Eyam Plague Village

Gravestones at Eyam. No, the skull and crossbones are not a ‘reminder of the plague’ Tony Bacon/Wikimedia Commons

I’ve been following John Campbell’s YouTube channel since early on in the current COVID-19 pandemic. He does a good job of science communication, but something he mentioned recently had me reaching for my internets. He claimed that in the great plague of 1665-6, the villagers of Eyam in Derbyshire had selflessly quarantined themselves to protect their neighbours and suffered disproportionately. Most retellings (notably Wood’s 1859 ‘The History and Antiquities of Eyam’) link those two facts, emphasising that people opted to get sick and die rather than spread the disease. I hadn’t heard of Eyam, but the claim is widespread, and there’s even a museum dedicated to the event. It’s so widespread that it’s essentially now an accepted fact. It’s no surprise that this evidence of the capacity for altruism in the face of infectious disease was wheeled out during the current pandemic, including by the BBC. This is quite a nuanced one. The village certainly did suffer from the plague, and there was a quarantine. However, Patrick Wallis’ 2005 article ‘A dreadful heritage: interpreting epidemic disease at Eyam, 1666-2000’ (he’s written a more accessible summary for The Economist as well) shows that there is really no evidence that this was voluntary in any meaningful sense. Instead, as elsewhere in England, restrictions were imposed by those in charge, and neither the village’s isolation nor its high death toll (36% of the population, in line with the average mortality for the British Isles) were particularly unusual. Even the museum (which owes its existence to this traditional story), today gives accurate mortality figures (previously wrongly estimated at more than half the population) and explains that it was the local religious authorities who were responsible for the lockdown rather than the ordinary folk. The story of the supposedly willing sacrifice of the population only emerged some two hundred years after the fact and only became more mythologised over time (complete with made-up love story!). In Wallis’ words:’ 

“Only a limited body of contemporary evidence survives, the principal artefacts being three letters by William Mompesson, which powerfully convey the personal impact the death of Catherine Mompesson had on him, and, in passing, mention some of the villagers’ responses. There is a copy of the parish register, made around 1705. Finally, there is the landscape of the parish, with its scattering of tombs. Two of the earliest accounts claim indirect connections through their authors’ conversations with the sons of Mompesson and Stanley. Beyond this scanty body of evidence, a voluminous body of ‘oral tradition’ published in the early nineteenth century by the local historian and tax collector William Wood provides the bulk of the sources.”

Mompesson, the rector, wrote three letters, which don’t mention anything about villagers volunteering for a cordon sanitaire. In one of them Mompesson describes the suffering of his fellow villagers and does describe anti-plague measures – the ‘fuming and purifying’ of woollens and burning of ‘goods’, ‘pest-houses’, and of course prayer – but there’s nothing on quarantine, voluntary or otherwise. Early printed accounts confirm that one was put in place, with provisions supplied by the Earl of Devonshire. They praise the behaviour of Mompesson and/or Stanley, his unseated nonconformist predecessor (who had remained in the village) in keeping inhabitants from leaving (even though Mompesson sent his children to safety) but again there is nothing about the residents choosing to sacrifice their freedom for the greater good (the greater good). The community spirit element of the story doesn’t enter the picture until 54 years later when Richard Mead updated his ‘Short Discourse Concerning Pestilential Contagion’ (8th Ed., 1722, see here) with this account:

“The plague was likewise at Eham, in the Peak of Derbyshire; being brought thither by means of a box sent from London to a taylor in that village, containing some materials relating to his trade…A Servant, who first opened the foresaid Box, complaining that the Goods were damp, was ordered to dry them at the Fire; but in doing it, was seized with the Plague, and died: the same Misfortune extended itself to all the rest of the Family, except the Taylor’s Wife, who alone survived. From hence the Distemper spread about and destroyed in that Village, and the rest of the Parish, though a small one, between two and three hundred Persons. But notwithstanding this so great Violence of the Disease, it was restrained from reaching beyond that Parish by the Care of the Rector; from whose Son, and another worthy Gentleman, I have the Relation. This Clergyman advised, that the Sick should be removed into Hutts or Barracks built upon the Common; and procuring by the Interest of the then Earl of Devonshire, that the People should be well furnished with Provisions, he took effectual Care, that no one should go out of the Parish: and by this means he protected his Neighbours from Infection with compleat Success.”

The information is pretty sound, coming from the rector’s son and so within living memory, and is much more plausible than a more ‘grassroots’ motive. Of course, the source is likely to emphasise his own father’s role, but the bottom line is that the actual primary sources are few, and none suggest that the villagers took an active role. As Wallis puts it: 

“The leadership of Stanley and Mompesson, respectively, is praised, but there is no hint or romance, tragedy, or even of distinction accruing to the rest of the community.”

He also suggests that the few villagers with the means to do so probably fled (certainly Mompesson ensured that his two children left and tried to persuade his wife to). The majority  could not afford to leave and at this period likely wouldn’t have friends or family elsewhere that they could go and stay with. They were also being provided with supplies to encourage them not to leave. This leads me to what I think is the key to whether you regard this one as myth or reality; the extent to which the quarantine can be seen as voluntary. The contradiction of a ‘voluntary’ quarantine that was actually instigated by those in charge is highlighted by this contradictory phrasing from the website;

“…Mompesson and Stanley, the Rector of Eyam at that time [sic], who had persuaded the villagers to voluntarilly [sic] quarantine themselves to prevent the infection spreading to the surrounding towns and villages.”

I suppose the quarantine was ‘voluntary’ insofar as they didn’t nail people into their dwellings, but this wasn’t standard practice in the countryside anyway as far as I can tell. This was done in towns and cities where too many were infected to quarantine them in pest-houses or hospitals, and the risk of escalating infection was too great not to do it. Personally, I don’t think you can meaningfully call what happened at Eyam ‘voluntary’. The people of Eyam were most likely just doing what they were told and, as noted above, had little other option. This aspect of the situation isn’t that different (save the much worse fatality rate of plague) from that in countries today where lockdowns have been put in place due to the current pandemic. Yes, these have a legal basis, as did period quarantines in urban centres, and we can at least admit that Eyam’s quarantine was voluntary in that it was not governed by any formal law, and there’s no evidence that force or the threat of it had to be deployed. However, the same is true of the recent lockdowns in England; aside from a handful of fines, there has been no enforcement and, in the vast majority of villages, very high levels of compliance. The same was true in the 17th century; people mostly did what they were told and in any case had little other option. For this reason I think praising Eyam’s population for not (other than some more well-off people, including Mompesson’s own children) breaking their lockdown is akin to praising modern English people for not breaking theirs. Indeed, we may get lip service gratitude from our governments for complying, but we are (rightly) not hailed as heroes. Obviously I’m not comparing the fatality rates of the two diseases, just the power relationships at play. The rector of a parish held a great deal of sway at that time, and going against his wishes in a matter of public health would have been bold. Finally, and something that Wallis doesn’t seem to pick up on, is that (as I mentioned above) Mompesson explicitly mentions ‘pest houses’ in the context of them all being empty as of November 1666. These would have been existing structures identified for use to house and attempt to care for anyone diagnosed with the plague. No-one placed in one of these houses would have been permitted to leave, for the good of the uninfected in the village. Thus although those yet to be infected could in theory try to leave the village (although, where would they go?), anyone visibly afflicted certainly could not. Those free of plague would have even less reason to leave, as they weren’t being asked to live in the same house as the infected. 

Overall, I think Eyam is an interesting and important case study (especially the rare survival of 17th century plague graves in the village) and, as Wallis capably shows, a reflection of changing knowledge and opinion on management of infectious diseases. In the 20th century the ‘meme’ shifted from heroic sacrifice to tragic ignorance. Quarantine and isolation didn’t work, and Eyam was proof. We are now witnessing another shift back toward quarantine as a viable measure and, along with it, a reversion to the narrative of English people ‘doing the right thing’ in the face of deadly disease. However we reinterpret their fate to suit ourselves over time, the people of Eyam were just some of the many unfortunate victims of disease in the 17th century, no more or less heroic than any others. 

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.

Plague Doctors and the ‘Bauta’ Mask

‘The Meeting’ by Pietro Longhi, 1746.
Metropolitan Museum of Art, New York/Wikimedia Commons – https://commons.wikimedia.org/wiki/File:The_Meeting_MET_DP123846.jpg

This is part three of what’s turned into a series on aspects of the plague doctor costume, and a rather cool little discovery that I think actually adds something to the scholarship around this admittedly niche subject. I’ve found a previously unrecognised source – in this specific context at least (and I can’t find any reference to it online. It is ‘Del Governo della Peste’ by Lodovico Antonio Muratori, first printed in 1710. On page 74 we find detailed advice on protective clothing for the plague;

‘…allora per tutti quei, che escono di casa, ma certo sarà spezialmente bene anzi necesario chi dee praticar gente ammorbata, il postare una sopraveste di tela incerata, o pure di Marocchino o d’ altro cuoio sottile (queste si credeno milgliori di tutte) ovvero di Taffeta, o d’ altra manifattura di Seta, perchè alle vesti di lana troppo facilmente s’attaccano gli spiriti velenosi del morbo, ma non già s’attaccano se non difficilmente (per quanto vien creduto) alle incerate, e a Marocchini, e non si possono ritener lungo tempo dalla Seta spiegata. Avvertasi però, che le vesti di Seta non debbono essere fatte con lusso, nè con gran cannoni, e piegature, ma hanno da farsi povere, e piu tosto corte, avendo lasciato scrito il Mercuriale, che alcuni medici nella peste di Venezia de’ suio di si tirarono addosso la rovina per aver nelle visite de gl’Infetti portate vesti lunghe e larghe, e belle pellicie, secondo l’uso d’allora. Chi non ha seta, ne altro di meglio, usi almen lino, a canape, piu tosto che lana.’

‘…it would be good then, for all those who leave the house and especially those who need to treat afflicted people, to wear an overcoat of waxed cloth, or even of Moroccan or other thin leather (these are believed to be the best of all) or taffeta, or other type of silk, because because the poisonous spirits of the disease attach themselves to woollen clothes too easily but they do not attach as easily (as far as is believed) to waxed fabrics, Moroccan leather, and smooth silk. It should be noted, however, that the silk garments must not be made with luxury, nor with great sleeves and folds, but they have to be made simple and more courtly, according to the writings of Mercuriale, that some doctors in the Venice plague of the swine ruined themselves by wearing long and wide robes and beautiful furs during visits of the infected, according to the custom of that time. Those who have no silk, or anything else better, use at least linen, hemp, more quickly than wool.

This is interesting confirmation of what we already knew; the discovery comes in the next sentence;

Alcuni hanno tavolta usato di coprir’ anche la faccia con una maschera, o bautta, a cui mettavano due occhi di cristallo; ma non e necessaria tanta scrupitolisita.’

Some have even used to cover their faces with a mask, or bautta, to which they put two crystal eyes; but there is no need for such scrupulousness.’

A Bautta or bauta (the latter spelling is favoured today) was a traditional Venetian headgear for the well-off to wear during carnival and at masked balls, designed to be worn with the larva facemask. Both are still sold and worn today, although the larva is more common and has today taken on the name (i.e. ‘bauta’/’bautta’) of the hood portion, probably because it’s the more visually striking part of the ensemble. Of course, there is a much greater variety of Venetian masks worn today, making the larva just one of many choices. It was practically de rigeur at the time, alongside the black oval moretta worn by some women. The so-called ‘bauta’ (henceforth ‘larva‘) was, and still is, a (usually) white facemask with a protruding lower face that allows the wearer to eat and drink. It is sometimes mistaken for a plague doctor mask, which by sheer coincidence, turns out to be somewhat appropriate. Unlike modern takes on the plague mask, the modern larva still looks just like it did 200 years ago, as you can see from these depictions.

Now, it is not clear whether the use of the bautta for medical purposes involved a form of the button-up hood on its own, with added eye glasses, or whether both hood and mask were worn. Francesco Romani’s ‘Ricordi su la peste redatti in un sistema teorico pratico’ (1816, p. 112) is useful here. Romani first relates the usual advice regarding clothing;

‘…trattar con persone o contagiate o sospette, è grandissima la utilità delle sopravvesti di taffettà o di tela incerata.’

‘…[when] dealing with people or infected or suspicious, the utility of the taffeta or tarpaulin overcoats is very great.’

He then explains the role of the bautta, with an interesting budget alternative;

‘I più scrupolosi ricopron la faccia con maschera, o bautta di cera munita di due grandi occhi di cristallo, od iu vece la velano con fazzoletto bianco inzuppato di aceto.’

‘The most scrupulous cover their face with a mask, or waxed bautta with two large eye glasses, or instead they veil it with a white handkerchief soaked in vinegar.’

Given that no period sources mention the larva, and Romani only mentions the bautta, it’s possible that only the latter was worn. However, I believe the larva is implied. Firstly, the bautta itself is already made of silk, which is one of the prescribed anti-plague fabrics. Waxing silk might be possible, but I haven’t come across waxed silk anywhere else. Secondly, the bautta alone didn’t cover the face, as you can see from period artwork, and as Englishman Peter Beckford explains in his ‘Familiar Letters from Italy: To a Friend in England, Volume 1’ (1805, p. 261):

‘A bautta is the best dress on all these occasions; and, though it gives a disagreeable gloom to every assembly, is very convenient, particularly to the women, who have no longer the trouble of a toilette, but as they are in the morning, remain all day. The bautta, with its white mask, is frightful; with the mask off, though they all look like Edward the Black Prince with his beaver [bevor] up, is not unbecoming: it buttons over the lower part of the face, and hides the chin only; the hair is pulled forward, and when the hat is well put on, most of the women look handsome.’

This portrait from the US National Gallery is the maskless look that Beckford mentions, by the way. Returning to my second point; according to the logic of the time (or of now, for that matter) there would be little point in covering the eyes if most of the face was left exposed. Finally, other period sources than Beckford lump the hood and mask together. This French commentator explains that the version imported to Tuscany was called ‘masque a bautta’, and this book on theatre masks, written in Rome, compares a mask worn by an actor playing Cupid with the Venetian bautta, hinting that Italians outside Venice may also not have appreciated the difference between the hood and the facemask. Ultimately though, I can’t be sure; if these sources don’t mean to include the larva, then they must be referring to a specialist form of bautta that did cover the face.

Whether the full bautta and larva combo or a modified bautta, I think the idea of doctors turning the Bautta into a plague mask is a fascinating discovery, even if there’s no suggestion of using the short ‘beak’ of the mask for fragrant herbs. Here it is used as a convenient smooth face-covering, retro-fitted with lenses to cover the eyes, and using the sheer silk of the hood as a protective fabric – silk being one of the smooth fabrics universally recommended to those working with the sick in Italy and France in order to prevent plague from adhering to the clothing. Incidentally, this didn’t just cover (literally) physicians providing actual medical care – it included surgeons, barbers, cleaning staff, those dealing with bodies, and priests, too. More on this in the next (and probably final) post on this subject.

Rats and the Black Death

Another excuse to feature Ghost…(relevant video here)

This is one that I’ve been meaning to catch up with for a while; the historical role of rats in the spread of Plague. Having seen the ‘Shadiversity’ ‘Misconceptions’ YouTube video on the subject I thought it was time to dig in. In this, Shad states that rats were responsible for later outbreaks of plague, but not the 14th century ‘Black Death’ pandemic:

“…the assumption that it was spread by the fleas on the rats… there’s actually no evidence for this…no such correlation exists for the medieval black plague.’ 

The video fails to provide an alternative explanation, other than something about a combined effect of the Bubonic, Pneumonic and Septicaemic forms of plague, which speaks to its severity, not its transmission or spread. Incidentally, whilst correctly pointing out that the plague doctor ‘beak’ mask is not medieval, it just as incorrectly states that it dates ‘from the Renaissance.’ As I covered previously, the ‘beak doctor’ is actually an Enlightenment phenomenon (and not a common sight at that).

So is the video right to say this? Yes, but with a hefty caveat that absence of evidence is not evidence of absence; the rat hypothesis is shaky, but so are all the others. And rodents or one species or another were almost certainly responsible for the spread of this plague… 

The Evidence

As far as I know there is no controversy over the role of fleas in carrying the Yersinia pestis bacterium, and to be fair I don’t think he is trying to claim that the fleas weren’t the main carrier. I have previously seen reports that the role of rats had been overstated, so I was prepared to accept that for this particular pandemic, scholarship had identified another mammal as the carrier of the infected fleas. However, I’m also very wary of the ‘pendulum’ effect in the media narrative of historical events; similar to medical reporting, where every new study is hailed as the new gospel truth, rather than just another datapoint. This is how the tabloids are able to claim that everything either causes or prevents cancer… 

Regardless, fleas have to live on some species of mammal in order to spread disease. I was aware that other mammals had been blamed instead/as well of rats, such as gerbils, but as noted, wasn’t sure what the current consensus on rats was. Although his video and description cite no sources, Shad does provide one in response to a commenter; a popular history website article from ‘historyextra.com’. His video appears to be based very closely on this one article, including the author’s confusing description of rat population changes. The article conflates rises and falls in populations, implying that an epizootic (animal-caused) outbreak must necessarily be preceded by a boom in the local rat population. The real indicator of a rat-borne plague in the various literature is die-off, not population increase. This is the real meaning of the term ‘rat fall’, not some sort of waterfall of rats as Shad seems to think. As Theilmann and Cate point out (more of them later);

“…chroniclers, however, paid so little attention to the plague that their failure to mention rats is hardly a surprise.”

So a lack of reports of a multitude of rats in the medieval period is irrelevant. The bigger problem for the rat fans is that Black Rats don’t seem to have been very common in 14th century Northern Europe. One of the first academics to challenge the rat hypothesis was David E. Davis, who published his article ‘The Scarcity of Rats and the Black Death: An Ecological History’ in The Journal of Interdisciplinary History in 1986 (Vol. 16, No. 3 (Winter, 1986), pp. 455-470). This is free to read at JSTOR with a free account, and I recommend it. However, even this also makes clear that a lack of ‘rat fall’ does not mean that rats were not spreading the disease;

“…mortality of rodents was not noted in some epidemics when it seems likely that Rattus was present.”

There is no mention of large numbers of rats preceding an epidemic here either; nor in the other sources that I checked. This seems to be a misconception borne of popular culture (meaning that Shad was right to query its appearance in a video game; but he should also be querying it in historical reality as well). It’s the die-offs that matter, but even these don’t preclude a given species as a factor. Having said this, Davis is emphatic that the evidence against (or rather, in favour of) rats is overwhelming; the rapidity of spread seen in the 14th century could not be down to rats alone (or even at all, as he argues). He also highlights the problem of sustaining the disease on board ship, when rats, being susceptible to plague, will die off in the course of a voyage and therefore be unable to spring from the gunwales and infect the landlubbers. Their fleas, on the other hand, and any infected humans, would have remained to spread the disease. This seems a little semantic though; in this scenario the rats have still spread the disease, possibly at both ends of the trip; they just weren’t physically there to pass it to their European cousins. Note that Theilmann and Cate challenge this; rats could survive some strains of Y. pestis, and/or survive through hibernation long enough to pass on the infection.

Ultimately, Davis’ article throws much doubt on Rattus rattus as the main carrier, but is not conclusive and nonetheless forms part of a broad consensus that it Y. pestis was in fact spread by as the University of Michigan puts it, “various rodents,” whether water voles, gerbils, some other species, or a combination of two or more of them. Paul D. Beull confirms in his article ‘Qubilai and the Rats’ (Sudhoff’s Archive, Vol. 96, H. 2 (2012), pp. 127-144) that “many other rodents are common vectors.” Yet there is clearly the same dearth of medieval references to mice, voles, or other rodents. The argument that there’s no evidence for rats spreading this plague is seriously undermined by the lack of evidence for any other species having spread it. Perhaps also by the significant part that rats did in fact play in other plague outbreaks. Basically, if rodents weren’t involved (and of these, rats remain a prime suspect), then bubonic plague wasn’t involved either; the Black Death would have to be one of the other forms of Plague or another disease entirely. If it was, then there is very clearly still room for rats to have some role. Even if the main disease of 14th century Europe wasn’t the bubonic form, it could still have originated in bubonic form within rats. If so, rats are ‘to blame’ (not that we should blame animals going about their business) just as much as the (likely) bats that originated the present pandemic. Bats aren’t flying around infecting us, yet we still blame them (rightly or wrongly). All we can say with any surety is that rats were not the only spreaders; the speed of the spread means that other mammals (including humans, as some emphasise) were involved. Still, it’s useful to know that the rat hypothesis is based upon such thin evidence and became received wisdom in the absence of a better explanation. It’s an educated guess more than a scientific hypothesis and as such should continue to be challenged. 

There’s a twist, however. Not only might rats not be involved in the Black Death, we don’t even know for sure that the three forms of plague caused by Y. pestis were actually the problem. If they weren’t, then the involvement of rats is obviously moot. Perhaps the real misconception here is that we know much of anything about the Black Death. It’s all hypothetical and/or speculative. We have no conclusive historical, DNA, or other evidence. All we know is that the pandemic doesn’t fit with the other outbreaks of plague. This is painfully clear from Samuel K. Cohn’s article ‘The Black Death: End of a Paradigm’ (The American Historical Review, Vol. 107, No. 3 (June 2002), pp. 703-738). Cohn offers no answers, and I’ve seen nothing to suggest that we are any further forward in our understanding. In ‘A Plague of Plagues: The Problem of Plague Diagnosis in Medieval England‘, John Theilmann and Frances Cate (The Journal of Interdisciplinary History, Vol. 37, No. 3 (Winter, 2007), pp. 371-393) make the very valid point that;

‘In one sense, the question of whether the Black Death was Yersinia pestis or some other ailment is a moot point, because only laboratory testing can provide conclusive evidence for a clinical diagnosis.’

As other authors do, they also explain that the medieval history is too sparse and too vague to support a conclusive identification. They do fall into the Y. pestis causal camp, as it were, and they still support rats as hosts. This alone challenges Shad’s confidence that there is ‘no evidence’ for rats causing the Black Death. There is as much evidence – more in fact, given the close association of Y. pestis with rats – as there is for any other possible host. The exclusively human hypothesis remains unproven and unlikely. Yet at the same time the article acknowledges that the rate of spread and mortality rate does not support plague alone – the devastation of the Black Death was likely not just a combination of plague variants, but of other diseases as well. The fact that there remains healthy debate about what diseases were even present renders the question of specific species of rodents involved almost irrelevant. We may never know the level of involvement of plague in the Black Death, never mind the extent of transmission or spread via rats. Of course, you might argue that this makes the formerly confident blaming of rats even less justified and even more in need of debunking. As usual, the more you know, the less you know…

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.