The Doctors

Meet the Doctors in their travel through time and space.

A Plague Doctor’s visit in 1649

‘When he is called to a sick person, he should send the servant ahead to open a window in the room where the plague patient is lying, and light a fire, and fumigate as far as it is possible (if the patient is not lying in a hayloft or on the straw in the stable); meanwhile the doctor shall rinse his mouth with vinegar, and rub it also on his face, wrists, and nose, and chew on some Angelica root, and go there in the name of God; but he should first stand still for a moment in front of the room and rest, so that he doesn’t have to breathe in too deeply when he is close to the patient.
When he nears the plague-stricken person, holding a candle in front of his mouth, he should turn his face away and question him in few words, examine behind his ears, armpits and groins, and take his pulse, but be cautious, so that the bedclothes are not moved or lifted, so that the stench of sweat, urine or stool does not get up his nose and the poisonous vapor is driven into his body.
When he has acquired enough information about the illness and general condition, he should concisely comfort the patient, admonish him to confess, and not stay with him any longer, and order for medication or prescribe the medicines outside the room.’

Plague diorama by Studio Mattie
Plague diorama – Studio Mattie

If this procedure was common practice all across Europe – and it was – what would people in those days have thought of a plague doctor going around in a dark attire with a raven mask? No doubt as something most peculiar. Something from another world. Something so bizarre, that it couldn’t be anything else but a fable. Enter the artists.

Doctor Zero

When the plague struck Rome in 1656, the papal government took strict measures to control the epidemic. The city was closed for people and trade goods from afflicted areas, there were restrictions on moving around, people were put into isolation, houses were fumigated, personal belongings of those who had died were burned, hospitals were set up and staff was hired for all sorts of plague-related tasks. Each district was appointed a team of two doctors and a priest. They were obliged to wear robes of waxed linen, and they had to carry a long stick with a cross at the top, so that they could be recognized from great distance. In case of disobediance they risked capital punishment so we may assume that they complied with them.

Woodcut by Sebastiano Zecchini of plague doctor from Rome in 1656, wearing protective clothing with mask.
Plague Doctor from Rome, broadside by Sebastiano Zecchini (publisher), 1656. British Museum, London.

This broadside, which was published in the near vicinity by Sebastiano Zecchini, is one of the earliest known pictures of a masked plague doctor. It is not an informative medium in a modern sense, but the caption agrees with other Italian sources where it mentions a robe of waxed linen, glasses in front of the eyes and fragrant materials in the nose ‘against infection’. Mind you; the nose, not the beak.
Stuffing the nose with herbs and other fragrant materials was fairly common for doctors who had to come near the plague-stricken until the late nineteenth century, when progressing medical insights brought a departure from the assumed relation between stench and contagion.
Ravens are drawn to the smell of decay, and there was plenty of that when the plague hit a city. Is this why Zecchini chose to equip his doctor with a raven-like beak? Or does the wearer just smell an opportunity?

Doctor Beak dissected

Believe this fable, if you will,
what they say of Doctor Bill,
while from contagion he flees,
he earns from this his ample fees.
He scavenges on human flesh,
like ravens do among the trash,
Trust me, scrap Rome from your plans,
for it is ruled by Pestilence.

Who wouldn’t find himself in fright,
when his rod comes into sight,
with which he gestures wordlessly,
to indicate his therapy.
As most of us believe for sure,
he’s tempted by the devil’s lure.
Hell is the wallet that he keeps,
His fortune is the souls he reaps.

(transl. HJM)

The Nurembergian publisher Paulus Fürst took the ominous doctor into his allegorical playground and adapted it to the taste of his customers. By adding a satirical poem and placing the figure against a background with a city (Rome, no doubt) and a second appearance of the doctor, he enriched the original with references and cross-references.

Doctor Schnabel, engraving by Paulus Fürst 1656
‘Doctor Schnabel von Rom’, broadsheet by Paulus Fürst, 1656. British Museum, London.

He is a raven. Plague doctors had a reputation for behaving like scavengers; just as ravens they lived from the death of others. This is stressed in the lines ‘Cadavera sucht er zu fristen / gleich wie der Corvus auf der Misten‘ (he seeks cadavers to devour / like the raven on the dung heap).
He is Death. The long black cloak, the bat-winged hourglass, his entire posture, remind us of the Grim Reaper. No wonder that the people in the background are running for their lives. There is a double satire here, hinted at by the third line of the poem: ‘der fugit der Contagion‘ / he flees from the contagion’. This alludes to the fact that those who could afford it, left the city in great numbers in times of plague, which was regarded by some as cowardly (and useless, for Death will get you anyway). But, again, the doctor makes profit out of this, as pointed out in the fourth line: ‘et autert seinen Lohn darvon / and earns his wages by this’.
He is a thief. The long fingers, his lust for gold; always ready to award himself a little hazard allowance. ‘To steal like a raven’ – there he is again – is a popular expression in any language.
He is a devil. He could even be the plague itself, as the disease was personified as a dark and devilish monster since the Middle Ages. This we find in the last lines, where a ‘Schwartzen Teufl’ is mentioned.

There can be a fifth capacity, that of a comedian. Originating in Venice, the improvisational theatre of the commedia dell’arte became very popular in Germany, not in the least in Bavaria, where this print was published, and an Italian doctor wearing a silly mask would easily remind audiences of the pompous and greedy ‘dottore’ from the plays. These doctors spoke in a mixture of pseudo-latin and vernacular language, much like the poem on the engraving. The name ‘Doctor Schnabel von Rom’ can refer to theatre doctors as well, as they were named after a trait or an attribute of their profession (more about masks worn by comedians as well as symbolic masks you’ll find in our mask department).

In 17th century graphic art, a doctor is seldom a doctor. Often he will represent something or someone within the broader context of an allegory. Allegorical depictions of the medical profession itself also abound. One well-known example, that may even have inspired Paulus Fürst, is a series of prints by Hendrick Goltzius, that show us a doctor in four appearances: God, an angel, a human and a devil.

Doctor as God by Goltzius
Physician as God (fragment)
Doctor as angel by Goltzius
Physician as an angel (fragment)
Doctor as human by Goltzius
Physician as a human (fragment)
Doctor as devil by Goltzius
Physician as a devil (fragment). All Rijksmuseum, Amsterdam.

Doctor to the Stars – Charles de Lorme

According to his biographer, Charles de Lorme protected himself during a plague epidemic in 1619 in Paris against contagion through a costume of his own invention, consisting of a jumpsuit of Morocco leather, combined with a pair of goggles to which he attached a nose of half a foot long, that was supposed to deflect the malignant air. He took rue and garlic in his mouth, his nose and ears he stuffed with incense. In this attire, he ‘helped the sick and he cured almost everyone to whom he gave remedies’.

Impression of Charles de Lorme in his plague costume. Studio Mattie.
Impression of Charles de Lorme in his leather plague suit.
©Studio Mattie

Perhaps this peculiar armour offered another advantage besides protection in comparison with other personal protective equipments. Plague workers were advised to change their garments at least twice a day, and disinfecting those clothes by fumigation or washing them with vinegar was of the greatest importance. Uncovered body parts such as the face (especially the temples for some reason) and hands were rubbed with vinegar after each patient visit. With this costume, De Lorme could have had himself washed off as often as he wished without taking his clothes off.

Charles de Lorme wasn’t just any doctor. He was private physician to three consecutive French kings during the seventeenth century, and many of his other patients belonged to the rich and the nobility. We can safely assume that in case of a plague epidemic, he acted just as his clientele and so many other doctors did, and what was recommended as rule number one: flee from the afflicted region and do not come back before it is over.

The Return of the Masked Doctor – Marseille 1720

Doctor François Chicoyneau was the son-in-law of the highest medical authority of France, court physician Pierre Chirac, and bound to follow in his footsteps. He was already a professor and Dean of the prestigious Medical Faculty of the University of Montpellier, when a gruesome plague broke out in Marseille. In response to demands for support by the city council, Chirac appointed Chicoyneau as head of a team of doctors that was to report on the situation. To the frustration of the local physicians, Chicoyneau’s conclusions were vague and in denial of the severity that grew by the day, the court responded even less concerned, yet when Chicoyneau returned to Montpellier, he was hailed as a hero. This must have set at least some people off. Roasting him openly was not without risk given his position, so what is an easier way to discredit somebody anonymously than to spread a good old deepfake picture?

Francois Chicoyneau and plague costume from Marseille
Right: broadsheet with the portrait of François Chicoyneau, 1721. Wellcome Collection, London.

An example was readily found in an old satire of a plague doctor wearing a ridiculous bird mask – which was the more hilarious since Chicoyneau was the major advocate of the idea that the cause of the epidemic that had hit Marseille was fear óf the disease, and that it couldn’t be transmitted from human to human. He saw no need in taking prophylactic measures except for a moderate diet and keeping his spirits up, and whatever his adversaries thought of him, cowardly he was not.
The joke was less about the scavenging business than the earlier prints, so there was no need for the beak to look that ravenlike – maybe it was even adjusted to make it look like a cuckoo.
The masquerade sorted the desired effect; it was believed by many, and Chicoyneau’s name became attached to the fabulous outfit for ever after.

The Industrious Doctor

When tourism in Venice received its formidable booster in the early 1980s, the revival of the carnival was the major ingredient. The artisanal masks satisfied the demand for a souvenir perfectly, and of these, the Medico della Peste-type grew rapidly to become the ultimate icon of Veniceness. It has a bit of everything that the lagune city is famous for: carnival and decadence, splendour and the sinister, extravaganza and the ravages of the plague. No less than three lazaret islands and five votive churches remind us of the many epidemics that have scourged Venice throughout its history, and by now everybody knows that the word ‘quarantine’ has Venetian origins, quarantena being the forty days period that foreign ships had to wait before people and cargo were allowed ashore.

Plague Doctor Venice
Medico Industrioso‘ in ‘Gli abiti de’ veneziani di quasi ogni età con diligenza raccolti e dipinti nel secolo XVIII‘ by Jan Grevenbroeck II, second half of the 18th century. Museo Correr, Venice.

Although Jan Grevenbroeck II (1731-1807) lived in Venice, he had never seen a plague doctor with his own eyes. When he compiled his manuscript of historical Venetian costumes, he found an example for his illustration of the plague doctor in a popular book on medical curiosities that was published in Copenhagen about a century earlier. The author of that book had copied the picture in his turn from a German broadside, Paulus Fürst’s Doctor Schnabel most likely, which was already a copy as we’ve seen.
Grevenbroeck added a touch of Serenissima by specifying the color white, after the color that was most commonly used for the masks that were worn by the Venetians in his days. And so they are white again as they fill the tourist shop windows in endless rows, unknowingly caricaturizing something that was already a caricature, and traditionalizing a tradition that is as old as their craftfully executed craquelures.

Quarantine Doctor

A century after the horrendous plague of Marseille in 1720, the city was well prepared for a new outbreak. The quarantine station was state-of-the-art, and hospital staff members such as the guard and the surgeon on these pictures, could dispose over personal protective equipment in case of an outbreak.

Guard and surgeon of the Marseille lazaret in 1819.
Guard and surgeon in the lazaret of Marseille in 1819. Illustration in L.J.M. Robert (1826), Guide Sanitaire des Gouvernemens Européens, ou Nouvelles Recherches sur la Fièvre Jaune et le Choléra-Morbus.

The plague was diagnosed only sporadically in the nineteenth century in these parts of Europe, but there were new dangers lurking: yellow fever and, even more impending, cholera. The mechanisms of contagion were still unknown, and the measures against cholera had not evolved much from those applied against the plague in earlier centuries. A handkerchief drenched in vinegar, like we see in the hand of the surgeon, held in front of the nose and mouth, was still widely in use for personal protection. The guard is holding a metal casket with burning coals, that was used for fumigation.
Disinfecting rooms and belongings by fumigation had always been one of the standard procedures, and the employees who fulfilled this task, wore protective robes and hoods of waxed linen. These parfumeurs, perfumeurs, désinfecteurs, maîtres désinfecteurs, nettoyeurs de peste, purgeurs, officiers de purge, escureurs, cureurs, aérieurs, airieurs, désairieurs, désaéreurs, dehaireux, esventeurs, marqueurs, marronds and bosserands, were with many, and they looked more like plague doctors than plague doctors did.

The Manchurian Doctor

The outburst of the plague that spread from Canton, Macao and Hongkong in 1894, meant that the disease was back – and so was the mask.
When, under the pressure of a terrible high in the region of Manchuria in 1910, the Malaysian doctor Wu Lien-Teh was appointed head of the anti-plague efforts by the Chinese imperial court, masks were still far from mainstream however. Initially Wu had a hard time convincing his colleagues that wearing gauze and cotton nose-and-mouth masks by medics and other plague-workers would help to prevent the contagion from spreading, after his then controversial discovery that this variant of the plague was airborne. But, supported by a well-orchestrated use of the emerging medium of press photography, he eventually succeeded in a general acceptance of the mask as an essential weapon in the combat against the plague.

Harbin Plague
A house-to-house inspection party. Photo from ‘Views of Harbin (Fuchiatien) taken during the plague epidemic, December 1910 – March 1911’. Royal College of Physicians (Wellcome Collection).

Wu’s French colleague Charles Broquet, who investigated the epidemic in service of the Pasteur Institute, presented a different type of mask around the same time, modelled after the illustrations of the Marseille lazaret employees. His was considered less practical for everyday use than Wu Lien-Teh’s version, but in time it was absorbed in the design of the hazmat suits as we know them today.

Plague mask by Charles Broquet
Charles Broquet’s anti-plague outfit, 1911.

Health authorities worldwide continued to recommend or oblige the use of anti-plague masks by civilians when a pandemic occurred, such as the Spanish flu (1918-1919) and COVID-19 (2020-2022), as a general preventive measure that helps to ‘flatten the curve’. The hazmat suit with an incorporated mask, supposedly first invented by Charles de Lorme, has become commonplace in its use by doctors, paramedics and disinfectors in the approach to many other contagious diseases.

To be continued

Here the fable ends. But the Doctor will continue to appear, in the persona of a fortuneseeker, an opportunist, a private physician or a heroic plague fighter, now here and then there, as he/she has already done for almost four centuries in Earth’s time stream.

Dancing plague doctor by Studio Mattie

HJMattie febr 17, 2022

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