Medieval artistic images most commonly used today to depict the Black Death are not, in fact, illustrations of plague. Rather, they are contemporary images of other diseases or of biblical analogues. This misidentification raises several questions, including why so few contemporary images exist with recognisable clinical symptoms of plague and when clinically relevant images first appeared. Initial answers to those questions – that artists focused more on the social chaos of disease than its symptoms and only in the later fifteenth century – now needs adjustment. We may have been looking in the wrong place for medical images of plague.

Medical and art historians are giving renewed attention to and asking new questions about the presence and function of diagrams in medieval and early modern medical man-uscripts and printed books. In the 1960–70s, Loren C. MacKinney and Robert Herrlinger interpreted these diagrams as straightforward medical illustrations, but recent work has taken a more nuanced approach that considers them within a broader interdisciplinary context of the production and use of health and healing information. Surviving sketches of surgical tools and procedures, urine wheels and flasks, Zodiac, Bloodletting and Wound Men, medicinal plants and therapies and medical practitioners at work are now being considered in a wider context that not only cuts across socio-economic, professional and intellectual strata, but also dismantles cultural, linguistic, geographical and medieval–early modern divides. This broader perspective lets diagrams ‘speak’ about the practical side of medicine. Some surviving medieval medical manuscript images also show people suffering from disease. A treatise in London, British Library (hereafter BL), Sloane MS 2276, for example, provides short textual descriptions of several disorders – including leprosy, gout, podagra and alopecia – accompanied by marginal sketches of people afflicted by these conditions. An even more fully illustrated example is an early fifteenth-century copy of John of Ard-erne’s De Arte Phisicali et de Cirurgia preserved in Stockholm, National Library, X118; here one finds images of people afflicted with a wide range of illnesses, including leprosy, falling sickness, consumption and dysentery.

Images of plague signs and symptoms, plague therapies and plague patients, by contrast, are notably absent from medical manuscripts before the fifteenth century and remain rare in both manuscript and print thereafter.