Medieval Plague Masks

Being in the middle of the Covid-19 outbreak, it is interesting to think about how societies in the past dealt with pandemics that they were faced with. Many of the approaches societies used were relatively useless, or, in some cases, did more harm than good. The toxic element mercury was commonly used in treatments for skin disorders and syphilis and bloodletting are examples of these. Religion was often commonly used. Considering that, for most of human history, people were unaware of the presence of bacteria, viruses, and other microscopic pathogens, it becomes less surprising that many of the theories of disease were extremely incorrect. However, even though physicians in the past may not have known of the presence of microorganisms, they had managed to accidentally come up with a way to protect themselves from the potentially fatal creatures, and what they created was, in many ways, genius.

At the time, physicians believed that the plague was caused by poisonous air. The modern germ theory of disease hadn’t existed, and the rapid spread of the disease made the air seem like a possible cause.

The image of the medieval physician, carrying a cane and wearing a long black coat, gloves, a hat, a hood, and, most notably, a mast that looked like the face of a bird, may seem horrifying to some. If I was a child at the time, I could imagine being frightened by physicians’ unique look. However, this unique getup provided many benefits to the physicians wearing them; especially during one of the worst pandemics of history: the black death. It is believed that this deadly pandemic was caused by the bacteria Yersinia pestis. The plague took on two forms: bubonic plague and pneumonic plague.

The bubonic plague was characterized by swollen lymph nodes and boils. Along with this, there was the tendency for fingers and toes to necros, turning black as they did. This version of the plague had a fatality rate of about 75%.

The pneumonic plague was worse. Having a fatality rate of about 90%, this disease was spread more easily from person to person and involved respiratory symptoms, such as chest pain, cough, and pneumonia. Even with modern medicine, over 500 people died of this disease between 2010 and 2015.

The clothing worn by the physicians during the black death was, in some ways, effective at providing protection to the brave medical providers who were willing to attempt to help people suffering from this bacteria. The coats and gloves helped protect their skin, keeping them covered to prevent bites from infected fleas. It also helped prevent bacteria from infecting them through wounds. The canes that the physicians carried allowed the physicians to keep their distance from the patients they observed.

The masks, however, were probably the most effective part of their getup. The beaks of their masks were filled with a mixture known as theriac, to help prevent the putrid odor of death from getting to the physician. Scented plants in this mixture often included roses, mint leaves, camphor, myrrh, cloves, and juniper berries. Viper flesh powder, cinnamon, and honey were also often included. The beak of these masks may have acted, in some ways, as a filter of infected aerosols that the physicians were exposed to while seeing patients. They also helped prevent patients from coming too close to them.

There is some evidence that very few physicians actually wore these elaborate and, in many ways, frightening costumes while practicing medicine. Whether or not these getups were common, they have become a classic image of past medicine and provide an interesting view on how medicine was perceived centuries ago.