A cosplayer wearing the long, black nose of a plague doctor poses with a woman in a face mask for a … [+]
Plague doctors, or at least images of plague doctors, are having a bit of a cultural moment again, roughly 300 years after their actual heyday. They’ve become popular motifs for stickers, pins, masks, t-shirts, and even stuffed animals during the Covid-19 pandemic (your faithful correspondent is a particularly gleeful collector). But what’s the reality behind the iconic mask?
Not Just Any Doctor
Plague doctors were government contractors. When the plague struck a European town, the local government hired a doctor specifically to treat plague patients. Some of those contracts still survive in various historical archives around Europe today, mostly in places like France, Germany, Italy, and the Netherlands, and they spell out the plague doctor’s responsibilities, the limits of their practice, and how much the city would pay them.
A plague doctor’s salary could range from a few florins a month to full room, board, and expenses – but it meant the doctor had to treat even the poorest patients, who wouldn’t have been able to pay on their own, and couldn’t refuse to go into a plague-stricken home or neighborhood. On the other hand, plague doctor contracts also forbade plague doctors from treating people who didn’t already have the plague, and they had to stay isolated from the rest of the community when they weren’t elbow-deep in plague victims. Both of those restrictions were meant to keep plague doctors from carrying the disease to uninfected people.
When the plague struck a city, it might already have a doctor or two, usually running a private practice in town. Those guys were not plague doctors, however. For one thing, they ran their own practices, instead of having a contract with the local government. And although they could treat plague patients if they wanted to, many preferred to avoid the risk – for good reason. In 1348, when the plague first reached Italy, many communities found themselves without doctors, because they all died of the plague or ran away. Plague doctor contracts were an effort to fix that problem.
Shocking, when medieval and Renaissance cities tried to hire doctors to do dangerous, depressing, highly stigmatized work that also put huge restrictions on how they lived, doctors weren’t exactly falling over each other to compete for the job. Plague doctors were often newly-trained physicians or surgeons who needed to gain experience and make names for themselves, or else they were doctors who had trouble finding other work or keeping a practice running. Sometimes they weren’t even doctors at all, just people who were willing to wade into the quarantine zone and do their best.
Here To Help
Plague doctors look menacing and spooky today, and they were even more terrifying in the 1600s and 1700s, because when a plague doctor showed up in your neighborhood, it was a sign that things were about to get a lot worse. Of course, that wasn’t the plague doctor’s fault.
In theory, plague doctors were trying to ease suffering and maybe even save lives, but neither they nor their patients had any illusions; plague was nearly always fatal. The best a plague doctor could do was drain blood and lymph from the swollen buboes that gave the bubonic plague its name – but sometimes that only helped spread the infection. By the time the plague doctor appeared on your doorstep, you were already doomed, so a nominally helpful figure became an omen of death.
In practice, the most useful thing most plague doctors could do was to keep records of the number of infections and deaths in their community. Sometimes they also served as witnesses while their patients drew up wills. Once in a very great while they performed autopsies in an effort to understand the disease that had ravaged Europe off and on for centuries.
Dressed for Success
For the first few centuries of bubonic plague outbreaks in Europe, 1348 to 1619, plague doctors didn’t have a particular costume. Around 1619, however, a court physician to Louis XII of France (and later the more famous Louis XIV) named Charles de Lorme proposed a costume to protect plague doctors from their patients’ illness. It caught on elsewhere in continental Europe (there are no known examples from the UK) and became the iconic Plague Doctor costume we know today.
To people who understand how bacteria and viruses spread, and who are used to seeing modern healthcare workers in protective equipment like surgical gowns and respirator masks, the plague doctor costume is clearly a stroke of genius. A long leather gown covered the doctor from head to toe, and beneath the gown they wore leather leggings, boots, and gloves. The beak-like mask, which was originally supposed to be just 6 inches long, was stuffed with dried flowers, strong-smelling herbs, and camphor or vinegar-soaked sponges.
Plague doctors also carried a wooden cane, which let them examine, undress, and direct patients without having to touch them or even get too close. Canes also make handy tools for enforcing social distancing, which was actually something medieval and Renaissance people had realized could slow the spread of plague. They topped the outfit off with a wide-brimmed leather hat, which was mostly a badge of office in case the mask was somehow too vague.
That looks like an early version of a respirator mask and surgical gown, but de Lorme devised the idea to protect not against germs, but against miasma – bad-smelling air which was believed, up until the 1800s, to be the source of diseases. In reality, the plague doctor costume probably did protect the wearer against droplets from coughing, in the case of pneumonic plague, or splattered blood and lymph in the case of bubonic plague. Most importantly, though, the waxed leather probably protected against fleas, which turned out to be the real carriers of the plague.
I am a freelance science journalist, bringing you interesting science tidbits, tales of discovery and critical looks at everything from deadly diseases to space