In medieval Europe, barbers operated as hair cutters and medical practitioners, pulling teeth, bloodletting with leeches, tending wounds and even performing surgeries such as amputations or gallstone removal. Physicians of the time were scholars who considered performing surgeries beneath their dignities. Barber-surgeons were also in great demand during times of war and learned many surgical techniques treating the wounded.
Though bacteria and infection were not yet understood, barber-surgeons used wine as an antiseptic. They also used natural substances as anesthetics, including opium, hemlock, mandrake root and gall of boar. Barber-surgeons performed many external surgeries, such as lancing of boils or treating facial ulcers. Internal surgeries, though attempted, frequently resulted in death from bleeding, shock and infection. The red and white stripes of the barber pole represented the blood and napkins of bloodletting, symbols for the medical treatment available inside the barbershop.
In medieval London, barbers would also advertise tooth-pulling services by displaying strings of pulled teeth and bloodletting by placing bowls of blood in their shop windows. The people of London were so disgusted by this practice that in 1307, they passed a law declaring that all fresh blood must be carried to the Thames for disposal. Typically, embalming and autopsies were also the province of the barber-surgeon.