Paris, March 9, 1802.
Among the national establishments in this metropolis, I know of none that have experienced so great an amelioration, since the revolution, as the
HOSPITALS AND OTHER CHARITABLE INSTITUTIONS;
The civil hospitals in Paris now form two distinct classes. The one comprehends the hospitals for the sick: the other, those for the indigent. The former are devoted to the relief of suffering human nature; the latter serve as an asylum to children, to the infirm, and to the aged indigent. All persons who are not ill enough to be admitted of necessity into the hospital the nearest to their residence, are obliged to present themselves to the Bureau Central d'Admissions. Here they are examined, and if there be occasion, they receive a ticket of admission for the hospital where their particular disorder is treated. At the head of the hospitals for the sick stands that so long known by the appellation of the
HÔTEL-DIEU.
Formerly, nothing more horrid could be conceived than the spectacle presented in this asylum for the afflicted. It was rather a charnel-house than an hospital; and the name of the Creator, over the gate, which recalled to mind the principle of all existence, served only to decorate the entrance of the tomb of the living.
The Hôtel-Dieu, which is situated in the Parvis Notre-Dame, Ile du Palais, was founded as far back as the year 660 by St. Landry, for the reception of the sick and maimed of both sexes, without any exception of persons. Jews, Turks, infidels, pagans, protestants, and catholics were alike admitted, without form or recommendation. Yet, though it contained but 1200 beds, and the number of patients very often exceeded 5000, and, on an average, was never less than 2500, till the year 1786, no steps were taken for enlarging the hospital, or providing elsewhere for those who could not be conveniently accommodated in it. The dead were removed from the wards only on visits made at a fixed time; so that it happened not unfrequently that a poor helpless patient was compelled to remain for hours wedged in between two corpses. The air or the neighbourhood was contaminated by the noisome exhalations continually arising from this abode of pestilence, and that which was breathed within the walls of the hospital was so contagious, as to turn a trifling complaint into a dangerous disorder, and a simple wound into a mortification.
In 1785, the attention of the government being called to this serious evil by various memoirs, the Academy of Sciences was directed to investigate the truth of the bold assertions made in these publications. A commission was appointed; but as the revenues of the Hôtel-Dieu were immense, for a long time it was impossible to obtain from the Governors any account of their application. However, the Commissioners, directing their attention to the principal object, reported as follows: "We first compared the Hôtel-Dieu and the Hôpital de la Charité relative to their mortality. In 52 years, the Hôtel-Dieu, out of 1,108,741 patients lost 244,720, which is one out of four and a half. La Charité, where but one dies out of seven and a half, would have lost only 168,700, whence results the frightful picture that the Hotel-Dieu, in 52 years, has snatched from France 99,044 persons, whose lives would have been saved, had the Hôtel-Dieu been as spacious, in proportion, as La Charité. The loss in these 52 years answers to 1906 deaths per year, and that is nearly the tenth part of the total and annual loss of Paris. The preservation of this hospital in the site it now occupies, and on its present plan, therefore produces the same effect as a sort of plague which constantly desolates the capital."
In consequence of this report, the hospital was enlarged so as to contain about 2000 beds. Since the revolution, the improvements introduced into the interior government of the Hôtel-Dieu have been great and rapid. Each patient now has a bed to himself. Those attacked by contagious disorders are transferred to the Hospice St. Louis. Insane persons are no longer admitted; men, thus afflicted, are sent to a special hospital established at Charenton; and women, to the Salpétrière. Nor are any females longer received into the Hôtel-Dieu to lie-in; an hospital having been established for the reception of pregnant women. At the Hôtel-Dieu, every method has been put in practice to promote the circulation of air, and expel the insalubrious miasmata. One of these, I think, well deserves to be adopted in England.
In the French hospitals, one ward at least is now always kept empty. The moment it becomes so by the removal of the patients into another, the walls are whitewashed, and the air is purified by the fumigation with muriatic acid, according to the plan first proposed by GUYTON-MORVEAU. This operation is alternately performed in each ward in succession; that which has been the longest occupied being purified the first, and left empty till it is again wanted.