The Redolent Plague Doctor?

We’ve all seen him. A dark figure, robed in black, carrying his long examining stick like a scythe. A pale beak glimpsing out from beyond his broad-brimmed hat. A carrion crow turned man. Such nightmare fuel could only spring forth from the fever dreams of a Dark Age mind, right? His beak stuffed with aromatic herbs, a foolish talisman against death from a more ignorant epoch. The plague doctor! An ominous but heroic figure that was a staple of medieval life.

Ya…not really…no.

While doctors used aromatics to protect themselves from ‘miasma’ for centuries, the steampunk Bird Man cosplay wasn’t really a thing, a least not as you know him.


The Scented History of the Plague Series:

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A Bird Is Born

The get-up we know as the plague doctor or Medico della Peste costume was first theorised by Dr Charles de L’Orme in 1630. We have no evidence L’Orme wore it or even treated plague victims. He certainly did not act as a plague doctor, which I will explain more below. It was just a theory on protective equipment for doctors modelled after lightweight waxed leather armour. The idea was to create an impenetrable barrier where the contagion would not have contact with the physician’s body.

Almost from the beginning the Medico della Peste was being satirised. engraving by Johann Melchior Füssli

The face cover wasn’t a super stylised ceramic or paper mache beak but a waxed leather over-the-head hood with a pouch for aromatics at the nose area. This was because the prevailing wisdom at the time was that plague was spread by miasmatic air. We can laugh at this, but miasma was the accepted medical paradigm for over 1,500 years and was only overthrown with the rise of Germ Theory in the 1860s. Miasma remained part of the popular understanding of disease well into the 20th century.

L’Orme was an interesting character. He lived to be 94 in an age when most people were dead by 50, which he attributed to regularly consuming antimony. He was the physician to the French court for three generations of kings. Most unusually, however, he was a university-educated doctor at a time when most physicians bought a pharmacopoeia, hung a shingle, and called it a day. L’Orme was known for asking questions and challenging the status quo. Dr Birdman was not born out of some Dark Age Bosch nightmare but out of medical curiosity.


And it certainly was not an invention of the Middle Ages. L’Orme was working on his Medico della Peste costume almost 300 years after the start of the Black Death. 1630 puts us smack dab in the centre of the Early Modern period (aka the Late Renaissance, aka The Enlightenment, aka Birth of the Age of Reason). Further proof that the Early Modern period was awful and the Middle Ages get a bad rap.

But Were They Real?

Sort of.

Muesum replica of a late 17th century Medico della Peste hood, provenance contested

Thousands of doctors treated plague victims. Most covered their faces at some point, especially by the late 17th century. Hundreds of men worked in the profession known as ‘plague doctors’, but only a few enterprising souls wore the full Medico della Peste costume and most did not look as cool as the popular image.

Plague doctors costume ‘Costume d’un chirurgien quarantenaire du Lazaret de Marseille,  1819

There are a few surviving examples of plague doctor hoods used during the Great Plague period of the 17th century, mostly in southern France, Italy and Switzerland. However, it can be difficult to trace the provenance of these items, and many have proven to be reproductions or theatrical costume pieces and not working medical garments. The few we are reasonably sure were used in the field do not look like what the plague doctor is in the public imagination.

19th century reporduction. Plague doctors costume ‘Costume d’un penitent a Sur, canton des Grisons (Suisse).

The beaks were more like tubes or pouches stitched onto the hood. The pouch would be stuffed with loose rags or straw and scented with some aromatic. Herbs, flowers, rosewater, and even ambergris were used, but robust acrid smells were more common. Camphor and vinegar will hold their odour far longer than delicate rose petals. Many physicians discouraged the use of expensive and pleasant aromatics as counter-corruptives on moralistic grounds. Funny how it never stopped the wealthy from using them though.

While the use of aromatic plague preservatives was widespread throughout the whole span of the Second Pandemic the masks were not, particularly the shaped ones. They freaked people out and not just in that ominous “death is coming” way. They looked weird. The face coverings dehumanised the caregiver, which was not normalised as today. The concept of the Medical Gaze or medical detachment from the patient is a late 18th-century invention that coincided with the rise of unanesthetised surgery. Medieval medicine, in comparison, stressed treating the whole person. A doctor was as much a confessor, therapist, and dietician as a physician. People had relationships with their caregivers, sometimes going back to the day they were born. To go from that to having a hooded stranger come into your room and poke you with a stick because he wouldn’t even touch you, must have been deeply traumatising.

This often used engraving of Doctor Schnabel [i.e Dr Beak], is the oldest image of the Medico della Peste costume. Pulished ca 1656 by Paul Fürst. It is a satirical drawing mocking the use of Peste hoods as frightening and macabre. 

Most importantly, for our purposes, these masks were not familiar to them, not even in the 17th century. This was not a staple of the plague in Europe. Yersinia pestis had been bashing around Europe, off and on, for 300 years by the 17th century. If the beaked plague doctor were commonplace, we would not have letters of townspeople complaining to magistrates about the plague doctor’s strange ‘mumming’ mask.

The plague in Leiden in 1574
The plague in Leiden in 1574: a doctor examines a urine flask surrounded by the ill, the dying and the dead.  Note that while the doctors are wearing leather coats, hats and using sticks they are not covering their faces or wearing masks. Line engraving.

We also don’t see them in art the way we see other doctors. We only have a handful of 17th-century medical illustrations, showing the beaked mask, with no visual evidence of the mask before 1656. These medical texts are mostly talking about whether or not L’Orme’s ideas were correct. There is as much satire there as discussion of their virtues. In fact the first and probably most influential image we have of the plague doctor costume is the Doctor Schnabel (Dr Beak) engraving which is satiricaly mocking the costume. The text surrounding these images makes it clear this was not everyday wear for doctors, not even plague doctors. These were experimental protective garments, made quickly and no one had time to paint little glasses on a porcelain beak.

While there are many pieces of art showing people caring for the sick from the 14th to 17th century, the prime plague years. I have only found one piece of art outside of medical texts that shows the bird beak doctor and that is the coat of arms of Dr Theodore Zwinger III from late in the 17th century. I have yet to find an images of the costume in action.


This is all to say there is a grain of truth to the plague doctor costume but a pound of fancy.

Plague Doctors Mostly Sucked

Also, let’s set aside the idea that all plague doctors were selfless heroes. Many physicians treated plague victims and risked their lives to do so, but they were not referred to as ‘plague doctors’. A plague doctor was a travelling medical professional who worked on contract between himself and a municipality and dealt only with the plague. Plague doctors had enormous power and often oversaw last rites and the execution of wills.

Now before I rag entirely on plague doctors, let me say again, some of them were real doctors and were utterly committed to helping the sick. Drs Giovanni de Ventura, Ambroise Paré, and Niall Ó Glacáin essentially invented mass illness triage and quarantine. They should be sainted. Physicians were so valuable during the Black Death, kidnapping one could raise a literal king’s ransom, and cities would happily pay to get their doctors’ back.


As time went on, however, there weren’t enough physicians for the masses of sick. The plague doctor became synonymous with low-skilled doctors, self-trained barber-surgeons, or worse, con-men. People who would do this kind of work were seen as suspect, perhaps desperate, foolish or plotting. The plague doctor’s reputation was fairly low, come the end of the Second Pandemic. You can understand why, even if sincere, these figures came from out of town, charged the city huge fees and did very little to turn the tide of the illness. They lanced bobos, bled people, advised rest and certain foods, but none of that helped. The lancing and bleeding probably caused people to die faster. There are also multiple cases of plague doctors taking the money and skipping town, being drunk during working hours, being accused of forging wills or lying about how many patients they were seeing. We don’t have a paper trail of plague doctors wearing the mask in the Middle Ages, but you know what we have a lot of, cases of city’s taking their plague doctor to court for dereliction of duty. It was a standard legal procedure throughout the Second Pandemic until plague doctors were outlawed from practising medicine in the late 18th century. The anger and frustration directed at the plague doctor, partially earned and partly just as the figurehead for the trauma of plague may, however, be the very reason why this obscure piece of experimental medical equipment has so gripped the public imagination.

Working Through Shared Trauma With Party Masks

So why do we have this clear cultural picture of Dr Beak? White mask, big black hat, wee glasses, the works?! Three reasons, Commedia dell’Arte, Carnaval, and processing collective trauma.

Remember a few years ago how everyone was sure the comedian Sinbad made a movie called Shazaam, only he didn’t. It was a composite memory shared by many people who were kids in the early 90s. Shazaam is a confabulation of the comedian wearing a vaguely “oriental” costume during a TV presentation of Sinbad the Sailor in 1994, the 1996 film Kazaam starring Shaquille O’Neal as a genie and reruns of the Hanna-Barbera cartoon Shazzan, also featuring a genie. This type of collective misremembering is sometimes referred to as the Mandella Effect in the press.


A similar Mandella Effect has happened with the plague doctor and the Commedia dell’Arte. If you ask people, “Is there a plague doctor character in the Commedia?” Most will say yes, but there isn’t. Now, I’m not an expert in Italian folk theatre, so maybe there was a one-off character in a performance at some point. However, the whole point of the Commedia is that stock characters are used, over and over again. There is no plague doctor stock character. There are, however, multiple masks in the Commedia dell’Arte that feature exaggeratedly large bird-like noses. Scaramouche, Zanni, Il Capitano, and Il Dottore all somewhat resemble the Medico della Peste mask that we know. The Scaramouche and Zanni characters were often played as plotters or tricksters. Il Capitano is pompous and swaggering, usually, an outsider showing up to outshine the romantic lead. Il Dottore is an out of touch self-righteous know-it-all. Both Il Capitano and Dottore are also sometimes played as underhanded, lustful, and/or mercurial. Remember how I said that the plague doctor as a profession had developed a bad reputation by the 17th century?

The public image of the plague doctor as a concept is basically a composition of all of these characters. Perhaps it started as a comparison of the masks made by those that interacted with the few doctors that wore the Medico della Peste hood. The first-ever image of the Medico della Peste was published in 1656 by Paul Fürst in Rome and might have been referencing the stage masks in his satirical engraving. Regadless, eventually, the similarities merged.


The popularity of the new-fangled Commedia dell’Arte led to many character’s masks becoming staples of the Carnival masquerade of Italy by the early 18th century. Colombina, Pantalone, Arlecchino, Pierrot and even Zanni, are familiar sights today. Along with the addition of these theatrical masks came a slight variation. A mask with a larger bird-like beak and pained on spectacles, reminiscent of the Fürst engraving. This mask was not part of Carnival before the 18th century. It is not clear who made the first plague doctor mask for Carnival, but it was lumped in with the Commedia dell’Arte in the collective consciousness. With his examination stick and professorial robes, it was clear to the audience that the character was a medical doctor. The monstrosity of the mask and its bone whiteness in a sea of colours, both conveyed the sinisterness of the plague doctor as a trope as well as the ubiquity of death in Italy during the plague years. The plague doctor costume during Carnival was a memento mori, not a historical recreation.

It was a reminder that even at this moment of frivolity, death is just around the corner. That your soul could be plucked up by this big black portent of death at any time. It was one of the ways in which people processed the trauma of the plague. Some developed black humour, some lost religion, others found it, but collectively everyone had to handle it on some level.

A modern plague doctor Carnival mask referencing a later copy of Fürst’s satrical illustration. 

The plague doctor became the visualisation, the physical manifestation, of the trauma, horror, and fear of the plague years. A composite memory, like Sinbad’s Shazaam.  A grain of truth but not completely factual either, more a spectre we’ve inherited from the past.

Read the next article in The Scented History of the Plague Series: