From Haircuts to Hangnails – The Barber-Surgeon

Imagine your monthly beauty routine. Perhaps you go to the salon and get a manicure and pedicure, or to the hairstylist for a cut and dye. Every six months you go to a dentist to have your teeth cleaned and examined, and to the doctor once a year for your physical exam. Three hundred years ago, your routine would have been much the same, except for one thing. It would all have been done at the barbershop.

Barbers in the modern period are known to do mainly one thing: cut hair. For much of the last hundred and fifty years, their red and white striped barber poles signified their ability to produce a good clean shave and a quick trim. This was not always the case, however.

Up until the 19th century barbers were generally referred to as barber-surgeons, and they were called upon to perform a wide variety of tasks. They treated and extracted teeth, branded slaves, created ritual tattoos or scars, cut out gallstones and hangnails, set fractures, gave enemas, and lanced abscesses. Whereas physicians of their age examined urine or studied the stars to determine a patient’s diagnosis, barber-surgeons experienced their patients up close and personal. Many patients would go to their local barber for semi-annual bloodletting, much like you take your car in for a periodic oil change.

Barbers through the Ages

Beginning in the Egyptian era, throughout Roman times and in the Middle Ages, barbers were known to perform much more than simple haircuts and efforts of vanity. They were called on to perform minor surgical operations, pull teeth, and embalm the dead. Their many duties made them the surgeons of the day.

The barbering occupation began in ancient Egypt, where both men and women shaved their heads and wore wigs, and higher-ranking officials often shaved their entire bodies. Egypt’s wealthy citizens and royalty were often tended to by personal slaves, who dressed their wigs, cleaned, and shaved their bodies. Gradually a working class of independent barbers developed, who would perform these duties for all members of society. Personal barbers would also perform additional duties, such as cleaning ears and examining teeth.

The Greeks, in their heyday, wore long hair and curled beards, which required much tending. Alexander the Great, fearing that enemies would use long hair as handles in battle, encouraged his men to cut their hair and shave their beards, which required a skilled set of haircutters. These expert Greek barbers spread along with the widening influence of the Greek state, eventually entering Roman territory, where they set up stalls in the city streets.

Many settled communities around the world also employed a set of skilled barber-surgeons. Cortez encountered barbers upon entering Tenochtitlan; European colonists relied on the surgical abilities of the newfound Indian populations in American colonies; and Chinese traveling barbers wandered through the streets, ringing a bell to announce their presence. Because barbers employed an array of sharp metal tools, and they were more affordable than the local physician, they were often called upon to perform a wide range of surgical tasks.

Barbers differed greatly from the medicine man or shaman, who used magic or religion to heal their patients. Surgery was considered a “lesser art,” and was not to be performed by the magical preist-physicians that ruled the mystical connection between the soul and the body. But this did not diminish their presence or usefulness.

In the ancient Mayan civilization, they were called upon to create ritual tattoos and scars. The ancient Chinese used them to castrate eunuchs. They gelded animals and assisted midwives, and performed circumcisions. Their accessibility and skill with precise instruments often made them the obvious choice for surgical procedures.

From Barbers to Barber-Surgeons

After the fall of the Roman Empire, barbers were a staple of monastery life. Monks required barbers to shave their faces and tonsures, the round area on the top of the head. At this time, physicians were forbidden to perform surgical procedures as the body was considered holy, and should not be violated by the hands of doctors. But monks, who also practiced as doctors, considered operations and surgical procedures as dirty and beneath their dignity, and passed those responsibilities to barbers.

One of the keystones of the barber’s surgical duties was bloodletting. Bleeding was done for a number of reasons, but the basis of the ideas was that by letting out the bad or morbid blood in the body, it would be replaced by fresh healthy blood. Bleeding of patients was done in many ways, including cupping and using leeches, but the most common was cutting a patient’s vein and letting the blood flow into a small basin.

As bleeding became one of the main responsibilities of the barbers, they came to signify their presence in the marketplace with a red and white striped pole, the colors reminiscent of the blood and rags used in bloodletting. This pole was usually capped with a small basin, used to symbolize the vessel with which they would collect the blood. Later, barbers placed bowls of blood in their shop windows, to indicate that they performed bloodletting services.

As they also often pulled teeth, they would string a row of teeth in front of their windows to alert potential customers of their services. In 1307, the people of London decried the bowls of blood sitting in barber’s windowsills, and passed a law that all fresh blood must be carried to the Thames.

In 1163, a papal decree forbade monks from shedding blood, and so all surgical tasks fell to the skilled barbers. In addition to bloodletting, barbers were called upon to perform almost all surgical and dental operations, as well as more unsavory occupations, such as embalmings and autopsies.

During the 12th and 13th centuries, secular universities began to develop throughout Europe, and along with an increased study of medicine and anatomy came an increased study in surgery. This led to a split between academically trained surgeons and barber-surgeons, which was formalized in the 13th century. After this, academic surgeons signified their status by wearing long robes, and barber-surgeons by wearing short robes. Barber-surgeons were thus largely referred to as “surgeons of the short robe.”

Barbers of both the short and long robes coexisted precariously during the next few centuries. In France in 1361, barbers and surgeons combined to form a united guild, but more often than not they formed separate guilds. The Barber’s Company guild, formed in 1462, merged with the surgeon’s guild in 1540. These guilds both helped ensure quality of service, by employing inspectors to verify the skill of the barber, as well as compete with other craftsmen, by negotiating contracts.

Certain barber-surgeons became very skilled at performing surgical procedures. Ambroise Paré, considered the father of modern surgery, was one such barber. Originally a wound-dresser at the Paris Hotel Dieu, Paré made history by his unconventional handling of gunshot wounds and open injuries, and later rose to be the surgeon to the royal family of France.

The Separation of Barber and Surgeon

Gradually, the split between barbers and surgeons became more severe, and in 1743 in France and 1745 in England, barber-surgeons who cut or shaved hair were not allowed to perform surgery. In 1800 the College of Surgery was founded in England, and the last practicing barber-surgeon in England died in 1821.

Dentistry, which was another one of the many responsibilities of the barber-surgeon, was also gradually relegated to its own specialty. Surgeon-dentists were practicing as early as the 17th century.

Barbers, who had once performed an entire plethora of surgical procedures, were now primarily responsible for the care of a patron’s hair and nails. Increasingly in the 17th and 18th centuries, barbers became wigmakers for the European elite, some of them eventually splitting off into their own specialty as hairdressers.

Even so, the barber-surgeons skills remained in high demand as late as 1727, when John Gay penned his poem, The Goat Without a Beard:

His pole, with pewter basins hung,
Black, rotten teeth in order strung,
Rang’d cups that in the window stood,
Lin’d with red rags, to look like blood,
Did well his threefold trade explain,
Who shav’d, drew teeth, and breath’d a vein.

It is hard to imagine going to the barber shop today to get a boil lanced or a tooth pulled, or for an occasional bloodletting, but for much of human history this was the case. As medicine, and surgery, advanced, so did the profession of barbery. From haircuts to hangnails, they did it all.

The barber shop was the common ancestor of many different occupations today; surgeons, dentists, tattooists, embalmers, doctors, hairdressers, wigmakers, manicurists, pedicurists, and more can all source their ancestry to that one common denominator: the barber-surgeon.


Dary, David. Frontier Medicine: From the Atlantic to the Pacific, 1492-1941. New York: Alfred A. Knopf, 2008.

Franck, Irene M., and David M. Brownstone. Healers. New York: Facts on File, 1989.

Hollingham, Richard. Blood and Guts: A History of Surgery. New York: St Martin’s Press, 2008.

Elizabeth Roberts, MA, CPC

Elizabeth Roberts, MA, CPC, holds a Bachelor of Arts in History and Philosophy, and a Master of Arts in Curriculum and Instruction. She is a freelance writer who enjoys sharing her love of history with others. She also enjoys writing as a way to get out of the boring gray cubicle that she occupies in her full time day job. She spends what time she has left with her two daughters and husband, family, and friends, cooking, reading, and creating just about anything with her hands. She also hopes to one day get her PhD in History, and finish one of the many books that she has been writing. Elizabeth has recently been credentialed as a Certified Professional Coder (CPC) by the American Academy of Professional Coders.
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