Old and New Paris: Its History, Its People, and Its Places, v. 1

by H. Sutherland Edwards

The old Hôtel-Dieu, after undergoing all kinds of repairs, was at last condemned as too small and too ill-ventilated. In 1868 a new hospital was begun just opposite the old one; and the building as it now stands, large, airy, and in every respect commodious, was finished in 1878. With abundance of space at their command, the architects of the modern Hôtel-Dieu made it their sole aim to secure for the patients every possible advantage, and their first care was to provide spacious wards replete with light and air. One result has been that in a larger edifice the number of the beds has, in accordance with the best hygienic principles, been greatly diminished.

In the time of Saint Louis the old Hôtel-Dieu received 900 patients. This number was increased under Henri IV. to 1,300, and under Louis XIV. to 1,900. At times, however, the sick or wounded persons admitted were far more numerous; and in 1709 the number of patients in the Hôtel-Dieu is said to have reached 9,000. Not, however, the number of beds; for in the same bed several patients, at the risk of infection, contagion, and frightful mortality, were placed together. The new Hôtel-Dieu, on the other hand, contains only 514 beds: 329 medical beds, 169 surgical beds, and sixteen cradles. The building having cost fifty million francs, it follows that each particular bed has cost nearly one hundred thousand francs; and philanthropists point out that at 6,000 francs per bed, “the ordinary figure in England and other countries,” more than 8,000 patients might have been provided for in lieu of 500. It must be remembered, on the other hand, that the Hôtel-Dieu contains, besides its hospital service properly so called, an administrative department: including amphitheatres of practical surgery, laboratories of pharmacy, chemistry, etc., which alone cost fourteen millions of francs. According, moreover, to the original plan as approved by the principal professors and physicians of the Hôtel-Dieu, there was to have been an additional storey containing 260 beds, to which the patients below were to have been transferred on certain days for change of air and to allow the lower rooms to be thoroughly ventilated and cleaned. This additional storey cost four millions of francs, and it had already been completed, when, for reasons unexplained, but which, according to M. Vitu, were political, it was pulled down.

The general plan of the Hôtel-Dieu as it now stands comprises two masses of parallel buildings: one beside the Parvis of Notre Dame, the other alongside the Quai Napoléon; the two façades, anterior and posterior, of the edifice being connected laterally by galleries at right angles to the Seine. The administrative department of the Hôtel-Dieu is in that part of the building which faces the Parvis. On the ground floor, to the left, is the Central Bureau of Hospitals; the head-quarters of the hospital service, not only of Paris, but generally of the Department of the Seine. The staff consists of twenty physicians, fifteen surgeons, and three accoucheurs chosen by competition; and from this body are selected the physicians and surgeons of the various Paris hospitals. Formerly patients were admitted on mere application; but at present they are carefully examined by the physicians of the Central Bureau, who give out tickets of admission and assign beds so long as there is room. If the Hôtel-Dieu is full the applicants for medical care are sent to other hospitals. Adjoining the Central Bureau are the rooms where out-door patients receive gratuitous advice.

The wards occupied by the patients are lighted by two rows of windows, north and south, and they look out upon the interior courtyards, which are planted with trees. This arrangement allows air to enter the {279} well-kept apartments, and the rays of the sun to light up the curtains and white beds of a model hospital, where everything possible has been done to relieve the suffering and depression of its unhappy inmates. In the ophthalmic wards curtains of a particular kind are so arranged as only to admit the degree of light which the patients can bear.

Visitors to the Hôtel-Dieu, as to other hospitals in Paris, cannot fail to observe that the air is less pure in the men’s than in the women’s wards. This is to be explained by the men being allowed the only solace possible under the circumstances, that of tobacco. Nor are their grey dressing-gowns by any means so becoming as the white frocks and white caps worn by the female patients.

Many of the wards contain only from two to eight beds. There is a sitting-room, moreover, with lounges, chairs, and sofas for the convalescent, not to speak of an open gallery above the portico, where patients who are well enough may, in fine weather, stretch their limbs. The upper storey of that part of the building which faces the Quai aux Fleurs used to be occupied by the community of Dames Augustines, who from time immemorial had had no other abode and no other head-quarters. But after the civil government had withdrawn from the Dames Augustines the hospital service of La Pitié and La Charité, they all assembled at the Hôtel-Dieu, where additional sleeping rooms were prepared for them beneath the roof. Subscriptions were solicited for them in a pastoral letter from the Archbishop of Paris, dated December 2, 1888; and a new retreat was then found for them in the Hospital of Notre Dame de Bon Secours. One duty imposed upon them, in the days when the Hôtel-Dieu was composed of two large buildings on the banks of the Seine, was to wash, one day every month, whatever might be the temperature, 500 sheets. The sisters, equally with novices, were obliged to take part in these laundry operations. An ancient print, preserved in the National Library, gives a faithful representation of the washing of the 500 sheets.

Admirable as has been the work accomplished in recent times by the Hôtel-Dieu, the place seems to have been little better than a pest-house at the period when Mercier wielded his conscientious pen. “A man meets there,” he wrote, “with a death a thousand times more dreadful than that which awaits the indigent under his humble roof, abandoned though he be to himself and nature alone. And we dare call that the House of God!—where the contempt shown to humanity adds to the suffering of those who go there for relief! The physician and servant are paid—granted; the drugs cost nothing to the patient—true again; but he will be put to bed between a dying man and a dead corpse; he will breathe an air corrupted by pestiferous exhalations; he will be subject to chirurgical despotism; neither his cries, his complaints, nor his expostulations will be attended to; he will have nobody by to soothe and comfort him; pity itself will be blind and barbarous, having lost that sympathising compassion, and those tears of sensibility, which constitute its very being. In this abode of human misery every aspect is cruel and disgusting; and this is called the House of God! Who would not fly from the bloody, detested spot? Who will venture within a house where the bed of mercy is far more dreadful than the naked board on which lies the poorest wretch? This hospital, miscalled Hôtel-Dieu, was founded by Saint Landri and Comte Archambaud in the year 660 for the reception of sick persons of either sex. Jews, Turks, and infidels have an equal right to admission. There are 1,200 beds, and constantly between five and six thousand patients. What a disproportion! Yet the revenues of the hospital are immense. It was expected that the last fire which happened in this edifice would have been improved to the advantage of the patients, by the construction, on a healthier spot, of a new and more extensive structure. But no; everything remains on the same footing; though it is but too well proved that the Hôtel-Dieu has every requisite to create and increase a multitude of disorders on account of the dampness and confinement of the atmosphere. Wounds soon turn to a mortification; whilst the scurvy makes the greatest havoc amongst those who, from the nature of their maladies, are forced to remain there for some time. Thus, the most simple distempers soon grow into complicated diseases, sometimes fatal, by the contagion of that ambient air. Both the experience and observation of the naturalist concur to prove that a hospital which contains above one hundred beds is of itself a plague. It may be added that as often as two patients are laid up in the same room they will evidently hurt each other, and that such a practice is necessarily injurious to the laws of humanity. It is almost incredible, yet not the less true, that one-fifth of the patients are annually {280} carried off. This is known and heard of with the most indifferent composure!”

Nor does Mercier stop here. “Clamart,” he continues, “is the gulf that swallows up the remains of those hapless men who have paid the last debt to nature in the Hôtel-Dieu. It is an extensive burying-ground, or rather a voracious monster whose maw is ever craving for new food, though most plentifully supplied. The bodies are there interred without a coffin and only sewed up in the coarsest linen cloth. At the least appearance of death the body is hurried away, and there are many instances of people having recovered under the hasty hand that wrapped them up; whilst others have been heard to cry “mercy” when already piled up in the cart that carried them to an untimely grave. The cart is drawn by twelve men. A priest, covered with filth and mud, carrying a hand-bell and cross, are all the funeral pomp reserved for these unfortunate victims. But at that hour all is one! Every morning at four o’clock the dismal cart sets off from the Hôtel-Dieu, and, as it rolls along, strikes terror into the neighbourhood, who are awoke by the awful sound of that bell. A man must be lost to all feeling who hears it unmoved. In certain seasons, when mortality was most rife, this cart has been seen to go backwards and forwards four times in four-and-twenty hours. It contains about fifty corpses, besides children, who are crammed between their legs. The bodies are cast into a deep pit, and are next covered with unslackened lime. This crucible, which is never shut up, seems to tell the affrighted looker-on that it could easily devour all the inhabitants that Paris contains. Such is the obedience paid to the laws, that the decree of the Parliament prohibiting all buryings within the walls of this city has at no time been carried into execution. The populace never fail on the day of All Souls to visit {281} that cemetery, where they foresee that their bodies will one day be carried. They kneel and pray, and then adjourn to a tavern. To this spot, where the earth is fattened with the spoils of mankind, young surgeons resort by night, and, climbing the wall, carry off the dead corpses to make upon them their bloody experiments. Thus, the poor find no asylum even in death. And such is the tyranny over this unfortunate part of the community, that it does not cease till their very remains are hacked and hewed so as not to retain the least resemblance of man.”