It’s a cold morning in 15th century France, and you're off to the barber for a shave and a haircut. You hear the familiar sound of singing inside and eye a bowl of blood in the window. Both chairs are taken. You grab a cup of ale and examine the array of teeth strung from the walls. Suddenly, a scream. The barber’s apprentice wipes pus from the boil he’s just lanced. By the other chair, the barber fixes a pair of pliers over a blackened, rotting tooth.
For centuries, barbers in western and northern Europe didn’t just cut hair, they also performed a range of surgeries; from tooth extraction to stitches, and even amputation. There were two main factors that led to barbers filling this position. Before this, these surgical procedures were mostly performed by monks. The clergymen were required by the Catholic Church to sport a very specific haircut, called tonsures, and to remove all facial hair, so the monasteries generally had at least one barber. Given their proximity and ability to work with sharp blades, these barbers often assisted in surgeries. And in 1215, the church issued an edict banning monks from any act that purposefully spilled blood.
At the same time, universities with medical schools were opening across Europe. However, these doctors saw themselves as academic scholars who would never dirty their hands by touching blood or wielding knives. Medicine and surgery became two separate, yet complementary, disciplines— like geometry and carpentry.
So operations were left in the hands and shears of barber-surgeons.
Rather than studying anatomy in textbooks, barber-surgeons trained through extended apprenticeships. They often combined knowledge of anatomy with astrology, taking both the patient’s symptoms and corresponding astrological events— such as lunar phases— into account when deciding on treatment. Like many people of the time, they regarded the position of the sun, moon, and stars to be highly significant. They also memorized poems to commit information to memory— such as one identifying where on the body bloodletting should be performed. For headaches, the temples; for liver problems, the little finger on the right hand; and for hemorrhoids, the back of the legs.
Barber-surgeons certainly kept busy. From around 1300 CE, unpredictable weather across the North Atlantic caused by what is now called the Little Ice Age, led to regular famines. People often had to choose between starvation or eating rye flour that was contaminated with the fungus ergot. This led to widespread illnesses, which in extreme cases caused gangrene, or the rotting of body tissue. When gangrene set in, the only hope of saving a patient was through amputation. Barbers would saw off infected limbs, covering the stumps with cow or pig bladders while they healed. And their work wasn’t limited to just shops and monasteries. Armies needed both hairdressing and wound care, and barber-surgeons accompanied them on campaigns near and far.
Through the centuries, barber-surgeons contributed important knowledge to the medical establishment. One of the most famous, Ambroise Paré, blurred the lines between doctor and barber-surgeon by publishing medical textbooks and teaching at France’s first surgical college. In the 16th century, he gained renown as a military surgeon, in part for advocating against the painful and medically useless practice of pouring boiling oil into gunshot wounds. Instead, he applied an antiseptic salve of egg yolks, rosewater, and turpentine, which soon became standard treatment on battlefields across Europe.
By the 18th century, medical knowledge started advancing rapidly. New surgical techniques emerged for closing wounds, controlling blood loss, and performing complex procedures, like removing cancerous tissue. Surgery became more specialized— and under pressure from the medical establishment— barbers and surgeons soon split into clear-cut occupations. Surgeons and dentists entered the ranks of university-trained medical practitioners, while barbers remained craftsmen who learned their trade through apprenticeships. However, the legacy of the barber-surgeon can still be seen today, perhaps most prominently in the red and white stripes on the barber pole— which, according to legend, represent blood and the bandages used by their pre-modern counterparts.
