Imagine walking through a city where half your neighbors are dead within a week. The year is 1348. People are desperate. They’re terrified. Honestly, if you were there, you’d probably try anything to stay alive, no matter how weird it sounds today. When we ask how was the black death treated, we usually think of plague doctors in bird masks. But here’s the thing: those iconic masks didn't even exist during the first big wave of the Black Death. They came centuries later.
The reality was much messier. It was a mix of religious panic, "science" that was actually just philosophy, and a genuine attempt to survive a biological nightmare with the wrong tools.
The Theory of Bad Air and Smelly Remedies
Medieval doctors didn't know about Yersinia pestis or fleas. They didn't have microscopes. Instead, they looked at the world through the lens of "miasma." Basically, they thought the plague was caused by "corrupt air" that had become sticky and poisonous.
To fight bad air, you needed good smells. It sounds simple. It wasn't. People carried "pomanders"—oranges stuffed with cloves—or pouches filled with lavender and rose. If you were poor, you just grabbed a handful of strong-smelling herbs. Some even sat between two massive fires, believing the heat would "cook" the poison out of the air. Guy de Chauliac, who was the physician to the Pope, actually recommended this. It worked for the Pope, mostly because the heat kept the fleas away, though they didn't realize that at the time.
Then things got gross. Some doctors suggested that if "bad air" caused the disease, you could fight it with even worse smells. This led to the "latrine method." People would literally spend time breathing in the fumes of public toilets, hoping the new stench would somehow cancel out the plague's miasma. It didn't work. It just made a miserable situation much, much smellier.
Blood, Pus, and the Four Humors
Most of the medical logic back then came from Galen, an ancient Greek physician. He taught that the body was made of four humors: blood, phlegm, yellow bile, and black bile. If you got sick, it meant your humors were out of whack.
So, how was the black death treated when someone actually had the buboes?
- Bloodletting: This was the go-to. If you had a fever, they assumed you had too much blood. A barber-surgeon would cut a vein or use leeches to drain you. When you're already fighting a massive bacterial infection, losing a pint of blood is the last thing you need. It weakened the immune system and likely killed people faster.
- Lancing the Buboes: The "buboes" were the swollen lymph nodes in the groin or armpits. They were hard, painful, and turned black. Doctors would cut them open. Sometimes they’d apply a "poultice" made of butter, onion, and garlic. Other times, they’d use something more extreme, like the backside of a live chicken.
The "Vicary Method" was a real thing. You’d take a live chicken, pluck its rump, and strap it to the swollen plague sore. The idea was that the chicken would "draw out" the poison. Usually, the chicken just died, and the patient followed shortly after.
Religion, Penance, and the Search for Scapegoats
You can’t talk about how the plague was handled without talking about God. In the 14th century, science and religion weren't separate. Most people believed the Black Death was a literal punishment from Heaven.
The Flagellants were the most extreme version of this. These were groups of men who wandered from town to town, whipping themselves with iron-tipped cords until they bled. They thought that by punishing themselves, they could satisfy God's anger and stop the plague. It backfired. All that travel and open wounding just helped spread the bacteria even faster.
💡 You might also like: Why the Beck Depression Inventory BDI Test Is Still the Gold Standard for Measuring Your Mood
The desperation also led to some of the darkest chapters in human history. People looked for someone to blame. In many parts of Europe, especially Germany and Switzerland, Jewish communities were falsely accused of poisoning wells. Thousands were murdered in horrific pogroms. It was a tragic, violent attempt to "treat" a biological problem with social cleansing.
Did Anything Actually Work?
Surprisingly, yes. But it wasn't the medicine. It was the logistics.
The word "quarantine" comes from this era. In 1377, the city-state of Ragusa (modern-day Dubrovnik) established a trentine—a 30-day isolation period for arriving ships. This was later extended to 40 days, or a quarantena.
- Isolation: Moving the sick out of the house.
- Burning clothes: They noticed that the "poison" lived in fabric. They were right; it was the fleas.
- Cleaning streets: Some cities started realizing that filth and rats were connected to the dying, even if they didn't understand the germ theory yet.
The Weirdest Cures People Actually Tried
If you had money, you could buy "Theriac." This was a "universal antidote" that had over 60 ingredients, including ground-up snake skin and opium. It probably helped with the pain because of the opium, but it didn't touch the bacteria.
There was also the "Emerald Cure." Wealthy patients would swallow crushed emeralds mixed into a drink. If you weren't rich enough for gemstones, you might try "Armenian bole," which was basically a type of red clay. These treatments were expensive, useless, and sometimes physically damaging.
Lessons for Today
Looking back at how was the black death treated, it's easy to feel superior. We have antibiotics like streptomycin and gentamicin that can wipe out the plague in days. But the medieval response shows us how humans react when they’re backed into a corner by a threat they can't see. We still see the same patterns: the search for a miracle cure, the blame shifted toward "outsiders," and the slow realization that public health measures—like isolation—are often more effective than individual pills.
If you’re researching this for a project or just because you’re a history buff, focus on the shift from "divine punishment" to "public health." That’s where the real story is.
Actionable Steps for Understanding Plague History
- Verify the source: If a website mentions "Bird Masks" in the 1340s, it's wrong. Those appeared in the 17th century (designed by Charles de Lorme).
- Check the mortality: Research how different cities responded. Milan had a very low death rate because they literally bricked up the houses of the sick, people and all. It was brutal, but it contained the spread.
- Look into the biology: Read about the Yersinia pestis genome. Scientists have extracted DNA from medieval teeth to prove exactly what strain killed these people.
- Visit the sites: If you're ever in London, look for "Plague Pits" near Aldgate or the Charterhouse. They are still there, marked by slightly uneven ground or small plaques.