In our time, surgery and medicine are closely allied disciplines. This was also true in ancient Greece and Rome. However, through the Renaissance and until the 18th century in Western Europe, surgery was considered more a trade than a profession, and surgeons had more to do with barbers than with physicians.

This separation between surgery and medicine may have originated in religiousattitudes. During the early Middle Ages, most healing (both medical and surgical) was carried out by members of the clergy. However, concern arose aboutthe shedding of blood by priests, and a papal decree (reinforced in 1215 by the Tenth Lateran Council) prohibited priests from doing surgery. As a result,responsibility for surgery passed to monasteries, where it was conducted bybarbers who had experience with razors. At first, this was likely done underthe supervision of priests. Eventually, surgery spread outside of monasteries, especially during times of war, when military surgeons were in great demand.

The academic and social status of these barber-surgeons was usually considerably less than that of physicians. If medicine was considered a profession practiced by university-trained physicians, then surgery was a trade, sometimescarried out by illiterates.

Barber-surgeon guilds began appearing in Europe around the 13th century. In London, for example, separate trade guilds for barbers and surgeons can be traced at least to 1308, in the case of the Company of Barbers (later known as the Barber-Surgeons' Company, and 1369 for the much-smaller but generally better-educated Fellowship of Surgeons.

Surgery was carried out by both of these guilds. A municipal ordinance issuedin 1307 forbade barbers from being "so bold or so hardy as to put blood in their windows, openly or in view of folks, but let them have it privily carried unto the Thames, under pain of paying two shillings to the use of the sheriffs."

Among the guilds, considerable importance was attached to the order in whichthey were represented in processions. In 1535, the Company of Barbers marchedin 17th position, between the pewterers and the cutlers. This was achieved only after considerable lobbying of civic officials, who had demoted the barbers from 17th to 28th place in 1516, followed by 17th place in 1532, 18th place a few years later, 17th place in 1533, and 28th place in 1534.

In 1493, the two competing guilds had started to co-operate on licensing of surgeons, and in 1540 they were amalgamated by an Act of Parliament. This lawforbade surgeons from practicing barbery and barbers from practicing surgery,except for the pulling of teeth. There were many more barber-surgeons than physicians, and there is evidence that barber-surgeons sometime ventured beyond their trade into the practice of medicine.

This amalgamation lasted for two centuries, until it was ended by an 18th-century trend that led surgeons across Northern Europe to disassociate from their hair-clipping colleagues.

In England, William Cheselden, a skilled barber-surgeon who could remove bladder stones in less than one minute, led a drive for professional recognitionof surgery. London surgeons left the Company of Barber-Surgeons in 1745 to form their own Company of Surgeons, which would evolve into the Royal College of Surgeons of England.

One of the best-known barber-surgeons was Ambroise Paré (1510-1590), who developed new amputation techniques in his work with French army troops, and abandoned the practice of using boiling oil to detoxify gunshot wounds. Paré recorded his knowledge about surgery in a 40-volume work that alsosummarized the teachings of Galen, Hippocrates, and Arabic surgeons.

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