A plague doctor was a physician who treated victims of the bubonic plague during epidemics. These physicians were hired by cities to treat infected patients regardless of income, especially the poor that could not afford to pay. Plague doctors are often depicted in Halloween costumes and seen as a symbol of death and disease.
Plague doctors had a mixed reputation, with some citizens seeing their presence as a warning to leave the area. Some plague doctors were said to charge patients and their families additional fees for special treatments or false cures. In many cases these "doctors" were not experienced physicians or surgeons; instead, being volunteers, second-rate doctors, or young doctors just starting a career. In one case, a plague doctor was a fruit salesman before his employment as a physician. Plague doctors rarely cured patients; instead serving to record death tolls and the number of infected people for demographic purposes.
In France and the Netherlands, plague doctors often lacked medical training and were referred to as "empirics." Plague doctors were known as municipal or "community plague doctors", whereas "general practitioners" were separate doctors and both might be in the same European city or town at the same time.
According to Michel Tibayrenc's Encyclopedia of Infectious Diseases, the first mention of the iconic plague doctor is found during the 1619 plague outbreak in Paris, in the written work of royal physician Charles de Lorme, serving King Louis XIII of France at the time. After De Lorme, German engraver Gerhart Altzenbach published a famous illustration in 1656, which publisher Paulus Fürst’s iconic Doctor Schnabel von Rom is based upon. In this satirical work Fürst describes how the doctor does nothing but terrify people and take money from the dead and dying.
The city of Orvieto hired Matteo fu Angelo in 1348 for four times the normal rate of a doctor of 50-florin per year. Pope Clement VI hired several extra plague doctors during the Black Death plague to tend to the sick people of Avignon. Of 18 doctors in Venice, only one was left by 1348: five had died of the plague, and 12 were missing and may have fled.
Methods and tasks
Plague doctors practiced bloodletting and other remedies such as putting frogs or leeches on the buboes to "rebalance the humors." A plague doctor's principal task, besides treating people with the plague, was to compile public records of plague deaths.
In certain European cities like Florence and Perugia, plague doctors were requested to do autopsies to help determine the cause of death and how the plague played a role. Plague doctors became witnesses to numerous wills during times of plague epidemics, and gave advice to their patients about their conduct before death. This advice varied depending on the patient, and after the Middle Ages, the nature of the relationship between doctor and patient was governed by an increasingly complex ethical code.
Some plague doctors wore a special costume consisting of an ankle-length overcoat and a bird-like beak mask, often filled with sweet or strong-smelling substances (commonly lavender), along with gloves, boots, a wide-brimmed hat, and an outer over-clothing garment. However, the costume was not worn by all medieval and early modern physicians studying and treating plague patients.
The typical mask had glass openings for the eyes and a curved beak shaped like a bird's beak with straps that held the beak in front of the doctor's nose. The mask had two small nose holes and was a type of respirator which contained aromatic items. The beak could hold dried flowers (including roses and carnations), herbs (including lavender and peppermint), camphor, or a vinegar sponge, as well as juniper berry, ambergris, cloves, labdanum, myrrh, and storax. The purpose of the mask was to keep away bad smells, known as miasma, which were thought to be the principal cause of the disease. Doctors believed the herbs would counter the "evil" smells of the plague and prevent them from becoming infected.
The wide-brimmed leather hat indicated their profession, and they used wooden canes in order to point out areas needing attention and to examine patients without touching them. The canes were also used to keep people away, to remove clothing from plague victims without having to touch them, and to take a patient's pulse.
A plague doctor's contract was an agreement between a town's administrators and a doctor to treat bubonic plague patients. These contracts are present in European city archives. Their contractual responsibility was to treat plague patients, and no other type of patient, to prevent spreading the disease to the uninfected. A plague doctor had to serve a long quarantine after seeing a plague patient. The doctor was regarded as a "contact" who by agreement had to live in isolation to be quarantined.
The bargaining which always preceded the final contract often consisted of serious negotiations. For example, the town administrators of Turin in 1630 were considering the terms of an agreement requested by one Dr. Maletto to become their plague doctor. After much negotiating, they instructed their broker representatives to make a fair and prompt deal as soon as possible with this Dr. Maletto. They were told to get the best possible deal for their city, but to be careful not to lose the opportunity of hiring this plague doctor, as it would be difficult to find someone else to perform these dangerous duties at such a low rate.
As an example of the tough negotiating that went on between plague doctors and infected European towns, there is in Pavia an original agreement between one Giovanni de Ventura and the city in their archives that shows a sixteen clause contract that was further amended even after originally written. Clause one originally showed 30 florins per month for pay, but later modified to be net of living expenses. Clause two was originally that the pay was to be given two months in advance, but later modified to monthly. Clause five provided originally a severance pay of two months, but later modified that to one month's pay. Clause six said the said master Giovanni shall not be bound nor held under obligation except only in attending the plague patients which was later amplified with ...the doctor must treat all patients and visit infected places as it shall be found to be necessary. Clause seven had to do with full citizenship and the original text was modified with according to how he shall behave himself.
Bernardino di Francesco Rinaldi obtained a clause in his contract when he was hired as plague doctor by the city of Volterra in 1527 that said essentially that the city had the obligation to provide Bernardino with all and everything necessary for his life support (i.e. food, water), and for these living expenses to be paid through the city expenditures.
In 1527, in the city of Prato, a plague doctor named Stefano Mezzettino was seen attending other patients without a custodian. The rule in the plague doctor contract was that a custodian must always be with the plague doctor when he visits other patients. This created much danger for the public. He was fined for his illegal act and breaking the rule of the plague doctor contract.
Notable plague doctors
- The Italian city of Pavia, in 1479, contracted Giovanni de Ventura as a community plague doctor.
- The Irish physician, Niall Ó Glacáin (c.1563?–1653) earned deep respect in Spain, France and Italy for his bravery in treating numerous people with the plague.[incomplete short citation]
- The French anatomist Ambroise Paré and Swiss iatrochemist Paracelsus were also famous Renaissance plague doctors.
- Nostradamus gave advice about preventive measures against the plague, such as the removal of infected corpses, getting fresh air, drinking clean water, and drinking a juice preparation of rose hips. In Traité des fardemens Part A Chapter VIII, Nostradamus also recommended to not bleed the patient.
- John Paulitious was Edinburgh's first plague doctor, but he died in June 1645 only weeks after beginning employment. He was succeeded by George Rae.
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