The barber surgeon is one of the most common medical practitioners of medieval Europe — generally charged with looking after soldiers during or after a battle. In this era, surgery was not generally conducted by physicians but by barbers (who had a sharp-bladed razor as an indispensable tool of their profession). In the Middle Ages in Europe barbers would be expected to do anything from cutting hair to amputating limbs. Mortality of surgery at the time was quite high due to loss of blood and infection. Doctors of the Middle Ages thought that taking blood would help cure the patient of sickness so the barber would apply leeches to the patient. Physicians tended to be academics, working in universities, and mostly dealt with patients as an observer or a consultant. They considered surgery to be beneath them.
They often took up residence in castles where they also provided medical assistance to the wealthy.
Due to religious and sanitary monastic regulations, monks had to maintain their tonsure (the traditional baldness on the top of the head of Catholic monks) and be bled regularly. This created a market for barbers, because each monastery had to train or hire a barber. They would perform bloodletting and other minor surgeries like pulling teeth or creating ointments. The first barber surgeons to be recognized as such worked in monasteries around 1000 A.D.
Because physicians performed surgery so rarely, the Middle Ages saw a proliferation of barbers, among other medical "paraprofessionals", including cataract couchers, herniotomists, lithotomists, midwives, and pig gelders. In 1254, Bruno di Longoburgo, a physician who wrote on surgery, was concerned about barbers performing phlebotomies and scarifications.
In Paris, disputes between doctors led to the widespread patronage of barbers. The College of St. Cosme had two levels of student doctors: doctors who were given a long academic robe were permitted to perform surgeries and doctors who were given a short robe and had to pass a special examination before being given that license. The short-robed doctors were bitter because the long-robed physicians behaved pretentiously.
The short-robed doctors of St. Cosme entered into an agreement with the barber surgeons of Paris that they would offer the barber surgeons secret lessons on human anatomy as long as they swore to be dependents and supporters of the short-robed physicians. This secret deal existed from around the time of the founding of St. Cosme in 1210 until 1499, when the group of surgeon barbers asked for their own cadaver to perform their anatomical demonstrations. In 1660, the barber surgeons eventually recognized the physicians' dominance.