Medieval Plague Doctors: Masked saviours or grim harbingers of impending death?

Medieval plague doctor standing in an empty street
© History Skills

The Middle Ages, a period marked by grand castles, knights in shining armor, and the rise of nation-states, was also a time of profound fear and suffering due to the rampant spread of deadly diseases.

 

Among these, the Black Death, or the Bubonic Plague, was the most devastating, wiping out an estimated 75-200 million people across Europe in the 14th century.

 

In the face of this unprecedented catastrophe, a unique figure emerged from the shadows - the Plague Doctor. Cloaked in a distinctive costume with a beak-like mask, these medical practitioners became the frontline warriors in the battle against the plague.

Who were the first plague doctors?

The advent of the Plague Doctor is deeply intertwined with the history of the Black Death, one of the deadliest pandemics in human history.

 

The disease first struck Europe in 1347, arriving on merchant ships infested with plague-ridden rats.

 

Within a span of five years, it decimated between 30% to 60% of Europe's population.

 

The scale of the catastrophe was so immense that it necessitated the creation of a specialized role to combat it - the Plague Doctor.

Early Plague Doctors were often second-rate doctors or surgeons unable to establish a successful practice, medical students still in training, or even individuals with no professional medical background.

 

They were hired by towns and cities, and their primary duty was to treat and care for plague victims, irrespective of their social status.

 

These doctors were also tasked with recording in public records the deaths due to plague, a grim statistic that helped authorities gauge the severity of an outbreak.


What did plague doctors wear?

One of the most distinctive aspects of the Plague Doctor was their unique costume, which has since become an iconic symbol of the Black Death.

 

The costume was not merely for show; it was designed with the intention of protecting the doctors from the deadly disease they were fighting.

 

The costume was first described by Charles de Lorme, a prominent physician of the 17th century who is often credited with its invention.

 

According to de Lorme, the costume was "made of Moroccan leather," and was designed to cover the doctor's entire body, shielding them from potential infection.

The most recognizable feature of the Plague Doctor's costume was the mask, which had a beak-like shape.

 

This 'beak' was not a whimsical design choice; it served a practical purpose. The beak was filled with aromatic substances and straw, which were believed to purify the air the doctor breathed.

 

This was based on the miasma theory of disease prevalent at the time, which postulated that diseases were spread through 'bad air'.

 

The costume also included a wide-brimmed hat, which indicated the doctor's profession, and a long, waxed overcoat.

 

The overcoat, along with leather breeches, gloves, and boots, created a barrier between the doctor and the outside world.

 

To further protect themselves, doctors carried a wooden cane, which they used to examine patients without touching them.

Despite its practical intentions, the costume was far from perfect. The understanding of disease transmission was rudimentary at best during the Middle Ages, and the costume provided limited protection.

 

However, it did offer some psychological comfort to the doctors and made them easily identifiable in a crowd.

Medieval plague doctor beaked mask
© History Skills

How did doctors try to cure the plague?

The medical practices and treatments employed by Plague Doctors were a reflection of the medical understanding of the time, which was, unfortunately, quite limited.

 

The germ theory of disease, which underpins modern medicine, would not be developed until centuries later.

 

Instead, the prevailing theory was that of miasma, or "bad air," which was believed to be the cause of the plague and many other diseases.

 

Plague Doctors were known to use a variety of treatments, many of which would be considered bizarre or even harmful by today's standards.

 

Bloodletting, for instance, was a common practice. This involved cutting open a patient's vein and allowing them to bleed, with the belief that this would balance the "humors" in the body - blood, phlegm, black bile, and yellow bile - and thus restore health.

Another common treatment was the use of "plague water," a concoction of various herbs and sometimes even crushed emeralds or gold.

 

This was either drunk by the patient or applied to their buboes - the painful swellings characteristic of the plague.

 

The effectiveness of these treatments was, at best, questionable, and at worst, detrimental.

In addition to these treatments, Plague Doctors were also responsible for issuing health advice to the public.

 

This often included recommendations for maintaining personal hygiene, cleaning homes, and avoiding crowded places.

 

They also advised on dietary habits, suggesting foods that were believed to strengthen the body against the plague.


What did people think of the plague doctors?

As the Black Death swept across Europe, decimating entire communities, Plague Doctors became a common sight, their beaked masks and long robes a stark reminder of the grim reality of the times.

 

On one hand, Plague Doctors were seen as figures of hope. They were often the only ones willing to treat the afflicted, venturing into areas where even priests feared to tread.

 

Their presence offered a semblance of order and control in a world turned upside down by disease.

 

For the sick and dying, the arrival of a Plague Doctor could mean the difference between life and death, and for the healthy, their presence was a reassurance that efforts were being made to combat the plague.

On the other hand, Plague Doctors were also figures of fear and dread. Their distinctive costumes, designed for protection, were alien and intimidating, adding to the overall sense of unease and terror.

 

Moreover, given the high mortality rate of the plague and the limited effectiveness of treatments, the appearance of a Plague Doctor often signaled impending death, leading to their association with the grim reaper.

The public perception of Plague Doctors was further complicated by their social status.

 

Many Plague Doctors were not fully qualified physicians, but rather individuals who had taken up the role out of necessity or opportunity.

 

This, coupled with their high fees and the general ineffectiveness of their treatments, often led to suspicion and resentment.


Famous plague doctors in history

While many Plague Doctors remain anonymous figures lost to history, a few stand out for their contributions to medicine and their impact on society during the time of the plague.

 

Perhaps the most famous Plague Doctor is Nostradamus, known primarily for his prophecies.

 

Born Michel de Nostredame in 1503, Nostradamus was a physician before he became famous for his predictions.

 

He worked during the outbreak of the plague in Provence in the 1540s. Unlike many of his contemporaries, Nostradamus favored hygiene and cleanliness in treating patients, practices that were not widely accepted at the time but are now recognized as crucial in disease prevention.

Another notable Plague Doctor was Giovanni de Ventura of Parma, an Italian physician who treated plague patients in the late 16th century.

 

He was one of the first doctors to perform autopsies on plague victims, a practice that was controversial at the time but contributed significantly to the understanding of the disease.

 

Charles de Lorme is another significant figure in the history of Plague Doctors. A physician to several French kings, de Lorme is often credited with designing the iconic Plague Doctor costume.

 

His contributions to the field, particularly his emphasis on protective clothing for physicians, marked a significant step forward in the history of medical safety.

Lastly, we have Dr. Thomas Sydenham, an English physician who worked during the Great Plague of London in 1665.

 

Known as the "English Hippocrates," Sydenham advocated for direct observation and clinical data in diagnosing diseases, a method that was revolutionary at the time and laid the groundwork for modern clinical practice.


Why did plague doctors disappear?

The era of the Plague Doctor came to an end as the frequency and severity of plague outbreaks diminished over time.

 

The last major outbreak in Europe, the Great Plague of Marseille, occurred in 1720, although smaller outbreaks continued into the 18th century.

 

As the threat of the plague receded, the need for specialized Plague Doctors gradually diminished.

The decline of the Plague Doctor was also tied to advancements in medical science.

 

The 19th century saw significant strides in understanding disease and the human body.

 

The miasma theory, which had been the basis for much of the Plague Doctor's work, was gradually replaced by the germ theory of disease, which posited that specific microorganisms, not "bad air," were responsible for illness.

 

This shift in understanding led to more effective treatments and preventive measures, further reducing the need for Plague Doctors.

Moreover, the medical profession itself underwent a transformation. The practice of medicine became more regulated, and standards for medical education and practice were established.

 

This led to a decline in the number of unqualified or minimally qualified individuals acting as doctors, including Plague Doctors.