It’s a chilly morning in 15th century France. You’re headed to the barber for a shave and a trim. As you approach, you hear singing inside and spot a bowl of blood in the window. Both chairs are occupied, so you grab an ale and look over the array of teeth strung up on the walls. Suddenly, a scream pierces the room. The barber’s apprentice dabs pus from a boil he just lanced, while the barber fixes pliers on a rotten tooth he’s about to pull. For centuries, barbers in Western and Northern Europe provided more than just haircuts – they performed an array of medical procedures like tooth extractions, stitches, and even amputations. This article explores the history of barber-surgeons, how they became the default providers of surgical care, and their lasting impact on medicine.
Monks as Early Medieval Surgeons
In the early medieval period, most surgical procedures were carried out by monks. As clergymen, monks were required by the Catholic Church to maintain the “tonsure” hairstyle, shaving their heads bald except for a ring of hair. Monasteries generally kept at least one barber on hand to maintain these distinctive cuts and remove facial hair. These resident barbers often assisted with surgeries, as their skills with sharp blades made them well-suited to perform incisions. However, in 1215 the Catholic Church banned monks from acts that purposefully spilled blood. Around the same time, universities with medical programs were spreading across Europe. But the academic scholars saw themselves as elite thinkers who wouldn’t dirty their hands with knives or blood.
The Separation of Medicine and Surgery
Thus, medicine and surgery became two distinct disciplines – like geometry and carpentry. Operations were left to the barber-surgeons. Rather than studying anatomy from textbooks, barber-surgeons trained through years-long apprenticeships. They combined anatomical knowledge with astrology, considering both the patient’s symptoms and corresponding astrological circumstances like moon phases when deciding on treatments. Like many medieval people, they believed the positions of the sun, moon, and stars greatly impacted health. Barber-surgeons memorized poems to remember medical information. For instance, one poem listed where to let blood for certain conditions – at the temples for headaches, the little finger of the right hand for liver issues, and behind the knees for hemorrhoids.
Treating Medieval Illness and Injury
Barber-surgeons stayed very busy. From around 1300 CE, volatile weather caused by the Little Ice Age led to frequent famines. People often had to choose between starvation or eating rye flour contaminated with ergot fungus, causing widespread illnesses. In extreme cases, this led to gangrene – the rotting of tissue. When gangrene set in, amputation offered the only hope of saving a patient. Barber-surgeons would saw off damaged limbs, covering the stumps with pig or cow bladders as they healed. Their skills weren’t limited to shops and monasteries. Armies required both haircutting and medical care, so barber-surgeons accompanied them on campaigns.
Advancements in Battlefield Medicine
Through the centuries, barber-surgeons made key contributions to medicine. One of the most renowned, Ambroise Paré, blurred the line between physician and barber-surgeon by publishing medical textbooks and teaching at France’s first surgical college. In the 1500s, Paré gained fame as a military surgeon partly by promoting an antiseptic salve over the agonizing and ineffective practice of pouring boiling oil onto gunshot wounds. His salve of egg yolks, rosewater, and turpentine became standard battlefield treatment across Europe.
The Split Between Barbers and Surgeons
By the 1700s, advances in surgical techniques, wound closure, controlling blood loss, and complex procedures like removing cancer emerged. As surgery specialized, barbers and surgeons split into distinct professions under pressure from physicians. Surgeons and dentists entered the ranks of university-trained medical professionals, while barbers remained craftsmen learning through apprenticeship. However, the legacy of barber-surgeons persists today, most iconically through the red and white barber pole representing blood and bandages.
For centuries, barber-surgeons filled the critical role of performing everything from basic wound care to amputations across Europe. Though largely self-taught, they pioneered treatments and added greatly to medical knowledge. Their legacy persists in the separation of medicine and surgery as well as symbols like the barber pole. Next time you visit the barber, remember the “barber-surgeons” of centuries past who helped shape modern medicine.