The Plague Doctor Mask and Coat

Whats Inside Plague Doctor mask

What if the last thing you saw before death was the terrifying plague doctor mask? It would be a horrifying sight, but the person wearing it was just trying to help you. In fact, knowing why the plague doctors wore the beak mask, and if it worked, could save your life from the next pandemic.

Whats Actually Inside the plague doctor mask and suit

Let’s start out with one of the crazier aspects of the plague doctor’s outfit. There was one piece of the costume that was just as important, if not more important, than anything else. The plague doctors included a wooden rod in their uniform, normally tied onto a belt. This was used to poke plague victims to see if they were still alive, but it also served another more brutal purpose.

The Plague Doctor Mask and Suit

The rod was also used to defend the plague doctors from people who might try to overwhelm them. Imagine a frantic group of people who are terrified, in pain, and dying. They would seek any help they could, even if that meant assaulting a plague doctor for his medicine or attention. This may seem counterintuitive for the victims to do, but when everyone around you is dying, common sense goes out the window, and sheer terror takes over.


The plague doctors would sometimes have to use their poking rod as a means to defend themselves. They would club plague victims who started pulling at their coat or tried to get too close to them. It was a dangerous job being a plague doctor, but someone had to do it.

How the Black Plague Spread

The plague first traveled across Asia and Europe via the silk road. The first recorded outbreak was the Plague of Justinian, which killed up to 10,000 people a day during the year 561. The next outbreak, which would become known as the Black Death, happened in the 1300s and wiped out a third of Europe’s population. You may be surprised to learn that the iconic coat that we associate with these outbreaks actually wasn’t around during this time period at all. It wasn’t until the 17th century that the plague doctor costumes were introduced to the medical world. 

Spread of bubonic plague through europe

derivative work: Andy85719, CC BY-SA 3.0, via Wikimedia Commons

Would the plague doctor’s iconic suit have made a difference during these earlier pandemics? What about the pandemics of today? In order to uncover the answer to these questions, we have to know the real reason physicians wore plague suits and masks. 


The origin of the plague doctor outfit

The plague doctor outfit may have had its beginning not in medicine, but in comedy. The outfit itself could actually have gotten its start in the theater, but then was adopted later by doctors to protect themselves from the plague. The first representations of the plague doctor outfit came from satirical writings and political cartoons, so the terrifying mask that can haunt people’s dreams may have originally been used to make people laugh.

The use of the plague doctor outfit is normally credited to Charles de Lorme who was a physician that treated the royals of Europe, including King Louis XIII. In his writings, he described the plague doctor’s outfit as a long coat covered in scented wax, leggings, long pants that connected to boots, a shirt that must be tucked in, and a leather hat and gloves. Moroccan leather was the preferred material for the plague doctor’s outfit, including the mask.

Moroccon leather used to create plague doctor mask

So what was the real reason for the costume? It did serve a purpose, but due to lack of medical knowledge of the time, it wasn’t as effective as the plague doctors had hoped.


Lorme described the shape of the mask as needing to be “half a foot long, shaped like a beak, filled with perfume with only two holes, one on each side near the nostrils, but that can suffice to breathe and carry along with the air one breathes the impression of the herbs enclosed further along in the beak.”

Inside the plague doctor mask

Jammed into the long beak of the masks were different flowers, perfumes, and exotic substances. This wasn’t just to counteract the bad smells of rotting corpses and human excrement; the concoction inside of the masks was for something else, something that you will probably find rather crazy. 

It was believed at the time that the plague was spread through “bad air.” This was called the miasma theory. Basically what physicians at the time thought was illnesses such as the plague was passed from one person to the next from noxious forms of “bad air,” which was also known as the night air. This deadly poison would come from the rotting flesh of bodies both alive and dead.


Once in the body, the noxious air would throw off a person’s bodily fluids and auras, or what was known as humors during this time period. The symptoms of diseases were attributed to a person’s body being out of balance, which could lead to death. Therefore, the plague doctors needed to protect themselves from the “bad air,” and this was done using the beaked masks that we associate with plague doctors.

The masks themselves were not enough though. Specific herbs and perfumes needed to be stuffed into the nose of the mask to separate the two small holes at the end of the beak from the face of the doctor. The holes were vital so the doctor could continue to breathe while wearing the mask, and the herb concoction was important to stop the miasma from reaching the doctor’s nose and mouth.

The masks would be filled with what was called theriac, which was made up of more than 55 different herbs and other compounds. Some of the more exotic ones were viper flesh powder, cinnamon, nosegays, and honey. The long length of the bird mask allowed enough herbs to be packed in to provide time for the “bad air” to be dealt with before it entered the plague doctor’s lungs.


The mask also contained openings for the eyes so that the plague doctor could see. Glass coverings over the holes were required to protect the eyes from the poisoned air. Basically the mask, and everything plague doctors wore, were to protect the body from the “bad air” connected to the miasma theory. In some ways this was helpful as the outfit served as a barrier from the actual harbinger of death that caused the plague, bacteria.

What was the rest of the plague doctor’s coat made out of?

The mask itself wasn’t meant to be scary so much as functional. But what about the rest of the plague doctor coat? Was there some special purpose to the long coats and brimmed hats?

The answer is yes. It was to keep the plague doctor’s body as contained as possible from the poisoned air around them. The clothing was also covered in different fragrances to protect the body from the miasma. We now know it wasn’t the “bad air” that was causing the plague, but a bacteria called Yersinia pestis. The bacteria was spread through flea bites, contact with contaminated bodily fluids, and inhalation of water droplets from people who coughed or sneezed that were infected. 


The interesting thing is that although the plague doctor’s outfits were not designed with the bacteria in mind, they actually provided some level of protection. When completely decked out in the plague suit the redundant layers of clothing, and the mask that would keep distance between a doctor and a patient, protected them from bodily fluids and contaminated water droplets. 

Obviously, the protection was minimal, and they could always have been infected by a flea that got into their suit, or when they weren’t wearing it. But the real reason the plague doctors wore their iconic suits was to protect them from the miasma around a plague victim, and keep their body from coming into contact with the “bad air.” 

How effective were the plague doctor’s mask and suit from preventing catching the Black Plague

So how effective were the plague doctors themselves who were contained within the masks and suits? Well as we know from history, they were not very good, but that was because the lack of medical knowledge at the time stood as a roadblock to their success. They did try to give antidotes and medicine to the victims, although none of these remedies were effective. One of the most common forms of treatment was giving an infected person the same theriac concoction that plague doctors stuffed into the beaks of their masks to help them breathe in clean air.

Black plague mask and suit barely protected the doctors

The victims of the plague suffered terribly before many eventually succumbed to the disease. Plague doctors had to deal with patients who had swelling of the lymph nodes that would often rupture causing blood and puss to seep out of the wounds. The infected would also have a high fever, chills, vomiting, diarrhea, and be in a lot of pain. The messiness associated with the plague allowed the bacteria to spread rapidly as most people didn’t know what precautions to take, or how useful good hygiene could be. 

By wearing their multilayered leather suits and long masks, the doctors were able to at least protect themselves from certain forms of transmission of the plague while they treated victims around Europe. But treating the infected were not the only thing the plague doctors did during the 17th century.

These physicians were also responsible for being the witnesses of wills as people died in the thousands. They would do this while wearing their plague suits to protect themselves, this may be one of the reasons the iconic image of plague doctors became associated with such horrifying nightmares. The suit was so closely connected with death, and everything that went along with it, that it became ingrained in people’s minds. 


The plague doctors were also responsible for performing autopsies. Again those lucky enough to be donning their plague suit at the time of inspection were given some protection from an infected corpse, which is better than no protection at all.

Modern-day use of the plague doctor mask

Modern-day plague doctor mask use

Venice, Italy – January 30, 2016: The Carnival of Venice is an annual festival held in Venice. Streets of the city fill up with colorful characters in disguise.

Today plague doctor masks are still worn throughout Europe and during different celebrations such as Mardi Gras. Other carnival celebrations, especially in Italy, often use the plague doctor suit as a commedia dell’arte. Although we often associate the elongated mask of the plague doctor with death and terror, its origins may have been more comedic, which is how the masks are most often used today.

What we can learn from the plague doctors and their iconic suits is that just because something looks interesting, terrifying, or funny does not mean it can protect you from a disease. We can follow the advice of medical professionals and scientists during the course of a plague or pandemic to keep ourselves safe. Given what we know today about infectious diseases, the plague doctors would most likely have swapped their bird masks and potpourri for surgical masks and antibiotics.