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The barber surgeon, one of the most common European medical practitioners of the
Middle Ages In the history of Europe, the Middle Ages or medieval period lasted approximately from the late 5th to the late 15th centuries, similar to the post-classical period of global history. It began with the fall of the Western Roman Empire ...
, was generally charged with caring for soldiers during and after battle. In this era,
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...
was seldom conducted by physicians, but instead by barbers, who, possessing razors and coordination indispensable to their trade, were called upon for numerous tasks ranging from cutting hair to amputating limbs. In this period, surgical mortality was very high due to blood loss and infection. Yet, since doctors thought that
blood letting Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily fl ...
treated illness, barbers also applied leeches. Meanwhile, physicians considered themselves to be above surgery. Physicians mostly observed surgical patients and offered consulting, but otherwise often chose academia or working in universities. Some chose to reside in castles, where they treated the wealthy.


Middle Ages in Europe

Due to religious and sanitary monastic regulations, monks had to maintain their tonsure (the traditional baldness on the top of the head of Catholic monks). This created a market for barbers, because each monastery had to train or hire a barber. They would perform bloodletting and other minor surgeries like pulling teeth or creating ointments. The first barber surgeons to be recognized as such worked in monasteries around 1000 AD. Because physicians performed surgery so rarely, the Middle Ages saw a proliferation of barbers, among other medical "paraprofessionals", including cataract couchers, herniotomists, lithotomists,
midwive A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; co ...
s, and pig gelders. In 1254, Bruno da Longobucco, an Italian physician who wrote on surgery, was concerned about barbers performing phlebotomies and scarifications.


Barbers in France and Italy

In
Paris Paris () is the capital and most populous city of France, with an estimated population of 2,165,423 residents in 2019 in an area of more than 105 km² (41 sq mi), making it the 30th most densely populated city in the world in 2020. Si ...
, disputes between doctors led to the widespread patronage of barbers. The College of St. Cosme had two levels of student doctors: doctors who were given a long academic robe were permitted to perform surgeries and doctors who were given a short robe and had to pass a special examination before being given that license. The short-robed doctors were bitter because the long-robed physicians behaved pretentiously. The short-robed doctors of St. Cosme entered into an agreement with the barber surgeons of Paris that they would offer the barber surgeons secret lessons on human anatomy as long as they swore to be dependents and supporters of the short-robed physicians. This secret deal existed from around the time of the founding of St. Cosme in 1210 until 1499, when the group of surgeon barbers asked for their own cadaver to perform their anatomical demonstrations. From the 1540s in France, the translation into French of the works of ancient authors allowed progress in the transmission of knowledge: barber-surgeons could add to their manual skills, an ancient surgical knowledge confronted with their actual practice. New problems appeared in war surgery, without equivalent in the past: wounds caused by firearms and mutilations caused by
artillery Artillery is a class of heavy military ranged weapons that launch munitions far beyond the range and power of infantry firearms. Early artillery development focused on the ability to breach defensive walls and fortifications during si ...
, the barber-surgeon being required to treat all the affections appearing on the surface of the body, the doctor treating those on the inside. There was already social mobility between surgeons and barber-surgeons. A surgeon's apprenticeship began with the practice of shaving. The young surgeon could thus have a source of income before mastering the surgery of his time. In the context of Renaissance humanism, this practical experience took place outside of academic scholasticism. The action is clearly sanctioned by the results, visible to all. For Michel de Montaigne, compared to medicine, In 1660, the barber surgeons eventually recognized the physicians' dominance. In Italy, barbers were not as common. The Salerno medical school trained physicians to be competent surgeons, as did the schools in Bologna and Padua. In Florence, physicians and surgeons were separated, but the Florentine Statute concerning the Art of Physicians and Pharmacists in 1349 gave barbers an inferior legal status compared to surgeons.


Barbers in the British Isles in the early modern period

Formal recognition of their skills (in England at least) goes back to 1540, when the Fellowship of Surgeons (who existed as a distinct profession but were not "Doctors/Physicians" for reasons including that, as a trade, they were trained by apprenticeship rather than academically) merged with the Company of Barbers, a London livery company, to form the
Company of Barber-Surgeons The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. The ...
. However, the trade was gradually put under pressure by the medical profession and in 1745, the surgeons split from the Barbers' Company (which still exists) to form the
Company of Surgeons The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. ...
. In 1800 a
Royal Charter A royal charter is a formal grant issued by a monarch under royal prerogative as letters patent. Historically, they have been used to promulgate public laws, the most famous example being the English Magna Carta (great charter) of 1215, b ...
was granted to this company and the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations ...
in
London London is the capital and List of urban areas in the United Kingdom, largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary dow ...
came into being (later it was renamed to cover all of England — equivalent colleges exist for
Scotland Scotland (, ) is a country that is part of the United Kingdom. Covering the northern third of the island of Great Britain, mainland Scotland has a border with England to the southeast and is otherwise surrounded by the Atlantic Ocean to ...
and
Ireland Ireland ( ; ga, Éire ; Ulster-Scots: ) is an island in the North Atlantic Ocean, in north-western Europe. It is separated from Great Britain to its east by the North Channel, the Irish Sea, and St George's Channel. Ireland is the s ...
as well as many of the old UK colonies, e.g.,
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by to ...
).


Traditions in the modern era

Few traces of barbers' links with the surgical side of the medical profession remain. One is the traditional red and white barber's pole, or a modified instrument from a blacksmith, which is said to represent the blood and bandages associated with their historical role. Another vestige is the use of the title "Mr" (or Miss, Mrs or Ms) rather than "Dr" by doctors when they complete their surgery qualifications by, for example, the award of an MRCS or FRCS diploma. This tradition is almost exclusive to the United Kingdom, Ireland and to a lesser extent the Commonwealth countries of South Africa, Australia and New Zealand. This practice dates back to the days when surgeons did not require a university education in medicine and this link with the past is retained despite the fact that all surgeons in these countries now require a medical degree as well as several additional years of surgical training and certification. They no longer perform haircuts, a task the barbers have retained.


History

A barber surgeon was a person who could perform surgical procedures including
bloodletting Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily f ...
, cupping therapy, pulling teeth and amputation. Barbers could also bathe, cut hair, shave or trim facial hair and give enemas. During wartime, the barber surgeon served in the army but during peacetime he could practice among civilians.


See also

* City physician * Feldsher * Elinor Sneshell * List of barbers


References


External links

{{Authority control Medieval occupations History of surgery Traditional healthcare occupations