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Gendered titles, barber surgeons and all that ... The Royal Australasian College of Surgeons (RACS), in providing a background document supporting the removal of gendered titles, noted that surgery is the only profession that continues to use gendered titles in Australia and Aotearoa New Zealand. The document’s supporting references included an article from the British Medical Journal of December 23, 2000, entitled, Why are [male] surgeons still addressed as Mr? The author, a medical historian, wrote: ‘to understand how the tradition arose it is necessary to go back to the beginning of the 18th century’. The RACS background document noted that the use of the term ‘Mister’ for surgeons, dates to the 16th century when ‘barber surgeons’ performed operations at the direction of physicians. Such statements warrant both clarification and closer scrutiny. The barber surgeon was one of the most common European medical practitioners of the Middle Ages and as Europe emerged from the Dark Ages, surgery was at an elementary level. Barbers originally aided monks, who by the early 14th century were the traditional practitioners of medicine and surgery. The barber’s assistance was necessary, as following the Council of Tours in 1162, monks were forbidden to let blood. Religious and sanitary monastic regulations required that monks maintained a tonsure—the traditional baldness on top of the head of Catholic monks—assuring a steady need for barbers. In addition to hair cutting and shaving, barbers performed simple surgical procedures including the lancing of abscesses, cupping, bloodletting, and the extraction of teeth. The existence of a Barbers’ Company was first evident in 1308. However, it was not until the Royal Charter of 1462 that the Worshipful Company of Barbers was finally incorporated. The barbers
being granted armorial bearings by the Clarenceux King of Arms in September 1451, described as, ‘sabull a cheveron bytwene iii flemys of silver’. A flem or fleam, is a form of lancet, representing the bloodletting activities of the early barber.
When Henry VIII enacted the dissolution of monasteries in England between 1536 and 1539, many monks with a knowledge of elementary medicine and minor surgery, found themselves homeless, among the general population, and they undertook medical or surgical work to survive. Their exodus was perhaps not without influence in leading to Henry VIII’s decision to unite the Barbers Company and the Fellowship of Surgeons by an Act of Parliament in 1540, thereby forming the Company of Barber-Surgeons, and thus regulating those services provided. Thomas Vicary, surgeon to Henry VIII, also played a pivotal role in the establishment of the new company, concerned as he was about the appropriate regulation of surgeons practising in the City of London.
In 1368 the surgeons had been allowed to form their own unincorporated Fellowship or Guild. They were granted a cognisance, or badge, by Henry VII, customarily flanked by the patron saints of surgeons, St Cosmos and St Damian. In heraldic parlance, the cognisance described as, ‘a spatter thereon a rose gules, crowned golde’. The spatter, which is visible beneath the crowned red rose, is a spatula, symbol of the surgeon’s craft: in fact, it is most difficult to discern in the final armorial bearings of 1569.
That memorable union is forever commemorated by the magnificent painting of Hans Holbein, detailing the monarch presenting Thomas Vicary, accompanied by surgeons and barbers, with their Charter. The original painting currently hangs in the Barber-Surgeons’ Hall in Monkwell Square, City of London: a cartoon is in the collection of the Royal College of Surgeons of England. The timing of this union was fortuitous as the works of Hippocrates and Galen were soon to become available to western European readers, and textbooks in English were to be written within a few
