Barber Surgeons Research Articles

History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt

BACKGROUND. Inspection of or interventions in the external ear canal and the nostrils pose similar technical problems. This is the reason why early instruments devised for otoscopy and rhinoscopy were based on an identical principle. They were shaped like a pair of tongs, comparable to nasal specula of today. A similar type of instrument had been developed earlier by barber surgeons for inspecting narrow wound cavities. TONG-SHAPED SPECULA. The first description and illustration of an aural and nasal speculum was provided by Guy de Chauliac in Montpellier, France in 1363. Sophisticated models were presented by Fabricius Hildanus in Germany in 1646 and J.J. Perret in Paris in 1772, who offered them in his illustrated catalogue of surgical instruments at fixed prices. W. Kramer (1836) in Berlin improved this tong-shaped instrument and devised the ear speculum named after him that was generally favored during the first half of the 19th century. Further variations of this type were presented by Lincke and Schmalz (1846) in Germany. FUNNEL-SHAPED SPECULA. Ignaz Gruber in Vienna in 1838 devised the first tunnel-shaped ear specula made of metal. They had a simple conical shape, were not divided into separate jaws, and could not be spread. Gruber himself did not publish his invention, but he demonstrated his ear specula to W. R. Wilde from Dublin, who had paid a visit to his office in Vienna. Wilde reported on this in 1844, and subsequently systematically refined Gruber's specula. A. v. Tröltsch from Würzburg (Germany) had seen these instruments at Wilde's office and it was Wilde himself and v. Tröltsch who helped this type of ear speculum to gain acceptance on an international scale. A different type of bottle-shaped ear speculum was first used by Schmalz (1846) and Erhard (1859) in Germany, but it was only developed into a commercially available instrument by Josef Gruber in Vienna in 1870. The ear specula most in use today were first presented by A. Hartmann in Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

Dentistry--the dependence upon medicine and surgery for its professional status.

As a profession, dentistry was set on its course in 1858. We are still living with the consequences of the 1858 Medical Act, which placed dentists under the authority of the general surgeons. Our history is more complex than just evolution from the barber surgeon. This essay traces the development of the profession of dentistry and makes a comment about its future autonomy.

Who doesn't need vascular medicine?—A team approach to vascular care and the role for vascular medicine

The possibilities for diagnosis, treatment and followup of peripheral vascular disease has come a long way since the old days when treatment was often dubious and frequently involved amputation by a barber surgeon. Where are we now? Fortunately, although dubious remedies are still available, we can now rely on medicine and surgery and the many subspecialties that have sprouted from these parent disciplines. The developments in both technology and biology demands the organisation of patient care by vascular teams and the recognition of vascular medicine as part of internal medicine. New hopes and promises of treatment for peripheral vascular disease emerge with surprising frequency. The balloon angioplasty catheter is the product of a dazzling evolution towards a high-tech versatile tool. The techniques and results of vascular surgery are continuously being improved, and intensive care facilities make more complicated operations feasible. Technological developments have led to a large increase in the volume of both angioplasties and operations, although amputation rates do not seem to have improved. 1 Tailor-made medical treatment has become more rational and may become more successful with the introduction of new drugs. Other classes of drugs will emerge based on insights in molecular and cell biology in general and on the mechanisms of atherosclerosis and intimal hyperplasia in particular. The crucial role of risk factors for the development or premature atherosclerotic disease has become better recognised. For some of these, e.g. hypercholesterolaemia, drug treatment has become more effective. With all of these developments the care of the vascular patient can no longer be regarded as a field for one specialist in the traditional sense. For example, it has become clear that balloon angioplasty can be applied effectively and safely in some vessel segments but that in other segments vascular surgery is required. The roles of the vascular surgeon and the radiologist have therefore become complementary and both specialists can co-operate fruitfully to restore the circulation. Territorial wars between surgeons and radiologists do not serve the patients'

Samuel Pepys and his Bladder Stone

Samuel Pepys, as a young man, developed a bladder stone and, by the age of 25 years, realised that only surgery could deliver him from his agony. The chances of success in an age that was ignorant of sepsis were slender, but he opted for surgery. The operation, carried out through the perineum without anaesthetic by a master barber surgeon, was successful and Pepys survived. Although left sterile, he was far from impotent and he went on to achieve fame and fortune as Secretary to the Navy and President of the Royal Society. His greatest fame came after his death with the publication of his diary, which was to become one of the best known and best loved books in the language.

The resurgence of the barber surgeon

The resurgence of the barber surgeon

The past, present and future of German surgery

It is imperative that all surgeons familiarize themselves with the history and development of his chosen field. Until the 18th century, surgery in Germany and other areas of Europe was not performed by physicians but by barber surgeons. Surgeons originated from these ranks. In the second half of the 18th century, Bernhard von Langenbeck was one on the founders of surgery in Germany. He was one of the most respected teachers of his time and his most famous student was Theodor Billroth who formed the school from which von Miculicz and Sauerbruch graduated. This was the time of remarkable innovations, namely the development of asepsis by Bergmann, the first laryngectomy and the first gastric resection by Billroth and the first cholecystectomy by Langenbuch. Bier introduced lumbar anesthesia, Schleich infiltration anesthesia, Kehr developed surgery of the bile ducts and von Esmarch performed amputations of the extremities, under conditions of exsanguination. In 1872, Langenbeck, Simon, and Volkmann founded the German Association of Surgery. The world-known Operationslehre von Bier-Braun-Kümmell and the surgical manual by M. Kirschner was then published. At the beginning of the 19th century, Sauerbruch paved the way for thoracic surgery with use of the low pressure method. Forssmann succeeded in the catheterization of the right heart. M. Kirschner performed the first successful embolectomy and the first bridging of an defect of the esophagus. During world War II, German surgery lost touch with international developments and reestablishment followed with the schools of K.H. Bauer in Heidelberg and of R. Zenker in Marburg and Munich and others. Zenker's contributions to cardiosurgery are particularly remarkable.(ABSTRACT TRUNCATED AT 250 WORDS)

The anniversary of a medical school: an exhibition

The anniversary of a medical school: an exhibition

The barber surgeons help the sick poor.

Journal Article The Barber Surgeons Help the Sick Poor Get access THOMAS R. FORBES THOMAS R. FORBES Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of the History of Medicine and Allied Sciences, Volume XXXI, Issue 4, October 1976, Pages 461–462, https://doi.org/10.1093/jhmas/XXXI.4.461 Published: 01 October 1976

The Plot Against the Patient

Here we go again. The a cappella choir of<i>The Plot</i>sings<i>l'allegro</i>about the modern barber surgeons who conspire against the patient for the sake of his money and without sincere regard for his health. The ending,<i>il penseroso</i>, is the plea for the total welfare state in medicine. Ho hum. For more than 300 pages the book repeats all the shoddy history of the American Medical Association, the private health insurance scandal, the shocking sink tests run by the best hospitals, and the burial of the hospital's and the physician's mistakes. The situation is dreadful, including the "huge publications projects centered about the<i>AMA Journal...</i>" In lucid English this book has quoted condemnatory records of the past generation or more, indicting American medicine, and occasionally praising foreign medicine as better than that in the United States. Taking the book at its face value, it is necessary to conclude

Canadian Pharmacy in Preconfederation Medical Legislation

No laws governed the practice of medicine in the early days in New France. Letters patent from the King, and even degrees, were easily obtained by those who would practice as physicians, surgeons, apothecaries, midwives, and bonesetters. Many of the more qualified persons were connected with the religious orders or with the military. 1(p14) In 1658, Jean Madry, "a practising physician of the Corporation of Barber Surgeons of Paris," returned to Quebec, carrying with him a King's commission authorizing him to institute a school of barber surgeons. He did not start such a school, and no law existed that physicians, surgeons, apothecaries, or midwives were required to attend any school. However, Madry did train apprentices. 2(p225),3(p16) Abuses of laissez-faire systems develop inevitably. When they did in New France, the Intendant Bigot responded in 1750 with a bill ( L'Acte Medicale du Canada ) which Heagerty considers the code of the medical profession

Pioneers of Medical Teaching in the Province of Quebec

Under the French regime (circa 1600-1763). medical education did not exist other than through apprenticeship. According to Nadeau,1only three men were in possession of a valid physician's or surgeon's diploma. They were Jean Bonamour, Antoine Briault, and Michel Sarrazin. All the others were barber-surgeons or assistants, trained in France before they left that country, or men who had been assistants to barber-surgeons, with no other training. Michel Sarrazin, a barber-surgeon, returned to France, and after two years of medical studies in Reims, he received a degree of doctor of medicine from the medical school of that city. Although the King of France appointed Jean Madry, Jean Demosny, Michel Sarrazin, and Jourdain Lajus as master barber surgeons, no formal instruction was available in New France other than by apprenticeship. In the majority of cases, sons were apprenticed to their fathers, as evidenced by the names of Alavoine, father and

Pioneers of medical teaching in the Province of Quebec

Under the French regime (circa 1600-1763). medical education did not exist other than through apprenticeship. According to Nadeau,¹only three men were in possession of a valid physician's or surgeon's diploma. They were Jean Bonamour, Antoine Briault, and Michel Sarrazin. All the others were barber-surgeons or assistants, trained in France before they left that country, or men who had been assistants to barber-surgeons, with no other training. Michel Sarrazin, a barber-surgeon, returned to France, and after two years of medical studies in Reims, he received a degree of doctor of medicine from the medical school of that city. Although the King of France appointed Jean Madry, Jean Demosny, Michel Sarrazin, and Jourdain Lajus as master barber surgeons, no formal instruction was available in New France other than by apprenticeship. In the majority of cases, sons were apprenticed to their fathers, as evidenced by the names of Alavoine, father and

The Case Reports and Autopsy Records of Ambroise Paré

Paré lived in an exciting time of change. By his great capacity he managed to survive the many fluctuating religious and political conflicts which characterized the dissolution of the medieval age in the Sixteenth Century. For the Huguenot doctor of Catholic rulers this was no small feat. Cracks were beginning to show in the hard carapace of authority, and man was beginning to get exciting new ideas about the possibility of shaking off traditional limits and exploring in many new directions. Medical and surgical knowledge had been sanctified, codified, and encrusted. The authority of the church established another body of authoritarian constraints. Paré used the only method available for a poor barber surgeon to advance. He spent several years as "house-officer" in the Hôtel-Dieu. Military surgery presented his best chance for progress and a magnificent opportunity for accumulating experience in developing the swift dexterity required to help salvage some of

Henry VIII and the Barber Surgeons — Keeping Warm — Patient's Association

A MOST interesting exhibition has recently been held at the National Portrait Gallery to mark the rediscovery of Holbein's original cartoon for his famous portrait group, Henry VIII and the Barber...

Medical specialism and the boards.

At Conference on Specialism in Medicine1in 1959 specialism and particularly Specialty Boards came in for considerable criticism. Gladston2reminded us that specialism was first pursued mainly by laity. The lens coucher, tooth extractor, lithotomist, bone setter, midwife, masseur and barber surgeon were specialists of middle ages . . . . They were, as so many are today, technicians, men skilled in crafts rather than knowledgeable in theories. Galdston divided practice of medicine into two major categories: episodic and maintenance. Episodic medicine, as term implies, is medicine practiced in emergency situations . . . . Maintenance medicine is devoted to fostering every day well-being of individual . . . . Episodic medicine is primarily and predominantly realm of specialist. In a previous paper Galdston3stated that the future of medical service is not to be envisaged as a continued refinement, as well as increase, in

SOME COMPLICATIONS OF TRANSFUSION, ENDOCRINE THERAPY AND OXYGEN ADMINISTRATION

IN NO FIELD has medical opinion reversed itself so completely as in that of blood letting versus blood replacement. A short time ago while visiting the reconstructed colonial town of Williamsburg, one saw the tools of the old barber surgeons. A copy of a manuscript on the wall stated that George Washington was bled on several occasions during his terminal illness, without seeming benefit. In this paper, I would like to emphasize some of the ills of blood replacement rather than withdrawal. Due to the impetus given by life-saving transfusions during the war, blood transfusion has become universally available in all parts of the country. This has not proved an unmixed blessing, however, for the dangers associated with blood transfusion have also been greatly multiplied thereby. The factors which give rise to these dangers are as follows: 1) those associated with donor; 2) those associated with stored blood; 3) those associated with act of transfusion; 4) those associated with recipient. 1. Factors Associated with Donor 1. Homologous serum jaundice. 2. Allergic reactions. 3. Transmission of tropical and other infections. The danger of transmitting the virus which causes jaundice is greater than may be realized, and is rebated to the incidence of the carrier state in the population. The incidence in the general population has been estimated as from 0.1% to 0.5% to 0.35%. In one Army Camp in the United States it was found to be as high as 5%. As one might expect the danger of transmission is greatest the more recently the donor has had jaundice, but some work in Germany suggests that even 6 years or more after having hepatitis, donors may transmit the virus to 3.6% of recipients.

Nursing in Sweden

TODAY Sweden is said to have the lowest infant mortality in the world, and its state control of medical education is often commented on. Regardless of this, Sweden's history of nursing dates back only to 1850. But if one ventures to investigate, one discovers the singularly illuminating history of the Swedish midwife who, up to the dawn of the modern nursing movement, held the respected state position of midwife and nurse in every district. Today there are 3,000 practicing, licensed midwives in Sweden, while the total quota of trained and semitrained nurses is 5,000. Only 800 of these midwives are practicing in cities and towns, while 2,200 have been assigned by the state to country sections. In Sweden 80 per cent of deliveries are conducted by midwives, while in America 80 per cent are conducted by physicians. In Sweden supervised midwife practice has been in vogue for more than 200 years. Aside from the midwife, Swedish medical history reads like the records from other lands. At the dawn of history the Swedes were warriors and exploring Vikings. In 800 A.D., disciples of Christianity began to spread the message of a forgiving God, who soon was to replace the heroes of war and thunder of the Norse mythology. With this new religion their social attitude changed slowly into compassion for their fellow men. A period of healing by supernatural means, crusades to saints' graves, et cetera, coincided with their adoption of the new faith. The first hospital of which we have any record was built at Lund, the university town in the south of Sweden, in 1149. The second was at Visby, the trading center of the Hanseatic League, 1218. These hospitals were established chiefly for the incurables, poor, sick, and mentally ill. The personnel who cared for the inmates of these hospitals of Catholic Sweden in 1300, were monks and nuns. The predominant diseases seem to have been leprosy, Oriental plague, and smallpox. The hospitals were built outside of the city walls, and they were supported by voluntary contributions. Since 1530 the state has been in control of all medical education in Sweden. In that year Gustavus Vasa adopted the reformation for Sweden, and since then the country has been predominantly Lutheran. At that time the cloisters, with all their property, were turned into hospitals of the state. Other new institutions were built, chiefly for the use of paupers and the sick. In the country districts small nursing homes of five to six beds were established. Undoubtedly the nuns did some of the nursing still, but the staff listed is a man helper, a housekeeper, a priest, and a doctor. Barber surgeons and quack apothecaries served with the army and navy in times of war. Definite steps to safeguard the public health of the country and to improve medical teaching were taken in 1595, when a medical faculty was established at the University of Upsala. At that time barber surgeons were compelled to take examinations before practicing their trade. In addition an appeal to professional men of the better classes was sent out, in which lawyers were urged to practice medicine as a hobby. Thus, often medicine and law became the dual lifework of many prominent men, and this combination is to be noted. For even today public health

The Company of Barber Surgeons and Tallow Chandlers of Newcastle-on-Tyne

The Company of Barber Surgeons and Tallow Chandlers of Newcastle-on-Tyne

The Gild of Barber Surgeons of the City of York

The Gild of Barber Surgeons of the City of York

Guy Patin and the Medical Profession in Paris in the XVIIth Century

THE present volume by Dr. Francis Packard, whose “Life and Times of Ambroise Pare (1510-1590)” was noticed in our columns on March 3, 1923, p. 281, has been reprinted with additions from the “Annals of Medical History,” of which he is the editor. The work is divided into nine chapters, commencing with a historical foreword which contains an account of contemporary politics, the later chapters dealing with Patin's education, his home life and literary interests, his opposition to cinchona and antimony, and his relations to the surgeons, barber surgeons and apothecaries. A special chapter is devoted to a description of the Paris medical faculty in which Patin's life interest was centred. “No praise,” says Dr. Packard, “was too fulsome for those who furthered its cause and no abuse too savage for those who dared to attack it.” Of particular interest are the pages concerned with Patin's relations to Moliere, his controversy with Theophile Renaudot, the gazetteer and quack, and his quarrel with the physicians of Montpellier.