REGINALD HEBER FITZ

Background

Reginald Heber Fitz the son of Albert Fitz, a government consul, and his wife, Eliza R. Nye, was born at Chelsea, Massachusetts.

Education

After attending the Chauncy Hall School he entered Harvard where he received the degrees of B. A. (1864) and M. D. (1868), both with distinction.

In 1868 he went to Vienna where he studied pathology for several months under Rokitansky and Skoda, and also had contact with Billroth, the surgeon.

Career

He began the study of medicine under Jeffries Wyman, and later came under the influence of H. J. Bigelow, O. W. Holmes, and Edward H. Clarke. During his last year at the medical school he served as house physician to the Boston City Hospital.

In 1868, however, the school of pathology at Vienna was in its decline. The Berlin school, on the other hand, was in the ascendant under Rudolf Virchow, who was then making his great contribution to scientific medicine through the application of the microscope to the study of diseased tissue (“cellular pathology”).

He taught that disease was not an independent entity, but merely life under altered conditions. Fitz spent a year in the stimulating atmosphere of Virchow’s laboratory, and laid the foundation for his career as a pathologist.

While in Berlin he published an important paper in Virchow’s Archiv fiir pathologische Anatomie und Pliysiologie (vol. LI, 1870, PP- 123-26) on the microscopic changes occurring in a respiratory disease known as bronchiectasis.

Much stirred by the methods and teaching of his Berlin master, Fitz returned to America in 1870 and became instructor in pathology at the Harvard Medical School. His academic advancement proved unusually rapid.

In 1873 he became assistant professor of pathological anatomy, and full professor in 1878.

In 1892 he was transferred to the Hersey Professorship of the Theory and Practice of Physic. From 1887 until 1908 he was visiting physician to the Massachusetts General Hospital. He was also an active member of all local and national medical societies, being president of the Association of American Physicians for the year 1893-94.

In 1889 he analyzed a second series of seventy-two cases. In the same year he elucidated a rarer abdominal disease known as acute pancreatitis, describing its characteristic pathology and indicating the chief clinical points of distinction between it and other acute abdominal conditions ( Boston Medical and Surgical Journal, Feb. 21-Mar. 7, 1889).

In addition to these two specific contributions, Fitz exerted a wide influence upon scientific pathology, especially in America. Being the earliest of Virchow’s students to return to America, he was the first to introduce the microscopic study of diseased tissue. In his constant emphasis upon the need for cooperation between pathology and clinical medicine and surgery, he did much to advance rational therapeusis.

Personally Fitz was conservative and industrious, with unusual gifts as a teacher, and a fondness for administrative duties. He served regularly upon committees at the Harvard Medical School, and secured many reforms in the curriculum of medical study.

On his sixty-fifth birthday his former students published a collection of medical papers dedicated to him (Boston Medical and Surgical Journal, May 7, 1908).

He died in his seventy-first year, following an operation for a long-standing gastric ulcer.

Achievements

• Fitz’s contributions to medicine were numerous and important. Soon after his return to America he began to write upon a great variety of pathological conditions, notably tuberculosis, ectopic pregnancy, and intestinal obstruction. For many years he interested himself in a group of cases in which the patients had rapidly succumbed after acute attacks of right-sided abdominal pain, and in 1886 published his remarkable paper, “Perforating Inflammation of the Vermiform Appendix ; With Special Reference to its Early Diagnosis and Treatment” (Transactions of the Association of American Physicians, I, 1886, 107-35) which he named the disease now known as appendicitis, proved its origin from the appendix, and advocated radical surgical intervention for its cure. He also described the more important features of the clinical diagnosis of the condition. This paper has always been looked upon as one of the three or four classics of modern scientific medicine, being a model of form as well as of substance. The literature of his subject was exhaustively treated, a series of more than 250 carefully recorded cases was painstakingly analyzed, and finally, by a process of shrewd deductive reasoning, he drew a few sweeping conclusions from the facts disclosed.

Works

More photos

• book

  • A Compend of Diagnosis in Pathological Anatomy: With Directions for Making Post-Mortem Examinations

    (This book was originally published prior to 1923, and rep...)

  • Medical Papers Dedicated to Reginald Heber Fitz (Classic Reprint)

    (Blood Cultures in Typhoid Fever with Comments Upon the Ho...)

  • Perforating Inflammation of the Vermiform Appendix: With Special Reference to Its Early Diagnosis and Treatment - Primary Source Edition

    ( This is a reproduction of a book published before 1923....)

  • Acute Pancreatitis: A Consideration of Pancreatic Hemorrhage, Hemorrhagic, Suppurative, and Gangrenous Pancreatitis, and of Disseminated Fat-Necrosis - Primary Source Edition

    (This is a reproduction of a book published before 1923. T...)

Views

It is said that before conducting a post-mortem examination he would often ask the physician in charge of a case to express an opinion as to the nature of the pathological process involved. If the findings failed to confirm the prediction Fitz never hesitated to point out the faulty logic or imperfection of the clinical examinations which had led to the diagnostic error. On such occasions he spared himself no more than his fellows, but his rather ruthless verbal dissections often irritated his older colleagues, though they never ceased to delight his students. His lectures were erudite, clear, and incisive. “He had a habit of tilting his head backward, closing his eyes, talking with extreme rapidity and fluency, never missing a word, for 61 minutes in the hour. . .. It was as if he read a carefully prepared lecture from the inside of his eye lids” (Blake, post).

Membership

He was also an active member of all local and national medical societies, being president of the Association of American Physicians for the year 1893-94

Personality

He taught that disease was not an independent entity, but merely life under altered conditions.

Connections

In 1879 he married Elizabeth, daughter of Edward H. Clarke, by whom he had two daughters and two sons, one of whom, Reginald, became a physician.

Father:

Albert Fitz

Mother:

Eliza R. Nye

Wife:

Elizabeth Clarke