If you were an average person living in Europe between the 12th and 16th centuries and feeling a little under the weather, it would be quite normal to visit the local barber-surgeon for a bloodletting.
Barber-surgeons would advertise their services with signs like this one, or simply by placing a bowl of blood in the shop window. Likewise, they displayed their dental treatments with strings of pulled teeth hanging from the walls. Note the anguished expression on the face of the patient having his tooth pulled – no anaesthetic here.
While you were waiting your turn, you might sip from a flagon of ale or strum a musical instrument. Barber-surgeons’ shops weren’t just medical offices – they were spaces for socialising, entertainment and even drinking. Learning to sing was part of an apprentice barber-surgeon’s training (sounds a lot more fun than a trip to the doctor’s office today).
The other visitors might be there for a bloodletting, a tooth-pulling or a simple shave and trim. True to their name, barber-surgeons were also barbers. In fact, in the early days of the profession, they probably used the same lancets to shave faces as they did to bleed veins.
To determine which vein to bleed, your barber-surgeon might refer to a diagram like this one. Unlike university-educated physicians, barber-surgeons were considered to be simple artisans, and most were of the same social status as their clientele. But that doesn’t mean they didn’t know their craft. In fact, the predominance of barber-surgeons led to a boom in the publishing of vernacular medical texts! Barber-surgeons made good use of these guides. Some of them are even marked with bloodstains.
Along with their guidebooks, your barber-surgeon would consult the heavens. Each sign of the zodiac was believed to govern a different part of the body, causing the humours within it to wax and wane. If the moon were in Aries, for instance, bleeding the veins of the face would be much too risky.
After cutting the appropriate vein, a bleeding bowl, like this one, would be used to track how much blood you had lost. Usually, patients would be bled to the point of fainting. The goal of the treatment was to restore the balance between the body’s four humours, as an imbalance of the humours was believed to be the source of all disease.
Even emotional problems like melancholy, rage and lovesickness could be cured by shedding blood. The physician George Thomson argued that, depending on the quality of our blood, “our morality may be good or bad”. Bloodletting was believed not only to cure disease but to safeguard general health. People went for yearly springtime bloodlettings, whether they were sick or not.
However popular, bloodletting was painful, harsh and sometimes dangerous. Eventually, concerns over its potential risks led many doctors to switch from the lancet to the leech, a much gentler and less painful process. As leeches grew in popularity, apothecaries began to display their wares in extravagant jars like this one. Inside, the jars were filled with rainwater, pebbles and moss, to mimic the leeches’ natural environment.
The leech was seen as not just a tool, but a worthy assistant – courteous, dutiful and even civilised. Nonetheless, the collaboration between doctor and leech was not always easy. In particular, it was sometimes a struggle to get the leech to latch onto the right spot. Eventually, this led to the development of glass leech tubes, like these, which were used to guide leeches to exactly where they were needed.
The ‘leech craze’ reached its peak in the late 18th and early 19th century. By then, leeches were in such high demand that gathering them became a lucrative occupation. Women would wade into leech-infested ponds and wait for the worms to attach themselves, then gather them to sell to the local apothecary. By the mid-1800s, the leech’s popularity had made it an endangered species. Even today, the medical leech is extinct in much of its natural range.