AN UNEASY ALLIANCE…
Competition grew between barber-surgeons and master surgeons. A separate Fellowship of Surgeons was approved in London in 1435 and claimed the right to practice surgery which inevitably led to a power struggle between them and the Barbers’ Company. Barbers held the monopoly on surgical practices, and in 1462, when King Edward IV granted a Royal Charter to the the Barber’s Guild, it became known as the Guild Company of Barbers. Barbers continued to have the power to regulate the practice of surgery in London, to maintain professional standards, and to stamp out impostors and charlatans.
By the end of the 15th century most physicians were accredited and licensed by the universities in which they studied, but barber-surgeons were not. They had to apply to the trade guild and would subsequently become apprentices to barbers. The apprentice training would occur for seven years within the household of an experienced barber-surgeon and assist in surgical care to gain hands-on experience. Once completed, the new member would satisfactorily demonstrate their skills and abilities to Company-appointed examiners before paying a membership fee to join the ranks of the Company.
Hans Holbein the younger (c.1497–1543) (attributed to)
In 1540, King Henry VIII signed a decree merging the two guilds into the Great Company of Barbers and Surgeons. The Act specified that no surgeon could cut hair or shave another, and that no barber could practice surgery; the only common activity was to be the extraction of teeth. The barber pole, featuring red and white spiraling stripes, indicated the two crafts (surgery in red and barbering in white).
Practical human anatomy had been prohibited by the Catholic Church until the early days of the Renaissance. The new Act of Parliament contained a vital clause which gave the Company of Barbers and Surgeons the right to claim yearly the bodies of four criminals who had been executed, and to dissect them or use them in any other way for the advancement of anatomy and surgery. Public demonstrations took place four times a year in the Great Hall of Barber’s Hall, London and attendance was compulsory for all ‘free’ surgeons with the crowd surrounding a table. By 1568, the ‘Court of Assistants’ of the Guild ordered wooden raised seating to be erected in the Hall during anatomies.
Barbers and surgeons had an uneasy alliance for the next 200 years. Barber-surgeons received higher pay than master surgeons until the latter were allowed into British warships during naval wars. The average surgeon was tasked with a variety of “healing” tasks that physicians would not do. The surgeon was expected to deal with basic wounds and lacerations, with burns and skin rashes, suture and stitch. They would set fractured bones and dislocated limbs, lance infections, topical applications, and applications of poultices, and deal with venereal diseases More skilled surgeons performed demanding procedures including trepannation, amputation, cauterization, and delivering babies. Unless the nation was at war, barber-surgeons rarely performed these procedures and many reverted to cutting hair for a living.
With time, surgery shifted from a craft to a profession, and barber-surgeons began to accept their role within the medical hierarchy. After 1660, they were becoming quickly phased out as surgery gained a more refined and important position. In England, lobbying from the medical profession ensured master surgeons split from the Barbers’ Company in 1745 and King George II established the London College of Surgeons. In 1800, The Company of Surgeons was established and a Royal Charter granted. The Royal College of Surgeons in London was later renamed to include all of England. Equivalent colleges were established in Scotland, Ireland and within the Commonwealth .The Guild Company of Surgeons became the Royal College of Surgeons in 1800.