The Plague Doctor: Did Medieval Doctors Really Wear Beak Masks?

Black hat, long dark coat, gloves, a cane and that unforgettable mask with a long bird-like beak: the plague doctor is one of the most popular Halloween costumes in the world, and one of the most recognisable images of the Middle Ages. But there’s a catch: the beaked doctor isn’t medieval. When the Black Death tore through Europe in the 1340s, no doctor wore anything like it. The famous outfit appeared about three centuries later. So where did the plague doctor costume really come from, what was the beak for, and what did the doctors of the Black Death actually do? I honestly thought the beak mask came from the Middle Ages; at least, that’s the idea films and television have spread. Let’s find out together what this mask really was and uncover the truth behind it.

Did medieval plague doctors wear beak masks?

No. There’s no evidence that any doctor wore a beaked mask during the Black Death of 1347–1351, or in the plague outbreaks of the following century. Medieval physicians treated plague patients in their ordinary clothes, typically the long robes that marked them out as learned men.

The beaked costume belongs to the 1600s. The earliest pictures of it come from that century, especially from Italy, and it seems to have been used mainly in Italy and France. For the real story of the 14th-century pandemic, see our article on the Black Death.

So who invented the plague doctor costume?

The design is usually credited to Charles de Lorme, a famous French physician who served several kings of France, including Louis XIII. According to a biography published in 1683, after his death, he claimed to have devised a protective outfit for doctors treating plague in the early 1600s: a coat of Moroccan goat leather, leather boots, gloves, a hat and a mask with a nose about half a foot long, shaped like a beak and filled with perfumes. Historians note that the story comes to us second-hand, so we can’t be completely sure he invented it, but the timing fits the first images.

The most famous of those images is a satirical engraving printed in Germany in 1656, during a plague outbreak in Rome. It shows “Doctor Schnabel von Rom”, Doctor Beak of Rome, in full costume, with a verse mocking him as a figure who frightened people and earned money from death. Much of our modern picture of the costume goes back to prints like this one.

What was the beak for?

The beak wasn’t meant to look scary. It was a piece of medical equipment, based on a theory that went back to the ancient Greeks. For centuries, doctors believed that diseases like plague were spread by miasma: corrupted, foul-smelling air. If bad air carried the disease, then good air should protect you.

So the beak was stuffed with sweet-smelling substances, such as herbs, spices, flowers or a strong-smelling medicine called theriac. Air breathed through the beak would, in theory, be purified on the way in. The rest of the outfit had a purpose too. The long coat, often waxed, was thought to stop the poisonous air from clinging to the doctor, the glass eye holes protected the eyes, and the cane allowed him to examine patients, or keep people at a distance, without touching them.

Did the costume actually work?

People thought an extra layer of clothing would protect them from the disease, but it didn’t work quite the way its wearers believed. Plague is caused by a bacterium, Yersinia pestis, spread mainly by fleas from infected rats and, in its pneumonic form, directly between people in coughed droplets. Herbs in a beak couldn’t filter it out. Some historians have suggested that the thick coat, gloves and mask may have offered a little accidental protection against flea bites and coughs, but there’s no way to measure how much it helped. The theory behind the costume was wrong, even if a few of its features made sense.

What did doctors do during the Black Death?

When the plague arrived in 1347–1348, doctors had no idea what caused it. In 1348 the medical faculty of the University of Paris, asked by the king of France for an explanation, blamed a conjunction of the planets Saturn, Jupiter and Mars that had happened a few years earlier, which they believed had corrupted the air.

Treatments followed from that idea. Doctors recommended bloodletting, purges, special diets, burning aromatic woods, and carrying sponges soaked in vinegar or pomanders filled with herbs to sniff. Some of the most practical advice was summed up in a Latin saying, cito, longe, tarde: flee quickly, go far and come back slowly. Wealthy people who could leave the cities often did.

Not every doctor fled. Guy de Chauliac, physician to the pope in Avignon, stayed during the outbreak of 1348, caught the plague and survived. He left one of the best descriptions of the disease, distinguishing between the form with swellings, the buboes, and a deadlier form that attacked the lungs. Towns also began hiring special doctors for plague victims, paid by the community to treat the sick, including the poor. For more on how medieval doctors thought and worked, read about medieval medicine.

Another plague myth: “Ring a Ring o’ Roses”

While we’re myth-busting, here’s another favourite. Many people believe that the nursery rhyme “Ring a Ring o’ Roses” (or “Ring Around the Rosie”) is secretly about the Black Death: the rosy rash, the posies of herbs, the sneezing and everyone falling down dead. It’s a great story, but folklorists point out that the rhyme isn’t recorded until the 1800s, and the plague explanation only appeared in the 20th century. For more legends like this, see our list of medieval myths.

Masks, then and now

During the COVID pandemic, masks were suddenly everywhere around us, and it made me think of the Black Death. Instead of beaks stuffed with herbs, I saw the same surgical masks that doctors wear in the operating room. The purpose of a mask hasn’t changed much over the centuries: it’s still there to protect the person who wears it, and today the people around them too. It felt strange to realise that a pandemic was all around us and that death might be just around the corner, maybe not for me, but perhaps for someone close to me. Images from medieval paintings kept popping into my head: bodies piled up, and doctors in strange clothes trying to save others. I’m glad medicine has come such a long way, and that it helped save so many lives during COVID.

Why the plague doctor became a Halloween icon

What more could you ask from a Halloween costume? You get a dark outfit, your face is completely hidden and, as a bonus, you look extra creepy with that beak. Walking through the night, you have a strange silhouette and a strong connection with death. That’s a spooky result right there! The costume also lives on in the Venice carnival, where the medico della peste became one of the traditional masks, and, as I mentioned at the beginning, in films and television, as well as in video games. Halloween itself has much older medieval roots, explored in medieval Halloween. At least now, if you decide to wear the costume, you’ll know you’re dressed as a doctor from the 1600s, not the 1300s.

Frequently asked questions

Were plague doctors medieval?

Doctors treated plague throughout the Middle Ages, but the famous beaked costume dates from the 1600s, roughly 300 years after the great pandemic of the 1340s.

Why did the costume have a beak?

The beak was filled with herbs and other sweet-smelling substances, which were supposed to purify the “bad air” that doctors believed spread the disease.

Who invented the beaked costume?

Most accounts name Charles de Lorme, a doctor to the kings of France, in the early 1600s, though the story comes from a later account and can’t be fully confirmed.

Is “Ring a Ring o’ Roses” about the plague?

Probably not. The rhyme is first recorded in the 1800s, and the plague interpretation only appeared in the 20th century.

Sources

• Wikipedia, Plague doctor
• Wikipedia, Plague doctor costume
• Wikipedia, Guy de Chauliac
• Wikipedia, Ring a Ring o’ Roses
• Encyclopaedia Britannica, Black Death