It was not until a pope in the thirteenth century forbade the clergy to engage in medicine that Christian laymen in Western Europe became involved in the field. However, though medicine was taught at European universities, surgery was not, and the knife in operations came to be wielded by barber - surgeons, sometimes operating independently, sometimes under the guidance of physician. standard and practices among such barber - surgeons varied tremendously, but some measure of control over qualifications was introduced in Britain, at least, when the company of barber surgeons of London was formed in 1540. some two centuries later, their guild developed into the royal college of surgeons, and by 1800, surgery had been firmly established as part of the medical curriculum.