A railroad construction foreman (1823-1860) on the New England railroad who, in 1848, survived a blast injury in which a tamping rod 3 cm in diameter was driven through his left eye and frontal lobe. Surprisingly, Gage survived. Years later, John Harlow, his physician of record, wrote about the case: "The equilibrium...between his intellectual faculties and animal propensities, was destroyed. He is fitful, irreverent, indulging at times in the grossest profanity... manifesting but little deference for his fellows... Previous to his injury...he was looked upon ...as a shrewd, smart businessman.... In this regard (he) was so decidedly changed that his friends and acquaintances said he was 'no longer Gage.'"