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ON JUNE 18, 1886, i n Washington, D.C., a stocky, balding, mustachioed, 43-year-old man mounted the podium at the inaugural meeting of the Association of American Physicians and delivered a monumenta l address on "Perforating Inflammation of the Vermiform Appendix, with Special Reference to its Early Diagnosis and Treatment. ''1 With this report on 257 cases, Reginald Heber Fitz (1843-1913), Shattuck Professor in Pathological Anatomy at Harvard University, initiated the modern concept of appendicitis and launched a revolutionary change in medicine and surgery (Fig. 1). In recognizing the true nature of appendicitis, he thus consigned to obsolescence and oblivion the old ideas of typhlitis, perityphlitis, and paratyphlitis. These terms, unfortunately inconstant in definition, referred respectively to inflammation of the cecum, inflammation of the per i toneum covering the cecum, and inflammation of the connective tissue behind the cecum. Fitz described the pathologic condition and clinical features of the disease and stressed the importance of early diagnosis and surgical intervention. No doubt the prestigious inaugural meeting of the Association of American Physicians and the presence of approving luminaries such as William Osler provided Fitz with a forum that greatly enhanced the impact of his presentation. This, together with the progressive scientific climate of the late nineteenth century, were undoubtedly major contributory factors to Fitz's success. William Osler (1849-1919), renowned clinician, teacher, bibliophile, and humanist, was a founder of the organization and a participant in this first meeting. He wrote: "The coming-of-age party of clinical medicine in America was held in June, 1886, in Washington, with the inauguration of the Association of American Physicians . . . . The meeting was made memorable by two pa |
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