Curiosities of Medical Experience

by J. G. Millingen

Unable to quit their cloisters, in surgical cases, which could not be so easily cured at a distance, sooner than lose the emoluments of the profession, they sent their servants, or rather the barbers of the community, who shaved, and bled, and drew teeth in their neighbourhood ever since the clergy could no longer perform these operations, on the plea of the maxim “Ecclesia abhorret à sanguine;” bleeding and tooth-drawing being, I believe, the only cases where this maxim was noticed. From this circumstance arose the barber craft or barber-surgeons.

These practitioners, from their various avocations, were necessarily dexterous; for, in addition to the skill required for good shaving, tonsurating the crowns of clerical heads was a delicate operation; and it was about this period that Pope Alexander III. revised the canon issued by the synod of Carthage respecting the tonsure of the clergy. Surgery being thus degraded, the separation between its practice and that of medicine became unavoidable, and the two branches were formally made distinct by bulls of Boniface VI. and Clement V.

St. Louis, who had witnessed the services of surgeons in the field of battle during the crusades, had formed a college or confrérie of surgeons, in honour of St. Cosme and St. Damian, in 1268; and wounds and sores were dressed gratis in the churches dedicated to those saints on the first Monday of every month. To this body, of course, the barber-surgeons, or fraters of the priests, who had not received any regular education, did not belong. Hence arose the distinction, which even to the present day obtains in various parts of the Continent, where surgeons are divided into two classes,—those who had gone through a regular course of studies, and those who, without any academical education, were originally employed as the servants of the priests and barbers. So late as the year 1809, one of my assistants in the Portuguese army felt much hurt at my declining his offer to shave me; and in 1801, some British assistant-surgeons, who had entered the Swedish navy, were ordered to shave the ship’s company, and were dismissed the service in consequence of their refusal to comply with this command.

But to return to our barbers.—These ambitious shavers gradually attempted to glean in the footsteps of the regular chirurgeons, and even to encroach upon their domain, by performing more important operations than phlebotomy and tooth-drawing; the audacious intruders were therefore very properly brought up ex officio by the attorney-general of France, and forbidden to transgress the boundaries of their art, until they had been duly examined by master chirurgeons; although these said masters were not better qualified than many of the barbers. Such was their ignorance indeed, that Pitard, an able practitioner, who had successively been the surgeon of St. Louis, Philip the Brave, and Philip the Fair, obtained a privilege to examine and grant licences to such of these masters who were fit to practise, without which licence all practitioners were liable to be punished by the provost of Paris; and in 1372 barbers were only allowed to dress boils, bruises, and open wounds.

Although this account chiefly refers to France and its capital, yet the same distinction and division between surgeons and barbers prevailed in almost every other country; and privileges were maintained with as much virulence and absurdity as the present controversial bickerings between physicians and surgeons.

In 1355 these master-surgeons constituted a faculty, which pocketed one-half of the penalties imposed upon the unlucky wights who had not the honour of belonging to their body. They also enjoyed various immunities and exemptions; amongst others, that of not keeping guard and watch in the city of Paris. To increase their emoluments, they granted as many honorary distinctions as they could in decency devise, and introduced the categories of bachelors, licentiates, masters, graduates, and non-graduates of surgery. The medical faculty now began to complain of the encroachments of the master-surgeons on their internal domain of poor mortality with as much bitterness as the masters complained of the impertinent invasion on the part of the barbers, of their external dominion. To court the powerful protection of the university against these interlopers, the surgeons consented to be considered as the scholars of the medical faculty, chiefly governed by clerical physicians.

In 1452 a fresh source of dissension arose amongst clerical physicians, lay physicians, master surgeons, and barbers. Cardinal Etoutville abolished the law which bound the physicians of the university to celibacy, when, to use the historian’s words, “many of the clerical physicians, thinking there was more comfort to be found in a wife without a benefice than could be expected in a benefice without a wife, abandoned the priesthood, and were then permitted to visit their patients at their own houses.” Thus thrown into the uncontrolled practice of medicine, these physicians became jealous of the influence of the surgeons, to whom they had been so much indebted; and they had recourse to every art and manœuvre that priestcraft could devise to oppress and degrade them. To aid this purpose, they resorted to the barbers, whom they instructed in private, to enable them to oppose the master-surgeons more effectually. The surgeons, indignant at this protection, had recourse to the medical faculty, supplicating them to have the barbers shorn of their rising dignity. Thus for mere motives of pecuniary interest, and the evident detriment of society, did these intriguing practitioners struggle for power and consequent fees; and, according to the vacillation of their interests, the barbers became alternately the allies of the physicians or the mercenary skirmishers of the surgeons.

From this oppression of the art, for nearly three centuries surgery was considered a degrading profession. Excluded from the university, not only were surgeons deprived of all academic honours and privileges, but subjected to those taxes and public burdens from which the members of the university, being of the clerical order, were exempted. This persecution not only strove to injure them in a worldly point of view, but the priests carried their vindictive feelings to such a point of malignity that when Charles IX. was about to confer the rites of apostolical benediction upon the surgeons of the long robe, the medical faculty interposed on the plea of their not being qualified to receive this benediction, as they did not belong to any of the four faculties of the university; and as the chancellor, or any other man, had not the power of conferring a blessing without the pope’s permission and special mandate, both surgeons and barbers ought to be irrevocably damned. The apostolical benediction in those days was considered of great value, since it exempted all candidates from examination in anatomy, medicine, surgery, or any other qualification, when they applied for a degree.

Ever since the healing art ceased to be a clerical privilege, and a state of rivalry prevailed between spiritual and corporeal doctors, the former have sought to represent their opponents as infidels and atheists—the unbelief of physicians became prevalent, and to this day medical men are generally considered freethinkers;—an appellation which in a strictly correct acceptation might be considered more complimentary than opprobrious, since it designates a man, who extricating his intellectual faculties from the meshes of ignorance or prejudices, takes the liberty of thinking for himself.

Sir Thomas Brown in his “Religio Medici,” alludes to this injurious opinion entertained of medical men, when he says, “For my religion, though there be several circumstances that might persuade the world I have none at all, as the general scandal of my profession, the natural course of my studies, the indifferency of my behaviour and discourse in matters of religion—yet in despite thereof, I dare, without usurpation, assume the honourable style of Christian.”