Plague doctor

thumb|Satirical [[Copper engraving of a plague doctor of 17th-century Rome, by Paulus Fürst, 1656.]]

A plague doctor was a physician who treated victims of bubonic plague during epidemics in 17th-century Europe. These physicians were hired by the affected cities to treat infected patients regardless of income, especially the poor, who could not afford to pay.

Plague doctors had a mixed reputation, with some citizens seeing their presence as a warning to leave the area or that death was near. 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 or trained physicians or surgeons, instead they were volunteers, second-rate doctors, or young doctors just starting a career. 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 city or town simultaneously.

History

According to Michel Tibayrunc's Encyclopedia of Infectious Diseases, the first mention of the iconic plague doctor is found during a 1619 plague outbreak in Paris, in a biography 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 (1656) 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 Angelo as a plague doctor in 1348 for four times a normal doctor's rate of 50 florins 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 placing frogs or leeches on the buboes to "rebalance the humors." A plague doctor's principal task, besides treating people suffering from 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 affected the people. Plague doctors sometimes took patients' last will and testament during times of plague epidemics, and gave advice to their patients about their conduct before death. This advice differed per patient, and after the Middle Ages, the nature of the relationship between doctor and patient was governed by an increasingly complex ethical code.

Costume

thumb|One of two only known surviving plague masks; dated between 1650 and 1750; held by the German Historical Museum, Berlin

Portrayals of the archetypal plague doctor costume of beak-like mask, ankle-length waxed overcoat, gloves, boots, wide-brimmed hat, linen hood, and overcoat date to the early modern period. Though these depictions come from satirical writings, political cartoons, and characters of theater; they may have been based in a historical reality. The origins of the plague costumes are unclear but have been traced to 17th century Italy and France. There is no evidence linking the early modern archetypal image of the plague doctor costume to medieval plague doctors. The beak could hold dried flowers (like roses and carnations), herbs (like lavender and peppermint), camphor, copper, or a vinegar sponge, as well as juniper berry, ambergris, cloves, labdanum, myrrh, and storax. The herb-containing mask would have allowed for the doctor to use both hands in examining the patient.

The wide-brimmed leather hat helped to indicate a plague doctor's profession. The canes were also used to keep people away. The doctor's long robe was made from linen because it was said contagion did not stick to linen as easily as other materials.

Contract

Plague doctors were contracted by municipal administrators 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.

Notable plague doctors

In 1479 the city of Pavia contracted Giovanni de Ventura as a community plague doctor.
Irish physician Niall Ó Glacáin earned deep respect in Spain, France and Italy for his bravery in treating numerous people with the plague.
French anatomist Ambroise Paré and Swiss iatrochemist Paracelsus were 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 Part A Chapter VIII, Nostradamus also recommends to not bleed the patient. but he died in June 1645 only weeks after beginning employment.

Notes

References

Primary sources

Nostradamus. The Prophecies of Nostradamus, self-published 1555 and 1558; reprinted by Forgotten Books publishing 1973,
Nostradamus. , self-published 1555

Secondary sources

(Chapter 4)