John Blair Deaver

Abstract

John B. Deaver was born July 25, 1855, in Lancaster County, Pennsylvania, the son of a country physician. He attended Nottingham Academy near his home and matriculated in America's first medical school, the University of Pennsylvania, graduating in 1878. Following internship at the Germantown Hospital and the Philadelphia Children's Hospital, he emarked in clinical practice. Shortly thereafter he became attached to his alma mater in the Department of Anatomy, a well-recognized stepping-stone into surgery. In 1886, he joined the staff of the German Hospital (now Lankenau) and developed an enormous personal practice in surgery. His Saturday afternoon operative clinics were attended by surgeons throughout the world while he performed as many as 25 operations in an afternoon. It was, in fact, at the German Hospital where he achieved his greatest recognition, although he was called to the post of professor of the practice of surgery at the University of Pennsylvania in 1911 and assumed the Chair seven years later. Deaver was considered an aggressive and radical surgeon—a great “slasher.” He was among the early advocates of immediate appendectomy for acute appendicitis. He often uttered the phrase, “an inch and a half, a minute and a half, a week and a half” to mean, respectively, the length of the incision, the time it took to perform the operation, and the duration of the hospital stay. “Cut well, get weli, stay well,” was another of his pet phrases. He is also responsible for introducing the use of the word “pathology” to mean pathologic findings or lesion rather than the study (e.g., “What is the pathology.”) While Deaver was considered a less skillful surgeon than others, his reputation was awesome. It is said even today that Deaver did more surgery in Philadelphia than any of his predecessors, and that no one again will perform a comparable number. Deaver wrote primarily on abdominal surgical conditions—ulcer, hepatobiliary disease, colon resection. His paper on lumbar versus inguinal colostomy, the subject for thisClassics presentation, represents a fascinating perspective of the surgeon's philosophy in the management of rectal cancer and colorectal obstruction prior to the 20th century. Deaver is a well-recognized name to every medical student and surgical resident who has had the misfortune of hanging on to his retractor. He, in fact, did not permit his assistants to perform and aspect of the surgery. He insisted that all operations be done by his own hands. While he was accorded many honors including that of President of the American College of Surgeons, the practice of surgery was his total commitment—that, and writing five books and almost 250 articles. Deaver died September 25, 1931, at the age of 76. Deaver JB. Lumbar versus iliac colotomy. Dis Colon Rectum 1987; 30:66-71.