Why did doctors wear bird masks during the Black Death?

The concept of germs was completely unknown to people in the past. Today, we wash or sanitize our hands when we feel they’re dirty or after coming into contact with someone who has the flu, because we understand how germs spread. However, people in earlier times were unaware of this. When an illness spread, it was widely believed that it was caused by bad air, known as "miasma," rather than invisible microorganisms. Even doctors didn’t know about the existence of germs.

While treating patients, many doctors themselves became infected with the plague. To reduce the spread of infection and continue treating the sick, especially during epidemic outbreaks such as the plagues of medieval Europe, governments or city authorities often appointed special medical professionals known as plague doctors. These doctors were hired under formal contracts that outlined their duties, the areas they were to serve, and their payment. 

They were expected to visit the most severely affected neighborhoods and provide care to everyone, including the poor who could not afford treatment. Because treating plague patients was extremely risky, many regular doctors fled the cities during outbreaks. As a result, plague doctors were often inexperienced or lacked formal medical training. 

Some were recent medical graduates, others had trouble finding work, and a few had no medical background at all. Despite this, they performed many important tasks beyond direct treatment, such as documenting the number of infections and deaths, witnessing wills, conducting autopsies, and keeping records that could help future medical research and prevention. Medical knowledge during the Middle Ages was limited, and the treatments offered were mostly ineffective. 

The Black Death 

The Black Death was a devastating pandemic caused by the bacterium Yersinia pestis, which spread primarily through the bites of infected fleas that lived on rodents. Often referred to as the bubonic plague, it struck Europe between 1347 and 1351, killing an estimated 25 million people in Europe alone and up to 75–125 million worldwide. This outbreak remains one of the deadliest events in human history, causing more deaths proportionally than any known war or epidemic before it. The disease caused severe symptoms, including fever, chills, weakness, and the formation of swollen, painful lymph nodes called buboes. 

Later outbreaks continued for centuries, including the Great Plague of London (1665–1666), which killed about 100,000 people in just 18 months. During this time, Charles de Lorme, a French physician, designed the now-iconic plague doctor costume with its long coat and beaked mask to protect physicians from the deadly disease.

The plague doctor costume

Plague doctors became widely recognized for their distinctive outfit, which emerged in the 17th century. This “Plague Preventive Costume” was designed in 1619 by Charles de Lorme, a French physician. The outfit included a long waxed coat, gloves, boots, and a wide-brimmed hat—all usually made of leather for protection. The most iconic part of the costume was the beaked mask. The beak extended about six inches from the face and had glass or crystal lenses over the eyes and small holes for breathing through the nose.

The reason this mask was created was because they believed the plague was spreading due to bad air. This belief came from the fact that doctors were unaware of the concept of germs. Whenever they sensed an unpleasant smell, they suspected disease. For this reason, doctors put herbs and flowers in the beak of their masks, often using mint, roses, or carnations.

While the reasoning behind the costume was flawed, the outfit may have unintentionally offered some protection against bodily fluids, respiratory droplets, and flea bites, which we now know were major sources of plague transmission. Some forms of the plague spread only through bites from fleas and rodents. The doctor’s uniform helped protect them from this hazard. However, it was mainly the coat, gloves, boots, and hat that offered protection—not the bird mask.

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It’s important to note that this costume was not worn during the peak of the Black Death from 1347 to 1351, but it became strongly associated with plague doctors in later outbreaks. Eventually, the image of the plague doctor became symbolic. It was used in satire, art, and carnival culture, especially in places like Venice, and even became a stock character in Italian theatrical traditions. [Rh/VP]