Benjamin Terry and his rapid razor section method for intraoperative diagnosis

Abstract

Benjamin Taylor Terry (1876-1955), a little-known pathologist, played a critical role in the popularization of intraoperative diagnostic techniques in the 1920s and 1930s. He developed both a stain and his own rapid razor section method. Intraoperative diagnostic techniques were ultimately responsible for the transition of the practice of pathology and laboratory medicine from private commercial laboratories to a hospital-based practice, forever changing the history of pathology and surgery in North America. Although the intraoperative diagnostic technique he personally developed was reportedly better, faster and more economical than frozen sections, the latter ultimately won the battle for intraoperative diagnostic supremacy.

The Politics Underlying the Provision of and Changes in Pathology and Laboratory Services in the United States During the Roaring Twenties

“…In some instances, surgery departments formed their own surgical pathology divisions, and this level of pathologist apathy almost resulted in surgical pathology becoming separated from pathology prior to the formation of the ASCP. However, the strong push of the ASCP and clinical pathologists such as Benjamin T. Terry, MD, 33 resulted in the practice of surgical pathology settling within pathology rather than surgery departments. By 1920, Benjamin Terry, the head of pathology at Vanderbilt University (Nashville, Tennessee), who had strong ties to the Mayo Clinic (Rochester, Minnesota), was one of the early and vocal proponents of intraoperative diagnostic techniques, noting that they were good for both the patient and the profession.…”

“…By 1920, Benjamin Terry, the head of pathology at Vanderbilt University (Nashville, Tennessee), who had strong ties to the Mayo Clinic (Rochester, Minnesota), was one of the early and vocal proponents of intraoperative diagnostic techniques, noting that they were good for both the patient and the profession. 33,34 During the 1920s, most of the membership of the ASCP embraced IFS, as this was a service that required immediate access to a pathologist and could not be provided by commercial laboratories external to the hospital. 7 The ASCP had strong allies in this arena as surgeons, who may not have cared who provided their chemistry, microbiology, and hematology testing, desperately wanted hospitals to provide inhouse anatomical pathology services.…”

Founders of Pediatric Pathology: Ward Thomas Burdick (1878–1928)

“…From my 30 years of writing historical papers on pathology and laboratory medicine [14,21–24] and from readings recently completed to finish an invited article on the politics of pathology and laboratory medicine in the 1920s [3], it is clear that Hillkowitz was the mouthpiece for the ASCP movement, that Burdick was its meticulous organizer, and that they worked together seamlessly through letter writing campaigns and numerous meetings with the ACS. Burdick's contributions to the field of clinical pathology were deemed so great by his contemporary professional colleagues that the ASCP named its first and still most prestigious award after him (Fig.…”

Philip Hillkowitz The “Granddaddy of Medical Technologists” and Cofounder of the American Society for Clinical Pathologists and the Jewish Consumptives' Relief Society

“…6 The former, because of high test volumes and lower personnel costs, often offered rapid service and cheap prices, while the latter, although sometimes less efficient, offered more personalized service, ease of consultation related to the appropriateness of tests and the interpretation of results, and, most importantly, the ability to perform inhospital intraoperative frozen section diagnosis to actually guide the surgeon's hand in real-time during operations. 18,19 By 1920, those practicing the new field of hospital-based clinical pathology believed that they were losing the battle with commercial laboratories and would soon be extinct. 6 At the same time, there were vicious battles as to whether the laboratory tests they performed were a medical consultation or simply a commodity and, if the latter, whether testing should be done by unsupervised or minimally supervised technicians.…”