot determine the exact location that the iron rod entered Gage’s skull to the millimetre. As brain
structure varies from person to person, researchers cannot ever know for certain what areas of Gage’s brain
were destroyed.
QUESTIONS

 How did Phineas Gage die?

 What part of the brain did Phineas Gage damage?

 How did Phineas Gage change after the accident?

 Why do scientists believe Phineas Gage survived?

 How long did Phineas Gage live after the accident?

 What did scientists conclude about this area of the brain?

 Why is Phineas Gage important to psychology?

List 3 strengths and 3 weaknesses of understanding the brain that relate directly to Phineas gages case study

strengths weaknesses

Over the page briefly research 3 of the following

H.M. (Henry Gustav Molaison)

Victor Leborgne (nickname “Tan”)
Wild Boy of Aveyron
Kim Peek
Auguste Deter
Richard Hammond
James Cracknell
Rik Mayall
Roald Dahl
In a paragraph explain who they are, what research do they provide information on, why is it useful to
psychology, (what area of research within Psychology)