Phineas Gage
In 1848, Phineas Gage was a foreman, efficient, capable, and smart, employed to clear a railroad route through rocky terrain. He and his crew broke up rock formations by drilling holes down into them, filling the holes partway with gunpowder, and very carefully inserting a fuse. The hole was then sealed with clay and/or sand, which was tamped in place with a rod to concentrate the force of the blast towards the rock when the fuse set off the powder.
On that day, September 13th, apparently no one added the sand. As Gage tamped down the charge, he turned to address the crew, putting his head straight above the hole.
When he did so, something set the charge off, most likely a spark generated by the tamping rod.
Gage’s tool was his custom made tamping rod: an iron rod 1-1/4 inch in diameter, almost 4 feet long, with the last foot tapered to provide a better grip. That end of the tool tapered to a small, rounded point.
It happened in an instant. The first thing Gage knew, he was lying on his back several feet away from the hole, probably with pain like he’d never known before throbbing in his head. A ringing in his ears may have been his only clue, besides a lot of blood, that the charge had exploded, propelling the tamping rod out of the hole and into Gage’s face beneath the left cheekbone. The 13 pound rod didn’t stop. It went completely through his head, passing out just back of the hairline, and landing 82 feet away.
After initial convulsions, Gage sat up, spoke, stood up. Co-workers helped him to a cart, which was used to take him for medical attention. When Dr. Edward Williams arrived, Gage was perfectly rational, saying, “Here is business enough for you.”1 He told the doctor and bystanders what had happened, but Williams didn’t believe a man could walk into his surgery after having a rod blasted through his brain. A second doctor, John Martyn Harlow, took over the case and cleaned and repaired Gage’s wounds as best he could, but didn’t expect him to live.
Gage’s left frontal lobe was extensively damaged, as were much of the adjacent regions. The path of the rod through Gage’s brain would seem to have missed the right frontal lobe, but one study states that the lower middle portions of both frontal lobes were were impaired. At least 2.5 fluid ounces of grey matter were missing, and probably a lot more during treatment and convalescence.
Though his injuries and a brain infection rendered the patient comatose for several weeks, he recovered. His speech and motor skills were unaffected. Only Gage’s mother noticed any memory deterioration. He was able to return to work in 1849. Other than the loss of sight in his left eye, there was only one major problem: Those who knew him said he was not the Phineas Gage they’d known. This man was, according to former friends, selfish, restless, profligate, disrespectful, and undependable.2
After a career as a stagecoach and wagon driver that took him as far away as Chile, Gage died from epileptic seizures in San Francisco, 12 years after the accident, at age 36.
The question remains: How could Gage go about his life after having a 1-1/4” rod blown through his brain? Did his Guardienne take over and replace some or all of the autonomous functions of his frontal lobe(s)? “Selfish, restless, profligate, disrespectful, and undependable” describes a person largely under the control of his Guardienne. Did Gage live that way for 12 years?
A statement by his doctor, John Martyn Harlow, gives us, perhaps, a better assessment of his mental state: “His equilibrium, or balance, so to speak, between his intellectual faculties and animal propensities seems to have been destroyed. He is fitful, irreverent, indulging in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires.” His behavior had degenerated to the point that the construction company that had employed him would not hire him again.
On the other hand: “The exact location of the trauma was found recently (1994) during examinations of Gage’s skull using photography, x-rays and 3-D computer modeling. These have shown that the regions of the frontal lobes essential for intellectual, motor and language function, the motor strip and Broca’s area, were left intact. The lower middle portions of both frontal lobes, however, were damaged. More specifically, the ventromedial region of the frontal lobe was destroyed, particularly on the left side. This localized damage seems to have been responsible for the temperamental and behavioral alterations.”3
It should be noted that the trauma estimate above is speculative and may be an understatement. Bone particles were carried along the wound, tearing neurons as they passed, and infection caused more loss of grey matter. It would appear that Gage’s brain still had considerable functionality. But was it intelligent, conscious functionality? Or semi-sentient and unconscious? The question remains, who was in charge? Whose will was being carried out? How much Gage remained and how much was his Guardienne?
“Popular reports of Gage often depict him as a hardworking, pleasant man prior to the accident. Post-accident, people described him as a changed man, suggesting that the injury had transformed him into a surly, aggressive drunkard who was unable to hold down a job.”4
According to the Guardienne Hypothesis, alcoholism is a common trait of an oversized emergency center of the brain, or, if not oversized, at least relatively more powerful than the conscious mind sometimes. It seems likely that the injury either destroyed Gage’s conscious mind or removed enough of his forebrain to make him susceptible to the will of his Guardienne, which has no conscience.
“The spirit indeed is willing but the flesh is weak.” –Jesus of Nazareth
“The flesh isn’t weak. It’s stronger than you are, at times. Beware of it.” –Damson Greengage
Other sources:
https://www.ripleys.com/weird-news/phineas-gages-impaled-skull/
https://www.explorepsychology.com/phineas-gage/
Footnotes:
1 https://www.smithsonianmag.com/history/phineas-gage-neurosciences-most-famous-patient-11390067/
2 https://www.britannica.com/biography/Phineas-Gage
3 https://serendipstudio.org/bb/neuro/neuro98/202s98-paper1/Johnson.html
jguentherauthor 
This is a fascinating blog post! The picture of Phineas Gage drew my attention and your research did not disappoint! Thank you for sharing this.
Best Wishes, Charlotte
Fascinating account. To think he actually survived such an injury, although his personality completely changed by all accounts. Poor man, to suffer like that and die so young.
Tragic. His photo shows an apparently personable individual with all the good qualities described previous to the accident. I wonder what forces drove him to move to Chile. He seems to have been a bit proud of being a medical curiosity, retaining custody of the tamping rod for many years. I believe he’s an example of the power of the Guardienne.