There is a very good chance that coins with motifs of this kind were used as amulets to protect against epidemics. The legends inscribed on them do not refer directly to a particular epidemic, however, but are broadly dedicated to the health of the emperor (Salus Augusti) or to good health in general. Many of the symbols that are today still associated with medicine and healing have their origins in ancient times. Probably the most well-known is the Rod of Asclepius, with a snake curling around it. The snake represented the deities of healing; it was associated with rebirth and immortality but could also be seen as a symbol of life and death. There was a good reason why the Ancient Greek word “pharmakon” meant not just “remedy” but also “poison”.

While no mediaeval numismatic artefacts have survived that directly relate to the Black Death, city medals appear during the early modern period with references to the plague. Unlike the coins from antiquity, these actually name the “plague years” on their obverse or reverse.

They often show the city or town hit by the disease, sometimes combining depictions of death with imagery representing rebirth. This is shown especially clearly by a medal from the Hanseatic city of Hamburg. On the obverse (front), Death is plucking leaves from the tree of life. On the reverse, beehives and departing ships represent the return of trading, and thus the end of the epidemic. The legend on the obverse, “Praestat putari quam concidi” (“Not cut down but cut back”) expresses the hope that Hamburg has survived the plague.

There are also city medals from during the 19th-century cholera epidemics. The images on these rarely focus on death, instead increasingly depicting care for the sick. The scenes portrayed on the medals become more relatable and personal, moving away from the fate of the town as a whole and thus becoming more moving as they reflect human vulnerability.