Plague Doctors – the Last Word

Disappointingly, this is probably what most plague doctors actually looked like.
Ivory figurine, circa 1700 (DMMI object no. AB / 0315)

To finish up what’s become a series of articles on this subject, I wanted to get back to the nub of things; what did plague doctors really wear, for the most part? How common was the beak mask really? It almost certainly did exist, but what was the typical plague doctor’s outfit, and by ‘typical’, I mean the outfit that was commonly used. If, as seems to be the case, the birdlike beak was the exception rather than the rule, the rest of the outfit is actually really common. So common, in fact, that it was worn by anyone that could afford it who found themselves dealing with the plague, not just the doctors (more on this later). Now, for all we know, the form of the waxed cloth robe for use by clergy may have differed from that worn by medical staff, but it’s the same idea. This is because the waxed coat or robe as protection from disease was pretty much received wisdom by the early 18th century, and had been around for at least a century, as we’ve seen in my previous witterings.

We’ve seen Muratori’s advice on waxed linen clothing in my last article – see also my first article for the advice of Delorme (c.1620) and Chicoyneau (1721) in France, and the wording of the Italian engraving (1656). I’ve since found more evidence for the clothing. Waxed canvas and smooth leather are the top recommendations pretty much across the board. Carlo M. Cipolla’s book ‘Fighting the Plague in Seventeenth-century Italy’ does a great job of showing how widespread the advice around clothing was in the Italian states. Intriguingly the waxed robe seems to have been an invention of Florence, and around the same time as the French were using smooth leather. Cipolla does rather conflate the beak mask version of the outfit with the more common waxed linen robe; I’ve chased down his various sources and none clearly detail the beak mask. He implies (p. 11) that the classic plague doctor costume was worn in Bologna, Verona, Lucca, Florence, and ‘minor Tuscan communities such as Montecarlo, Pescia, and Poppia.’ His quoted source for Verona (Pona, Il Gran Contagio, p. 30) states “During this bad epidemic, following the practice of the French physicians, the town of Lucca made a provision that the plague-doctors ought to wear a long robe of thin, waxed cloth. The robe had to be hooded and the doctors had to visit the patients with the head covered and wearing spectacles.” There’s no mention of a beak or even a mask here; just a hood and spectacles. Likewise, his source for Florence actually states; ‘…surgeons, and apothecaries wore a robe made of waxed cloth and garnished with a red color; this sort of apparel is useful and protects from contagion and for this reason is also worn by the clergymen when they administer the sacraments to the sick” (Catellacci, ed., “Curiosi ricordi,” p. 38). Cipolla also references Rondinelli, Relazione del contagio, p. 54, but this doesn’t seem to address protective clothing at all, as far as I can tell, and is part of a section discussing quarantine. If anyone can find anything relevant in this source, please comment below. Page 89 does mention a waxed canvas habit for clergymen visiting the sick, but again, no details of a beaked mask or hood. Cipolla (p.11 again) explains that in 1631 the ‘health board’ at Florence was supplying waxed robes to doctors in other communities that could not obtain suitable robes otherwise. He also mentions one of the approved alternatives; silk “or other material with little or no hair,’ from a Piedmontese ordinance of 1630. This is also the source for barbers wearing these robes, not just physicians and surgeons.

I’ve found more to add to his cited sources too. ‘Trattato della peste’ by Giovanni Francesco Fiochetto (1631) specifies ‘…che si facino sopravesta di tela incerata ben allistciata…’ – that those at risk wear an overcoat of waxed canvas. ‘Ricordi di Fabritio Ardizzone fisico intorno al preservarsi, e curarsi della Peste’ (1656, p. 36) also recommends waxed robes, but gives another option; taffeta:

‘…oltre che può anco rimediarsi con rener sempre sopra i vestimenti una cappa di coio bagnata d’aceto, è vero di taffettà, è tela incerata.’

Accounting for archaic spelling, this translates as;

‘…it can also be remedied by always wearing over the clothes a leather cloak covered with vinegar, or taffeta or waxed canvas.’

This isn’t the only source that I found specifying soaking in vinegar, presumably following the same ‘strong smells’ logic as the herbs in the plague mask’s beak, or simply recognising the (actual) cleansing potential of dilute acetic acid. Finally, travelling antiquarian, Domenico Sestini, also reported advice on dealing with the plague, in this case that of Constantinople in 1778, in ‘Della Peste di Constantinopoli del MDCCLXXVIII’ (1779):

‘Assistendo infermi, o associando cadaveri, dovrebbero essere obbligati a lavarsi frequemente.

E converrebbe per quanto soffe possibile, che usaffero abiti di materie meno suscettibili. Nell’atto poi, che soffero in attuale assistenza di malate peste, converrebbe che soffero coperti di una cappa d’incerato.’

‘When assisting the sick, or associating with corpses, they should be forced to wash frequently.

And it would be worthwhile, as far as possible, that they should wear clothes of less susceptible materials. In the event that they must assist victims of the current plague, it would be worthwhile that they would be covered with a waxed canvas cloak.’

This advice goes way back. ‘Informatione del pestifero, et contagioso morbo’ by Giovanni Filippo Ingrassia was published in 1576 (p. 203), stating;

‘La terza cautela farà quanto ai loro vestiti, cioè che si facciano una coverta sopra i suoi vestiti di tela incerata, molto ben allisciata, di modo che maneggiando le robe, non si piglino quei seminari principi; da quelle infettate, è li còmunichino poi alle altre non infette, come farebbono con vestiti di lana, o altri pelosi, Inoltre si lauino, & nettino spesso, che non stieno sozzi, come è le solito, che in questo modo essi mantenerebbono la peste.’

My terrible machine-assisted translation being;

‘The third caution will take as far as their clothes are concerned, that is, that they cover themselves over their very well-smoothed waxed canvas clothes, so that when handled in seminaries the infection is not passed to other uninfected people, as would occur with woollen or other ‘hairy’ clothes, moreover they wash and clean often, so as to not be filthy, as is usually the case, that in this way they maintain the plague.’

There are also two other depictions of plague doctors – or others rendering aid to plague victims wearing presumably this waxed canvas gear, this time with a hood-style mask, albeit without the iconic beak (or for that matter, the Bautta & Larva). Significantly, these hoods feature the same long bib at the front as two of the recorded Italian beaked examples that I’ve covered previously; but they lack the beak and are floppy cloth, not stiff leather (or whatever those photographed and sketched beak masks were actually made of). These depictions are both French and both from the Deutsche Medizin Museum – an ivory statuette (see top of this article) dated circa 1700 (DMMI object no. AB / 0315), and an 1826 watercolour painting depicting a doctor (or other medical person?) of the Marseille plague of 1819 (DMMI, Hyg 354 1826-2 Europe). Both are published in Marion Ruisinger’s recent chapter ‘Fact or Fiction: Ein kritischer Blick auf den »Schnabeldoktor«’ (part of this German-language book, but there is a series of blog posts available on the museum’s website, including a summary of her very sceptical take on the museum’s own plague doctor’s mask here). 

Plague clothing from the Marseille plague of 1819
(DMMI, Hyg 354 1826-2 Europe), 1826. Note the clogs – 18th century crocs?

These guys look a little KKK for modern sensibilities, but the idea is a cheaper, easier version of the plague doctor outfit. There’s no hat, and no glass eye lenses. The old rod or cane is replaced by a stick with a burning end, used to burn plague bruises (!), or by a long wooden handle with a basket of smouldering material to essentially fumigate indoor spaces against miasma. As a quick aside, Muratori mentions this as well (1710 edition, p. 103);

‘Entrino colà portando avanti a se vasi di fuoco, che faccia fumo. Entrati aprano le finestre, e gli uscì, ritirandosi, finchè l’Aria abbia fatto un poco di ventolamento, e dispersi que’ maligni vapori.’

‘They go in there, carrying pots of fire ahead, making smoke. Once inside they open the windows, and retire until the air has made a little ventilation, and the evil vapors are dispersed.’

The sleeves on this get-up are tight to the wrist like modern protective gear, which fits the admonition above to not wear fancy sleeves (Ruisinger questions the 1656 engraving on this basis; the man has voluminous sleeves and may not even be wearing gloves. To this I would suggest that views on miasma were a matter of opinion, not science). The most interesting aspect for me is that the hood has a long bib at the front; a feature shared with two of the Italian beaked masks that I featured in my other article. Perhaps those were the ‘Gucci’ option, or just an alternative view on what would work best? There is an interesting parallel for the simple simple with eyeholes a century later in China, by which time miasma theory was obsolete and so the doctors are wearing buttoned-up white coats and gloves, and the workers (because again, this get-up was not just for doctors) have overalls. 

Whilst writing this follow-up I realised that I hadn’t addressed the rod, staff, or cane of the plague doctor. Muratori gives us an indirect confirmation that this was, in fact, a form of ‘social distancing’;

‘…gli espurgatori abbiano manopole, legni lunghi, graffi di ferro, mollette, forchette ed altri ordigni per maneggiare il men che potranno con le mani le robe.’

‘…the expurgators have gauntlets, long wooden sticks, pitchforks, clothespins, forks and other devices to handle things as little as possible.’

Ruisinger also provides a further source for plague clothing in Marseille in 1720-21; Swiss doctor Johann Jacob Scheuchzer, who described the clothing worn in the Marseille plague based upon letters he had received from colleagues;

“Der Kleideren halb hat man sich zu hüten vor allem, was auß Tuch, oder Baumwolle gemachet wird, weilen das Gifft sich leicht an dergleichen Sachen henket. Besser sind die leinernen, seidenen, tafteten Kleider, oder von Cameel-Haaren, noch besser, sonderlich vor die, so um die Kranken seyn müssen, dicht lederne, oder gar von Wachs- und Harz-Tuch, welche von denen Marsilianischen Doctoribus sollen gebraucht worden seyn. Alle Kleider aber sollen reinlich gehalten, offt abgeänderet, zuweilen beräucheret, und in freye Lufft gehenket werden.”

“You have to be careful of clothes that are mostly made out of cloth or cotton, because the poison is easily attached to such things. Better are clothes of linen, silk, or taffeta, of camel-hair, or even better in front of those who are sick, thick leather, or even wax and resin cloth, which are used by the Marsilian doctors. But all clothes should be kept clean, often changed, sometimes smoked, and aired out.”

Again we see the same materials and extensive coverage recommended, the idea being not just that bad smells caused disease, but that particles from rotting tissue were carried into the air. Smooth clothing and cleanliness, as well as a mask to stop you breathing the particles in, would help prevent the spread of disease. This isn’t so far removed from modern science as all that, and the full get-up would have done much toward preventing infection from other people with the pneumonic form of plague, and along with scrupulous hygiene and cleaning of clothes (which these slick fabrics aided in) would have helped against fleas passing on the primary, bubonic form. This was certainly believed at the time, as this line from ‘Li lazaretti della citta’, e riuiere di Genoua del 1657’ by Father Antero Maria di S. Bonaventura (1658, p. 518) shows; 

‘…apertamente li dissi, se voi entrate nell’Infermarie, siate certi di restar uccisi, ò feriti, perché la tonica incerata in un Lazaretto, non hà altro buon effetto, solo che le pulici non si facilmente vi s’annidano, e la spongia [spugna impregnata di aceto] al naso, non serve ad altro, che a mitigar il fetore.

Se parlassimo di quelli, che pratticano solamente per la Città, e che alla sfugita passano ne’ luoghi infetti, non negarei, che qualche cosa valessero li preservativi, e contraveleni, ma in un Lazaretto bisogna mettere la mente in pace, che niente vagliono.’

‘… openly I told them, if you enter the Infirmary, be sure of being killed, or injured, because in a Lazaretto the waxed tunic does nothing other than prevent fleas from lurking in it, and the spongia [sponge impregnated with vinegar] to the nose serves no other purpose than to mitigate the stench.

If we talked about those, who practice only for the city, and who pass through the infected places in passing, I would not deny that sheaths were worth anything, but in a Lazaretto you have to put your mind in peace, that nothing will help.’

In his 1744 follow-up book ‘Lazzeretti della citta, e riviere di Genova del 1656’, Father Antero confirms that he was made to wear ‘una sopraveste di tela incerata’ or a waxed canvas overcoat (1744, p. 190). Clergy wearing anti-plague clothing seems to have been somewhat common. Here’s more evidence from the source that I referenced in my previous piece, ‘Del Governo della Peste’ by Lodovico Antonio Muratori (1721, p. 245);

‘Nel portare il Viatico ai malati, usino i Sacerdoti Veste corta con Cotta e Stola, lasciando stare il Piviale, in cui vece terranno sopra la Cotta una veste di tela incerata.’

‘In bringing Communion to the sick, the priests should wear a short robe with surplice and stole, over which they should wear a waxed cloth robe instead of a cope [priest’s mantle or cloak].’

‘A Doctor of Marseille’

A third variation of plague costume depicted as in use during the Marseille plague is the bulbous-nosed ‘quack’ doctor shown in this engraving by Johann Melchior Füssli (1677 – 1736). I included this last time because Wadd’s 1827 impression of a plague doctor was partially based upon it (plus Manget’s 1721 version). Füssli’s version was popularised by Robert Fletcher’s much later (1898) ‘A tragedy of the Great Plague of Milan in 1630’ (available here). Füssli’s work is another piece of German satire, but rather than copying an original like the Italian-derived ‘Doctor Schnabel’, this piece is an original; a grotesque depiction of a French doctor in his prescribed leather clothing including, perhaps coincidentally as this is France and not Italy, a version of a bautta with the integral buff-like cover for the lower face. Rather than a proper facemask, he has just the nose portion, enlarged and filled with smouldering plant material. The caption translates as ‘Sketch of a doctor of Marseilles clad in Cordovan leather and equipped with a nose-case packed with plague-repelling smoking material. The wand is to feel the patient’s pulse.’ The latter claim is obviously made in jest, implying that the doctor is literally out of touch with his patients. Despite leveraging a fair bit of artistic licence, this is still something of a key source for the existence of masked plague doctors; the impression of the artist at least is that this is something that French doctors – plural – were doing. Unless, perhaps, this is a direct dig at Chicoyneau, but he was stated to wear Morrocan leather aka goatskin, not Cordovan leather, which is a type of horse leather. in which case it may not speak to multiple doctors so dressed. But then again we have the Italian source above suggesting that multiples of doctors there really were wearing masks with snouts. In any case, it certainly reinforces the prescribed dress of the plague doctors across several centuries and numerous countries; enveloping clothing made of a smooth, pliant fabric – and adds another approved option; horse leather. It’s important to note that waxed cloth wasn’t restricted to Italy; Salzmann’s “Masques Portés par les Médecins en Temps de Peste” (Aesculape, vol. 22, no. 1, 1932, pp. 5-14) explains that other doctors wore robes made of ‘toile-cirée’; the waxed linen cloth so common in Italian states.  

L0025226 Plague doctor as a quack Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Quackery: a plague doctor as a quack, anon., n.d. Aesculape Published: 1932 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

 
Taken together, all of this evidence supports Ruisinger’s position that the beaked mask was less common than either the hood (with or without glasses) or no head protection at all; just the robe. The hat (which I’ve yet to find mentioned or depicted outside of the iconic engravings) and the rod or staff were optional, although as previously noted, gentlemen typically carried these anyway. Even the hood and glasses were not universally worn, and despite my discovery that Venetian doctors used larva masks – these too would not have been common outside of Venice (where they were conveniently available). Only those with the money, personal preference, and belief in the prophylactic power of plant material would have donned a pointy-faced mask. At this point, it’s even possible that only one idiosyncratic doctor in Rome wore the avian-style beak mask, and thanks to artistic licence, we don’t even know that this is a true representation. The French masks, described with respect to Delorme and Chicoyneau, may well have more closely resembled the surviving examples; hoods with conical ‘beaks’. And of course there are the Larva masks in Venice, which sort of fit the bill (ha, ‘bill’) but didn’t contain any herbs. There’s no evidence of such masks outside of those two regions of Europe, and there’s no real evidence even of the leather or wax-cotton/oilcloth robes beyond these regions either – nothing from the British Isles, for example (I’m sure Pepys would have informed us otherwise if England had had its own variant).

It’s fair to say that robes with KKK-esque hoods don’t really fit the modern gothic image of the plague doctor, and there is much more evidence for robes without masks (either with built-in hoods or no head covering at all) than for outfits with masks of any kind. And of course plenty of doctors would have attended plague victims without even the robes. Still, I’m comfortable in saying that many doctors operating c. 1620 – 1820 wore the leather or waxed cloth robes, some also wore a beaked mask (even if most of these weren’t styled after a bird per se) with glasses, and many would have affected a hat and/or staff too. The full outfit just wasn’t as ubiquitous, as standardised, or as bird-like as popular culture would have us believe.