Famously, the Black Death swept through Europe in the fourteenth century, killing between a third and half of the entire population. It was a watershed in the history of the West. The plague subsided after about 1352 but stuck around for centuries to come. In 1665, the Great Plague of London killed about 100,000 people. There were outbreaks all over Europe during the sixteenth, seventeenth, and eighteenth centuries. France was particularly hard hit. It was in France, in the early seventeenth century, that the distinctive plague doctor costume was devised.
The costume was designed by Charles de Lorme (1584–1678), physician to King Louis XIII of France. The clothing was designed to cover the doctor’s entire body so that he would not risk physical contact with those infected. The stick he carried was used to poke about the patient. The bird-like beak of the mask was filled with sweet-smelling flower petals to help ‘purify’ the ‘bad air’ assumed to be the cause of the plague. Plague doctors across Europe would go on wearing this type of costume through the eighteenth century.
This image of the plague doctor has proven to be one of the most recognizable symbols associated with the disease. A seventeenth-century rough equivalent of the hazmat suit in an age well before the development of germ theory. People at the time knew the plague could spread from person to person but held to a miasmatic theory of disease — the idea that disease was spread by bad air. Though there were early scientific developments in terms of the understanding of the microscopic world (see the work of Robert Hooke), this was not immediately associated with diseases. The idea of a scientific revolution is a twentieth century projection back onto the seventeenth and eighteenth centuries. While the scientific method was popularized and used to solve problems to a much greater degree, older medical theories still lingered. Bloodletting, and Galen’s theory of the humors still remained from medieval Europe and the Islamic world.
Plague doctors kept their distance from patients through use of a stick. Often, professional doctors would not have stayed around to care for those infected, in fear of catching the disease themselves. This meant that people with very little, if any real medical training, would have been tending to the infected.
The plague doctor is perhaps the best representative of a profession in transition. The medieval medical theories lingered on through the eighteenth century, being gradually replaced. The concern with contact with an infected person was the closest Europe got to any type of concern for cleanliness in the medical profession before the nineteenth century. This was to protect the doctor, not the patient. Before the advent of the germ theory of disease, there was no push for doctors to wash their hands or their implements.
The last major European outbreak of plague occurred in France in 1720 — the Great Plague of Marseilles.
The virulence of the disease led to widespread fears of it spreading far beyond the city. A quarantine system was put in place. Even that term ‘quarantine’ has its origins in plague history. It comes from the Italian for ’40 days,’ a period of time the Venetian authorities in the fourteenth century demanded that ships from plague-infected areas remain waiting at a distance from the port. The French authorities made sure that the quarantine would be successful by erecting plague walls through Provence at a distance from the city and threatening anyone who left the area with the death penalty. The plague was limited to Provence and the ultimate death toll was about 100,000 people.
The Bubonic Plague has devastated the West in numerous outbreaks from at least the 1340s through the eighteenth century. It struck China in the nineteenth century and is threatening to make a comeback in unhygienic environment of modern Los Angeles, California.