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.

Mask of the Plague Doctor

Promo image from the recent Ghost tour. Not entirely fanciful as it turns out.

tl;dr – although not in use until the Enlightenment era (sorry, the plague doctor is not a medieval or renaissance figure) the beak doctor outfit really was an historical reality of the early 17th – early 19th centuries, but was likely rare; especially in its iconic form with corvid-like mask and separate hood.

Update: my original intent was to write something up for the lovely people at Fortean Times, who very kindly allowed me to do so, but after I’d posted this initial debunking of the claim that they didn’t exist. As I’d already written it, and the angle is somewhat different, I’ve left this up. But if you get the chance, do grab a copy of Issue 393, because they did a cracking job with the much revised and enhanced text that I gave them and the illustrations look great; including a never-before published original of the Zwinger painting. Anyway, read on…

Given the current rash of people dressing as plague doctors in weird defiance of the novel Coronavirus that we find ourselves beset by, as well as their recent use by the ‘12 Monkeys’ TV show and one of my favourite bands, Ghost, I felt I had to tackle the iconic plague doctor mask; the one with the long, curved snout with impressed (or stitched) line down the side mimicking a bird’s beak (sometimes a full-on replica beak with nostril openings). I’ve been sceptical about this for a while now, mostly due to Kathleen Crowther’s blog article ‘Did Plague Doctors Wear Those Masks?’ (2013), available here. Crowther states that the bird’s beak was parody, not reality – that these physicians in their early versions of HAZMAT suits were derided and compared to scavenging ravens (post-medieval Europe hated corvids, unfortunately), and this is where our modern misconception of the plague doctor’s costume comes from. This conclusion does make a lot of sense, but as it turns out, I don’t agree. The plague doctor’s outfit and mask are genuine. Yes, the costume was probably the exception, and the really birdlike masks that fascinate us today even more rare than that, but there’s plenty of evidence that both did in fact exist from about 1619 for perhaps two centuries in one form or another.

OK, time for the deep dive…

The Evidence for An Historical ‘Dr Beak’

The earliest extant plague doctor depiction. Unknown artist (published by Sebastiano Zecchini), 1656. (British Museum archive document 1880,0710.522, AN186495001, from https://research.britishmuseum.org/research/collection_online/collection_object_details/collection_image_gallery.aspx?assetId=186495001&objectId=1539871&partId=1

There is actually a reasonable amount of evidence for the iconic form of the plague doctor’s costume. What isn’t clear is how old this form actually is. Medical practitioners have probably been protecting themselves from infectious diseases (in this case forms of plague) for centuries, but the first version of the iconic outfit dates to the French plague of 1615-21 (which reached Paris in 1618). This clothing is attributed by Michel abbé de Saint-Martin to royal physician Charles Delorme. The full description of Delorme’s costume that appears on Wikipedia (taken from here and in turn from this 1896 article) is in fact a weird mashup of sources, fancifully (irresponsibly?) rewritten as one long interview between Michel and Delorme by N.M. Bernardin, an historian of French literature (not social or medical history). Despite this, it’s close to being accurate. It is mainly based upon ‘Remarques critiques sur le dictionnaire de Bayle’ (1748). Although written a long time after the fact, this does credit its information to Michel and may have been taken from a different source (possibly the 1683 second edition of ‘Moyens’, which I can’t find a copy of online):

‘Il se fit faire, dit-il, un habit de maroquin, que le mauvais air pénètre très difficilement : il mit en sa bouche de l’ail et de la rue ; il se mit de l’encens dans le nez et dans les oreilles, couvrit ses yeux de bésicles, et en cet équipage assista les malades, et il en guérit presque autant qu’il donna de remèdes.’

‘He had himself made, he says, a leather suit, which bad air penetrates with great difficulty: he put garlic and rue [a type of plant] in his mouth; he put incense in his nose and ears, covered his eyes with spectacles, and in this equipment assisted the sick, and he healed almost as much as he gave remedies.’

This has been combined with the only actual information on Delorme’s outfit that does appear in Michel’s ‘Moyens faciles et éprouvés dont M. de l’Orme, médecin, s’est servi pour vivre près de cent ans’ of 1682, which is a mention of his coat and mask (pages 424-425):

‘Il n’oublioit jamais fon habit de marroquin dont il étoit l’autheur, il l’habilloit depuis les pieds jusques à la tefte en forme de pantalon , avec un masque du méme marroquiņ où il avoit fait attacher un nez long de demy pied afin de detourner la malignité de l’air…’

‘He was never without his own design of (goatskin) leather coat, and dressed from head to toe with pantaloons and a mask of the same leather to which he attached a long nose half a foot in length in order to keep out the bad air.’ 

This certainly sounds like the plague doctor we know and love, but at this point there is no mention of a birdlike beak, eyeglasses, gloves (although they are implied by ‘head to toe’), rod or hat (although no gentlemen would set foot outside without some sort of walking stick or hat). Michel goes on to say that Delorme gave another coat and mask to the daughter of Monsier Renaud, chief chirurgeon to King Louis XIII, so there were at least two of these outfits in existence at this time.

However birdlike or otherwise Delorme’s outfit may or may not have been, and whether or not others took the idea from him or came up with it independently, the first certain visual depiction of a plague doctor and also the first to feature a naturalistic bird-face mask is not French but Italian, dating to 1656. [edit – as an aside, after I published this article I spotted this intriguing claim by Francesca Falk that there are in fact two beak-masked plague doctors incorporated into the 1651 frontispiece of Thomas Hobbes’ Leviathan. This seems impossible to prove, and there is no prior (or subsequent) English depiction or mention that would help to verify it, but I think Falk makes a good case.] One original copy of this 1656 Italian engraving resides in the British Museum’s collection (reproduced at the top of this article – see a later sketched copy here). It was produced in Rome and Perugia by an unknown artist, pubilshed by Sebastiano Zecchini;

‘L’habito con il quale vanno i Medici per Roma a Medicare per difesa del mal Contagioso è di tela incerata, il Volto ordinario, congli Occhiali di Christallo, & il Naso pieno di Profumi contro l’infettione. Portano una Verga in mano perdare a vedere, è dimostrare le loro operationi.’

In Roma, & in Perugia, Per Sebastiano Zecchini, 1656.  

This (hopefully!) translates as;

‘The outfit in which the doctors in Rome go to medicate in defence of the infectious disease is of waxed canvas, the face with eyeglasses, & the nose full of perfumes against the infection. They hold a staff because of their reduced vision and to demonstrate their operations.’

In Rome, & in Perugia. For Sebastiano Zecchini, 1656.

Pretty similar; and the type of cloth or leather used to make the clothing isn’t specified. I have to wonder how much ‘later’ Delorme had the idea of the perfume-filled beaked mask. Did he or the doctors in Rome come up with it first? Or did the two hit upon the idea independently? We have no way of knowing unfortunately, but it’s clear that the basic outfit was in use in both French and Italian regions. 

The German Piss-Take Versions

One of two German derivatives of the Italian original, this one by Gerhart Altzenbach and titled ‘Kleidung widder den Todt’ or ‘Death’s Clothing’ (Wikimedia commons – https://commons.wikimedia.org/wiki/File:Gerhart_Altzenbach,_Kleidung_widder_den_Todt_Anno_1656.png)

Paul Fürst’s ‘Der Doctor Schnabel von Rom’ or ‘Dr Beak of Rome’ (Wikimedia Commons – https://commons.wikimedia.org/wiki/File:Paul_F%C3%BCrst,_Der_Doctor_Schnabel_von_Rom_(Holl%C3%A4nder_version).png)

The German states were clearly fascinated by the sensational appearance of the Italian plague doctor(s?) and copied the artwork to produce two later engravings (presumably made within a few years of the original), both with the extensive additional satirical commentary that Crowther points to in her article, poking fun at the odd-looking birdlike man and his ineffectiveness in actually helping the afflicted. One of these satirical ‘broadsides’ is by Gerhart Altzenbach (there is a very brief 1965 academic note on this here, JSTOR account required), the other by Paulus Fürst. Due to the identical date it’s hard to say which of the German ones came first (pun not originally intended) but Fürst’s added memento mori winged hourglass on the tip of the doctor’s staff and the closer resemblance to the Altzenbach version suggests that it followed the latter. Fürst also makes the gloved fingers even more pointed and sinister-looking. This version of the design also suggests that the original artist for the doctor figure was an ‘I. Columbina’, hinting at another Italian version pre-dating all of the known examples. However, the BM points out that Columbina was a character in the commedia dell’Arte, the implication (given that this attribution does *not* appear on the Italian version and that no other reference to an artist of that name has ever been found) being that this was a joke; i.e. this bizarre person was sketched by a fellow weirdo – Columbina… That in itself is pretty speculative though.

As Crowther notes, Altzenbach’s broadside is where we get the satirical comparison to the raven:

“Cadavera sucht er zu fristen

Gleich wie der Corvus auf der Misten”

Or…

“He seeks cadavers to eke out a living

Just like the raven on the dung heap”

I kind of want to see a Rammstein version of the full thing, but I digress. With all due respect to Kathleen Crowther (and in fairness she does not discount the idea but simply states that she has not seen the evidence), this does not in fact debunk the plague doctor’s beaked mask, or even the more overtly birdlike version of it. The birdface mask cannot be purely satirical; not only because of the other period evidence for similar costumes in France, but because the mocking German ‘Doctor Schnabel’ artwork is very clearly copied directly from an Italian original that is played entirely ‘straight’ with no smirking commentary, criticism or embellishment.

As it turns out, there’s even more evidence to support this. If the three depictions we’ve seen so far are all based on the same original, there is an absolute corker of an original artwork from almost half a century later. That is, the coat of arms of Swiss doctor Theodor Zwinger III (1658 – 1724). There are at least two versions of this; the below is an oil painting on a wooden panel, dated to c.1700 by the Wellcome Collection but likely a close copy (whether period or later it’s hard to say) of the more detailed original in the in Historisches Museum Basel, which is painted on copper plate (I have a copy of this but won’t post it online; it appears in my Fortean Times article (Issue 393, 2020). It shows a very gothic-looking black robed figure with very birdlike, curved beak, complete with dividing line between upper and lower:

This is my favourite. – Theodore Zwinger in and out of plague doctor costume (From https://wellcomecollection.org/works/mr4znzgp)

That’s definitely Zwinger III on the right, and although his dress seems decidedly old-fashioned for the late 17th century, portraits of him show a large ruff and voluminous shoulders on his doublet. Of course, this artwork is essentially fantasy, and does not necessarily mean that Zwinger ever wore this clothing or even that it was still in use at the end of the century. It could in fact mean the opposite – representing the unenlightened past on the left (based on what those silly Italians used to wear) and the modern physician on the right, acknowledging the debt owed to past beliefs whilst distancing the subject from them. It might even be a direct reference to ‘Doctor Schnabel’ as a figure of fun. Even so, it’s another piece of evidence that this outfit was at least a meme of sorts, and very likely a real costume at one time.

Later Forms

The next version appears in 1721 in a much cruder form (below) as the frontispiece to (Genovese) Jean-Jacques Manget’s ‘Traité de la peste‘. Produced by an unidentified artist, is in fact considerably later than the Zecchini original and presumably the German derivatives. This is apparent from this source (note also the much less birdlike depiction over the page in the same book) and indeed from the clear debt owed, down to the specific pose of the doctor, to the design used in the three earlier engravings. This doctor also has an updated style of hat and gloves.

Manget’s 1721 version of the plague doctor (Wikimedia Commons – https://commons.wikimedia.org/wiki/File:A_Plague_Doctor_%E2%80%93_from_Jean-Jacques_Manget,_Trait%C3%A9_de_la_peste_(1721);_WHO_version.png)

The accompanying description (the annotation on the drawing covers the eyeglasses) offers more detail than the earlier ones in terms of clothing and is the first to comment on the resemblance of the ‘beak’ to, er, a beak;

‘Le nez en forme de bec est rempli de parfums et oint intérieurement de matières balsamiques … sous le manteau, on porte ordinairement des bottines, des culottes de peau attachées audites bottines et une chemise de peau unie dont on referme le bas dans les culottes, le chapeau et les gants sont aussi de même peau de maroquin du levant.’

‘The beak-shaped nose is filled with perfumes and anointed internally with balsamic materials… under the coat, one usually wears ankle boots, skin breeches attached to said ankle boots and a plain skin shirt whose bottom is closed in the breeches, the hat and the gloves are also of the same goatskin leather.’

Interestingly, Manget and other sources of this period (including this version of the Manget engraving, that specifically namechecks Chicoyneau) explain that the costume was brought back by physician François Chicoyneau, 100 years after the previous plague (no mention of Delorme as either inventor or plague doctor, interestingly), to help tackle a new outbreak of plague in Marseille. Interestingly (and eerily, because as I write this my country has just gone into COVID-19 lockdown), this was probably because Chicoyneau was utterly convinced by miasma theory and did not hold with the idea of a cordon sanitaire to prevent the spread of disease. Of course, the medical treatments of the day were unlikely to help anyone near as much as a cordon, although the plague doctor costume might protect the physicians to some extent. By implication at least, there were now multiple classical ‘plague doctors’ mooching about in this get-up. So far, so birdy. This early 18th century revival provides some important continuity with respect to my next section…

What Plague Doctor Masks Exist?

As far as I can determine, there are between five and seven (two may be recreations) documented ‘beaked’ plague masks (see below). Two to four of them (including both of the possible recreations) seem to have been lost or destroyed. One of these was originally collected for the Museum of Hygiene in Rome from the lazaretto or plague hospital in Venice. It now exists only in a photograph held by the Wellcome Collection in the UK. Even then it was in a sorry condition, missing its lenses. A very similar style of mask was photographed on the island of Poveglia (also in the province of Venice). Both appear below. The interesting thing about this is that Poveglia wasn’t made a lazaretto until the end of the 18th century, so any plague mask collected there is likely not contemporary with the 17th century depictions. It stands to reason that the basic design of mask/hood would remain in use, as the miasma theory of disease was not abandoned for another hundred years.

The Wellcome’s photograph of the Italian mask (from https://commons.wikimedia.org/wiki/File:Plague_apparatus_from_a_lazaretto_in_Venice;_an_oil_cloth_ma_Wellcome_V0029672.jpg)

The Poveglia mask.

The two questionable ones were apparently once part of the Wellcome Collection itself. The Collection has photos of one of them including one in situ in the Wellcome Library (mid-C20th). They were clearly both on open display and by the time of this photograph were in a state of disrepair (one being held together with tape!). I am as sure as I can be that both are actually Victorian recreations, produced mid-late 19th century as teaching aids, handled to death, then binned. The one on the left is made of either plaster or papier mache. The right hand one is made of the same worn fabric (wax cotton, oilskin?) as the robes, and there’s no way that set of robes has survived the 150+ years to the mid-20th century. The biggest point against is probably that the Wellcome called one of them a ‘model’ and didn’t keep either of them. If they were genuine, they likely would have saved at least one. 

The three still-extant were also collected by German museums; the Deutsches Historisches Museum in Berlin, the Reiss-Engelhorn-Museum in Mannheim, and the Deutsches Medizinhistorisches Museum in Ingolstadt. All appear (as we might expect from items collected by bona fide museums) to be genuine, although they are only loosely dated to some time during the 17th century and in reality could be recreations closer in date to Manget’s 1721 depiction. The Reiss-Engelhorn example has a distinct flat goggle section but is otherwise substantially the same as the others. The DHM hood (AK 2006/51) is the only one that I could find provenance information on – it’s a recent acquisition, purchased at auction in April 2006 from a private art dealer based in Vienna. It’s not clear whether this or the other German examples reflect any actual period German/Austrian/non-Italian use of the masks or (more likely) collection as medical/scientific curiosities by German visitors to one or more of the Italian states. 

The DMM (left) and DHM (right) masks (from the useful thread on the Taleworlds forum; https://forums.taleworlds.com/index.php?threads/plague-doctors-beaked-physicians.357671/)

The Reiss-Engelhorn version (from https://www.paimages.co.uk/search-results/fluid/?q=Conservator%20Bernd%20Hoffmann-Schimpf%20holds%20a%20plague%20mask&category=A,S,E&fields_0=all&fields_1=all&imagesonly=1&orientation=both&words_0=all&words_1=all)

Typologically, these masks seem to represent a further evolution from the Manget type, being bulkier, bulbous full hood designs with integrated eye lenses instead of separate spectacles and without the beak line or nostrils. Almost like early C19th diving helmets with beaks. I believe that all are late 18th or early 19th century in date. Frankly it would be remarkable if any of the early type masks had survived for 350-odd years. There is one very classical-looking but also highly dubious example currently included in the Wikipedia articles on plague doctors and their costume. Judging by its condition alone, this must be a modern recreation, and I cannot find any museum in Jena (to which the image is attributed) that would be likely to have anything like this. There is a museum of optics there, which would explain a diorama recreation of a plague doctor, which is what I believe this image to represent. 

These examples are more similar to the artistic depictions than they may appear. As well as a general form resembling the Manget version, and the obvious beak-like snout, if we look closely at the artistic depictions, these too were likely all full, over-the-head affairs, more like hoods than facemasks (the German museums call the later forms ‘pesthaube’ in fact). This which would make them more effective protection against actual diseases as well as imaginary miasma/bad air. All have more conical than realistic-looking ‘beaks’ (two leather, one bronze or more likely copper), not as birdlike as those shown in the period artwork, although in fairness, they are all very old and in a bit of a state; they may have looked more classically plague doctory in their day. Interestingly, the only real change in the 1721 Manget depiction from earlier versions was to depict the doctor’s mask as a full-head hooded affair, albeit still with a more birdlike snout. In fact though, the main difference is that the Manget version doesn’t have the robe wrapped up and over the mask itself. What look like separate facemasks akin to the modern Venetian carnival/commedia dell’arte il Medico della Peste‘ mask are also actually depicting a hood – just one sitting underneath an enveloping robe. In this respect a lot of the modern depictions are actually off-base, showing a balaclava-style hood with a facemask slipped over the top, or sometimes just the mask. Incidentally, ‘il Medico’ himself seems to be a recent phenomenon; a variation/play on the vague similarity of the plague mask to the long-nosed masks worn by the Zanni characters and the modern-day popularity of the plague doctor. There is actually no historical commedia character based on the plague doctor (although there is historically a very different doctor character). 

Conclusions

Whether styled closely after a bird’s face or just resembling one by coincidence (most likely both at different times, in different places and depending upon the individual doctor’s preference), the look of these masks was secondary to their intended function. The main goal here, then as now, was to protect themselves as best they knew how against unseen agents of infection. The masks (especially the simpler forms) are not too different to the early gas masks or ‘gas hoods’ of the First World War. The ‘beak’ is a direct analogue to the later mask filter, albeit full of items thought to combat ‘miasma’ rather than anything medically effective. 

To wrap this up; yes, the full-face bird-like ‘beaked’ mask/hood with glasses, the robes, the gloves, the funky hat, the point-ed stick, thin leather or waxed cloth; all of it was a real thing. Many masks/hoods probably had a conical ‘beak’ that only vaguely resembled a bird’s bill; others probably leaned into the look more like the earliest depictions and our modern conception. Of course, as we’ve seen, the ‘look’ sort of backfired; almost immediately critics were comparing them to that infamous bird of death, the raven – complete in the Fürst version (bottom left of frame) with several terrified prospective patients running away from the doctor, who is waving his winged hourglass of death at them and presumably wondering why no-one wants to be ‘treated’. Even Zwinger’s coat of arms seems to paint (literally) his plague doctor self as an ominous harbinger of disease and death. This, of course, is how we see the plague doctor to this day; a relic of scientific ignorance and a symbol of an elitist, distant, uncaring medical profession. We should probably recognise though that these people were trying to help the infected, not terrify them – just as our (thankfully much more capable) healthcare professionals are trying to do as I type this. Their methods may have been questionable (even by the 1720s) but in terms of protective equipment, they were thinking along the right lines in terms of overlapping fully enveloping clothing that might prevent the ingress of…whatever was causing the infection. They thought it was ‘bad’ air, we know that it’s microscopic organisms (in the case of bubonic plague, passed on by flea bites).

Thankfully, in the current pandemic, we don’t need to experiment with protective clothing for medical practitioners; we know what works and we just have to do our bit and help prevent the spread. If people find the iconic plague doctor interesting, amusing or even comforting rather than scary, that’s a great use for this fascinating piece of (not BS!) history.