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Bruno J. Strasser and Thomas Schlich, "The Mask: A History of Breathing Bad Air" (Yale UP, 2025)
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- [00:00]
A
Hello, everybody.
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B
This is Marshall Po. I'm the founder and editor of the New Books Network. And if you're listening to this, you know that the NBN is the largest academic podcast network in the world. We reach a worldwide audience of 2 million people. You may have a podcast, or you may be thinking about starting a podcast. As you probably know, there are challenges basically of two kinds. One is technical. There are things you have to know in order to get your podcast produced and distributed. And the second is, and this is the biggest problem, you need to get an audience. Building an audience in podcasting is the hardest thing to do today. With this in mind, we at the NBM have started a service called NBN Productions. What we do is help you create a podcast, produce your podcast, distribute your podcast, and we host your podcast. Most importantly, what we do is we distribute your podcast to the NBN audience. We've done this many times with many academic podcasts, and we would like to help you. If you would be interested in talking to us about how we can help you with your podcast, please contact us. Just go to the front page of the New Books Network and you will see a link to NBN Productions. Click that, fill out the form, and we can talk. Welcome to the New Books Network.
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C
Hello, and welcome to another episode on the New Books Network. I'm one of your hosts, Dr. Miranda Melcher, and I'm very pleased today to be speaking with both of the authors of a book published by Yale University Press in 2025, titled the A History of Breathing Bad Air. The Two authors are Dr. Bruno Strasser and Dr. Thomas Schleich, who are here to tell us about a history of a thing that many of us are probably pretty intimately familiar with. But these not come about for the first time with the most recent pandemic. In fact, the history goes back not just a few decades, but quite a number of centuries, across all sorts of different places and for many different reasons, too. So there's a lot of intriguing history here to investigate. Bruno and Thomas, thank you so much for joining me on the podcast.
- [01:56]
D
Thank you, Miranda, for having us.
- [01:58]
C
Could we start off with some introductions, maybe each of you introducing yourselves and telling us why you decided to write this book and do it together. Bruno, perhaps you'd like to start.
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A
Sure. So, I'm a historian. I'm a professor at the University of Geneva and an affiliate of History of Medicine at Yale University. I studied biology before turning to history. I first worked on the history of biology. My last book was Cloud Collecting Experiments Making Big Data Biology. And I really love history because I feel it really helps me understand so much better the world we inhabit today. And that's why I love history. And I reached out to Thomas to write this book, the Beginning of the Pandemic. I knew Thomas through his work earlier, and he had a complimentary expertise to mine, and I thought it would be really fun to write this together.
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D
Yeah. My name is Thomas Schlich. I have actually a background in medicine. I went to medical school. I even worked as a doctor for a couple of years before I switched to history of medicine. That's my expertise. And I've been working on the history of surgery where the mask plays a role. So I guess that's why Bruno reached out to me in the first place, so that we have fields of expertise that are complementary to each other. And I was very happy when Bruno first asked me to if I was interested in some research on the history of the mask. That was in the early stages of COVID And we started working on it together. We first wrote. Wrote an article for the journal the Lancet, and then another one for a journal that's called Medical History in our field. And then we discovered that there is so much material and so much to say that we have more than enough for a book, to write a book. And that's how this project, this book project came about.
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C
I find so often the origin stories of books are. We thought it would be an article, but. Right. There's so often, once we start pulling the threads of investigating something, that the wealth of material really comes through. So having read this book, I'm not surprised it wouldn't fit well into an article. There is certainly a lot to talk about in terms of masks, and obviously we'll get to the more recent use of masks with the COVID pandemic. But I think the other kind of obvious place to start with a history of masks is before the most recent pandemic. I think the perhaps most famous set of masks for people to be aware of outside of those, Thomas, like you, who study surgery and medicine, would be the beaked plague masks, right all the way back from the Black Death. That's something that I think goes well beyond people just interested in medicine to kind of an iconography of the Middle Ages. But I think we should probably start there with the simple question of, is that actually a thing? Did plague doctors really wear those masks?
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A
So the very short answer to that is simply no. And that's. I think, one of the things we reveal in the book in the first chapter and that was a big surprise to both of us. We reasoned exactly like you did. We said, well, if you start a book on the history of masks, we should start with the most iconic masks of all, the one that everyone knows, because you see it at Halloween, you see it in video games, you see it in movies, and that's this beaked plague doctor mask. And so we started looking at the sources, historical sources, and digging in archives and reading all kinds of texts. And finally we came to the really sort surprising conclusion that the plague doctor mask did not exist. And not only did not exist, but it could not have possibly existed in the 17th century, for reasons that we discuss in the book. And the first kind of misconception that is often associated with this mask is that it comes from the Middle Ages. And there's no evidence. There's absolutely no evidence or no image, no text that ever refers to that from the Middle Ages. The first images we have are from 1656, and these are a series of drawings and engravings of a doctor wearing a beak mask. And these images have circulated widely over the Internet, on the social media during the pandemic. So everyone has seen some of these images and they've really become iconic. So the idea is, what we wanted to see is what are the. What were these images supposed to represent? And what kind of text and writings were associated with this image? And that's when we started to look deeper into that. And to make a long story short, these images were all satires. They were not at all descriptions or representations of how plague doctors actually dressed at the time in Italy, because the first images are published in Italy, then you have others in Germany and other places, and they all show the same thing. So all these images are actually copies of one another. And in the book we have eight of these images, one next to each other, and you see immediately that they're all exactly displayed the same way. The layout is exactly the same. And so there was one original, maybe one of these eight images, we don't know, but all the others are actually anyways copies of one another. And they were a way of mocking doctors. So it was a satire, a joke, caricature. And everyone perfectly well understood that at the time, and so nobody misunderstood the joke. And for some reason, the 19th century, we stopped understanding that this was a joke, and we kind of missed the humor behind these images. And we took them at face value. And we still live in that moment when we mostly think that these masks were actually worn by plague doctors during plague epidemics in the 17th century.
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C
This is Epic. This could have been something you did an entire book on and led it to the reveal at the end. And as you said, it's right in the beginning. Right. There's so many cool things here. So thank you for starting us off with that. Thomas, is there anything you want to add?
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D
Yeah, one could add that these masks, these images of the masks became so popular because they look so ridiculous. So they are actually suitable, even today we, for making fun of the backwardness of people in the past. So it's something that makes us feel good compared to people in the past because wearing a beak is something ridiculous. And it's quite interesting to then find out that nobody actually wore these masks in the past.
- [08:42]
C
Yeah, it's definitely interesting. Bruno, is there anything further you wanted to discuss on this point?
- [08:47]
A
Yeah, sure. Maybe you shouldn't believe us that at face value, such as what we said about people, that nobody wore these masks, some of the reasons why we believe that. So quite a few historians have been suspicious about these masks. They said, well, the evidence was thin. They weren't absolutely sure how widespread they were, how many people wore them. And so when we started looking at all the published text about plague around that time in Italy, we did not find a single mention of these masks. And if we look at a particularly important source, so a 900 page treaty about all the measures that were taken during plague times, how people should dress, what they should eat, when they should sleep, what they should do to prevent getting the plague, there are mentions of many things, of clothing, of shoes, of gloves, of hats, of all kinds of things, but not a single mention of this plague doctor mask. So you would imagine that if that had been a thing, it would have been mentioned in the book. So that's just one reason why we think not only there's no evidence, but the evidence is missing from where you would expect it. But the funny thing is that this mask is really a mask of a bird. And what does it mean in the 17th century to be dressed up as a crow or as a raven? And this bird is one of the most negatively connotated bird at the time. So for the Catholic Church, they're trying to get rid of the idea that this bird should be part of the animals that people like in some pagan rituals. And the, the crow, the raven at the time is an animal that is believed to steal money from people. It's an animal that is, of course, an omen of death. That has been the case for a long time. It's an animal that preys also on cadavers and carrion, it feeds on carrion. And this is exactly what people said of plague doctors at the time. When a plague doctor came knocking at your door in the 17th century, he would send you to the lazaretto and where you would probably die. So it was really bad news when you would see one of these coming. And plague doctors would say things in Latin or Latin sounding sentences that you would not really understand. And it would be something that people associated with these birds that are very loud and talkative and say things that nobody really understand. And they were of course black and dressed up in black, as many plague doctors were at the time. So all these actually associations that people had with ravens at the time are exactly what people said about plague doctors. And most people hated plague doctors at the time for number of reasons. They thought they were greedy, they thought they were useless at best. Useless that often they would actually kill people. They would take your money. And that's why someone at some point had the idea of drawing a caricature of a plague doctor dressed as a raven. And that's the origin of this idea that there's a plague doctor wearing a raven mask. But it was never, never a thing at the time. It was real in the sense that unicorns and mermaids were real at the time, but it was never something that existed as a material object at the time.
- [12:01]
C
Love some myth busting, this is great. Thank you both for doing it and explaining it to us here. Of course, though, just because those masks were not real doesn't mean that people at the time, for example, in that plague or in other sorts of disease outbreaks, but the idea of kind of protecting oneself by wearing something wasn't relevant. So what kinds of masks did people actually wear and what sorts of protective purposes were they hoping to get from it?
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A
Right, so that's, you know, it's exactly right to say there's something in the plague doctor Mac that did make sense. And that's exactly why it was, you know, a funny joke and a good caricature, a good satire. And the thing that did make sense is that the beak was holding aromatics that would change the air around you because at the time people believed that there was bad air. And that's the subtitle of the book, Bad air could make you sick and bad air smelled really bad. So if you wanted to protect yourself from disease, you had to change the olfactory qualities of air. And that's what this plague doctor mask was supposed to do. So people did it in a completely different way. What they did since the Middle Ages, was to wear a piece of cloth over your face and nose, which was often soaked in vinegar or that held sometimes aromatics that you would breathe then through your mask. These masks, to be clear, were not at all filtering masks. They had nothing to do with the filtering masks that we see from the 19th century and that we have been using ever since. They live in a completely different world, a world in which bad odors kill and where protecting yourself from bad odors means changing the smell of air. So if you walk in the cathedral, for example, of Basel in Switzerland, there's a bas relief from the 13th century carved in limestone, where you see three people pulling out the corpse of St. Vincent of Saragossa, decomposing corpse. And all three of them have a piece of linen over their mouth and nose. And what you don't see, of course, in the sculpture is that it was soaked in vinegar. So it smelled. And the idea was to prevent the smell of the decomposing corpse from reaching you and making you sick. And that is very central to all the paintings you see all the way into the 19th century. When you see an epidemic somewhere in the picture, look carefully. You will see someone holding his nose with his hand. The hand is usually also soaked in vinegar. And this is a sign that somewhere there's bad air in the painting. Because, of course, it's quite a challenge for an artist to show visually that the air smells bad. So the trick was to show someone with this hand over his nose. And so these pieces of cloth were widely used. And you see, we have found plenty of sources that say that is the thing you should do when you walk in a city infected by plague. Take a handkerchief, or you could even take an orange with cloves in it, or you can take a pomander. So a little piece of jewelry which holds aromatics in it. You hold it in your pocket and you pull it out as soon as you feel. Or you smell suspicious odors. And that's how you would protect yourself from disease all the way into the 19th century.
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D
Yeah. One could add that at the time, this was a very different way of understanding disease. It's kind of alien to us. But at the time, the bad smell was the disease. So if you found a way to counteract. To neutralize the bad smell, you neutralize the disease. That's very different from our modern way of understanding smell as an indicator of disease, for example.
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C
That's definitely helpful to understand as well, given how much that's not necessarily how we think about disease today. So Useful to get that perspective on masks further in the past. If we're thinking then, though, about what you've just described in terms of mask wearing sort of understandings, who is it specifically that is wearing these masks? One aspect of the book that I found interesting was that today, I mean, Thomas, your expertise, you mentioned was on sort of surgery, and masks definitely show up there now. But in the book, there were some discussions of how in the past that was not the case. Doctors were not the ones wearing masks. Who was?
- [16:21]
A
Right. So an interesting fact that we found out is that doctors often recommend masks, but they never wear them themselves. And I'm talking here about the 19th century. And we realized that there was something that helped us explain also some of the attitudes during the COVID pandemic, and especially why men were so resistant to wearing masks. And sociologists have studied that during the COVID pandemic that most people who did not wear masks in public were mentioned. It wasn't just men. It was men who held a specific view of masculinity. The kind of tough guy who is never afraid of anything and is not going to wear any type of protection because that will show that he is weak or afraid and therefore not really a man. During the pandemic, there was this commentator on Fox national who said Joe Biden might as well carry a purse with his mask. So there was something effeminate about Joe Biden carrying a mask, whereas a real man like Donald Trump would never wear a mask, you know, were never in public, at least. And so, you know, the gendering of masks was an important reason why also doctors did not want to wear masks in the 18th and 19th century. They were too strong, they were too proud, they were too heroic, they were too manly, if you want to wear a mask. And masks were associated with women with veils that women would wear, you know, on some occasions. Or they were associated with the effeminate aristocrats of the ancien regime who, you know, wearing dresses and all kinds of other things that were considered ridiculous in the 19th century. So that's when masks became really gendered in the 19th century. And that's why we have a chapter called Of Masks and Men playing on Steinbeck's Mice and Men. And I thought it was really illuminating to see how the gendering of masks had an old history and helps us understand what's going on today. And there's nothing inevitable about how masks became associated with the feminine and not with the masculine, because in Asia, it's the exact opposite. It in China, for Example, it was women who were most resistant in the early 20th century to wear masks, and men were absolutely fine with it. So there are different ideas of masculinity and different ideas of femininity, but masks were gendered in all cases. And I think that if public health officials had been more aware of that, they might have designed public health campaigns that would have taken that fact into account, instead of making blanket statements about wearing masks that would talk about would be understood very differently by men and women. And so that's another way in which I think history can help us also design maybe better policies or communicate better with people, because it helps us unpack all the meanings that go with these objects that have very long histories like masks.
- [19:03]
C
Yeah, that's definitely something interesting and helpful to trace through time. Thomas, was there anything you wanted to add on this one?
- [19:10]
D
Maybe just that in the 19th century, covering one's face was already gendered because of the veils that Bruno just mentioned. So you lived in a world where covering one's face was typical female, and it's a short step towards then rejecting masks. Because that's what women wear.
- [19:36]
C
Yeah, of course. Because obviously, things that are happening within medicine are not just about what's happening with medical practice. Right. There's the kind of whole of society that's influencing things, too. And that's, of course, the case with masks. They are relevant to medicine and disease, as we've been talking about, but they also show up in contexts that don't really seem to have anything to do with medicine. For example, factories. So can we talk about when and why masks were important in that context and the extent to which workers were wearing masks in factories?
- [20:07]
A
Sure. So when we think about masks today and the one we have been wearing during COVID we think immediately of other epidemics, and we think that, you know, today's masks actually emerge in the context of epidemics, mostly plague, and then maybe the Spanish flu and other epidemics. And so when we started working on this chapter about masks and occupational health, we realized that that was actually the place where the modern masks actually emerged. And as I said earlier, most of the masks used during past epidemics before the 19th century had a completely different function. They were perfuming devices. They were never filled and intended to be filters as the mask we have today. And where the idea of a filtering mask emerges is in the middle of the Industrial Revolution. And that is a time when there's an increasing awareness of the harm being caused by dust produced in factories and vapors of arsenic and mercury and Other compounds that could hurt a worker's health. And that is when a number of people start to design and eventually patent all kinds of filtering masks. And these masks actually are always. Are built, they're sold, and they're almost never worn in the workshops and the factories. So during the entire century, hygienists keep telling workers that they should absolutely wear a mask. If only they wore a mask, they would be safe and they would be in better health. And in fact, workers actually never wear them. So you realize that recommending masks is also a way of deflecting the responsibility for the health of the employees. Employee on the workers themselves. So instead of telling employers to clean up the space or to install expensive ventilation, or maybe to design new ways of production or making factories environments more healthy, the solution was simply to recommend workers to wear masks. And then if workers fell sick, eventually, it was just because they failed to wear a mask or to wear it properly. And what hygienists did not completely understand or what they did not want to acknowledge was that wearing a mask in a factory was often simply unbearable. These places were often extremely hot, and you could not simply put a mask on top of that on your face. It would just be unbearable at the time. Mask also prevented you from doing certain things that was a common thing to do in a factory. Sing during the work, talk to a coworker, spit on the floor, chew tobacco. And all these things that were so much part of shop floor sociabilities Were just impossible with a mask. And so the call for wearing a mask was just mostly a way of deflecting responsibilities, as I said, Rather than a real solution to an actual health problem, an occupational health problem. And that's, I think, one of the key arguments we have also in the book is to say that the mask is often and repeatedly a quick technological fix. It's an easy solution and a convenient solution to a complex problem, in this case, unhealthy factories and workshops. And it's often. It's also very political if you want a solution, as I said, because it shifts responsibilities. And in many other cases that has been. Masks have played exactly that role. It's been an easy solution to a.
- [23:26]
C
Complex problem that sounds all too familiar in many senses. Thomas, anything to add?
- [23:32]
D
Yes. I mean, factories is one work environment, one risky work environment. Another one is actually healthcare. So there's a parallel argument that we can make about wearing masks, wearing individual protection in a healthcare environment and hospitals, because there is also the risk of occupational disease, of catching an infection. And there we can Also see this strategy of individual protection as a technological fix to a complex problem in a parallel work environment. We will talk about that a little bit later. A bit more.
- [24:14]
C
Yeah, no, fair enough. But good to have that on the table at the moment. The other place where masks show up both then and now is in questions of urban air pollution, which is definitely still relevant today, but perhaps goes back further than we might expect.
- [24:33]
A
Yeah, that was another surprise when we were researching for this book. So we're all familiar with images of people in Beijing or in Delhi who are wearing masks and before COVID because of air pollution. And again, this is a perfect example of a technological fix. I mean, instead of fixing urban air pollution by regulating transportation or other forms of energy production, you just recommend people that people wear a mask, which of course doesn't solve anything of a problem. So we started looking back, what's the history of that? And we found out that in the second half of the 19th century, especially in Britain, so in cities like Manchester, Leeds, London, so the these industrial cities, a lot of people were actually wearing masks against air pollution. So it wasn't called air pollution at the time, but it was really at that moment that the awareness that air pollution was a real problem and that you could do something about wearing masks emerged. And there's. We found two interesting sources from a journalist from the United States who travels to London in the 1880s and he says he's very surprised. And he says there's one person, one in three person is wearing a respirator, so a kind of mask in his face in the city in the winter. And the time when there's a lot of fog and smog, as we would say today, because a lot of everyone is heating his place with coal and cooking with coal, and there's lots of factories also releasing all kinds of smoke. And so one and third person. And there's another source that says that 50% of the people in London are wearing these respiratory. And the respirator is designed by a physician, a British physician called Julius Jeffries. And nobody's ever written about this story. And if you look at the ads in the press In Britain, the 19th century, these respirators are all over the place. The first time I searched in a massive database of newspapers, of British newspapers, I found several thousand ads and I just couldn't believe it. I said, this is impossible, I must be finding something else. And actually, no, there are thousands of ads for respirators in Britain in the second half of the 19th century. And people wear these because they warm up the air, they dry up a little bit. The air, which is humid in the fall, and it takes out some of the smoke. And people think it's going to help them get through the day and walk through the city and without falling sick. And these things have been massively used in the second half of the 19th century. Then they stop being used around 1900 for various reasons. And then they're used again in 1952 when there's the great London smog, which some of us, some people talked about during the pandemic, where about 10,000 people actually die in London because of the smog. So this is a very heavy episode of smog, which is related, again, to coal combustion, but also to public transportation and individual transportation. And the government is really cornered. They don't know what to do. They don't want to fight against the coal industry. Churchill winning World War II was fine, but going against the coal industry was something he was really not up to. And so at that moment, the Minister of Health realized that since there's nothing he can do, the only kind of political fix he could find is recommending that people wear a mask. He's fully aware, and we found that in their archive, that he. He knows it's not going to be useful at all. It's not going to save anyone's life, but at least it might save his political life. And so there's a massive recommendation that people wear masks in 1952 against the smog. And that goes on every fall, each time you have a smog episode in British cities, and that continues all the way into the early 1960s. And it's really a British phenomena. And we show this incredible image in the book of the Beatles showing up at a concert in Manchester in 1952, and they're all wearing a mask except John Harrison, who is actually smoking through his mask. So he was not too concerned about air quality at the time, but it really shows how, you know, this was very common the time, and we completely forgot about it. And so one of the revelations of the book is also how quickly we forget past public health measures, and we seem to reinvent them each time. So all the lessons we have learned from this episode, or from the Spanish flu we might talk about that later, seem to have been completely forgotten when Covid broke out in 2020 or in 2019. It's as if a black hole had absorbed all the knowledge, all the experience and everything we had learned about masks and what masks can do, but also the limitations of masks in fighting disease and as a tool of public health.
- [29:13]
C
One place, though, we haven't fully forgotten or didn't fully forget the usefulness of masks is the surgical room. So we have mentioned it a number of times now, but now that we've kind of moved closer in time to where we're at now tomorrow, could you tell us a bit more about how, when and why surgical masks came to be such an established part of what happens in operating rooms?
- [29:34]
D
Yeah, that happened towards the end of the 19th century. So the 19th century was a time when surgery was in full expansion, so there were more operations being done, operations on areas of the body that had been a taboo before, such as the abdomen. So there was a technological development that allowed doing that. But surgeons were shocked when they found out that even after an operation that was, as such, successful, their patients died. And it took them a while to find out that this is because of wound infection. So that there are germs in the environment, in the air, everywhere, that enter the operation wound and cause an infection and actually could kill the patient through sepsis, for example. And this they noticed around the mid 19th century. And they then tried out different strategies to deal with this problem. So once they found out that the germs are the cause of this problem, of course, that was the place where you could intervene, where you could try to prevent the wound infection in the first place. And there the main strategy in the late 19th century was what's called asepsis. So in asepsis, you try to keep the germs out of the operation wound, out of the whole operation environment, mainly by sterilizing anything that could get in touch with the wound. So that's a strategy that's as opposed to. To antisepsis, which was a strategy that built on killing the germs that were already there. So asepsis, you try to keep any germs out of the wound, but that's a very precarious strategy, because the idea was that even one single germ could cause a wound infection, because germs are alive, they propagate, and so one germ could propagate and then cause the patient to die. It's an all or nothing principle. So you need to be 100% sure that no germs reach the operating rooms. And there are a lot of the operating wound, and there are lots of possible gaps there in sterility. So one of them would be the surgeon's hands. So surgical gloves were invented, and another one, of course, is the surgeon's mouth and nose. So the idea is that that germs can be ejected by the operator, by the doctor while doing the operations from the nose and mouth. Just by breathing or by talking. You don't even need to sneeze or anything. Just by being there, the germs would come out of the operator's mouth. And one of the, the surgeons who was dealing with this problem was, was Johan Mikuli in Breslau, today Roslaw in Poland. And he actually thought of just using one of the dressings that he was, that they were around, kicking around there and to put them over his mouth and nose. He called that a mouse dressing. And that was the first mask in the operating field. Now what was new about this is that this mask was not worn to protect the wearer, so the surgeon, it was worn to protect someone else, to protect the patient that's being operated on. So that's actually a new principle because up to then, all the masks that were used were used to protect the person who was wearing the mask themselves. Health.
- [33:47]
C
Yeah, no, that's a very key distinction. But as you said, this is a very sort of intensive all or nothing proposition to try and achieve. Did the use of masks in this context of surgery lead to masks being used in broader medical contexts?
- [34:03]
D
Yes. In fact, the same doctors and scientists who worked on the question of wound infection and who were testing these, this new surgical mask for their effectiveness, we're also immediately working on the use of this mask and its efficiency for other purposes. So, for example, for the propagation of tuberculosis or other germ induced diseases. So they broadened their research program around surgical masks to include other germs and other medical situations. And in that context, the masks became kind of bidirectional. So there were testing masks in terms of protecting someone else rather than the wearer, but they were also testing the masks in terms of the protection of the person who wears them. So that was a broadening again of the purpose of masks. So this first happened in medical contexts. So they were first used, these masks by medical personnel, for example, obviously in the operating room, but then also in tuberculosis hospitals or sanatoria or such institutions. And then in the next step, they were also used in epidemics. And in epidemics, what was new in that context was that they were now recommended for the whole population or for parts of the population. So also people who were not doing some medical work. And again, in both directions, for protection. In both directions. So for protection of the wearer of the mask, but also to protect others from being infected by the wearer of the mask. So that's a broadening and a spread of the. The broadening of a purpose and the spread of the use of masks after they had been introduced into the operating theater.
- [36:17]
C
Bruno, is there anything you want to add?
- [36:18]
A
Yeah, Miranda. One thing I find fascinating is that Thomas has explained perfectly well how these masks were intended to protect the patient, and surgical masks were intended to protect the patient. But when we remember during the COVID time, how often were actually surgical masks recommended to protect yourself, and they had never been designed for that purpose, and that was not at all how they were intended to work. And it's fascinating how this very basic purpose of the surgical mask became misunderstood later and forgotten. And then public health recommendations were completely at odds with what these masks were actually supposed to do. And so that was, again, about this forgetting about what the different kinds of masks were intended to do and how they were supposed to perform form.
- [37:06]
C
Yeah, no, that's definitely important to emphasise. As well as these ideas of masks broadening from the operating room further into medicine, Thomas, as you've told us about, but also into fields that have nothing to do with medicine, or in fact, might even be the exact opposite, which would be the use of masks in military contexts, perhaps most famously, certainly in the UK in the First World War. But maybe you can tell us more about how and why the military gas mask changed technologically and socially over the process of the 20th century.
- [37:39]
D
Yes. So the First World War was the first war where there was gas warfare used at a large scale. So the Germans started it, but then both sides took it up. And from the very start, there were attempts of protecting the soldiers in some way against these gases. So it all started with chlorine gas. And to keep the chlorine gas out of the respiratory tract of the soldiers, they were trying to find ways of neutralizing that gas, of avoiding to breathing it in. So it was a protective measure in the first place, but it very quickly became an element in what we can describe as an arms race. So it all started, as I said, with chlorine gas. And then there were relatively primitive ways of protecting soldiers against that gas in the form of very simple gas masks. But then the other side of the conflict was starting to develop new gases that could then kind of break through that protection, which then led to the, let's say, the German side to invent new gas masks, which then provoked the Allies to invent even stronger gases. So you end up with something like mustard gas towards the end of the war. Mustard gas can circumvent the gas mask because its Effect is through contact with the soldier's skin. So it's a terrible gas. And so the gas mask, which was actually protective measures, was a very important element in accelerating this war, this arms race. So that's technological. Culturally, the gas masks very quickly became a symbol of evil. First of all, it was the symbol of the evil enemies. So the enemy side was often depicted with gas masks on their face. Sometimes it was also the own soldiers that were depicted with gas masks as a symbol of the braveness of one's own soldiers. So it could be used for both. But over time, and that even happened during the First World War, the gas mask became more and more of a symbol of the evils of war more generally. So especially then in the interwar period, the pacifist anti war movement used the gas mask as an iconic symbol of all the evils of war. And in the next step, actually the gas mask became a symbol of other evil stories too, very often in connection with environmental pollution. So you can see in the recent past or even today, people who are demonstrating against global warming or against nuclear power wearing gas mask as. As. As a symbol of that particular evil. So that's how. How this symbolic value of the gas mask actually broadened and spread over time.
- [41:20]
C
See, this is what's so interesting about histories like this. It's both, as you said, the technological aspect, but also the kind of social and cultural perception side, too. Bruno, is there anything else you want to throw in?
- [41:32]
A
Yeah, sure. To add to this, I mean, World War I was really a turning point with regard to the attitude towards masks. I mean, a lot of workers who were kind of suspicious about masks who did not want to wear them for all kinds of good reasons. Reasons they often change their attitudes after World War I. And there's a beautiful quote in Scientific American just after the war talking about factory workers who say they want their masks back. So after experiencing gas warfare in the trenches and seeing that a gas mask could save your life, a lot of them were more ready actually to accept wearing a mask in factory or occupational settings. So this was really a turning point in the advocacy attitudes towards masks. Effy?
- [42:15]
C
Yeah, that's key to understand. And links back to what we were discussing earlier. So thank you for adding that in. And as you say, a lot of these ideas of what a gas mask sort of represents culturally are still very much with us. But of course, we do have other masks that are key symbols still today. So starting with masks in sort of pandemic context, obviously we will talk, I think, a little bit more about COVID in a moment, but. Oh, I don't remember which of you now mentioned mentioned it, that even before COVID masks were more commonly worn in Asian countries like Japan or China. And before we got to Covid, you know, talking about other pandemics like H1N1 or SARS. So when, why and how did that become just kind of a normal thing in, again, China or Japan, rather than sort of hyper politicised the way it was in the west during COVID Bruno, do you maybe want to take this one on?
- [43:07]
D
Sure.
- [43:07]
A
So masks are often associated with Asia as if, you know, masks is kind of an Asian thing. It's something that it's natural for Asians to put on their face. And what this attitude or these statements reflect, it says a lot about Western attitudes and stereotypes about Asia, rather than anything significant or actually true about mask wearing in Asian countries. And if you start looking at the history of mask wearing in Asia, you see that it's a very complex story. And Asia is not a place by itself. It's many different countries which all have very different trajectories. So we looked at China and Japan and South Korea, and each has a rather different story with regard to masks. And what is interesting is that in each one of these countries, masks were something foreign. Just like people in the United States or in Europe thought that masks were something Asian, in these Asian countries, masks were also thought as something that was foreign. In the late 19th century and early 20th century century. In the case of Japan, the mask was something European, it was something German specifically, it was a symbol of German medical modernity. And German physicians would study in Berlin, Japanese physicians would study in Berlin and come back to Japan and promote masks in the operating room first. And then Japan embraced actually masks in many different contexts and during the. The Spanish flu also. And then they imposed masks in China, in Manchuria, which was under Japanese domination, and then in South Korea. And so in China and in South Korea, the mask was a Japanese thing. It was not something Asian in any way. It was something that was being imposed by a foreign country and that was also very much resisted. So in all these countries, there was always this feeling of that mask was something that was imposed, coming from the outside and being imposed. And the only country on earth where masks have become really part of a national culture is Japan. And this country has really have a very specific and particular relationship with masks. And all the other countries, there's been something that has been often imposed either by political powers or under Mao in China, something that was imposed on People and they were not always very happy to wear that or something that was foreign. And the fact that we think in the west that Asian people kind of naturally wear masks is really kind of Orientalism is the kind of, you know, it reflects our prejudice and our stereotypes about Asia that, you know, Asian people are submissive anyway, so that's why they wear a mask or they wear. They have wear little emotions anyway. So wearing a mask is not going to change anything. And that Asian men are effeminate. So therefore don't. It's not a problem for them to wear masks which are also associated with females or with women, as we discussed earlier. And all these horrible stereotypes were exactly what was being at stake when people were associating masks with Asia. Because there's nothing inherently Asian with masks any more than there's anything inherently Asian with your iPhone, because it's being produced in China. So these stories really have to be discussed in the different context context. And the only thing that is kind of different in these Asian countries is that there have been more epidemics in the 20th century. So H1N1 and SARS and these episodes have been kind of rehearsals for what happened during COVID So when COVID 19 broke out, some of these countries have had already experiences of wearing masks or masks being thought as a public health measure, whereas that hadn't been the case case in France or in Germany and Britain for about 100 years. So there's never been considered as a proper public health measure in the 20th century between the Spanish flu and Covid. But so Asian countries have had a little bit more experience with that. But there's nothing inherently Asian with masks.
- [47:14]
C
Let's talk about that last experience in Europe with masks. Because of course, 100 years is a long time, but plenty of European countries remember and care about and pay attention to things that happened longer than a hundred years ago. So it's not inevitable that just because something was 100 years ago, therefore that's the only reason why it's been forgotten. So what sorts of things could have been remembered about masks and mask debates if the consciousness had been more aware of the Spanish flu in more recent times?
- [47:46]
D
So about the Spanish flu, it's quite an interesting example. I mean, we think during the Spanish Flu, everybody was wearing masks. That's actually not at all true. So in general, we have not much evidence that many people wore masks at a worldwide level. There were only very few places in the world where masks were worn, and even fewer where masks became mandatory and they wore were most of them were in the US but even within the US it was only some municipalities where this happened. And the most famous one is San Francisco. And in San Francisco, when the first wave of the Spanish flu hit, there was a mask mandate. And people at the beginning were actually kind of. Of enthusiastic to. Of wearing masks. But that wore down very quickly as soon as the, the numbers of cases decreased. I mean, the, the. The US Is also a special context because in the US you have a particular approach at that time that became dominant in, in public health that's called the new public health in the early 20th century. It's all based on bacteriology, which was new at the time time. And that new public health came with a lot of public health interventions into people's personal lives. And best known example is probably compulsory vaccination or the compulsory isolation of people with some infectious disease. So this is all about protecting the general population and if necessary, at the cost of personal freedom of, of some people. So who were forced to undergo vaccination, who were forced to wear masks. So that's a principle. But that principle also in the American context caused a lot of resistance. So there were people at the time who were rejecting masks so violently that they said, I'd rather die from the flu than wearing. Than being forced to wear a mask. So we can see that there is. Is this weighing of different values against each other so that the general welfare, the welfare of the whole population versus, in this case, the individual freedom of choice of wearing a mask or not. And the situation was quite similar actually during COVID and in particularly actually in the United States, I think.
- [50:28]
C
Bruno, do you want to jump in?
- [50:30]
A
Sure, yeah. One thing I found fascinating is how during the COVID pandemic, people kind of immediately thought, a lot of people thought that what happened in San Francisco was what happened everywhere on Earth. So what happened in a few American cities was taken as just an example of what would happen everywhere else. But that was absolutely untrue. So the US Was really an exception during the Spanish flu. And there's really no other country on earth where you had major cities with mask mandates. And not neither in France nor in Britain, nor in Germany, nor in Italy. So we've looked carefully and nowhere do you see mask mandates. But there's another, I think, interesting story which really goes to the visuals of masks. We've all seen these beautiful images of people masked in San Francisco, in St. Louis, or in Denver and some other cities in the US and they circulated widely again on social media, in the press during the pandemic. And we said, oh, that was a precedent to what was happening during COVID 19. And what is interesting is then when you start looking not just at these few images that were published, but at all the other images of the time, very often you don't see a single mask. And that is true during the entire century. So I found out, for example, one image in China during sars, and it's an image that made the front page of Time magazine. And you see a couple, two young men, young woman wearing a mask. Mask. In front of a poster of someone wearing a mask. So it's kind of a beautiful image, iconic image. And I got the high resolution file for this image, which we reproduce in the book, and I zoomed into the background. In the background, you see 12 people, not a single one of which is wearing a mask. And it really shows how much we have used this kind of visual grammar of the person wearing a mask to show that there's an epidemic going on. And if you want this visual tradition, as we discussed at the very beginning of this podcast, goes back all the way to the 17th century, when you wanted to show that there was bad air or infectious air around you. You would show someone in the picture wearing a mask or holding his hand over his face or holding his nose. And this is exactly what we've been doing during the entire 20th century with photography, showing someone with a mask as a way of showing that there's an epidemic going. And if you look, for example, at all the pictures taken by Macri Bu, a French photographer in China, and he took one beautiful picture of a woman at a ball in Shanghai in the 1950s wearing a mask, it's an iconic image, a really beautiful image. And if you look at all the other pictures he's taken and all the contact sheets he has, not a single one shows someone wearing a mask. So masks were extremely. But they were a way for us to show that there was either an epidemic going on or that Asians were so different than we. They were wearing masks, whereas we in the west would never do such a thing. And so it was always a way of othering, you know, people who come from. From other places. And so I think that's also something to take into account when we read the images also, that future historians will have of the pandemic of people wearing masks are much more common than the images of people not wearing masks. Mask. Although in many situations, people were not wearing masks at all.
- [53:49]
C
Well, we shall certainly have to make sure that future historians don't fall into the same trap that you helped us bust right at the beginning of this conversation around plague masks. So I think that does nicely bring us back to where we started and therefore is probably a good place to conclude our discussion, leaving me to just ask what each of you might be working on next. If there's anything you want to give us a sneak brief preview of whether together or separately. Thomas, maybe you want to go forward first?
- [54:16]
D
Sure. So my current project is about the history of how modern surgery came about. So that kind of surgery that we take for granted, with all its technological successes, with the strategy of curing a complex internal disease by opening up the body and fixing something that's something that does not exist, let's say, in 1800, but it was firmly in place before the First World War. And my project is to tell the story of how that happened between 1800 and 1914, of how modern surgery as we know it came about in the course of the 19th century.
- [55:02]
C
Well, that certainly sounds intriguing. Bruno, what about you?
- [55:04]
A
Yeah, so I have a completely different project which is a spin off of one of the chapters of the book which we did not discuss, called Mask Consumption, which is how masks became disposable, which is actually how we started getting interested in masks. When there was this mask shortage during the pandemic, we realized that the reason why there was a mask shortage was because masks had become disposable in the 1960s. And before that time, they were always reusable, and people washed them or sterilized them, and there was never a shortage of masks for that very reason. So my new project here is a collective project, an international project called after the Single Year Use. And it's a history of disposables in medicine. So how syringes, masks, cas, and all kinds of surgical and medical devices have become disposable. Each time you enter a hospital and you do any type of care in the hospital, you will generate huge amounts of waste, often plastic, but also metal or linen or all kinds of other kinds of waste. And that is a very new situation that has emerged in the mid 20th century. We're trying to understand that historically and seeing why we live in that disposable culture today.
- [56:14]
C
Okay. Also very interesting. Both of you are clearly going to be very busy investigating sort of how we've ended up in places that, you know, are so normal that we maybe don't always investigate. So glad you're both figuring out what has gone on. And, of course, that's very much what you've done in the book we've been discussing. So for anyone who wants to learn more, it is called the Mask A History of Breathing Bad Air, published by Yale University Press in 2025. Bruno and Thomas, thank you both so much for joining me on the podcast.
- [56:43]
A
Thank you so much, Miranda. It was great talking with you. Thank you, Miranda.