part of ecclesiastics by the popes and church councils of the twelfth
century, culminating in the decree of Pope Innocent III in 1215,
which forbade the participation of the higher clergy in any operation
involving the shedding of blood (_Ecclesia abhorret a sanguine_); the
relatively scanty supply of educated lay physicians and surgeons, and
finally the pride and inertia of the lay physicians themselves; all
these combined to relegate surgery in the thirteenth century to the
hands of a class of ignorant and unconscionable empirics, whose rash
activity shed a baleful light upon the art of surgery itself. As a
natural result the practice of this art drifted into an _impasse_,
from which the organization of the barber-surgeons seemed the only
logical means of escape.

The earliest evidence of the public surgical activity of the barbers,
as a class, is found, I believe, in Joinville's Chronicle of the
Crusade of St. Louis (Louis IX) in the year 1250. According to
Malgaigne, no trustworthy evidence of any organization of the
barbers of Paris is available before 1301, and the fraternity was not
chartered until 1427, under Charles VII. The barbers of London are
noticed in 1308, and they received their charter from Edward IV in
1462. The parallel lines upon which the confraternities of the two
cities developed is very noticeable--making due allowance for Gallic
enthusiasm and bitterness.

Lanfranchi, the great surgeon of Paris, about the year 1300 is moved
to write as follows:

"Why, in God's name, in our days is there such a great difference
between the physician and the surgeon? The physicians have abandoned
operative procedures to the laity, either, as some say, because they