Dr. Reginald Fitz popularized early appendectomy for the treatment of appendicitis with his treatise, "Perforating Inflammation of the Vermiform Appendix," published in 1886 while he worked at the Massachusetts General Hospital along with Dr. Maurice Howe Richardson, the inventor of the Richardson retractor. Their collaboration over the ensuing years led to improvement in outcomes for patients with appendicitis. This historical article describes the importance of this collaboration with information from operative reports, letters, and manuscripts and echoes the discussion today of safely adopting new medical technologies.