What if I told you that a single bacteria was responsible for the death of around 20 million people in just six years?

Origin of the 14th-Century Pandemic

It’s the year 1346. The residents of Caffa (now Feodosija, Ukraine) wake up to a thunderous noise and realize the town is completely surrounded by the evil Tartar warriors. With no army for a head-to-head battle, they don’t have a choice but to resist even knowing it’s just a matter of time before the town falls. Everything changes when something unexpected happens. A mysterious disease begins to devastate the invading army. As the days go by more and more Tartar soldiers die around the wall. But the town’s luck begins to change when the invaders start deploying one of the first biological weapons in history. Using catapults, they start throwing rotten corpses into the town. This makes the mysterious disease spread among the residents increasing the number of victims even more. Their desperation is such that many decide to abandon the town, leaving on ships bound for Italy. What they don’t know is that the ships aren’t taking only fugitives. The disease is also on board. Thus the famous Black Death managed to spread across Europe causing millions of deaths along its way.

How the Middle Ages really were?

When I think about the Middle Ages the first thing that comes to my mind… are the castles. These structures are the symbols of the Middle Ages. But at the same time the story of that period goes way beyond towers kings and princesses. Actually those were extremely troubled times.

The Middle Ages began in the 5th century and ended only in the 15th century. In other words they lasted around 1,000 years. And the story I told about Caffa took place during the second period of the Middle Ages, the Late Middle Ages, which started around the year 1000 a time when many things changed in Europe.

Historians even compare what happened during that time with the Four Horsemen of the Apocalypse from the Bible. The first rider represents famine. In the early 14th century climate change turned winter colder and made summer rainier for some years. This made food production in Europe decrease a lot. It was the Great Famine. People didn’t have any food and 10% to 25% of the continent’s population was eradicated. The second rider represents war. In that period the famous Hundred Years’ War happened. For over a century thousands of soldiers from France and England killed each other day by day to see who would occupy the French throne. The third rider was plague. Or more precisely the Black Death. During that time it killed over 20 million people. And who was the last rider of the Apocalypse? Death, which can be interpreted as the result of wars, famine, and the plague itself.

This was one of the most tense periods in history with poverty war and political intrigue. Living in a world like that is far from being an epic and romantic adventure. It looked more like an endless nightmare. Life in that period was extremely hard. Most of the time the servants lived in shacks with one single humid dark room where they slept and stored food and animals. Entire families slept huddled on straw mattresses to get warm during winter. Those people used to wake up at daybreak and work nonstop until nightfall. That also applied to children who would start working at around the age of five. In cities between narrow and dark alleys life was even more chaotic. There was no sewage everything was filthy and people would walk and eat alongside garbage human waste and even dead animals. Food was basically bread and soup made of vegetables and bones because meat and cheese were too expensive for commoners who might have no choice but to eat rotten food. There wasn’t any concern for cleanliness or health. People ate with filthy hands didn’t have oral hygiene and basically didn’t shower. For many people it was normal to wear the same underwear every day for years.

But what was the Black Death exactly?

The Black Death was an epidemic of bubonic plague that spread incredibly fast throughout Europe. Scientists believe that from 1347 to 1352 the disease killed from 15 to 23 million Europeans. It was the most brutal period of the disease that possibly killed from 75 to 200 million people. At that time the world population was around 365 million people. This number had been increasing since the beginning of mankind but one of the first times it decreased was due to the plague.

The Yersinia pestis

The Yersinia pestis, an evolution of the bacteria Yersinia pseudotuberculosis, that due to mutations over thousands of years, ended up transforming. This bacteria causes an infection and its most common form is the bubonic plague. The symptoms are one of the reasons why the disease is so scary. As soon as the infection settles in the body there’s fever, chills, weakness, and headache. As the bacteria settles in other parts of the body, the suffering intensifies with the appearance of bulges, especially on the neck, armpits, and groin, which can grow to the size of an apple, before bursting into a pus-filled wound. These swollen lymph nodes, also known as buboes, are so distinctive that people named the disease after them.

Lymph nodes are small defense organs spread throughout people’s bodies. When a foreign body is detected, they start producing antibodies to attack it. And the bubonic plague is named after the lymph nodes. If someone contracts the disease, the lymph nodes, usually located on the neck, armpits, and groin, start swelling and become visible. People call the swelling “bulges” or “buboes.” So it was named the bubonic plague.

The disease can manifest itself in other ways too. Like the pneumonic plague, which affects the respiratory system. And the septicemic plague, in which the bacteria affects the bloodstream.

Why is it called Black Death?

This term was used in the Middle Ages because of another symptom. Many people developed wounds, and the extremities of their bodies, like feet and hands, gangrened. The skin would blacken and literally die. So it was named the Black Plague or the Black Death.

Why is this disease so different from others?

Because it’s really aggressive and can kill in a few days. But the most interesting thing is how it spread super quickly. The bacteria that causes the bubonic plague likes to live inside wild rodent fleas. Since Asia suffered severe flooding in the early 14th century, these rodents, full of infected fleas, had to leave their homes and came into close contact with black rats, which used to live near people. Black rats would breed very easily, and even lived in merchant caravans and ships.

Since trade in Asia was really intense, the bacteria spread out through the continent. A single flea bite was enough to infect someone. European travelers were always crossing Asian trade routes, especially the famous Silk Road. Along with riches, these caravans transported hundreds of rats with infected fleas. The same thing happened with merchant ships. That’s how the plague began to spread throughout the world.

In 346 the disease was only in Eastern Europe, but a year later, it appeared in the Mediterranean regions. Over the next five years it’d come to dominate Italy, France, Germany, England, and finally Russia.

In a sense we can say the plague was democratic. It made no distinction between rich and poor, noble and commoner. Nowadays you could imagine that the poorest people from that time were at greater risk of contracting the disease. The elite were protected inside castles, which were a symbol of power, and far from the dirt of the streets. But the nobles who lived in these castles were not immune. The castles’ strong defense and huge walls could stop enemy invasions, but they didn’t stand a chance against the plague bacteria. At that time these castles weren’t exactly hygienic role models. They were humid and dark, and had food storage rooms that were literally paradise for rats.

Did you know there’s a theory that rats aren’t the only villains here? A recent study showed rats alone wouldn’t have been enough to spread the disease across such a vast area in such a short time. So scientists ran a simulation and found out that this bacteria probably wasn’t just in rat fleas, but also in people’s head lice. This is entirely possible because with the lack of hygiene in the Middle Ages, cities were like feasts for lice, which contaminated one person after another.

Black Death in London

Actually the bubonic plague was never gone for good. There were outbreaks up to the 19th century. One of the outbreaks occurred right here in London. From 1665 to 1666, 100,000 people fell victim to the bubonic plague here. I’m talking about a quarter of the entire population of London.

Over many years London had small outbreaks of the disease due to a lack of hygiene. In the 17th century the town was surrounded by walls that kept thieves on the outside and tons of filth on the inside. So the plague struck again. There were so many deaths that cemeteries became full, and the bodies were buried in ditches. After some time, they didn’t even do that anymore, and the corpses were literally abandoned on the streets.

The plague doctors

This is the clothing doctors used to walk around contaminated cities in the 17th century:

The clothing could protect the doctors because it was made of leather. The mask in the shape of a beak was full of herbs and other substances that filtered the air. They believed the disease was transmitted by the malodor (Bad Air) released by contaminated or dead people. The mere presence of these doctors was even scarier than the clothing. They were hired by the cities themselves to treat infected people. So, when they showed up somewhere, it was a sign that the place was completely contaminated, with thousands of people dying. That’s why nobody wanted to see those doctors. Everybody knew that wherever they were, death was near.

Actually in most cases they were second-rate doctors, prohibited from practicing medicine under normal circumstances. Basically, they would go to the cities to count the dead and infected. They’d charge the families a fee and prescribe fake medicine. In other words, they’d take advantage of people’s despair to make even more money.

How Black Death was controlled and cured?

A hypothesis says that after a great number of deaths, most of the survivors were the people most resistant to the disease. Then, it was hard for the bacteria to spread. But of course, it’s just a hypothesis. The fact is that the bubonic plague has never been cured. European medicine has never developed a definitive medication that would eliminate the disease for good. People also developed habits that helped decrease the transmission rate, like using Arab hygiene techniques and simple actions, like washing your hands.

Another method to keep the plague away was by watching the ocean closely. Since ships were full of rats, people from coastal cities knew that any vessel could bring death closer to them. There was so much fear that the French determined that any ship arriving at the shore should remain isolated for 40 days before docking. All that to confirm that nobody on board was infected. That’s where the term “quarantine” came from. Seems cruel, but that was done to prevent the disease from spreading to other places.

Black Death in Eyam Village, England

There’s an interesting story about that took place in Eyam Village, England, in the 17th century. This place with only 900 residents today, was also stricken by the bubonic plague. People died here every day. Residents knew the disease was highly contagious, so they did the only thing they could do: isolate themselves on their own. Nobody could get in or out of this town. They even built a rock barrier for that purpose. But people needed to eat, so they would dip coins into vinegar, because they thought vinegar could work as a disinfectant, and they would put the coins into rocks. Residents from nearby villages would come, take the coins and leave food there. It was a kind of long-distance trade. They literally sacrificed themselves. The population of 344 residents was reduced to less than 100. Even now, if you walk around the village, you can find markers with the names of people who lost their lives to the plague.

Black Death in Brazil

As centuries went by, countless people died due to the plague in many places across the planet, including Brazil. In 1899 a ship that arrived at the Port of Santos, was full of rats that brought the bubonic plague to the Brazilian territory. The disease began to spread, and eventually reached Rio de Janeiro, which was the Brazilian capital at the time. The epidemic claimed hundreds of victims, but the most affected were the port area residents and warehouse workers. In other words, the poorest people in the city.

Things started to change in 1904. To fight epidemics of bubonic plague, smallpox, and yellow fever, the government started an authoritarian campaign that led to an uprising known as the Vaccine Revolt. But at least their actions to improve sewage treatment ended up helping to control the bubonic plague in the former Brazilian capital.

The last reported case of the plague in Brazil was in 2005. The disease is still around, but we already have ways to deal with it. Science can identify the bubonic plague in its early stages. So, it’s easier to treat it by taking antibiotics.

Black Death today

The Black Death was controlled, but not completely eradicated. Since the bacteria lives in wild rodents, we can’t eradicate the disease. We still have reported cases of the bubonic plague to this day. From 2010 to 2015 there were a little over 3,000 cases which caused around 500 deaths. The numbers are low compared to that time. But yes the disease is still out there. And if the disease is around, an epidemic is still possible, for many reasons. First of all, scientists believe that global warming could interfere in the dynamic of the plague transmission, since an ecological imbalance could create an unpredictable scenario, like the Asian floods at the beginning of the 14th century. Besides, Yersinia pestis is still undergoing mutations and has become resistant to some antibiotics. So it continues to be a very dangerous bacteria.

Would an epidemic change the world now just like in the Middle Ages?

Black Death was one of the biggest tragedies in history. However, we can’t deny it increased our knowledge in many areas. After the epidemic, the way society of the time considered medicine, for example, changed completely. The importance of surgeons became even more evident, and hospitals gained a new importance. These places that basically served as guesthouses for travelers, began to offer medical care, getting closer and closer to the hospitals we know today. One century after the epidemic, the Middle Ages came to an end, opening the doors to a new period in the history of mankind. Without the plague, the story could have been completely different.

Now, in 2020 we are facing a new pandemic, the coronavirus or COVID-19 pandemic, with more than 1 million deaths at the time of this writing. But that is another story and shall be told another time. Will it change our world forever?

Take care, and thanks for reading.

The post Black Death (bubonic plague) facts, origin, cure and history appeared first on Plague Doctor Masks.

“Please note. If you test positive for COVID-19, or have you been in contact with a positive, you will not be able to do any of the activities mentioned in this article. Stay home and contact your doctor as soon as possible.“

These are the most essential tips for celebrating Halloween during the coronavirus pandemic:

1. Wear a Halloween-themed cloth mask (Do not wear a costume mask over a protective cloth mask because it can be dangerous if the costume mask makes it hard to breathe). You can find thousands of Halloween-themed cloth mask on Etsy.
2. Take a bottle of alcohol-based hand sanitizer with you, and use it every time you need it. For example, before touching your face or after touching any street furniture.
3. Keep the recommended social distance, stay at least 6 feet (about 2 arms’ length) from other people who are not from your household. This includes no handshakes, kisses or hugs.

Should I make trick-or-treat at my house?

Yes, we are allowed to trick-or-treat with children on Halloween night, but it is imperative to do so by following the safety indications:

1. Wash your hands before handling candy.
2. Have individual bags ready for each child and leave them on the porch of your house, so the children can safely take them while keep the social distance.
3. Keep the recommended safe distance. Don’t let them get closer than 6 feet from your door.
4. Wear a protective mask if you want to go out to greet someone.

Should I let my kids trick or treating?

Yes, we are allowed to go trick-or-treat this year, but always following the security measures mentioned above. Accompany your child to make sure that they comply with these recommendations at all times.

Ideas for celebrating Halloween in quarantine:

If you have decided to stay home this Halloween, it is also a good plan! These are some funny ideas to celebrate the Halloween night without going outside:

1. Decorate your house with crafts made by yourself and with materials that you have at home or can order online. There are thousands of tutorials on Youtube for making Halloween crafts. Several days of family fun guaranteed!
2. Horror movie night. Spend Halloween night with a good set of horror movies.
3. Costume contest! If you are several people at home, have a scary or fun costume contest.
4. Video call with friends or family. How about a scary video call in costumes? You can have fun without having to be in direct contact with someone. Start the video call and let it run the whole party!
5. Learn a Halloween dance. This could be a great way to get some exercise and laugh together as a family. Search YouTube for “monster mash dance,” “monster shuffle”, or choreograph your own, featuring your child’s best moves! Practice then perform, preferably in costume.
6. Make a photo booth. Prepare a scene or photocall, a set of accessories and costumes, and let the party begin! Laughter guaranteed. You can find thousands of Halloween photo booths on Etsy.

If you have more ideas to celebrate Halloween at home, share them in the comments section! Thank you!

What are the CDC recommendations for celebrating Halloween?

CDC (Centers for Disease Control and Prevention) recently released a list of activities grouped by risk level (lower, moderate and higher risk):

Lower risk activities:

• Carving pumpkins with members of your household.
• Decorating your house.
• Doing a Halloween scavenger hunt.
• Having a virtual Halloween costume contest.
• Having a Halloween movie night with people you live with.

Moderate risk activities:

• Participating in one-way trick-or-treating where individually wrapped goodie bags are lined up for families to grab and go.
• Having a small group, outdoor, open-air costume parade where people are distanced more than 6 feet apart.
• Attending a costume party held outdoors where protective masks are used and people can remain more than 6 feet apart.
• Going to an open-air, one-way, walk-through haunted forest where appropriate mask use is enforced, and people can remain more than 6 feet apart.
• Visiting pumpkin patches or orchards where people use hand sanitizer before touching pumpkins or picking apples, wearing masks is encouraged or enforced, and people are able to maintain social distancing.
• Having an outdoor Halloween movie night with local family friends with people spaced at least 6 feet apart.

Higher risk activities (Please AVOID these activities):

• Participating in traditional trick-or-treating where treats are handed to children who go door to door.
• Having trunk-or-treat where treats are handed out from trunks of cars lined up in large parking lots.
• Attending crowded costume parties held indoors.
• Going to an indoor haunted house where people may be crowded together and screaming.
• Going on hayrides or tractor rides with people who are not in your household.
• Using alcohol or drugs, which can cloud judgement and increase risky behaviors.
• Traveling to a rural fall festival that is not in your community if you live in an area with community spread of COVID-19.

You can read the full article on the CDC website.

From PlagueDoctorMasks we hope that you all enjoy a great Halloween party this year!

The post Halloween in COVID times 🎃 How to celebrate halloween safely. Guide appeared first on Plague Doctor Masks.

A plague doctor

The Medieval and Renaissance city was affiicted with a problem which was essentially ecological in nature, namely a violent disequilibrium between the density of the population and the prevailing levels of hygiene and public health. The dire result of this disequilibrium was the recurrence of epidemics, mostly of bubonic plague, which at closely spaced intervals wiped out a large portion of the population. Ever since the outbreak of the great pandemic of 1347 – 1351 people recognized the infectious nature of plague, but because they were totally ignorant of the sequence rat – rat’s flea – man they overrated the possibility of man to man infection.

Thus it was not easy in time of epidemic to find doctors willing to treat plague patients. On the other hand, if the plague were so highly contagious, a doctor visiting a patient – it was argued – would not only easily contract the infection but would also carry it to other people or to patients suffering from other ailments.

The solution to this double-edged problem was found with the institution of the community plague doctors. These were physicians or surgeons, especially hired by an infected town or village in time of an epidemic, who were responsible for the treatment of the plague patients only and had to refrain from intercourse with the rest of the population.

Their job was not only particularly dangerous but also very unpleasant because the plague doctor was quarantined, so to speak, for the entire period of the epidemic and some til the thereafter.

Those who applied for such positions were normally either second rate doctors who had not been particularly successful in their practice or young doctors trying to establish themselves.

Texts of agreements between town administrations and plague doctors are not difficult to find in the archives and some have been published. Although they inform us about the terms eventually agreed upon by the parties involved, the cold and detached juridical prose of the notaries hardly reveals the bargaining which always preceded the final settlements. The bargaining was often hard.

Real case of a plague doctor: Dr. Maletto

On May 10, 1630, the town council of Torino considered the conditions requested by one Dr. Maletto to serve as a plague doctor. After some discussion the council instructed its representatives “to deal promptly with Dr. Maletto. They should try to reduce his pretenses and extract the best possible deal for this community but they ought to be careful not to lose the opportunity of hiring Dr. Maletto because it would be difficult to find a substitute at the same salary.”

In the Communal Archive at Pavia (Lombardy) there is the original draft of an agreement reached between the community and a plague doctor. The document is of special interest because it shows a series of corrections and additions to the original text that are suggestive of the bargaining that took place.

Real case of a plague doctor: Giovanni de Ventura

The document is dated May 6, 1479, and it contains the “conditions agreed upon between the magnificent Community of Pavia and the doctor of medicine Giovanni de Ventura in order to treat the patients suffering from the plague.”

The first clause deals with the salary. The community promised to pay to the doctor a monthly salary of 30 florins, which, as we shall see, had to be net of living expenses.

The second clause originally provided that the community would pay the salary two months in advance. This amounted to an interest free deposit equivalent to two months’ salary in favor of the doctor. However, in the bargaining that followed, the clause was modified, and the town’s representatives managed to cut the advance to one month’s salary.

Obviously the doctor had some doubts about the solvency of the community, and he was not satisfied with the advance payment. He wanted more guarantees, and the third clause of the contract stipulates that the community had to give the doctor an adequate pledge for the payment of his salary. On this point there seems to have been no further discussion.

A fourth clause also raised no difficulties. It was common practice in the hiring of an immigrant community doctor, whether plague doctor or not, that the community would provide him with a convenient house free of charge or at a reduced rent. In this particular case, the community of Pavia promised to provide Dr. Ventura with “an adequate house in an adequate location,” completely furnished, at the community’s expense. The clause suggests that Dr. Ventura had not been living in Pavia.

Disagreement must have flared up again on the fifth clause. Originally it had been stipulated that the city administration would continue to pay the doctor his salary for two months after the termination of his employment. Later on, however, the town’s representatives backed out, and in the subsequent bargaining, as in the matter of the advance, they managed to reduce the extra pay to one month’s salary.

In both clause two and clause five, the final text is less favorable to Giovanni Ventura than the original draft. Were the administrators beginning to feel some doubts about the quality of the doctor’s services? Or, having brought the doctor to the verge of acceptance, did they feel that toughness might extract from him an even better deal? We shall never know, but the modifications to the original text of clauses six and seven seem to favor the first hypothesis.

The sixth clause originally specified the duties of the doctor, emphasizing the limits of his obligation. It stipulated that “the said master Giovanni shall not be bound nor held under obligation except only in attending the plague patients.” Later on, however, the town’s representatives felt that they needed a better guarantee of a satisfactory performance and pressed for an addition which specified the doctor’s duties in more positive terms: “namely, the doctor must treat all patients and visit infected places as it shall be found to be necessary.”

With the seventh, clause the town’s administration committed itself to give a free grant of Pavian citizenship to the doctor in appreciation for his good services. But again, at the time of the final draft, it was felt necessary to qualify the original text by the conditioning clause “according to how he shall behave himself.”

What kind of man was Master Giovanni Ventura? We have no information on him and all we can do is to speculate on the limited basis of the agreement he made with the town of Pavia during a time of a social tragedy. He was ready to risk his life for some 30 florins a month, and it is doubtful whether he assumed this risk for purely humanitarian reasons.

He was obviously anxious to obtain the citizenship of Pavia. One is tempted to think of him as an uprooted adventurer. But I doubt that that was the case. More likely he was an obscure doctor from the countryside, and the fact that he was normally addressed as “master” clearly shows that he was of humble social standing. There were in the villages young men who, thanks to scholarships or to the economic sacrifices of their parents or to both, managed to obtain a university degree. But it was not easy for them to practice in the cities because the city doctors did not welcome competition, and they therefore resisted the immigration of more doctors. On the other hand, as the memoirs of Jerome Cardano testify, toward the end of the fifteenth century a physician did not fare well in the countryside where peasants often had recourse to barbers and quacks. The dream of a young country doctor was to be admitted to the city. Perhaps Dr. Ventura was such a one, and when the plague hit the city, he played his version of Russian roulette: if all went well, he would have obtained the citizenship of Pavia, thus establishing there both his residence and practice.

Did Dr. Ventura have a family? In all likelihood he had neither wife nor children; otherwise their presence would have been mentioned in the clause referring to the house that the community had to provide for him. Yet Dr. Ventura must have had relatives in mind when he made the stipulations in the agreement. The chances of survival of a plague doctor during an epidemic were not high, and in clause eight, with obvious reference to the advance payment granted by clause two, Dr. Ventura obtained the promise that “in the event – may God forbid it – that the said Master Giovanni should die in the exercise of these duties, that then and in that case his heirs should not be required to make restitution of any part of his salary that might remain unearned.” Was he thinking of his parents?

The institution of the community doctor in the Italian cities dated back to at least the end of the twelfth century. The idea behind the institution was to make available free medical treatment and care for the poor. The community plague doctor was but a special kind of community doctor and clause nine is similar to the analogous clauses that one finds in all agreements relating to the hiring of community doctors: “the said Master Giovanni shall not be able to ask a fee from anyone, unless the plague victim himself or his relatives shall freely offer it.”

A plague epidemic was not only a human tragedy for a city; it was also an economic disaster. All too often, enormously swollen expenditures on public health measures were accompanied by drastic diminution of revenues, and all this meant bankruptcy for the frail public finances.

Reading the agreement, one has the impression that Master Giovanni was more worried about the solvency of the city than about his chances of survival. With clause two he had obtained an advance payment. With clause three he had obtained from the city a special pledge to guarantee his salary. With clause ten he obtained that “whenever and however it of this kind the city may be brought so low that Master Giovanni cannot have his wage nor the things necessary to his existence, that then and in that case Master Giovanni may be released from his obligation without any penalty.”

By the end of the fifteenth century the gulf between physicians and barber-surgeons was widening in Italy; the physicians were more and more regarded as upper class while the barber-surgeons were increasingly considered part of the lower orders. By the end of the sixteenth century a physician was no longer addressed as “master”; that title being normally reserved to the barber-surgeons. In 1479, things had not yet gone so far, although even then it would have been unusual for a high-ranking, distinguished physician to be addressed with the title of “master.” Dr. Ventura was obviously neither distinguished nor high-ranking. However, he was a physician and not a barber-surgeon, because clause eleven stipulates that “the Community is under obligation to maintain a barber who should be at least adequate and capable.” The reason for the clause is obvious: a main task in the treatment of plague patients was lancing their suppurating bubos and the operation was normally performed by a barber-surgeon and not by a physician.

A city infected with plague was quarantined by all other places; trade and communications were halted, victuals became scarce and difficult and expensive to obtain. Many of those who were spared by the plague could hardly escape starvation. Dr. Ventura protected himself against these unpleasant events with clause twelve, which stipulates that “the Community has and is under the obligation to provide said Master Giovanni with all and everything which is necessary for his life, paying and exbursing the money therefore.” Master Bernardino di Francesco Rinaldi obtained a similar clause when he was hired as plague doctor by the city of Volterra in 1527.

With clause four Dr. Ventura had already secured for himself free housing facilities: clause eleven took care of all other living expenditures. Thus the 30 florins of the monthly salary could be left untouched and put aside. When one’s life is at stake, it is hard to decide whether pecuniary compensation is adequate or not. As we shall see below, however, by the standards of the time, the financial terms extracted by Dr. Ventura were reasonably adequate. But he kept worrying about the solvency of the community. He had already obtained the promise of an advance payment (clause two). He wanted a special pledge to guarantee his salary (clause three). He had made certain that in case of insolvency he would be released of his obligation (clause ten). But these guarantees were seemingly not enough to set his mind at rest. In a final assault on the problem he extracted clause thirteen, which stipulates that “however the community would not observe the previously agreed conditions, either partially or totally, then and in that case it would be possible to said Master Giovanni to be totally free from any engagement, notwithstanding the previous clauses or others to be made.” Clause thirteen practically repeats what was already established by clause ten.

What the town’s administrators thought of this obsession of Dr. Ventura and of his being more concerned with the possible insolvency of the Community than with the probability of his catching the plague we shall never know. We know, though, that after they had accepted clause thirteen and had recognized the doctor’s right Ito leave the job under the aforesaid conditions, the administrators pressed to have this addition inserted: “that the doctor should notify the community at least ten days in advance so that the Community would be in the condition to provide (for a substitute).”

While Giovanni could not take his mind off the community’s possible insolvency, the town’s administrators kept worrying about the kind of service that the doctor would provide to the patients. The minds of the two parties were following different logics and as the doctor persistently returned to his own point, the administrators felt that they had to reiterate their own. They had already managed to add to clause six the condition that “the doctor must treat all patients and visit infected places as it shall be found to be necessary.”

They had also succeeded in emphasizing that the grant of citizenship would be dependent on “how shall he behave himself” (addition to clause seven). But they were still uneasy. They therefore requested the insertion of clause fourteen, which stipulates that “said Master Giovanni would have and should be obliged to do his best and visit the plague patients, twice, or three times or more times per day, as it will be found to be necessary.”

The town administrators were understandably concerned with the capacity of the doctor to resist the assault of the infection and to deliver his services. This concern was not motivated by pure humanitarianism. Clause fifteen stipulates that “in the case – may God forbid it – that the said Master Giovanni would fall ill, and could not perform his office, that then and in such case he should receive a salary only for the time of effective service.”

The last clause stipulated that “said Master Giovanni will not be allowed a man especially designated by the Community.” The explanation offered is that Dr. Ventura when accompanied by the deputy would be “identified as the doctor appointed to that office,” but the real reason behind the clause was to ensure that the doctor would not intermingle with other people. The deputy’s function was to monitor Giovanni’s movements.

Real case of a plague doctor: Stefano Mezzettino

In Prato, in December 1527, the community made an inquiry on the behavior of the local plague doctor Stefano Mezzettino. It was noticed that, according to the rules, “when the community plague doctors move around they always have to be accompanied by a custodian especially appointed, but said Master Stefano went to treat a patient in Pinzidemoli and went there alone, without the custodian, with great danger for all concerned.” He was reprimanded and fined. A plague doctor was regarded as a contact and all contacts had to live in isolation.

From the remarks I have made on some of the clauses, it will be apparent that the agreement made between Dr. Ventura and the city of Pavia was not dissimilar from analogous agreements made in other cities. One has, indeed, the distinct impression that by the last quarter of the fifteenth century a standard formula had evolved. This formula was adopted, with minor variations, in places as different as Turin in Piedmont, Pavia in Lombardy, and Volterra and Prato in Tuscany. The pecuniary reward, however, varied considerably from place to place, largely depending on the quality and prestige of the doctor, the availability of substitutes, the severity of the epidemic, and the urgency of the town’s needs. Dr. Ventura, we have seen, was granted 30 florins per month, the free use of a house, and his living expenses.

The salary of a plague doctor

The florins mentioned in the contract were units of account. Thirty such florins corresponded to 11 1/2 gold florins and therefore to approximately 40 grams of pure gold. What this meant in terms of purchasing power is difficult to say because the price structure of those days was totally different from the price structure of today. Books of medicine were then valued in Lombardy between 5 and 13 florins each, with many having the value of 6.5 florins. Thus the 30 florins that Dr. Ventura received each month hardly bought five books of medicine. But manuscripts cannot be compared with the printed books of today, and few doctors owned more than some dozen books. Compared to other salaries, the salary of Dr. Ventura was not at all bad. A skilled worker, if he managed to be employed 200 days a year – which was virtually impossible – hardly made 60 florins in a year. The accountant of the community made 84 florins a year. The mayor of the city made 540 florins. At the university here were two or three famous professors who earned more than 1,000 florins per year, but 75 percent of the lecturers earned less than 200 florins per year. A contemporary living in a developed country may think that 40 grams of gold per month do not represent an exceptionally attractive salary. But in fifteenth century Europe gold was a scarcer commodity. Life was often brutish and short, and death was a more familiar event. Our story proves that a monthly salary of 40 grams of gold plus living expenses was high enough to attract a doctor to a job which bordered on suicide.

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Due to the risk of their job, many professional doctors refused to accept it, so the majority of plague doctors were recent graduates, inexperienced young people who took the job to improve their career, although the majority of they died of Black Death.

These people were hired by city governments, they were public workers, and they cared for all the inhabitants free of charge, regardless of whether they were rich or poor.

Their appearance was different from the other doctors, since they had to wear clothing that protected each part of their body to avoid contact with the “Bad Air”. Long robes, high boots, gloves, hat, and a strange beak-shaped mask. The masks had this bulky shape in the nose to be able to put aromatic herbs, which filtered the bad air. They were the first masks to incorporate an air filtering system, based on natural herbs. Predecors of the surgical masks that we use today to protect ourselves from COVID-19.

They also used a cane that they used as a measure of distance from patients. Yes, social distancing was also applied in the Black Death pandemic, as in the coronavirus pandemic.

Their outfits were different in each wave and in each country, since these doctors were present in every wave of the bubonic plague, from the 1300s to the 1900s.

Today there are many replicas of the plague doctor masks, based on ancient illustrations, with different shapes, colors and designs. You can find thousands of handmade masks on Etsy: Plague doctor maks for sale.

If you want to know more curiosities about the Black Death, in our blog you will find more interesting articles. Thanks for reading!

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Short answer: NO.

We see in the media many people wondering if the plague doctors were evil or bad. So we want to clarify it definitively. This may be due to their terrifying masks and outfits, but they were doctors! Doctors who offered support to people with the Black Death and helped cities fight this pandemic, usually hired by the governments of each city.

So, the plague doctors were not evil, but heroes who put their lives at risk to help others during the Black Death pandemic, just like today’s doctors who are putting their lives at risk during the COVID-19 pandemic. With the difference that now the surgical masks are friendlier and less terrifying than the plague masks

For this reason, our small business started with the idea of ​​paying tribute to all the plague doctors who helped fight the Black Death in centuries past.

If you too want to pay tribute to the plague doctors, keep their memory alive with these plague doctor t-shirts.

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Our Salem Plague Doctor Mask has been chosen for the filming of the Plague Doctor Horror Film.

“A twisted horror based around the horrid goings on of a Plague Doctor’s operating theatre. One day a troubling case turns for the worst.”

A horror film directed by Matt Sheridan and produced by Marzena Maliszewska.

/// Buy the Salem Plague Doctor Mask
/// Visit the movie website

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