Surgery in the Middle Ages

Period of time: 500 AD – 1400 AD (1500 AD)

500 – 1000 AD: In the early middle age (500 AD to 1000 AD) the development of medicine and surgery stalled. The period is characterized by population decline, massive migration and civil wars ¹. Christianity advances as a religion in Europe bringing with them monks who can write and share knowledge.

Around 1000 AD: Catholic monks drive the advances in medicine and surgery, treating people with herbs. Due to their religion they must not spill blood and therefore Barbers are hired and educated in Catholic monasteries to shave the head of monks, perform minor procedures such as bloodletting, pulling out teeth, cupping, using leeches, cleansing ears, incision of abscesses and create ointments ².

1000 – 1400 AD: In especially northern Europe medical physicians consider themselves above performing dirty surgical procedures. Instead, they prescribe i.e. phlebotomy (bloodletting) to restore the imbalance of the “four humours” and attend the Barber surgeon do the procedure. The doctor’s unwillingness to perform procedures lead to the emerge of paraprofessionals such as cataract couchers, herniotomists, lithotomists, midwives and “wise old women/men” ²,³.

In wartimes the “Barber surgeon” joins the army, treating soldiers during battles. The barber-surgeons expand their knowledge to amputate limbs and treat fractures with splints ².

1180 AD: In Universities of Southern Europe doctors begin to perform surgery and publish their work. Roger Frugard (Rogerius), an Italian surgeon of Salerna published “The Practice of Surgery” or “Chirurgiae Magistri Rogerii”. The work was based on a rational pathologic-traumatological system and included anatomic and practical treatments ⁴. Rogerius was the first to describe lupus (wolf in Latin) – a classic malar rash.

1210 AD: In Paris doctors patronage barbers, who are not allowed to train on cadavers. At St. Cosme College two levels of doctors are educated; The well respected, granted with a long rope who may perform surgery. And those with a short rope who may not perform surgery before passing an exam and are not as well respected ².

1275 AD: William of Salicet (1210 -1277 AD), an Italian surgeon and professor at the University of Bologna publishes “Chirurgia”. Now promoting pus should be removed using surgery – breaking with Galen. He lectured in the importance of special hygiene for women and the bathing of children 5.

1308 AD: “The Worshipful Company of Barbers” – the first documentation on an organization of Barbers in London ^6,7. The Barber Richard le Barbour was elected by the Court of Eldermen to keep order amongst his Barber fellows.

1312 AD: Surgeon Henry de Mondeville (1260-1320 AD), the “father of French surgery” published “Chirugia”⁸. He treated king Philip IV (Philippe le Bel) and his son Louis X of France. Henry de Mondeville stated an important aspect of surgery: “No craftsman should work on an object without knowing it” ⁹