Plague Doctors

Scary or smart?

Plague doctors are, by anyone’s standard, terrifying. Armed with a nightmarish uniform and little to no medical training, they are the last thing you would want to see on your deathbed. But have they been treated unfairly? 

In our minds, they seem like terrifying individuals who would end up not only killing, but also scaring the living daylight out of everyone they treated. However, considering the limited knowledge and flawed science available, they are arguably pioneers of modern medicine and provided a basis for the healthcare we have today. 

Let’s start with the costume. Even though the plague began in Europe in the 1300s, the infamous outfit was not made official until 1619. Invented by Charles de l’Orme, the chief physician of Louis XII, the outfit consisted of waxed clothing, gloves, spectacles and the horrifying bird-mask. While this probably was quite a fashion statement at the time, it served another purpose- protection from infection.  

At the time, miasma theory dominated medical science and stated that disease was caused by a noxious form of ‘bad air’. In order to protect the doctor, bird-like beaks were filled with herbs and spices such as camphor, mint and cloves to cleanse the air and ward off infection. While the contents of your kitchen cabinet probably won’t ward off deadly diseases, this was the Middle Age equivalent of modern respirators, used to protect against air-borne diseases, and did have some logic behind it. Unfortunately for the plague doctors, oxygen tanks didn’t exist and holes were cut into the beak to allow them to breath, meaning many doctors ended up as patients themselves.  

Clothing was also waxed with suet to protect against these miasmas, inadvertently protecting them against any and all bodily fluids. Glass spectacles built into the mask completed the ensemble, and, although these were intended to protect against evil, they did a pretty good job of stopping any splashes from contaminating the doctors. Despite giving death metal bands a good run for their money, the outfit is reminiscent of modern protective equipment used in hospitals everywhere. All the basics: eyewear, respirators, full-body protection and splash-proofing, are covered in a similar way to now, just using limited resources and a dash of religious dogma.  

The perfect accessory? A long wooden stick, as essential as a sturdy handbag in the plague doctor’s wardrobe. As single-use silicone gloves were not invented, this seemingly primitive tool could be used to examine and communicate with plague victims, while still protecting their doctors from illness. Reports even suggest that plague doctors could take pulses using these sticks to assess a patient’s condition. Pretty impressive, considering how often we struggle to feel our own. Not only was it the perfect Medieval diagnostic tool, it was also pretty handy in avoiding the more aggressive patients, proving constant protection in more than one form. 

Now onto the treatments. This is where it gets a bit dicey as most of these would have worsened the illness and killed their patients even quicker. The plague was caused by Yersinia pestis, a bacteria carried by rats, and nowadays would be quite easily treated with a course of antibiotics. Unfortunately, penicillin was hundreds of years away, so plague doctors had to get a bit inventive. 

Therapies ranged from the usual blood-letting and pus drainage, to more outlandish treatments involving smearing human excrement on open wounds and sores. These got more extreme as the disease progressed, with some patients being covered in mercury and baked in an oven. While nowadays this would be considered barbaric and cruel, at the time there was a method to this madness. Humorism reigned supreme amongst medicine, and it was accepted by physicians that the body contained four humours: blood, yellow bile, phlegm and ‘black’ bile (probably partially digested blood caused by internal bleeding). Any imbalance in these humours was thought to cause disease, so practices like blood-letting were seen as the first line of treatment for most ailments. Perhaps a little outdated now, but at the time this was top quality healthcare. Even nowadays we recognise that draining pus is a good way to alleviate and prevent infections, but in a more sterile way. Compared to other prevailing theories, including zealous self-flagellation to avoid ‘God’s punishment’, this seems rather tame. 

Moving on from the wackier aspects of the job, plague doctors also contributed to the more tedious aspects of medicine. They kept detailed track of the number of casualties, even performing autopsies to certify the cause of death and learn more about the disease. These resembled medical records at a time when healthcare was a competitive and fragmented business. Around 150 million people (a third of the world’s population) died from the plague, but those seen by plague doctors were explained and accounted for, something quite difficult to do in the midst of a deadly pandemic.  

Plague doctors also abided by strict contracts, similar to the guidelines followed by modern day doctors. Employed by local authorities, plague doctors were required to treat everybody, regardless of wealth or status. Sound familiar? Bound by strict guidelines, clauses included how doctors were expected to behave around the public. This included that a custodian had to be present, similar to the idea of chaperones, whose job it is to protect patients’ rights and hold doctors to account. 

Infection control was also a huge part of their lives. Plague doctors agreed to only treat plague patients to prevent the spread of disease to patients with different illnesses. This was the Medieval equivalent of ward isolation and would have contributed to reducing the rate of infection. Not only this, doctors even agreed to live in complete isolation and quarantined themselves for lengthy periods of time after visiting patients. Considering most Medieval hospitals didn’t even have access to any medical care, this was quite a sophisticated practice. 

The most amazing part? Plague doctors weren’t even real doctors. Physicians at the time wouldn’t go near the plague, so it was up to those with little to no medical qualifications at all to pick up the slack! 

Were plague doctors kooky? Yes, undeniably so. But were they also ridiculously brave and way ahead of their time? Also yes. So next time you dress up for Halloween, remember that not only did they quite intelligently stand up to one of Europe’s most deadly diseases, they did it in style.  

Ashleigh Blood