FITZ 390 FLAGG immediate objective and the only rational means of saving life, where there is not a prompt subsidence of threatening symptoms. His conclusions were firmly based upon some two hundred and fifty-seven cases of perforat- ing ulcer, and two hundred and nine cases diagnosed as typhlitis and perityphlitis and perityphlitic abscess, in which the diagnosis was clinical only and not anatomical. The treatment recommended at the outset was opium, rest and liquid diet, and food in small quantities often repeated ; but if general peri- tonitis seemed imminent at the end of twenty- four hours the abdomen should be opened and the appendix removed. In 1889 he analyzed a further series of seventy-two cases, occurring since 1886, and urged, the interval operation. In this year he delivered another memorable address before the New York Pathological Society on "Acute Pancreatitis." He carefully distinguished the hemorrhagic, the suppurative and the gangre- nous forms of acute pancreatitis. Since that time this disease, which was at first regarded as rare and curious, has come out into the light of day, and is now well known, and often diagnosed by all educated physicians and sometimes cured by operation. Here appears the earliest suggestion that fat necrosis is the result of a lesion of the pancreas, confirmed a year later by Langerhans. In 1888 Fitz read a paper on "Intestinal Ob- struction" before the first Congress of Ameri- can Physicians and Surgeons, based on a critical study of two hundred and ninety- five selected cases; here again the conserva- tive physician urges surgery. In 1903 he again addressed the sixth Con- gress of American Physicians and Surgeons on pancreatic disease, and was elected president. In 1875 he wrote on tubo-uterine or inter- stitial pregnancy (Am. Jour. Med. Sci. 1875). He wrote the article on diseases of the esoph- agus for the "Twentieth Century Practice," New York, 1896. The following year, in col- laboration with H. C. Wood of Philadelphia, he published "Practice of Medicine." He prepared a large number of anatomical specimens to illustrate his lectures; these are now in the Warren Museum, Harvard Medi- cal School. Dr. Fitz married Elizabeth Loring Clarke, daughter of Dr. Edward Hammond Clarke (q. v.), of Boston, and they had four children, a son Reginald, following his father in the practice of medicine. It seemed to be Fitz's mission to explore obscure medical territories and thus to en- large the domain of his aggressive surgical confreres. As a lecturer he was clear, com- prehensive, logical and thorough. His diction was rapid and he always seemed to have more to say than could be crammed into an hour. The knife of logic in his hand, like that of steel in the hand of the surgeon, was guided solely by the intellect, as the unwary student often found. His critical faculty was highly developed and fairness of mind was instinctive. He died September 30, 1913, at Brookline, Massachusetts, after an operation for chronic gastric ulcer. Howard A. Kelly. Boston Med. and Surg. Jour., 1913, vol. clxix, 815. Canadian Med. and Surg. Jour., Toronto, 1913, vol. iii, 1897. Harvard Grads. Mag., Boston, 1913, vol. xxii, No. 86. Memorial addresses delivered at the Harvard Medical School, Nov. 17, 1913, n. d., privately printed, 86 p. 8vo. In Memoriam, Reginald Heber Fitz. W. S. Thayer, Johns Hospkins Hosp. Bull., 1914, vol. xxv, 87-89. Ragg, Josiah Foster (1789-1853). Josiah Foster Flagg, dentist, inventor and anatomical artist, was born in Boston, January 11, 1789. His father. Dr. Josiah Flagg, was long known as the "Boston Dentist," being almost the only person who confined' his whole attention to dentistry. His mother was Eliza Brewster, a descendant of Elder William Brewster of the Mayflower. Josiah F. Flagg received an indifferent early education, learned the trade of cabinet maker and attended an academy in Plainfield, Con- necticut, finally, in 1811, becoming a student of medicine under Dr. J. C. Warren (q. v.). •In 1813 he made some engravings of the large arteries for Dr. Warren's work on "The Ar- teries." A few years afterwards he made the drawings for "Comparative Views of the Ner- vous System" published by Dr. Warren. Dr. Warren stated that the representations of the anatomy were beautifully and accurately executed. He invented a bone forceps which was ex- tensively used by the medical profession, and in 1821 published in the New England Jour- nal of Medicine and Surgery, vol. x, page 38, a description of his improvements on Desault's apparatus for treating fracture of the femur, an apparatus which was long used in the Massachusetts General Hospital. He graduated from the Harvard Medical School in 1815 and practised medicine for two years in Uxbridge, Massachusetts. Returning to Boston, he married May Wait, a daughter of T. B. Wait, of the publishing firm of Wait and Lilley. In 1833 and the succeeding years he allied
