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Historical Plague Doctors

With their rather bizarre appearance and sinister connotations, plague doctors tend to be seen as a single, nebulous entity. Men dressed in dark robes and beaked masks, here to confirm what will be, for most, a tortuously painful death from which there is almost no escape. Some even believe that they didn’t actually exist and are something that has been over exaggerated in popular media.  

To a certain extent, this might be true. But plague doctors did exist. They lived and died, put themselves at great personal risk to carry out their duties, much like any doctor would today. For this post, we’re going to be looking at three different accounts of plague doctors that have survived in historical documentation. It’s not known whether or not they wore the distinctive outfit that is typically seen to mark their station, but they definitely held the title from what documents indicate. Before we go into the individuals themselves, it would do well to remind ourselves about the profession they held and what they were up against.

A Bunch of Quacks

The Plague, or the Black Death, first struck Western Europe in 1348 and is believed to have wiped out around 50% of the world’s population at the time. The disease itself made a number of comebacks over the years, most notably in the 1600s. With symptoms ranging from a high fever, lumps around the armpits and legs, vomiting and painful spasms, death usually followed in 5 days. Medical practitioners at the time were wholly unprepared for such a virulent disease and no contemporary treatments were effective against it. There was little recourse but to hope you wouldn’t be next to be struck down.

The title of plague doctor has existed since at least the early 14th century (we’ll be exploring a specific case a little later) but the outfit we know wasn’t devised until around the 17th century. Charles d’Lorme, a French physician, came up with the design around 1630. He describes it as follows, referenced by Christian Mussap in his journal:

The nose [is] half a foot long, shaped like a beak, filled with perfume with only two holes, one on each side near the nostrils, but that can suffice to breathe and carry along with the air one breathes the impression of the [herbs] enclosed further along in the beak. Under the [waxed] coat we wear boots made in Moroccan leather [goat leather] from the front of the breeches in smooth skin that are attached to said boots, and a short-sleeved blouse in smooth skin, the bottom of which is tucked into the breeches. The hat and gloves are also made of the same skin… with spectacles over the eyes.

It should be noted that the way the outfit is typically depicted is a heavily stylised version. Below you can see an example of a modernised plague doctor next to a surviving example of a historical version.

Now that we’ve covered that, let’s get into specifics! All of the following has been based on research done through Google, accessing verified, free-to-read historical journals (at the time they were accessed). References are provided at the end of the post.

John Paulitous and George Rae

I’ve decided to place these two together because, unfortunately, I haven’t been able to find a great deal of specific information about them. However, it is known they both served during the outbreak of Edinburgh in 1645. Records, referenced by H.P Tait in their article, indicate it was a very hard time for those who lived there. Special carts were used to carry the dead, fixed with bells to announce their arrival. Only people who paid would get buried in a church. The rest would all be hauled off to a large quarry for mass burial. ‘Odiferous’ substances were burned to ward away the foul smells believed to spread the plague, clothes of the deceased were burned and white cloths were hung on windows to indicate the sick.

Paulitous and Rae are both referenced as plague doctors who were employed to work by the city. Paulitous is noted 25 December 1644 and Rae seems to be his replacement after his apparent death, taking up the role 6 June 1645. There’s not much that seems to be noted about their methods or what their conduct was, but Rae appeared to survive the outbreak since he makes an application for payment in 1661. It seems that Rae wasn’t paid the amount which was owed to him for his work, even after nearly two decades. It must have been quite an amount, if our next doctor is any kind of indication.

Giovanni de Ventura

Early map of the city of Pavia

Going back a couple of centuries, the primary record for this gentleman was drawn up 6 May 1479 in the form of his employment contract. It was written up for the town of Pavia in Italy and survives today in their local archives. While again we don’t have much insight into his particular conduct, the contract is very informative as to the particulars of his job.

Firstly, his payment was quite a generous sum. It offers Ventura 30 florins a month, paid a month in advance. For comparison’s sake, a skilled worker employed for 200 days a year would struggle to make 60 florins. 30 florins itself is equivalent to around 40 grams of pure gold. Considering this was a job that bordered on suicide, it’s certainly quite an attractive prospect. He would also be offered a free furnished house and citizenship for Pavia, as long as his conduct was agreeable. Now it goes without saying that a free house is very welcome, but what about citizenship? Simply put, it would be difficult for a doctor, especially one who is young and just starting, to establish a practice, especially in a city. Doctors already there wouldn’t want the competition. This clause would allow Ventura to get his foot in the door with both a place to live and practice without worrying too much about competing with other doctors.

As for treating his patients, the contract is quite clear. He is charged with treating all patients, regardless of social standing. He is to ask no fees of his patients, unless they willingly offer them. Apparently, the practice of a community doctor on hand for the poor was an Italian practice going back to the 12th century. The plague doctor seems to be a special extension of that, but was required only to treat plague patients to minimise the spread. One thing to note about treatment in the contract is that the community was required to keep the employment of a barber. Ventura was a physician, who were not trained or expected to perform surgery as it was regarded as a ‘lower’ practice. This would be left to barber surgeons since one of the methods of plague treatment was lancing the buboes: piercing the lumps to drain them of fluids.

Nathaniel Hodges

Jumping in both time and space, we arrive at the case of an English plague doctor. Educated at a number of institutions including Westminster School, Christ Church in Oxford and Trinity College in Cambridge, Hodges practiced in Walbrook Ward in London and was admitted as a member of the College of Physicians in 1659. When the Great Plague of 1665 erupted in the city, the King ordered the appointment of doctors to treat the disease ‘at all occasions’. Hodges was one of them, staying at his practice in London.

Falstaff enjoying a mug of sack.

Unlike the other two, there some details to note about his practice. For one, he seemed to test the effectiveness of certain ‘popular’ medicines in treating the plague. These included such things as swallowing beazor stones, drinking potions made with unicorn horn and the use of amulets like dried toads to draw out the plague. He found none of them useful, noting how amulets tended to stem from ‘imagination’ with their use. He didn’t advise smoking of tobacco as some did, believing that it may draw poison into the lungs. He tended to approach patients with individual treatments rather than general solutions. Such examples would be encouraging a gentle sweat, the use of medicines like Theriac (an ancient Greek treatment, also known as treacle) and always burned ‘some proper thing’ before entering a house. This is likely referring to something with a strong odour like herbs or flowers. In congruence with miasma theory, he believed that the plague was spread by corrupted air which came from the earth after earthquakes released foul gases.

Of particular note is in how he guarded himself from the plague. ‘Ranked among the principle antidotes’ was fortified white wine, also called sack. He drank it to discharge the plague and refresh his spirits, doing so even at the slightest sign that he might have it. To his credit, he did survive the Great Plague so he must have been doing something right. Sadly, his story doesn’t have a happy ending. His work declined in the 1680s and he fell into debt, ending up in debtor’s gaol where he eventually died in 1688.

So there we have it. In regards to Newcastle’s plague, there don’t seem to be any records of a plague doctor who attended it. However, we do have a resident plague doctor within the castle who can certainly tell you more about it if you see him! That’s if you don’t mind getting a little closer, of course…

References

Two Notable Epidemics of Edinburgh and Leith, H.P Tait, The Book of Old Edinburgh Club Vol.32, 1966

Plague Doctor of Venice, Christian Mussap, Internal Medical Journal no.5, 2019

A Plague Doctor, Carlo M. Cipolla in Medieval City, Harry Miskimin, David Herlihy and A.L Udovitch (eds), Yale University Press, 1977

Nathaniel Hodges (1629–1688): Plague doctor, CJ Duffun, Journal of Medical Biography, vol. 24 issue 1, 2016