We believe that this is the only known photograph of the famous patient, Phineas P. Gage, holding his well-known tamping iron.

Phineas P. Gage was a railroad construction foreman now remembered for his incredible survival of an accident in which a large iron rod was driven completely through his head, destroying one or both of his brain’s frontal lobes, and for that injury’s reported effects on his personality and behavior — effects said to be so profound that friends saw him as “no longer Gage.”

“The powder exploded, carrying an instrument through his head an inch and a fourth in [diameter], and three feet and [seven] inches in length, which he was using at the time. The iron entered on the side of his face, shattering the upper jaw, and passing back of the left eye, and out at the top of the head.

Weighing 13-1/4 lb (6 kg), this "abrupt and intrusive visitor” was said to have landed some 80 feet (25 m) away.

Amazingly, Gage spoke within a few minutes, walked with little or no assistance, and sat upright in a cart for the ¾-mile ride to town.