Louisville Medicine Volume 69, Issue 2 | Page 26

AUTHORS Brooke Barrow , MEng , MS4 & Abhishek Alur , MA , MBA , MS4


AUTHORS Brooke Barrow , MEng , MS4 & Abhishek Alur , MA , MBA , MS4

Wh e n choosing a medical specialty , medical students are often asked , do you want to be a surgeon , or not ? Interestingly , the evolution of surgeons was historically separate from that of physicians . During the Middle Ages ( 500 - 1500 A . D .), most physicians were university-trained , spoke in Latin and cared for the wealthy . 1 On the other hand , surgeons took care of the lower classes and came from much more humble origins : laypeople , monks and barbers . After the Catholic Church prohibited any intervention that shed blood in the 12th century , apprentice-trained barber-surgeons rose to provide the majority of Europe ’ s medical care well into the 19th century . The rise and fall of the barber-surgeon is a fascinating and pivotal aspect of surgical history .

The first records of surgical procedures date back to ancient civilizations . In some regards , these procedures by physicians were discouraged . In 1700 B . C ., the King of Babylon warned in the Code of Hammurabi , “ If a doctor has treated a man with a metal knife for a severe wound , and has caused the man to die .... his hands shall be cut off …” 2 , 3 However , the Greek physician Hippocrates felt that surgical aptitude was vital for all healers , stating “ he who desires to practice surgery must go to war .” 3 Nearly all cultures and civilizations have documented rudimentary surgical techniques , however , the study of surgical procedures was often separate from the study of medicine .
During the early Middle Ages , the Catholic Church rose to power as the center for healing . Instead of lay practitioners , who provided most direct patient care before this , clergymen and Catholic scientists cared for the sick . For nearly one thousand years , monasteries served as the critical medical centers of Europe , and the monks providing the healing services came to develop considerable skill in performing surgery and curing diseases . 4 , 5
In 1163 , Pope Innocent III established the Fourth Lateran Council , banning the shedding of blood by clergymen . 3-5 The church believed that “ contact with blood contaminated the men of the church .” 3 Physicians , primarily clergymen or monks during this time , were stuck with “ clean ” patients ’ ailments , and could no longer perform procedures on patients or even inspect their wound . This forced care for patients and their wounds onto the layperson , untrained practitioners and the barber-surgeons , who had already been providing wound care and haircutting services to Europe ’ s more impoverished population .
Documents of barber-surgeons begin around 1100 . In 1308 , the formation of the Barber ’ s Company in London established guilds that trained future barber-surgeons . 3 Most barber-surgeons received no other formal training , but some were given special privileges to attend physician-led lectures on anatomy and surgery