Pestdoktor

Print of the linocut pest doctor.

     In an attempt to distract myself from devastating news about the federal mismanagement of the current covid-19 pandemic, I decided to make a linocut of a plague doctor. As if emerging from a nightmare as a cross between a crow and the grim reaper, the doctors wore long cloaks, a hood with a long beak, and eye protection. I searched for images to use for inspiration and a simple engraving print caught my eye. As I went to research more about the image, I realized it wasn’t just any plague doctor outfit, this was supposed to be an image of a real doctor, Ijsbrand van Diemerbroeck, who not only treated plague patients, but wrote a book of case studies in hopes of educating other doctors about symptoms and treatments. 

Portrait of Van Diemerbroeck from Museum Het Valkhof in Nijmegen, the Netherlands.

     Just as we saw the novel coronavirus expanding from Asia, across Europe, and finally to North America, Europeans in 1347 began hearing about an incurable disease spreading across the continent. When it finally arrived in 1348, it killed thousands of people and became known as the Great Pestilence. For three hundred years, plagues and pestilences came and went in Europe every twenty to thirty years, devastating the population each time. No one understood germ theory, no one knew what caused the disease, and no one knew how to treat it. Their only real hope was containing the disease, which included quarantine and isolation for patients and having dedicated plague doctors. 

     Van Diemerbroeck was born in 1609, in this era of waxing and waning plague outbreaks and became a physician, although at the time, medicine was more like a mix of herbalism and witchcraft. Doctors believed the body’s health was determined by four substances that had to be kept in balance with one another by plant tinctures or draining blood, for example. Although one late 17th century doctor, Hans Sloane, also tapped into some more modern ideas like limiting alcohol and rich foods to keep his humors balanced and healthy. 

     One pestilence broke out in the Dutch city of Nijmegen in 1635, and Van Diemerbroeck began treating patients. By the mid 1500s, Europeans understood the plague to be contagious and started setting up quarantines and special houses for the ill. When he visited patients, Van Diemerbroeck likely wore the pestdoktor suit, the creation of which is credited to a French physician in 1619. The outfit was both supposed to protect doctors from the miasma or bad air that they thought could have been transmitting the disease and offer protection for the noxious smell of the dead through incense in the costume’s beak. In the Encyclopedia of the Black Death, Joseph P. Byrne also writes that Van Diemerbroeck smoked tobacco in hopes of getting rid of the bad air, including a pipe after any time he’d been around infected corpses. 

From Museum Het Valkhof

     In November 1635, Van Diemerbroeck went to see the maid of local wine merchant Anthoni Vos. He found her “sick at Heart, and sick of a Feavor, with great pain in Her Head.” This wasn’t what worried him, those could be symptoms of any number of illnesses. She also had “two small Pustules,” red and painful, “A certain signe of the Plague.” He prescribed a “Sudorifical Drink,” a recipe that reads more like a witch’s brew than medicine: extract of thistle, and thistle water, salt of wormwood, treacle androm (a sugary tincture in itself), and oil of vitriol (also known as sulfuric acid). This caused the patient to sweat through the night, but the pustules only grew and new black abscesses appeared. He gave her more of the drink and other drinks, treated her pustules, and eventually, she recovered. 

     He continued treating patients with medicines, sometimes the same ones, sometimes new ones. Some lived, some died. Doctors didn’t yet know that the plague was caused by a bacterium and transmitted by fleas. Stopping transmission was one thing that they could control, but actually getting rid of the bacteria On thing he believed is that, “In this acute Disease, delayes are very dangerous, and I have often observed those, who in the beginning take Medicines, are soon cured, but being neglected in the begining, the danger is very great.”

"Tractatus de Peste," the plague case-studies in Latin, from Google Books.

The English translation, from the Wellcome Collection.

     Van Diemerbroeck must have been recording his interactions with patients and taking careful notes. After the outbreak abated, he compiled patient case studies into a book, giving descriptions of patients, how he treated them, and notes about lessons learned, published in Latin in 1645 . According to the Museum Het Valkhof in Nijmegen, “The high quality of his research ensured that Van Diemerbroeck’s treatise remained a fundamental and indispensable study well into the nineteenth century.” 

     The British Library states that the book “was the standard medical work consulted by physicians and surgeons at the time of the plague of 1665,” an outbreak that caused over 7,000 deaths in a single week. The severity of this plague, often considered the last large outbreak of the bubonic plague, may be why it was translated from Latin to English and published in London in 1666, with some choice case studies. 

Just because an outbreak is over doesn’t mean a doctor’s work is over. Van Diemerbroeck continued working as a physician in the Netherlands, and went on to write a series of case studies of hypnogogic hallucinations, or the hallucinations that occur between being awake and asleep, published in 1664 and a book of anatomy, published in English in 1694, twenty years after his death.