The Barber Pole
“Have by some surgeon, Shylock, on your charge, to stop his wounds lest he do bleed to death.”
The Merchant of Venice 4.1.254-5
Reddy Aesthetics recently expanded to our second location located on Roswell Road in Buckhead. This location named SkynBar, was opened in collaboration with dedicated Aestheticians with over 50-years of collective experience.
We happen to be located next door to The Boardroom Men’s Hair Salon which proudly displays a traditional barber pole. Most of us are familiar with the red and white spiral pole universally emblematic of the barber shop (in the USA the barber pole fittingly bears the tricolor of red, white, and blue). But where did the colors originate from and why would a Plastic Surgeon be interested in sharing this important history?
In Medieval Europe, medicine was practiced by the clergy and was separated from the practice of surgery — the latter being viewed as a lesser non-academic pursuit. Surgery of this era was limited to practices such as bloodletting, the application of leeches — ostensibly to suck out evil humors, lancing of boils, application of ligatures, and dental extractions. Barber’s, already equipped with a plethora of clean and sharp instruments, came to be the purveyors of the early surgical arts. Thus the barber shop, in addition to offering hair cuts, became the earliest outpatient Surgery centers. The barber-surgeon was not viewed as a serious academic pursuit but more of an apprenticeship. In some countries, one could still undergo a dental extraction without anesthesia at the barbershop until as recently as the 1950s.
A court petition by the warden of the Guild of Surgeons, a separate entity from the Guild of Barbers, in London in 1519 described his job as: “In manuall application of medicines; in staunchying of blod, serchyng of woundes with irons and other instruments, in cuttying of the sculle in due proporcyon to the pellicules of the brayne with instruments of iron, cowchying of catharactes, takyng owt bonys, sowyng of the flesshe, launchung of bochhis, cuttyng of apostumes, burnying of cankers and other lyke…”
In 1540, Henry VIII of England, by Royal decree, created the Union of Barbers and Surgeons. It was the merger of the separate Guilds of Barbers and Surgeons respectively. It was one of the first unions ever established and represented the formalization of the practice of surgery. These establishments were readily identified by the bloody bandages that were washed and hung to dry at the store front explaining the origins of the red and white stripes with which we are so familiar. The pole came to signify the staff that patients were given to clutch while undergoing painful surgical procedures without the benefit of anesthesia. Anesthesia came into existence centuries later. The brass bowl capping the barber pole was emblematic of the bowl for storing leeches. A second brass cap at the base of the pole signified the vessel in which blood was collected during blood-letting procedures. This assembly came to symbolize the practice of the barber-surgeon.
As the medical establishment in England came to recognize the importance of surgery in the cure of disease, efforts were made to bring the barber-surgeon into the fold of academic medicine. The United Barber-Surgery Company eventually became the Royal College of Surgeons of England which it remains today. Many modern surgical societies, charged with establishing, promoting and advancing surgical disciplines, can trace their roots back to the creation of the Royal College of Surgeons including our own American College of Surgeons. Surgery has since made tremendous advances and we simply cannot envision a modern healthcare system without surgery. In fact, it is estimated that 11% of the global burden of disease requires some form of surgical treatment and lack of access to surgical services remains a Global Public Health challenge.
The Barber Pole serves as a sentinel reminder of the humble and tortuous beginnings of a field of study which has benefited untold millions and elevated the human condition. It is a fascinating testimonial to the business, politics, and social evolution involved in formalization of an important discipline which we take for granted today. It is the reason why accomplished Senior Surgeons in the UK prefer the appellation of Mister to Doctor — a nod to the unadorned (by academic title) and pioneering Barber-Surgeon of a few centuries ago.
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon with additional training in Breast & Microsurgery. Dr. Reddy was fortunate to have studied the History Of Medicine at St. John’s College, Oxford University while an undergraduate.
P. Pravin Reddy, MD is a Board Certified Plastic & Reconstructive Surgeon and a member of the American Society of Plastic Surgeons.