How Did Phineas Gage Die?

In the late 19th century, Phineas Gage was a 25-year-old man working as a railroad construction supervisor in Cavendish, Vermont. As a supervisor, Gage primarily used explosives to prepare land for the Rutland and Burlington Railroad to lay tracks.

He led a fairly normal life until, on September 13, 1848, he sustained a severe injury to his brain on the railyard. When preparing the ground for construction that day, Gage falsely assumed that the procedure for explosions had been correctly followed. 

How did Phineas Gage almost die?

Not knowing that a crucial step had been missed, Gage put an iron rod into a hole filled with gunpowder and tried to pack the contents. The friction he created caused the powder to ignite and launch the rod directly into Gage’s upper cheek. The rod found its way into his left eyeball, through his brain, and out through his skull. 

Miraculously, Gage did not die. Instead, he was able to speak a few minutes after the accident took place and even walked (with help) to an ox-cart to receive medical care. Dr. John Martyn Harlow tended to Gage, and as a result, Gage ended up recovering from his physical injuries. 

Why was Phineas Gage able to survive?

Researchers attempted to understand precisely where the rod entered Gage’s brain years after the accident.  Additionally, they aimed to understand why Gage did not immediately die, despite the severity of his injury.

Studies showed that Gage’s brain trauma was only limited to the left side of Gage’s frontal lobe, where the rod entered. This injury eliminated brain matter but did not cross to the other side of Gage’s frontal lobe, meaning functioning was still occurring.

The study also found that Gage’s ventricular system was not seriously damaged, and vital blood vessels in Phineas’s brain were not impaired. As a result, Gage was able to continue living but underwent severe changes. 

How did Phineas Gage change after the accident? 

Though he was able to heal, the 13-pound rod did severe damage to Gage’s frontal lobe. An infection from the wound site also caused Gage to have even more brain tissue removed.

After the surgeries, Gage’s observed behavior dramatically changed. Before his accident, Phineas Gage was described as a kind man who was considerate of others and extremely polite. 

After, Gage’s personality was reported to have changed completely. Now, Gage was erratic, abusive, and rude. He was incredibly stubborn when others did not agree with him and often acted without thinking. Those close to him said that Gage was no longer the person he once was. 

Curiously, Gage’s memory and cognitive understanding were not significantly impacted. Dr. Harlow published articles on Gage’s brain during this time and documented some of the first insights into how damage to the frontal cortex impacted an individual.

Gage’s accident also led to an early influence on neuropsychiatry, the study of understanding how the interaction of neurobiology and psychology works to create behaviors. 

How long did Phineas Gage survive after the accident? 

After the accident, Gage was healthy and able to work as a stagecoach driver in Chile for seven years. Eventually, he became ill and moved to California to be with his family. In 1860, about 12 years after his accident, he died of an epileptic seizure.

Gage’s body did not undergo an autopsy, however, it is assumed that the seizure was related to his brain injury. 

Where is Phineas Gage’s skull now? 

Years after his death, Dr. Harlow requested Phineas’s bones from the Gage family.  Following exhumation, Gage’s skull and the iron rod that had entered Gage’s brain was in Dr. Harlow’s possession.

He secured them for scientific preservation and later donated them to Harvard University. To this day, they are still displayed in the Harvard Medical School’s Anatomical Museum. 


Gearhart, S. (2022, June 27). Phineas Gage. Encyclopedia Britannica. 

Ratiu, Talos, I.-F., Haker, S., Lieberman, D., & Everett, P. (2004). The Tale of Phineas Gage, Digitally Remastered. Journal of Neurotrauma, 21(5), 637–643. 

Sevmez, Adanir, S. S., & Ince, R. (2022). Legendary name of neuroscience: Phineas Gage (1823–1860). Child’s Nervous System, 38(5), 855–856.  

Teles. (2020). Phineas Gage’s great legacy. Dementia & Neuropsychologia, 14(4), 419–421. 

Van Horn, Irimia, A., Torgerson, C. M., Chambers, M. C., Kikinis, R., & Toga, A. W. (2012). Mapping Connectivity Damage in the Case of Phineas Gage. PloS One, 7(5), e37454–e37454. 

Saul Mcleod, PhD

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Educator, Researcher

Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education.

Kayla Saucedo

Research Assistant at Harvard University

Undergraduate at Harvard University

Kayla Saucedo is a psychology undergraduate and research assistant at Harvard University.