Plagued by Worry: An Historical Look at Pandemics in Four Parts

I asked historian and chronicler of social justice history Anne E Lynch to help us understand the social justice implications of the COVID-19 pandemic – Sue.

Part One

Some of you may be seeing memes posted around social media of people in strange bird masks, wearing dark clothes and/or cloaks and carrying canes, and you may be wondering what on earth is going on.  These bird-faced creatures are known to history as Plague Doctors, or, more accurately, were the mask of plague doctors.

: Copper engraving of a plague doctor; Rome; 1656. The doctor is wearing a dark robe, carrying a long cane, wearing a flat-brimmed hat, and wearing a white mask that comes out into a bird’s beak on his face. There are also tan gloves on his hands.

The long, beaked masks worn by doctors treating plague patients in the 1600s served a couple of purposes.  Firstly, they were supposed to be frightening to the spirits that carried plague, to ward them away from both the doctors and their patients.  The beaks were stuffed with plants, herbs, and resins that were thought to protect the doctor from catching the plague.  This is intriguing, because it shows that there may have been some inkling of one scientific way of how the disease spread but combined it with the superstitious idea of spirits who could be frightened away by the grotesque mask.  The cane carried by the doctors allowed them to distance themselves from physical contact with their patients.  However, for the most part, the plague doctors just as easily succumbed to plague as others, not because masks are ineffective, but because of the lack of sanitary conditions most people lived in at the time that allowed plague-carrying lice to proliferate.

Caption: A white mask in the shape of a bird’s beak, with black filigree and “Dottore delle peste” written on the beak (“Pest Doctor”). Bought by the author in Venice, Italy.

It is often presumed that the Black Death – the outbreak of Yersinia pestis – in the 1300s launched the plague doctor mask.  That is incorrect – as stated above, they emerged in post-Renaissance Europe. Technically, then, a Plague Doctor mask would be anachronistic in a Medieval recreation, but the Black Death is what most people think of when they hear “Plague.”  We may also think of Monty Python and the Holy Grail, where we see carts being pulled through the streets to calls of “Bring out your dead!” and monks punishing themselves.  The carts were real – with hundreds of people dying in a day in some of the most populous areas, mass graves were all that could be done.  And religious folks did punish themselves to appeal to God to take the plague away, though maybe not by smacking themselves in the face with books.

The Plague can actually take three forms: bubonic (bacteria enter the skin from a flea bite and travel via the lymphatic system), pneumonic (bacteria enter the person via breathing in airborne droplets from an infected person and settles in the lungs), or septicemic (bacteria can come from a flea bite or an open wound coming into contact with infected blood, and travels through the body via blood).  Pneumonic is perhaps the most fatal of the three forms, but bubonic is the most common – both in the past and now.  Septicemic is relatively rare.  The Black Death was largely the bubonic plague.  It was typified by swollen, painful lymph nodes, known as buboes (singular: bubo).  Symptoms could show up as early as 24 hours after exposure, and in the 1300s, once they symptoms showed up, there was next to nothing anyone could do to cure them.

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In this essay (series), we’re going to explore some of the plagues and other pandemics that have happened in history, and how we can learn from them – both in regard to what worked and what hampered healing.  So, come take a virtual stroll with me, sans body carts and at a socially-appropriate distance, as we examine disease history and lessons!

The Black Death – Bubonic Plague in the 1300s

The 1300s Black Death wiped out anywhere between 75,000,000 to 200,000,000 people (not a typo – yes, that many millions).  It probably originated in or near what is now Northwestern China or Mongolia in the 1330s.  It was carried by trade merchants through Turkey and what is now Russia and the Baltic countries into Europe and Northern Africa.  The culprit of the Bubonic Plague – the bacterium Yersinia pestis – was carried by fleas, who in turn were carried by rats onto ships.  Once ships docked, the rats went on land to search for food, and the fleas jumped to new humans, infecting a new location.  Needless to say, port cities like Venice and Genoa, Italy, and Constantinople, Turkey were often the earliest and hardest hit.

Caption: A plush doll of the bacterium Yersinia pestis. It is black and rod-shaped, and has a fanciful blue eye, with a tag stating that the plush is 1,000,000 times the actual size.

Many religious folks – Muslims, Christians, and Jews – felt that the plague was a sign of God’s wrath.  Some even questioned whether it should be treated at all because it was part of a divine plan.  Some took to extreme forms of penitence to appeal to God to stop the plague (self-flagellation with whips, for one example).  Doctors at the time were little help.  The speed at which the plague killed people made it nearly impossible to save anyone once they presented with symptoms.  Now we know that Y. pestis blocks a flea’s digestive system, causing them to be ravenous, seeking out more and more hosts.  Basic sanitation could have saved millions, but people at the time lived in crowded housing with straw bedding, no running water, and sharing living space with chickens and other animals – paradise for lice.  The first place that tried quarantining victims was in modern-day Croatia, in 1377.  It worked, and Croatia’s continuing outbreaks slowed.  Other cities took notice and then started quarantines.

Once the Black Death started petering out in 1353, Europe, Western Asia, and Northern Africa were decimated.  Some areas lost up to 60% of their population.  But the bubonic plague wasn’t gone for good – in fact, the Black Death was actually its second pandemic incarnation, following what is known as the Plague of Justinian which tore through the Byzantine Empire in the 500s CE.  Outbreaks continued, and thousands continued to die, up until the late 1800s.  Even today there are still outbreaks – Madagascar is currently having one of the pneumonic variation (when the bubonic one becomes airborne, transmitted through the lungs).  The bacterium thrives in warm weather but can hold its own in colder temperatures.  Now it is treatable with antibiotics (as with all medical treatments, though, some people don’t respond to treatment).  There are still around 700-800 deaths annually worldwide due to plague.


Historical look at plagues

Anne E. Lynch is the Executive Director of Three Rivers Community Foundation, an organization dedicated to funding progressive social change in the Southwestern Pennsylvania region.  She graduated from the University of Pittsburgh with a BA in anthropology and a minor in history.  She penned On This Day in Pittsburgh’s Progressive History, a small book with important events and people from the region that furthered social justice, and from that developed the Progressive History of Pittsburgh Facebook page (  She is also the author of two cookbooks under her Vegan Goddess persona.  She has some odd passions, however, one of which is the history and imagery of the Black Death and other plague outbreaks.


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