Barber Surgeon defunct profession | |
|---|---|
 | |
| Education | apprenticeship |
| Occupations | battlefield medicine,expedition medicine |
| Era | 11th through 19th century |
| Known for | Surgical procedures, basic medical care, and grooming services
|
| Successor | Modern Surgery andBarbering trade |
Thebarber surgeon was one of the most common Europeanmedical practitioners of theMiddle Ages, generally charged with caring for soldiers during and after battle. In this era,surgery was seldom conducted by physicians. Instead,barbers, who possessedrazors and dexterity, were responsible for tasks ranging from cutting hair to pulling teeth to amputating limbs.
In this period, surgical mortality was very high due to blood loss, shock and infection. Yet, since doctors thought thatbloodletting to balance "humours" would improve health, barbers also used bloodletting razors and appliedleeches. Meanwhile, physicians considered themselves to be above surgery.[1] Physicians mostly observed during surgery and offered consulting, but otherwise often chose academia or working in universities.
Due to religious and sanitary monastic regulations, monks had to maintain theirtonsure (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 minor surgeries, pull teeth and prepare ointments. The first barber surgeons to be recognized as such worked in monasteries around AD 1000.[1]
Because physicians performed surgery so rarely, the Middle Ages saw a proliferation of barbers, among other medical "paraprofessionals", includingcataract couchers,herniotomists,lithotomists,midwives, and piggelders. In 1254, Bruno da Longobucco, an Italian physician who wrote about surgery, expressed concern about barbers performingphlebotomies andscarifications.[1]
In 16th centuryParis, barber-surgery was divided into two categories: "Surgeons of the Short Robe" and "Surgeons of the Long Robe."[2] "Surgeons of the Long Robe", a qualification offered in institutions such as the College of St. Cosme, required students to take a formal exam.[3] This was opposed to "Surgeons of the Short Robe", who did not need to take an exam to qualify[2] and, alongside barbering, would perform minor surgical procedures.[3] However, despite the different education requirements, both types of surgeons were called "barber-surgeons".[2] This distinction between "short coat" and "long coat" continued in surgery until relatively recently.[4] Eventually, in 1660, the barber surgeons recognized the physicians' dominance.[1]
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, and ancient surgical knowledge could be conformed to actual practice.[5]
"If you want a servant to follow your orders, you can't give them in an unknown tongue."
New problems arose in war surgery, without equivalents in the past: wounds caused by firearms and mutilations caused byartillery. The barber-surgeon was required to treat all the effects on the surface of the body, the doctor treating those on the inside.[7]
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. ForMichel de Montaigne, compared to medicine:
“Surgery seems to me much more certain, because it sees and handles what it does; there is less to conjecture and guess.”[8]
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 separate, but the Florentine Statute concerning the Art of Physicians and Pharmacists in 1349 gave barbers an inferior legal status compared to surgeons.[1]
Surgical practices in the Iberian Peninsula date back to the Megalithic era (2000 BC), with evidence oftrepanation. Until the Renaissance, Spanish surgery followed Greek, Arab, and medieval traditions, with significant progress in the 16th century through anatomical studies. Despite this, military, naval, and barber-surgeons performed operations, as physicians distanced themselves from surgery. Aroyal decree regulated barber-surgeons inSpain.[9] There were active barber surgeons operating inValencia in the 15th century.[10] One notable practitioner wasAntonio Fernando de Medrano, a professional barber surgeon active inMadrid during the 17th century.[11]
The establishment of surgical chairs in Spanish universities in the late 16th century gave surgery social and academic recognition, but a standardized system emerged only in the 18th century with the Reales Colegios de Cirugía (Royal Colleges of Surgeons), founded by military surgeons.[12] The first institutions in Cádiz (1748) and Barcelona (1764), led by Virgili, were followed by Madrid (1780), founded byAntoni de Gimbernat. These colleges formally integrated surgery into medical education, solidifying its scientific status.[9]
Formal recognition of surgeons' skills (in England at least) goes back to 1540,[13] when theFellowship 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 theCompany of Barbers, a Londonlivery company, to form theCompany of Barber-Surgeons. However, the trade was gradually put under pressure by the medical profession and in 1745, the surgeons split from theBarbers' Company (which still exists) to form theCompany of Surgeons. In 1800 aroyal charter was granted to this company and theRoyal College of Surgeons inLondon came into being. Later it was renamed to cover all of England—equivalent colleges exist forScotland andIreland as well as many of the old UK colonies (e.g.,Canada).[14]
There are few studies on barber surgeons inFinland. The first known account is that of Hinzikinus from 1324 to 1326, originating fromTurku (Åbo), a city in the southern region of the country, who provided medical preparation and wound care for ViceroyMatts Kettilmundson. The second barber surgeon documented was Henrik Bardskärare, who worked in the castle ofViborg in Finland (Vyborg, now part ofRussia). Each company of 400–500 men in the Swedish Army was assigned a barber during the rule of KingGustav I Vasa in the 16th century. A barber surgeon was available to tend to the injured in almost every division. In 1571, the barbers organized into a professional guild that governed their training, jobs, pay, and the number of barbers. Barbers from other countries could join the guild as well. The guild mandated that barber surgeons receive their training from established masters as apprentices, and in order to receive their degrees, the apprentices had to pass an exam. The guild provided guidelines for the barber surgeons' fees or pay, which varied and occasionally depended on how many patients were treated and surgeries were carried out.[15]
Few traces of barbers' links with the surgical side of the medical profession remain. One is the traditional red and whitebarber's pole, or a modified instrument from a blacksmith, which is said to represent the blood and bandages associated with their historical role.
In the United Kingdom, Ireland, Australia, New Zealand, and South Africa, another vestige is the use of the titlesMr,Ms,Mrs, orMiss rather thanDr by physicians when they complete their surgery qualifications by, for example, the award of an MRCS or FRCS diploma.[16] This practice dates back to the days when surgeons were not required to obtain a university education in medicine, and is retained despite the fact that all surgeons in these countries must earn a medical degree and spend additional years insurgical training and certification.[17]
Media related toBarber surgeons at Wikimedia Commons
