Old and New Paris: Its History, Its People, and Its Places, v. 2

by H. Sutherland Edwards

The council of superintendence consists, amongst its other members, of the Prefect of the Seine, the Prefect of Police, a Councillor of State, a member of the Court of Appeal, a Professor of the Faculty of Medicine, a member of the Chamber of Commerce, and two members of the Municipal Council, with a doctor and a surgeon attached to the hospital.

The medical service of the hospitals is effected by doctors and surgeons, aided by resident and non-resident assistants, sisters of charity, etc. The doctors and surgeons are appointed by competition, and they can practise, in the case of the former, till sixty-five, in that of the latter, till sixty years of age.

As regards the conditions under which patients are admitted to the hospitals, the first of these is not, as one might suppose, that the applicant be ill, but that he or she have been resident six months in the department of the Seine. This condition, which excluded poor patients coming to Paris from the provinces for special treatment, caused some years ago a good deal of lively criticism. Complaints, too, have frequently been made of the alleged extravagance of the administration and of the architectural embellishment of Paris hospitals, to the detriment of the patients upon whom in a direct manner the funds should, it was held, have been spent. Another defect which has been much commented upon is the inability of the surgeons to assign beds, on their own authority, to sick applicants whom they have pronounced to be in need of clinical treatment. Every morning, it should be explained, gratuitous advice is given at each hospital. Those applicants whose case is serious cannot, without further preliminaries, have beds assigned to them. The physician has first to represent their condition to the administrative director, and it is within the power of this latter functionary to grant or to refuse the admission. In practice, no doubt, the recommendation of the physician is acceded to; but the formality might well become, in some instances, a mischievous one.

During the day urgent cases can be received at the hospitals on the advice of the deputy medical officers. There exists, moreover, on the Parvis of Notre Dame, under the name of “central bureau of admission,” an establishment in which, from ten a.m. to four p.m., advice may be had from able physicians. Every morning the directors of the different hospitals send to this bureau a list of their vacant beds; and the consulting physician assigns them to applicants at his discretion.

Every invalid entering a hospital loses his or her individuality to take a number. Monsieur 6 and Madame 8 are the kind of appellations by which the patients are known. After having given in his or her name, age, address, and occupation at the registration office, the patient is taken up into the ward and undressed, receiving a grey cloak in exchange for the vestments put off. It used to be complained that these cloaks were passed from one patient to another without being in any way purified, whatever diseases they might be infected with. It may be hoped that this is no longer the case.

Soon after the new patient’s arrival he is visited by the house-physician, who prescribes for him a treatment which the physician-in-chief will confirm or rectify on his daily round next morning. At five a.m. the ward-servants come on duty, and then a clatter begins, the brush and the broom being freely plied. “So much the worse,” says Dr. Le Fort, a severe critic of the Paris hospital system, “for the patient who, having passed a sleepless night, is beginning to get a little repose.” In English hospitals, however, the same turmoil reigns at the same hour, and the sufferer from insomnia is as badly off as his Parisian fellow.

From eight to nine a.m. the physician goes his round of visits, accompanied by his assistants. He passes from bed to bed, feels pulses, looks at tongues, prescribes medicines, and so forth. At ten o’clock the breakfast-hour is sounded. Large cans, containing soup and vegetables, are brought into the ward. The ward-servants, or infirmiers present to the sister a succession of tin basins, into which she serves out the precise quantity of food ordered for the patients by the doctor. The quality of the food leaves nothing to be desired. The meat supplied is the best procurable, the fish is fresh, the vegetables irreproachable; but the cooking is the reverse of satisfactory. A mutton cutlet, cooked half an hour before dinner, and put in the oven to keep hot, comes sometimes to the patient’s bedside rather like a cinder; the joints are admirable, but as it is found convenient to carve them up some time before the meal, and keep them likewise in the oven, a cut off the joint occasionally means a slice of leather. Attempts have been made from time[{195}] to time by the administration to reform this style of cooking, but the reformation has not yet, in practice, been effected.

After breakfast the patient reads or walks about. From one till three o’clock on Sundays and Thursdays he may receive visits from his family. At four o’clock the evening repast is served, and at eight the night commences, all conversation, as in English hospitals, abruptly ceasing. Thenceforth the repose of the vast wards is disturbed by nothing but the snoring of sleepers, and the sighs or groans of those to whose eyelids sleep will not come. The wards would now be in total darkness but for the faint glimmer of a little lamp suspended from the ceiling.

THE CHILDREN’S HOSPITAL, RUE DE SÈVRES.