Modern scholars have noted that the work of surgeons and physicians in the later-medieval period often overlapped. In the thirteenth century, surgeons who also practised as physicians reserved authority over both the practical and theoretical arts. In doing so they claimed that a medicus should not only be a surgeon but also a learned physician as bloodletting and purgation were also necessary in carrying out their work. The dynamic interaction of social, economic, and intellectual pressures that underpinned medical practice is evident in the medical texts of this period. This paper examines a work produced c. 1300 referred to by its translator, Jean de Prouville, as a Ciurge or Chirurgie: ‘A Book of Medicine’. Its contents are based on an earlier Latin surgical work by an Italian writer but it is known to have undergone numerous changes in the course of its transmission. At one point in Jean de Prouville’s vernacular version he claims that he only intends to treat infection and not to embellish. Nevertheless, there are signs that his advice aims to do more than that and in doing so authorises its own forms of disfigurement to achieve the goal of acquiring a perfect complexion.