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Plague doctor

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Paul Fürst, engraving (coloured), c. 1721, of a plague doctor of Marseilles (introduced as 'Dr Beaky of Rome'). His nose-case is filled with herbal material to keep off the plague.[1]

A plague doctor was a physician who treated victims of bubonic plague[2] during epidemics. These physicians were hired by cities to treat infected patients regardless of income, especially the poor that could not afford to pay.[3][4]

Plague doctors had a mixed reputation, with some citizens seeing their presence as a warning to leave the area.[5] Some plague doctors were said to charge patients and their families additional fees for special treatments or false cures.[6] In many cases these doctors were not experienced physicians or surgeons; instead, being volunteers, second-rate doctors, or young doctors just starting a career.[7] 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.[5]

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.[2][8][9][10]

History

According to Michel Tibayrenc's Encyclopedia of Infectious Diseases,[11] 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.[12]

The city of Orvieto hired Matteo fu Angelo in 1348 for four times the normal rate of a doctor of 50-florin per year.[9] 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 twelve were missing and may have fled away.[13]

Methods and tasks

Plague doctors practiced bloodletting and other remedies such as putting frogs or leeches on the buboes to "rebalance the humors."[14] A plague doctor's principal task, besides treating people with the plague, was to compile public records of plague deaths.[5]

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 affected the people.[15] Plague doctors also sometimes took patients’ last will and testament during times of plague epidemics,[16] and gave advice to their patients about their conduct before death.[17] 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, many people got sick And died [18][19]

Costume

Main article: Plague doctor costume
Plague doctor outfit from Germany (17th century).

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.[20][21][22][23] However, the costume was not worn by all medieval and early modern physicians studying and treating plague patients.[24] The exact origins of the costume are unclear, as most depictions come from satirical writings and political cartoons.[25] The beaked plague doctor inspired costumes in Italian theatre as a symbol of general horror and death, though some historians insist that the plague doctor was originally fictional and inspired the real plague doctors later.[26] Depictions of the beaked plague doctor rose in response to superstition and fear about the unknown source of the plague.[27] Often, these plague doctors were the last thing a patient would see before death; therefore, the doctors were seen as a foreboding of death. It appears that the only contemporary sources which claim witness to this infamous costume are based in Italy during the 17th century. Later sources based in other areas do claim that this costume was in use in their country (Most specifically during the black death), however, it is possible that they are being influenced by theatre and other works of fiction, already cited in this article.

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.[8] The mask had two small nose holes and was a type of respirator which contained aromatic items.[28] The beak could hold dried flowers (like roses and carnations), herbs (like lavender and peppermint), camphor, or a vinegar sponge,[29][30] as well as juniper berry, ambergris, cloves, labdanum, myrrh, and storax.[5] 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.[31] Doctors believed the herbs would counter the "evil" smells of the plague and prevent them from becoming infected.[32]

The wide-brimmed leather hat indicated their profession,[20][21][22][23][33] and they used wooden canes in order to point out areas needing attention and to examine patients without touching them.[34] The canes were also used to keep people away[35][36] and to remove clothing from plague victims without having to touch them.[37]

Contract

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.[7] Their contractual responsibility was to treat plague patients, and no other type of patient, to prevent spreading the disease to the uninfected.[38] 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.[39][18]

Negotiations

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.[7]

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 after it was originally written. Clause one originally showed 30 florins per month for pay but was 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.[7][40]

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.[41]

Reprimands

In 1527, in the city of Prato, a plague doctor named Stefano Mezzettino was seen attending to 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.[7]

Notable plague doctors

Footnotes

  1. ^ Füssli's image is reproduced and discussed in Robert Fletcher, A tragedy of the Great Plague of Milan in 1630 (Baltimore: The Lord Baltimore Press, 1898), p. 16–17.
  2. ^ a b Cipolla 1977, p. 65.
  3. ^ Cipolla 1977, p. 68.
  4. ^ Andrew Whalen (2020-03-19). "Are surgical masks the new plague masks? A history of the not-always-helpful ways we've reacted to pandemics". Newsweek. Retrieved 2021-03-09.
  5. ^ a b c d Byrne 2006, p. 170.
  6. ^ Rosenhek, Jackie (October 2011). "Doctor of the Black Death". Doctor's Review. Archived from the original on 2014-05-06. Retrieved 2014-05-06.
  7. ^ a b c d e Miskimin, Harry (1977). The Medieval City. Yale University Press. p. 66. ISBN 0-300-02081-3.
  8. ^ a b Ellis 2004, p. 202.
  9. ^ a b c Byrne 2006, p. 169.
  10. ^ Simon, Matthew, Emergent Computation: emphasizing bioinformatics, Publisher シュプリンガー・ジャパン株式会社, 2005, p. 3. ISBN 0-387-22046-1
  11. ^ Michel Tibayrenc, ed. (2007). Encyclopedia of Infectious Diseases : Modern Methodologies. Hoboken, New Jersey: Wiley-Liss. ISBN 978-0-471-65732-3. OCLC 181344580.
  12. ^ Black, Winston (19 May 2020). "Plague doctors: Separating medical myths from facts". livescience. Retrieved 15 January 2021.
  13. ^ Byrne 2006, p. 168.
  14. ^ Byfield 2010, p. 37.
  15. ^ Wray 2009, p. 172.
  16. ^ Wray 2009, p. 173.
  17. ^ "The Plague Doctor". Jhmas.oxfordjournals.org. 2012-04-02. Archived from the original on 2013-02-12. Retrieved 2012-06-12.
  18. ^ a b Gottfried 1983, p. 126.
  19. ^ Gottfried 1983, pp. 127–128.
  20. ^ a b Pommerville 2010, "Body Systems", p. 15.
  21. ^ a b Bauer 2003, p. 145.
  22. ^ a b Byfield 2010, p. 26.
  23. ^ a b Glaser, pp. 33–34[incomplete short citation]
  24. ^ Black, Winston; May 2020, All About History 19 (19 May 2020). "Plague doctors: Separating medical myths from facts". livescience.com. Retrieved 2021-03-09.{{cite web}}: CS1 maint: numeric names: authors list (link)
  25. ^ "17th-century Plague Doctors Were the Stuff of Nightmares". HowStuffWorks. 2020-02-12. Retrieved 2021-03-09.
  26. ^ Black, Winston; May 2020, All About History 19 (19 May 2020). "Plague doctors: Separating medical myths from facts". livescience.com. Retrieved 2021-03-09.{{cite web}}: CS1 maint: numeric names: authors list (link)
  27. ^ Mussap, J.C. (2019). https://onlinelibrary.wiley.com/doi/abs/10.1111/imj.14285 "The Plague Doctor of Venice". Internal Medicine Journal. 49 (5): 673. doi:10.1111/imj.14285. PMID 31083805. S2CID 153311347 – via Google Scolar. {{cite journal}}: Check |url= value (help)
  28. ^ *Time-Life Books, pp. 140, 158[incomplete short citation]
  29. ^ O'Donnell 1936, p. 135.
  30. ^ Stuart 2004, p. 15.
  31. ^ "Plagues of the Past". Science in the News. 2014-12-31. Retrieved 2021-03-09.
  32. ^ Irvine Loudon, Western Medicine: An Illustrated History (Oxford, 2001), p. 189.
  33. ^ Center for Advanced Study in Theatre Arts, p. 83[full citation needed]
  34. ^ "Imagery From the History of Medicine". art-bin.com. Retrieved 2021-03-09.
  35. ^ Association, American Medical (1900). JAMA: The Journal of the American Medical Association. American Medical Association.
  36. ^ Byrne 2008, p. 505.
  37. ^ Pommerville 2010, p. 9.
  38. ^ Gottfried, Robert S. (1985). The Black Death: Natural and Human Disaster in Medieval Europe. Simon & Schuster. ISBN 0-02-912370-4.[page needed]
  39. ^ Earnest, Mark (2020-09-03). "On Becoming a Plague Doctor". New England Journal of Medicine. 383 (10): e64. doi:10.1056/NEJMp2011418. ISSN 0028-4793. PMID 32433862.
  40. ^ Miskimin, Harry A. (1977). The Medieval City. Yale University Press. p. 67. ISBN 0-300-02081-3.
  41. ^ Miskimin, Harry A. (1977). The Medieval City. Yale University Press. p. 69. ISBN 0-300-02081-3.
  42. ^ King, Margaret L., Western Civilization: a social and cultural history, Prentice-Hall, 2002, p. 339. ISBN 0-13-045007-3
  43. ^ Woods, J. Oliver (1982). "The History of Medicine in Ireland". Ulster Medical Journal. 51 (1): 35–45 (40). PMC 2385830. PMID 6761926.
  44. ^ Körner, Christian, Mountain Biodiversity: a global assessment, CRC Press, 2002, p. 13. ISBN 1-84214-091-4
  45. ^ Hogue, John,Nostradamus: the new revelations, Barnes & Noble Books, 1995, p. 1884. ISBN 1-56619-948-4
  46. ^ Smoley, Richard (2006-01-19). The essential Nostradamus: literal translation, historical commentary, and ... By Richard Smoley. ISBN 978-1-4406-4984-4. Retrieved 2012-06-12.
  47. ^ Pickover, Clifford A., Dreaming the Future: the fantastic story of prediction, Prometheus Books, 2001, p. 279. ISBN 1-57392-895-X
  48. ^ a b "Excellent et moult utile opuscule à tous/ nécessaire qui désirent avoir connoissan/ ce de plusieurs exquises receptes divisé/ en deux parties./ La première traicte de diverses façons/ de fardemens et senteurs pour illustrer et/ embelir la face./ La seconde nous montre la façon et/ manière de faire confitures de plusieurs/ sortes... Nouvellement composé par Maistre/ Michel de NOSTREDAME docteur/ en medecine... by Nostradamus". Propheties.it. Archived from the original on 2012-03-17. Retrieved 2012-06-12.
  49. ^ "Edinburgh's Dark Side". 2007-07-18. Archived from the original on 2007-07-18. Retrieved 2021-04-08.
  50. ^ a b "Discover" (PDF). National Library of Scotland. 2015. Archived from the original (PDF) on 24 December 2015. Retrieved 8 April 2021.
  51. ^ a b c "Brit History: Plague Doctors in British History". Anglotopia.net. Retrieved 2021-04-08.
  52. ^ "The Real Edinburgh Plague Doctor". Real Mary Kings Close. 2019-06-24. Archived from the original on 14 May 2020. Retrieved 2021-04-08.

References

Primary sources

Secondary sources

Further reading

  • Fee, Elizabeth, AIDS: the burdens of history, University of California Press, 1988, ISBN 0-520-06396-1
  • Fitzharris, Lindsey. "Behind the Mask: The Plague Doctor." The Chirurgeons Apprentice. Web. 6 May 2014.
  • Haggard, Howard W., From Medicine Man to Doctor: The Story of the Science of Healing, Courier Dover Publications, 2004, ISBN 0-486-43541-5
  • Heymann, David L., The World Health Report 2007: a safer future : global public health security in the 21st century, World Health Organization, 2007, ISBN 92-4-156344-3
  • Kenda, Barbara, Aeolian winds and the spirit in Renaissance architecture: Academia Eolia revisited, Taylor & Francis, 2006, ISBN 0-415-39804-5
  • Reading, Mario, The Complete Prophecies of Nostradamus, Sterling Publishing (2009), ISBN 1-906787-39-5
  • Rosenhek, Jackie. "Doctor's Review: Medicine on the Move." Doctor's Review. Web. May 2011.
  • Pavia city archives Envelope, 443
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