Plague Pictures or Art in Times of Pestilence

By Claudia Rousseau, Ph.D. on April 20, 2020

The effects on society at large, and the massive toll that the current pandemic is wreaking on our world will probably also profoundly affect the character of art made in the coming months and years.  We thought it would be both interesting and appropriate to take a look back at the artistic response to widespread pestilences of the past.   A simple look at art made during and after outbreaks of the plague in western Europe alone produces a huge and fascinating inventory.

We can begin with the most famous of all plagues in our common memory: the Black Death of 1347-51.  In the space of those years, it now the consensus that approximately half of the population of Europe, including countries in eastern Europe and Scandinavia, was wiped out.  Moreover, the disease was indiscriminate, killing people of all classes, from royalty and the highest clergy to the very poorest.  Whole villages were laid waste, landowners died leaving the large numbers of people living on that land unsure of their status, while living conditions, especially for the less well-off, deteriorated significantly, further weakening the population.  The sociological consequences of such a huge biomedical event were equally significant.  The prosperous period in the early 14th century that preceded the plague’s arrival had resulted in a flowering of humanism and naturalism in the arts, particularly, but not uniquely, in Italy.  All this came to a crashing halt with a sharp return to older artistic forms and expressions of deep religious fervor in the face of so much suffering and loss.  By the 1390s economic conditions began to improve, but it is not an exaggeration to say that the recovery from this experience took at least fifty years, eventually resulting in the rebirth of European civilization that began around 1400.

Contemporary accounts of what life was like during the plague reflect the helplessness felt by ordinary people facing the enormous number of deaths.  The Sienese chronicler Agnolo di Tura del Grasso described his experience:

The mortality in Siena began in May [1348].  It was a cruel and terrible thing … Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so, they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without priest, without divine offices … great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night … And as soon as those ditches were filled more were dug … And I, Agnolo di Tura … buried my five children with my own hands… There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world.[1]

In such an atmosphere, it is no wonder that an iconography of the Triumph of Death might have become a popular means to express the fear and devastation connoted in this passage.  Among the most well-known images from the period is the vast fresco generally attributed to Francesco Traini that was painted in the chapterhouse of the Camposanto in Pisa c.1350—just as the virulence of the plague had begun to subside.

Francesco Traini, The Triumph of Death, fresco, 18.3’ x 49’. c. 1350, Camposanto, Pisa (Tuscany, Italy).  Photo public domain.

The fresco has suffered serious damage which makes the already cinematic image difficult to decipher on a small scale.  However, on the lower left we see a group of well dressed people on equally well dressed horses leaving the city—presumably to escape the plague.  On their way they encounter three open coffins.  They contain respectively the decomposing body of a peasant, a crowned figure, and a prelate.  The young man at the head of the group points, while those next to him cover their faces with handkerchiefs.  The pointing figure seems to say: “there, but for the grace of God, are we”.  To the right of the door at the bottom, there is a pile of dead, while devils and angels capture souls in the air.  A thoroughly disturbing image.

Yet, one of Traini’s contemporaries, Andrea Orcagna, also painted a Triumph of Death in the rectory of the Church of Santa Croce in Florence where it is estimated that 80 percent of the population may have died.  This included a hideous figure of death devouring bodies into various orifices, and a pathetic detail from the much damaged fresco of poor and disabled people calling to Death to take them—life being so unbearable.


Andrea Orcagna, Fragments from the fresco of the Triumph of Death, Santa Croce, Florence (Italy), c. 1350.  Photo public domain.

Although the worst was over at the turn of the century, the plague repeatedly returned in more localized outbreaks throughout the 15th-early 18th centuries, often very virulently.  Hence, a canon of saints particularly invoked against the disease formed early on, and foremost among them were Saint Sebastian and Saint Roch both of whom regularly appear in this imagery throughout the period.

Venice was often hit badly by these subsequent outbreaks, and public and private patrons commissioned works representing the plague saints as protection and as devotional aids.

Titian, St. Mark Enthroned with Plague Saints, oil on wood, 1510-11, Church of Santa Maria della Salute, Venice (Italy).  Photo public domain. The church was built as a votive to “Our Lady of Health” in thanks for the end of the plague of 1630.  The painting was located there at a later date.

This painting by Titian, a sacra conversazione, is an early work from about 1510-11, and it retains the 15th century format of pictures of this type.  St. Mark, patron saint of Venice, sits impossibly enthroned on a raised platform, while on his right are the doctor saints, Cosmas and Damian, and to his left are St. Roch and St. Sebastian.  St. Sebastian was invoked against plague as his martyrdom included being shot with arrows that left marks like the lesions of the plague.  He survived the arrows, so he became an appropriate intercessor.  The saint also offered artists the opportunity to paint a handsome male nude, and so he served both an iconic and artistic purpose in these works.  St. Roch’s history is vague, but it seems he was from Montpellier in the south of France and went as a pilgrim to Italy where he administered to the ill, curing them of the Black Death until he also succumbed to it.  He also survived through the auspices of a nobleman who sent a dog with bread for the saint.  For this reason, he is shown in art as a pilgrim with his staff and his dog.  Often, as in Titian’s painting, he shows his plague lesion.

Giovanni Cariani, Saints Sebastian, Roch and Margaret, oil on canvas, c. 1530?  Photo public domain.

Another example of this iconography is this painting by Titian’s Venetian contemporary Giovanni Cariani.  The date of the Cariani is uncertain, but is probably between 1518-30, a period that saw a number of subsequent bouts of the plague in Italy.  A rather balletic St. Sebastian stands between St. Roch and St. Margaret.  The latter was invoked in childbirth as well as against the plague since, according to her fantastic legend, she was swallowed by Satan in the form of a dragon (her attribute in art—here under her skirt) and then came out again alive.  The painting was therefore made as a powerful icon against the recurring nightmare of plague.

Tintoretto, St. Roch Healing Victims of the Plague, oil on canvas, 10’ x 22’, 1559, Church of San Rocco, Venice (Italy).  Photo public domain.

St. Roch is called San Rocco in Italy, and both a church and a grand scuola are dedicated to the saint in Venice.  This large painting by Tintoretto from inside the church, which houses the saint’s relics, depicts St. Roch healing victims who surround him in close quarters.  Looking at an image like this, one wonders if it reflects what a hospital for the sick might actually have been like at the time.  The strange lighting and odd posing of some of the figures on the left give it a surreal feeling.

The plague returned to Venice in 1630, but its end was credited to the intercession of the Virgin, in answer to the supplications of St. Roch on behalf of the city.  This chain of prayers became a popular theme in a number of works after this date both in and outside of Italy.  A work painted by Pietro Negri of about 1673 recalls the Madonna’s miraculous appearance in 1630 with a good dose of baroque drama.  Located in the Scuola di San Rocco, it is also of enormous size, approximately 28’ x 24’.  As it was painted on the wall beside the marble balustrade of an interior staircase, it is effectively impossible to get one photo of the entire work.   Here below are two details. In the center of the painting, St. Roch is seen supported by angels imploring the Virgin who gestures to St. Michael Archangel to her left, who turns to defend the people below. The group below them includes a wealthy woman who gestures as if offering her belongings in return for the Virgin’s help.

Pietro Negri, The Madonna Saves Venice from the Plague of 1630, two details. Scuola di San Rocco, Venice (Italy). Photos public domain.

Port cities were particularly vulnerable to the plague.  As such, Naples was another Italian city hard hit by the plague.  Mattia Preti was an important artist there during the plague of 1656 which killed approximately 145,000 people in Rome and 300,000 in Naples alone.  In response to this horrific situation, Preti was commissioned to create a series of large frescoes, ex-votos of the plague[2], that were painted on seven city gates, but have since been lost from exposure. These depicted the Madonna or other saints delivering people from the plague.  Two bozzetti (oil sketches) survive.  One, here illustrated, shows the Virgin appearing with the Archangel Michael coming to the defense of the dead and dying below.

Mattia Preti, Bozzetto for Votive painting of the Madonna and Saints delivering the people of Naples from the Plague, oil on wood, 1656-7, Capodimonte Museum, Naples. Photo public domain.

The outbreaks of plague in the seventeenth century were fairly widespread, and the death toll equally so.  Although doctors were unable to do much for patients, it was recognized that they needed protection from contagion.  Charles de Lorme, a French physician, is credited to have invented the first “PPE” for “plague doctors” in 1619.  The costume, used widely, consisted of an ankle length overcoat made of leather or waxed canvas, a crow-like white mask, gloves with long nail-like extensions, boots and a broad-brimmed leather hat.

Paul Fürst, Der Doctor Schnabel von Rom (Dr. Beak of Rome), colored engraving, mid-17th c.  Photo public domain.

The mask had glass covered openings for the eyes.  The curved beak had two small holes and functioned as a kind of respirator in that its purpose was to hold herbs and spices that were meant to filter the air of miasma and protect the wearer from disease.  The doctors also carried long canes in order to examine victims without touching them.  Paul Fürst’s colored engraving shows “Dr. Beak” from Rome with this head-to-toe protective costume, which, nevertheless, was terrifying because it was a sign of imminent death.  Indeed, the costume and the character of the “plague doctor” came to signify death and was deeply ingrained in popular culture.


Chevalier Roze à la Tourette, The Plague of Marseille, oil on canvas, 1720.  Photo public domain.

A terrible outbreak of plague occurred in and around the port city of Marseille in the south of France in 1720 that carried off about 100,000 people.  It is considered the last major outbreak, although there is artistic evidence that suggests the existence of plague in Europe as late as the 1780s.  A remarkable painting by one Chevalier Roze à la Tourette attempts to give an impression of the scene at the port of Marseille in 1720.  What is interesting about this work is the complete absence of religious imagery.  Instead, the sharp class distinction between the people on the quay and those on horseback is made quite evident.  As now, the poor are doing a lot worse than the wealthy.

Later in the century, about a decade before the French Revolution of 1789, we have a painting by Jacques-Louis David returning to the imagery of St. Roch pleading with the Virgin for help against the plague.  As mentioned above, it may refer back to the outbreak of 1720, or to another since.  Also, from the 1780s, is a colored engraving by the German artist Joseph Erasmus Belling representing the plague saints Roch and Sebastian, indicating that they are the “most excellent patrons against the plague.”

Jacques-Louis David, St. Roch Interceding with the Virgin Mary to Heal Victims of the Plague, oil on canvas, 102.3” x 76.7”, 1780, Musée des Beaux-Arts de Marseille.  Photo public domain.


Joseph Erasmus Belling, S. Sebastianus et S.Rochus, insignes Patroni contra pestem [most excellent patron saints against the plague], colored engraving, imprint Augustae Vindelicum (Augsburg), 12.2” x 8.3”, 1780’s.  Photo public domain.
The world-wide influenza pandemic of 1918-19 came with its own horrors and shocking death toll.  Although there is some disagreement on the number of fatalities, it is believed that as many as nearly 50 million people succumbed to the disease worldwide in that two year period.  Although it was called the “Spanish flu” recent research has suggested it originated in New York.[3]  It broke out among troops in France in January 1918, while the war was still raging.  This may account for the almost complete lack of artist response to the pandemic.

In September 1918 John Singer Sargent was in France with British troops making sketches for his painting Gassed—a heartbreaking image of young soldiers blinded by gassing.  Sargent himself came down with influenza and was taken to a military hospital near Roisel.  During the week he spent there next to others with the disease and the war wounded, he made this small watercolor which he later gave as a gift to the Imperial War Museum in London.

John Singer Sargent, The Interior of a Hospital Tent, watercolor, c. 15.5” x 21”.  Imperial War Museum.  Photo public domain.

With that, we come back to the present coronavirus calamity.  A gouache painting by local artist and art preparator Bonner Sale was meant to be in a spring show at American University Art Museum at the Katzen Arts Center.  Created in 2018 it now seems a prophetic image—and remarkably reminiscent of the “plague doctor” print discussed above.

Bonner Sale, Troubled Magic: No Need for Conscience, gouache on paper, 22” x 15”, 2018.  Photo used with permission from the artist.

Just as the plague doctors terrified a community with the beaked mask, the long costume and the strange gloves, this figure with its long snout seems to terrify the sick couple below, surrounded by skulls.  From that point of view, the little dog behind them might be a reminder of St. Roch. The cat might be a reminder of how cats (and Jews) were believed by some to be causes of the original 14th century catastrophe and horribly persecuted—most ironic since rat fleas were the real cause of the spread.   Let us hope that this one passes soon with only a fraction of the mortality of the trials we have reviewed.  It will be interesting to see what comes out of it artistically.

[1] P. M. Rogers, Aspects of Western Civilization, Prentice Hall, 2000, pp. 353–65.

[2] An ex-voto is a votive offering given in fulfillment of a vow, or in gratitude or devotion.

[3] Cf.

Banner image: Pieter Bruegel the Elder, The Triumph of Death, 1562, Prado.  Photo public domain.

This article was funded in part by a grant from the Capitol Hill Community Foundation.  Visit their website at