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Long Before PPE Suits: Why Did Bubonic Plague Doctors Wear Those Strange Beaked Masks?

Image credits: YouTube/AFP.

Image credits: YouTube/AFP.

We have PPE suits and masks during Coronavirus. But long back, the beak face-mask from the early days of bubonic plague wasn't just a spooky fashion statement, it was intended to protect the doctor from 'miasma', also commonly called 'bad air.'

In the last few months, as the Coronavirus pandemic spread across countries, we learned to become familiar with personal protective equipment that acts as a barrier to stop transmission of the disease. Although, there are many who still won't wear a mask!

The PPEs look like plastic coverings, resembling hazmat suits. Then there's the N95 masks, gloves, face shields, shoe coverings, and many more added layers. However, during an earlier pandemic, none of these existed.

The Bubonic plague which started in October of 1347, is so far the most fatal pandemic recorded in human history. Also called 'Black Death' and 'Pestilence' and 'Great Mortality', it resulted in the deaths of up to 75–200 million people in Eurasia and North Africa.

The Bubonic plague is back in the news after a city in northern China on Sunday sounded an alert after a suspected case of the same was reported, according to official media. Bayannur, Inner Mongolia Autonomous Region, announced a level III warning of plague prevention and control, state-run People's Daily Online reported.

The local health authority announced that the warning period will continue until the end of 2020.

So how did doctors protect themselves from the Bubonic plague that happened in another century? Since PPEs are a modern concept, the most common image of the bubonic plague is the costume of the 'bubonic plague doctor,' which a basic Google search will tell you, looks scary, to say the least.

The garb compromises of long dark robes, covering the person from head-to-toe, as well as a round hat, and 'clawed' gloves. The eeriest part, however, was the mask.

The mask resembled a bird, complete with a beak on it.

Today, we have N95 masks, but back then, the beaked mask was as close as a physician could get to 'warding off the disease,' as it relied on the misconception that the bubonic plague spreads through air.

The face-mask wasn't just a scary looking fashion statement, it was intended to protect the doctor from miasma, also commonly called 'bad air.' Physicians believed that the plague spread through 'poisoned air' and could create an imbalance once breathed in.

To prevent the poisoned air from entering, incense, smellers, and perfumes were common, and the beak served as a place to store mixture to filter the 'bad air.' The mixture usually was composed of viper flesh powder, cinnamon, myrrh, and honey as well as theriac, a compound of more than 55 herbs.

The beak shape of the mask was thought to give the air sufficient time to be purified by the protective herbs before it hit the doctors' nostrils or lungs. This is the 17th-century equivalent to our modern-day 'filters' on masks.

The origin of the costume is largely credited to Charles de Lorme, a physician who catered to the medical needs of many European royals during the 17th century.

Lorme described an outfit that included a coat covered in scented wax, breeches connected to boots, a tucked-in shirt, and a hat and gloves made of goat leather. Plague doctors also carried a rod that allowed them to poke (or fend off) victims, much like a necessary means to ensure social distancing, today.

However, the cause of the plague, which took almost three large-scale pandemics of the plague to discover, was not 'bad air,' but actually a kind of bacteria called Yersinia pestis, and can be caused by flea bites, which was commonly transmitted through rats as carriers.

The plague can also be transmitted by coming in contact with contaminated fluid or tissue, and inhalation of infectious droplets from sneezing or coughing people with pneumonic plague.

So while the spooky outfit became an instant distinguishing factor - anyone looking at the ensemble now knows it means the bubonic plague doctor, and it has also been adapted as a costume for Halloween and as a festival in Venice, Spain - but ultimately, the outfit did little to protect the doctors from the disease.