Elizabeth Roberts, MA, CPC – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Wed, 30 May 2018 15:00:03 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.6 Human Dissection, Part 2 – Murderers, Body Snatchers and Burkers http://brainblogger.com/2011/09/17/human-dissection-part-2-murderers-body-snatchers-and-burkers/ http://brainblogger.com/2011/09/17/human-dissection-part-2-murderers-body-snatchers-and-burkers/#comments Sat, 17 Sep 2011 14:25:28 +0000 http://brainblogger.com/?p=7141 The history of medical students using human cadavers for dissection is a long and choppy one (no pun intended). Before Christianity, mutilation and use of human corpses was widespread. It is common knowledge that ancient Egyptians mummified their dead, dissecting and preserving specific organs. After Christianity became a widespread influence, however, the practice of dissecting human cadavers to study was considered taboo. The remaining 1700 years of European history in regards to human dissection ranged from the illegal body-snatching of human corpses to using only the cadavers of executed criminals as subject of study, and finally, making human dissection a regulated scientific practice.

Unlike France, which made it easier for medically minded men to obtain human bodies for dissection, Great Britain had a much more difficult time obtaining and normalizing the practice of using real human cadavers for study.

The Murder Act

In 1752, Great Britain passed an act for better preventing the horrid Crime of Murder. Otherwise known as the Murder Act, it essentially legalized the dissection of human bodies for medical study. More specifically, it gave the bodies of executed murderers to medical universities, so that they could be dissected for medical examination. The Murder Act served dual purposes: it was an extra deterrent for murder, as no one wanted to be dissected, but it also made a legal supply of fresh human cadavers on which medical students could study.

The executions of murderers were usually held at eight o’clock on Monday mornings, after which the body of said murderer would be left hanging for an hour for good measure. This would ensure that he (or she) was actually dead. After the execution, the body would then be delivered to the London’s Royal College of Surgeons, who’s College Master, dressed in his full regalia, would receive the body, taking it into the college for dissection and study.

At this time, the Royal College of Surgeons had the only legal right to human bodies, and as the supply of murderer-bodies was relatively scarce, there were few legal avenues for human cadavers. Because of this, they often performed a “proper examination,” consisting of little more than a cut over the sternum, and then donated the rest of the body to other London hospitals, private schools of anatomy, or other well-connected surgeons or students. This was one way in which the Royal College remained in favor with London’s most powerful surgeons.

Body Snatchers and Burkers

Fortunately (or perhaps not so fortunately), there were very few executions that were eligible for human dissection, averaging about a dozen a year. This meant that there had to be another means of obtaining human remains to study. This meant that medical students and surgeons often had to raid the gravesites of the recently deceased, obtain unclaimed bodies from almshouses or hospitals, or purchase freshly dead bodies from body snatchers and murderers.

In the 1820’s, two men made a killing (pun intended) by murdering people and selling their bodies to medical professionals. In 1828 it was discovered that William Burke and William Hare, two Irishmen living in Edinburgh, had murdered and sold the bodies of at least sixteen men and women for dissection by doctors at the medical school of Dr. Robert Knox.

The two men had carefully crafted a method of murder, which went completely undetected by the medically-minded men to whom they sold their prey. They would douse their unsuspecting victim with a good amount of liquor, and once passed out drunk, would suffocate them in their sleep. Their method was so complete that the doctor dissecting the patient would have no knowledge of the way in which the person died. They would then pack the body in a tea-chest and carry it through the streets of Edinburgh, where they would present it to the school of Dr. Knox for sale.

By the time they two criminals had been caught, it was found out that Knox had personally bought the bodies of sixteen of Burke and Hare’s victims.

Burke and Hare were not the only ones to follow the same model, however, as further rings of murderers were later found in London, each of whom sold the bodies of their victims to doctors for medical study.

An Ironic Twist of Fate (or, A Fitting Punishment)

The most interesting (and fittingly ironic) part of the history of Burking, as it came to be called, was the fate of the movement’s founders. Having been found out by the authorities, Hare sold out his partner in crime, Burke, and escaped the noose by providing enough evidence to convict his partner of murder. Burke, on the other hand, was not so lucky. He was found guilty of murder, and sentenced to both death and dissection.

The hanging and subsequent dissection of Burke turned out to be a festive affair, as tens of thousands of spectators jostled for a peek. Small pieces of Burke’s body were souvenired out at the dissection, and a purse was made out of his skin. This Burke-skin purse is still on display at the Police Museum in Edinburgh.

The Anatomy Act

As a direct result of the Burking controversy, and the ensuing episodes of Burking in London, the British Parliament passed an Act for Regulating Schools of Anatomy, in 1832. In addition to rescinding the Murder Act, which allowed the dissection of executed murderers, this new act provided additional legal ways in which doctors could obtain human bodies for dissection. It also established a system of licensing physicians for “anatomical examinations” and specified where such “examinations” would take place.

After the implementation of the Anatomy Act, all physicians who were in legal possession of human bodies, such as hospitals and workhouses, could make the bodies available for dissection. Essentially, the act made it legal to claim all bodies that had been unclaimed for more than 48 hours for dissections.

After this legislation the heretofore theatrical act of hanging a murderer, delivering his body to the Royal College of Surgeons, and publicly displaying it’s dissection was regulated into a scientific affair. The British Anatomy Act of 1832 changed the scientific method of dissection from a public punishment for a crime into a regulated, scientific practice.

By the middle of the 19th century, the “necessary inhumanity” of human dissection for medical study had transitioned from a moral dilemma, to a punishment for vicious crimes, to a purely scientific practice. That being said, there was (and still is) serious moral, ethical, and legal issues regarding the use of human cadavers for study, and the use of human bodies for scientific study is still an important issue in contemporary medicine.

References

MacDonald, Helen. Human Remains: Dissection and Its Histories. London: Yale University Press, 2005.

Warner, John H., and Edmonson, James M. Dissection: Photographs of a Rite of Passage in American Medicine: 1880-1930. New York: Blast Books, 2009.

]]>
http://brainblogger.com/2011/09/17/human-dissection-part-2-murderers-body-snatchers-and-burkers/feed/ 4
Human Dissection – From Galen to the Great Revelations of Andreas Vesalius http://brainblogger.com/2011/08/20/human-dissection-from-galen-to-the-great-revelations-of-andreas-vesalius/ http://brainblogger.com/2011/08/20/human-dissection-from-galen-to-the-great-revelations-of-andreas-vesalius/#comments Sat, 20 Aug 2011 12:00:28 +0000 http://brainblogger.com/?p=7071 Humans have been cutting open cadavers and dissecting corpses almost since the beginning of recorded human history. Ancient Egyptians went to great lengths to mummify their dead, including cutting open bodies, dissecting out organs, and preserving remains. Following closely in their footsteps, ancient Greeks also pursued human dissection, in much more of a scientific vein. Rather than an immoral view of desecrating the human body, Greeks thought of human dissection as an extension of the empirical nature of science.

Two early Greek physicians, Erasistratus and Herophilus made the first systematic, scientific explorations of the human body, and they are now thought to be the first physiologist and the founder of human anatomy, respectively. Together, these two doctors advanced the study of the interior of the human body, which was once a sacrosanct mystery, into a field of scientific query. Herophilus dissected the entire human body, and differed from the authority at the time, Aristotle, when he claimed that consciousness was stored in the brain rather than in the heart. Erasistratus explained the workings of human organs in mechanical terms.

Unfortunately, the spark of empirical study of human anatomy that these two physicians should have set off did not light, as their two schools reverted to bickering over theoretical disputes. As if the fire of human dissection was not already flickering, it was snuffed out completely with the burning of the library of Alexandria and the widespread introduction of Christianity, when it became impossible to dissect human bodies anywhere in the Hellenistic world. This marked a great transition in the study of human anatomy, and for hundreds of years the European world valued the sanctity of the church more than scientific inquiry.

Galen’s Anatomical Influence

The first of the great anatomists was Galen of Pergamon (AD 130-200) who made vast achievements in the understanding of the heart, the nervous system, and the mechanics of breathing. Because human dissection was forbidden, he performed many of his dissections on Barbary apes, which he considered similar enough to the human form. The system of anatomy he developed was so influential that it was used for the next 1400 years. Galen continued to be influential into the 16th century, when a young and rebellious physician began the practice of using real human bodies to study the inner workings of the human body.

Enter Andreas Vesalius

Vesalius, who came from a line of four prominent family physicians, began as a young and precocious anatomy student. As a child, he would often catch and dissect small animals, and later as a medical student, he would go to great lengths to obtain human remains to study. At age 18, he entered the University of Paris, where they strictly adhered to the antiquated works of Hippocrates and Galen, and the medical professors thought it below themselves to perform actual dissections. During any actual demonstrations, the professor would lecture on high as a barber-surgeon did the actual cutting on the dissection floor.

Unlike Britain, in which only the bodies of executed murderers could be used for dissection by medical men, France’s revolutionary edicts made it easy for medically minded men to obtain bodies to study. This did not mean, however, that lowly students such as Andreas Vesalius would have direct access to any of these bodies.

Vesalius and other like-minded anatomy students would raid the gallows of Paris for half-decomposed bodies and skeletons to dissect. They would sometimes find the courage to go outside of the walls of Paris, braving the feral dogs and stench, in order to steal cadavers from the mound of Monfaucon, where the bodies of executed criminals were hung until they disintegrated.

Rather than considering dissection a lowering of his prestige as a doctor, Vesalius prided himself in being the only physician to directly study human anatomy since the ancients. During only his second anatomical lecture, Vesalius stepped onto the dissecting floor, took the knife away from the barber-surgeon, and began cutting at the cadaver himself, demonstrating his great skill with the knife.

Vesalius’ Rise

His professors quickly noticed his great knowledge and ability, and by the age of 22 he was giving his own anatomical lectures, all of which centered on a dissection. Some of his subjects were animals, but more often than not they were human cadavers. He also suspended a skeleton above the dissecting table during his lectures, and taught that the skeleton was the foundation of the body.

Similar to the influential works of Galen, Vesalius’ work on human anatomy revolutionized the scientific world. The publication of his book De humani corporis fabrica (On the Fabric of the Human Body) stands as a monument in the history of science and medicine. Whereas his contemporaries relied on the antiquated accounts of Galen, who dissected animals rather than humans, Vesalius relied on the actual human body to inform his theories.

Vesalius’ work provided the first accurate description of the internal structures and workings of the human body, and more importantly, revived the use of the scientific method for studying human anatomy. The birth of Christianity supplanted hands-on, empirical study of the human body with the philosophical reliance on a Supreme Intellect. This idea was that every human body part was a product of the Supreme Intellect’s design, whether or not it coincided with what actually lay out on the dissecting table.

Vesalius, on the other hand, could not support the ancient writings of Galen, who relied on this idea of Supreme design. Although he revered him highly, Vesalius often found that his study of the human form did not fit with the descriptions provided by Galen, whose descriptions often matched the anatomies of dogs, apes, or sheep. He eventually found over 200 discrepancies such as these, and publicly announced his break from the Galenic tradition.

A Revolutionary Physician

De humani corporis fabrica, published in 1543, was a turning point in the history of modern medicine. For the first time, the understanding of medicine and the treatment of disease was rooted in an accurate representation of the human body. This book revolutionized the medical world. Similar to the findings of Copernicus and Galileo, Vesalius’ works help spur an empirically-based, scientific study of the world around us.

Like his fellow revolutionary scientists, Vesalius’ masterpiece was met with harsh criticism. Many of these criticisms understandably came from the church, but the most strident of all came from Galenic anatomists. These critics vowed that Galen was in no way incorrect, and so if the human anatomy of which he wrote was different from that which was proved by Vesalius, it was because the human body had changed in the time between the two.

As a response to the harsh criticisms of his work, Vesalius vowed to never again bring forth truth to an ungrateful world. In the same year that he published de humani, he burned the remainder of his unpublished works, further criticisms of Galen, and preparations for his future studies. He left medical school, married, and lived out the rest of his conservative life as a court physician.

Even though Vesalius abandoned further studies of human anatomy, before he died he recognized the great contributions he had made to the scientific world. He understood that his revelations represented an awakening of inquiry into the human body, and a reliance on facts, rather than adherence to an antiquated text.

The remainder of the history of human dissection is just as rocky. Although France in the 16th century was open-minded about the use of human cadavers for scientific inquiry, the rest of the European world was not so revolutionary. Great Britain had its own tradition of illegal trade in dead bodies, and even the United States had a hard time opening up to the idea that human bodies should be used for scientific study.

Continue to Part 2 – Murderers, Body Snatchers and Burkers.

Resources

Adler, Robert E. Medical Firsts: From Hippocrates to the Human Genome. Hoboken, New Jersey: John Wiley &Sons, Inc., 2004.

MacDonald, Helen. Human Remains: Dissection and Its Histories. London: Yale University Press, 2005.

]]>
http://brainblogger.com/2011/08/20/human-dissection-from-galen-to-the-great-revelations-of-andreas-vesalius/feed/ 21
Extracting the Stone of Madness – The Search for the Cure to Insanity http://brainblogger.com/2011/05/27/extracting-the-stone-of-madness-the-search-for-the-cure-to-insanity/ http://brainblogger.com/2011/05/27/extracting-the-stone-of-madness-the-search-for-the-cure-to-insanity/#comments Fri, 27 May 2011 12:00:24 +0000 http://brainblogger.com/?p=6502 Both psychiatry and psychology have their roots in ancient practices and belief systems, which traced insanity back to the treatment of emotional disorders. Ancient Egyptians and Mesopotamians, more specifically, believed that all diseases, including mental ones, were the result of demonic influences on the soul.

Later, Greeks and Romans tried to create a rational approach to mental disorders by labeling them mental illnesses and writing texts examining their many manifestations. Nevertheless, most Greeks and Romans also believed that mental problems were caused by evil spirits, or the wrath of the Furies, the Greek goddesses of vengeance.

Trepanning also had its roots in the ancient world. Scientists have found many prehistoric skulls, which indicate that trepanning, or cutting a hole into a person’s skull, has been in practice since 10,000 BC. These prehistoric skulls have been found all over the world, in isolated geographic locations, indicating that prehistoric populations practiced trepanning independently of each other. This means that since the beginning of human history, people have been cutting into the head, opening a small hole in the skull.

But the question remains, why? Some early trepanned skulls indicate trauma, so perhaps it was performed as a treatment for injury. It may also have been performed as a healing method for headaches or epilepsy, to relieve the pressure within the skull. Other theories indicate that by cutting a hole on the top of ones skull, early populations believed that it would allow spirits to enter the soul, and to give the recipient magical powers.

On the other side of the coin, however, ancient trepanning may have been performed as a way to cure insanity, as it had been done in the Middle ages under the guise of cutting out stones of madness from the individual’s skull.

Cutting out Stones

After the Greco-Roman world was conquered by Christianity, insanity and mental illnesses went practically untreated. Those with mental disorders were compassionately taken care of physically, but their psychological needs or problems were not dealt with. In the Early Middle Ages, this compassionate attitude changed. Those with mental illnesses were no longer looked at as poor souls needing someone to take care of them. Mental illness was once again, as it had been hundreds of years prior, seen as a direct result of demonic possession of the soul and evil influences.

The prevailing theory that insanity was caused by evil demons made it necessary to treat, if not cure, the mentally ill. In the 15th, 16th, and as late as the 17th centuries, a group of charlatans came to the forefront to cure the diseases of the mind. These quacks were often men and women untrained in the medical sciences. Among them were astrologers, chemists, monks, nuns, alchemists, jugglers and street peddlers, all who claimed to have the cure for mental illness.

Mental illness, they said, was the result of a small stone inside the brain, and they could cure this disorder by trepanning the skull, and letting out the stone. It made sense, to a point, that an individual could produce mental results through physical intervention in the brain. Thus developed a mythical stone of madness, after removal of which, the insanity would be cured.

The great artist Hieronymus Bosch immortalized the scene of a physician trepanning the skull to remove stones in his painting The Cure of Folly, otherwise known as The Extraction of the Stone of Madness. This painting depicts the scene with a dry wit and sarcastic view of the removal of the stone of madness. The “doctor” in the scene is wearing a funnel hat, an early symbol of madness, indicating that he is also insane. He is trepanning the skull of a patient, in order to retrieve the stone from within the patient’s skull.

The rest of the painting is ripe with symbols of folly, foolery, madness and insanity. As a whole, the painting depicts not only the insanity of cutting out the “stone of madness” from a patient’s skull, but also reflects the reality of the situation. Bosch finished his painting around 1494, when charlatans and quacks came out in droves to cut into people’s heads. His painting is a sharp critique on the ridiculousness of it all.

Link to More Invasive Procedures

Whether ridiculous or not, the practice of removing stones from the heads of the insane continued as late as the 20th century, when practitioners would produce a small stone after the procedure, stating that they had removed it from within the brain.

It is not hard to see, that if removing stones was performed as late as the 20th century, how the practice of lobotomy could have developed. The theory that mental illness had a physical basis, rather than the result of demonic possession or evil influences, was sure to produce a more invasive form of cure for the insane. Lobotomy, which sought to cure mental illness through direct intervention and damage of the brain tissue, was a logical expansion of the cutting of stones and trepanning.

Luckily not all physicians of the mind went the same route as the stone-cutters (or the lobotomizers, for that matter). The fields of mental health developed into psychology and psychiatry, each of which focused on the mental health of the individual, although focused on treating the patient in different ways.

But this does not mean that trepanning is a dead science. It is commonly used in neuroscience, as well as in surgical procedures for injured patients. There are also modern alternative therapy groups, which advocate trepanning as a cure for a number of mental maladies. The recurrent use of trepanning is continuing a human tradition, started over 10,000 years ago with the earliest human. Whether to relieve headache pressure, let out demons in the skull, or to remove the stone of madness, trepanning is a fundamental part of our history of using medicine to better the human condition.

References

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.

Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. John Wiley & Sons, 1997.

]]>
http://brainblogger.com/2011/05/27/extracting-the-stone-of-madness-the-search-for-the-cure-to-insanity/feed/ 3
The Strangling Angel of Children – Birth of Endotracheal Intubation http://brainblogger.com/2011/05/12/the-strangling-angel-of-children-birth-of-endotracheal-intubation/ http://brainblogger.com/2011/05/12/the-strangling-angel-of-children-birth-of-endotracheal-intubation/#comments Thu, 12 May 2011 12:00:06 +0000 http://brainblogger.com/?p=6459 Up until the beginning of the 1920’s in the United States and contemporarily in many parts of the world, diphtheria has been a leading cause of death in children. Referred to as “the strangling angel of children,” large outbreaks occurred in Europe and in America in the 18th century, and more recently in the 1990’s in Russia and Eastern Europe. In the western frontier of the US in the 19th century, illnesses were common, and epidemics such as cholera, smallpox, and typhoid fever came recurrently. Diphtheria was second only to malaria in taking the lives of young children. The disease was awful, causing pain, swelling of the neck and lymph nodes, and eventually suffocation and death.

To allow a patient to breathe, tracheotomies were common. This technique, which was fatal in nearly a quarter of all cases, was gradually replaced with endotracheal intubation, or the act of inserting a breathing tube directly into the patient’s trachea through the mouth. This method was so effective that it is still practiced today, in generally the same form as almost 100 years ago.

Diphtheria and Its Victims

Early scientists discovered the bacteria that cause diphtheria in the 1880’s, and they had developed an antitoxin for the disease as early as the 1890’s. Although the development and administration of a vaccine against diphtheria significantly decreased the prominence of the disease, it remains a stealthy killer of young children. In the United States today, diphtheria is rare, with no reported cases since 2003, but it remains endemic to many places around the world.

Diphtheria is an infectious disease, caused by a contagious bacterium, Corynebacterium diphtheriae, which primarily affects the mucous membranes of the respiratory tract, as well as the skin, and other sensitive areas of the body, including ears, eyes, and genital areas.

The symptoms of respiratory diphtheria include sore throat, fever, lethargy, difficulty swallowing, and difficulty breathing, and usually appear after a two to five day incubation period. As the disease worsens, a pseudomembrane often develops over the tonsils and nasopharynx. In other words, the bacterium collects and coagulates into a film, which covers the lining of the throat, causing swelling of the neck and difficulty breathing.

As the pseudomembrane gets larger, swelling worsens and lymph nodes become enlarged, giving the neck a “bull-neck” appearance. In untreated cases, this pseudomembrane will become large enough to obstruct the larynx and the trachea, slowly cutting off the airway, causing suffocation and death.

Unfortunately, diphtheria often affected the youngest of children, who were weaker and harder to treat. The pseudomembrane resulting from the infection would make it impossible for the patient to swallow, speak, and later, breathe. Early surgeons had made use of the tracheotomy, which was a small incision at the base of the throat. This allowed for a curved hollow tube to be inserted into the airway to allow the patient to breathe.

Tracheotomies bypassed the swelling of the pseudomembrane in the neck and opened an airway to allow the patient to breathe. They were, however, difficult, painful, and due to the risk of infection, often fatal.

From Tracheotomy to Intubation

Because it was a childhood disease, it is fitting that a pediatrician invented a better method of allowing young diphtheria patients to breathe. In 1858, Eugene Bouchut developed the method of endotracheal intubation, which bypassed the diphtheria pseudomembrane and opened the airway. This method was less invasive than the tracheotomy, and often resulted in a higher survival rate. Bouchut’s first experiment with intubation was by insertion of a small metal tube into the larynx, and simply leaving it in the airway until the pseudomembrane had resolved.

Bouchut’s invention did wonders for the medical world. Although it was at first negatively received, its use in medical procedures other than treating childhood cases of diphtheria was soon obvious. In 1878, endotracheal intubation was used in a surgery to remove vocal cord polyps, and later in treating patients with glottic edema.

After the turn of the century, intubation was used not only in patients requiring an airway, but as a way of administering general anesthesia. In 1919, Ivan Magill was the first to use endotracheal intubation, using a rubber tube rather than a metal pipe, to pass anesthetic gas directly into a patient’s lungs. Perhaps humorously, this was more than an easy way to administer anesthesia. Before intubation, gas anesthesia pipes were prone to leak, and surgeons, leaning close to anesthetic gas for hours at a time, would often fall asleep on top of their patients.

Endotracheal intubation was also used to administer drugs directly into the patient’s lungs. Mercury, for example, was administered in the form of a vapor, and was used as a treatment for membranous croup and ulcers of the mouth and throat, as well as for diphtheria.

Sometimes, good things come from bad, as in the case of diphtheria. An awful disease, which still causes hundreds, if not thousands, of deaths each year, led to the invention of a valuable piece of technology. Endotracheal intubation is now a common procedure in emergency rooms and operating rooms throughout the world. It is used in nearly all major surgeries and is a basic form of emergent care, and diphtheria, no longer the “strangling angel of children,” has now receded to an afterthought of the American way of life.

References

Bethard, Wayne. Lotions, Potions and Deadly Elixirs: Frontier Medicine in America. Lanhan, MD: Taylor Trade Publications, 2004.

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

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

Schwartz, MD, Seymour I. Gifted Hands: America’s Most Significant Contributions to History. New York: Prometheus Books, 2009.

]]>
http://brainblogger.com/2011/05/12/the-strangling-angel-of-children-birth-of-endotracheal-intubation/feed/ 1
From Haircuts to Hangnails – The Barber-Surgeon http://brainblogger.com/2011/05/06/from-haircuts-to-hangnails-the-barber-surgeon/ http://brainblogger.com/2011/05/06/from-haircuts-to-hangnails-the-barber-surgeon/#comments Fri, 06 May 2011 12:00:52 +0000 http://brainblogger.com/?p=6457 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.

References

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.

]]>
http://brainblogger.com/2011/05/06/from-haircuts-to-hangnails-the-barber-surgeon/feed/ 12