The Plague Doctor, Popular Culture, and COVID-19

“But in many ways, the protective uniform worn by these doctors seems similar to what current medical professionals wear when treating those with infectious diseases.”

At the time when doctors believed that miasmic fumes were responsible for the transfer illnesses, rather than germ theory, medical professionals developed elaborate outfits to protect against the believed noxious air. The bubonic plague ravaged across Europe and Asia through the 14th to 17th centuries, with the prevailing theory was that it was caused by the miasmic theory of “malignant air”. In reality, the bubonic plague was actually spread when infected fleas from small animals entered into the human system by a flea bite. “The Plague Doctor” uniform was quite useless in assisting to protect against the disease, which killed an estimated 200 million people worldwide. But in many ways, the protective uniform worn by these doctors seems similar to what current medical professionals wear when treating those with infectious diseases.

The costume worn by the Plague Doctor was designed by Charles de Lorme and described in Jean Jacques Magnet’s 1721 Traité de la peste (Treatise on the Plague) as a uniform consisting of a heavy goat skin coat overlaying a leather shirt tucked into breeches, which in turn was tucked into leather boots. The doctor would additionally wear a wide brimmed hat and gloves made of the same materials, a beaked leather mask, and would carry a long stick.[1] The Plague Doctor uniform provided a physical barrier between the patient and the doctor, as well as serving as an image made for horror movies. The image of the Plague Doctor has become popular in comic books, video games, and as a popular costume during the annual Carnivale di Venezia – a street festival known for people’s elaborate masks celebrating the end of lent.

People dressed in the traditional Medico della Peste (Plague Doctor) masks, participating in the Plague Doctor Procession in Piazza San Marco during Carnivale di Venezia in February 2020. (Courtesy of AFP via Getty Images.)

The largest difference between De Lorme’s Plague Doctor uniform and the current uniform of medical professionals is the acknowledgement and adoption of germ theory. During the time of the plague, there were no sanitary precautions in place to ensure that the doctors were sanitizing their uniforms. Likely, doctors at this time would have travelled from patient to patient in the same clothes, with no sanitation measures in place. This could have allowed all kinds of infectious diseases to be transferred from patient to patient while the doctors wore the same filthy clothes. Two hundred years later, these standards would appal everyone living in the current era who is accustomed to the cleanliness and sterility enforced by the attire of healthcare professionals.

Habit des Medecins et autres personnes. 1911. Courtesy of the Sir William Osler Collection, Museum of Health Care (Link).

In the early-mid 1900s the medical field was transitioning to a disposable system, in which reusable masks and other products were put aside in favour of items that would be thrown away after one use. This total disposable system was partially an attempt to improve hospital sterility – an idea long ago implemented by Joseph Lister – and also an attempt to save labour costs associated with cleaning and folding the previous, reusable-style medical materials.[2] However, from head to toe, take a close look at the Plague Doctor uniform current and how it parallels the uniform used by healthcare professionals during COVID-19.

Mask? Check: The beaked mask has been swapped for N95 masks.
Hat? Check: The traditional goat skin leather hat has been replaced with a surgical cap.
Gloves? Check: The goat skin gloves are now disposable rubber gloves, typically nitrile.
Jacket and Pants? Check: The leather jacket ensemble has been replaced with scrubs and sometimes with additional gowns and protective coverings to protect against more infectious diseases.

Ontario nurse in PPE outfit during COVID-19. 2020. Courtesy of the Ontario Nurses’ Association. (Source)

So, would the uniform have equipped the Plague Doctors to be safe against the Coronavirus pandemic? The answer is likely no. While the Plague Doctor mask covered most of the face, it did have breathing holes at the end of the beak. And we can be quite certain that doctors at this time were not properly cleaning and disinfecting their uniforms. We have the resources available to us right now that make the control of infectious diseases significantly more feasible, both because of personal protective equipment and because of our more robust knowledge of disease transference.

During the COVID-19 outbreak, parents around the world have expressed that face masks are terrifying their children.  While it may not be ideal, the precautionary facemasks and face shields are easy to come by and are an important part of minimizing public transference of the disease in crowded areas.  Not to mention, they are also significantly less terrifying than a Plague Doctor walking down the streets in the 21st century – just take it from the people living in the small town in the east of England who had a resident dressed as a Plague Doctor roaming their streets this spring.

Individual dressed in a Plague Doctor costume in Hellesdon, UK strolling through the neighbourhood in April 2020. Courtesy of BBC News, Norfolk. (Source.)

About the Authour

Jessica Lanziner

(Margaret Angus Research Fellow, 2020)

Jessica Lanziner is currently in the Master of Museum Studies program at the University of Toronto and an alumna from Queen’s University, holding a Bachelor of Fine Art and Art History. With previous positions like work at the Uxbridge Historical Centre, Jessica has had the opportunity to work with collections of dental materials from a local early 20th century dental offices, igniting her interest in the history of healthcare in Canada.  


Citations

[1] Lucenet Monique. “La peste, fleau majeur – Extraits de la Bibliothèque Universitaire du Paris” (1994). Quoted in Encyclopedia of Infectious Diseases: Modern Methodologies, edited by Michel Tibayrenc. 680. Hoboken: Wiley & Sons Inc, 2007.

[2] Strasser, Bruno and Thomas Schlich. “A History of the Medical Mask and the Rise of Throwaway Culture”, The Lancet, (May 22 2020). https://doi.org/10.1016/S0140-6736(20)31207-1.  


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