A Philosophical Dictionary, Volume 03

by Voltaire

It is impossible to avoid frequently drawing a contrast between a fête at Versailles or an opera at Paris, in which all the pleasures and all the splendors of life are combined with the most exquisite art, and a Hôtel Dieu, where all that is painful, all that is loathsome, and even death itself are accumulated in one mass of horror. Such is the composition of great cities! By an admirable policy pleasures and luxury are rendered subservient to misery and pain. The theatres of Paris pay on an average the yearly sum of a hundred thousand crowns to the hospital. It often happens in these charitable institutions that the inconveniences counterbalance the advantages. One proof of the abuses attached to them is that patients dread the very idea of being removed to them.

The Hôtel Dieu, for example, was formerly well situated, in the middle of the city, near the bishop's palace. The situation now is very bad, for the city has become overgrown; four or five patients are crowded into every bed, the victim of scurvy communicates it to his neighbor and in return receives from him smallpox, and a pestilential atmosphere spreads incurable disease and death, not only through the building destined to restore men to healthful life but through a great part of the city which surrounds it.

M. de Chamousset, one of the most valuable and active of citizens, has computed, from accurate authorities, that in the Hôtel Dieu, a fourth part of the patients die, an eighth in the hospital of Charity, a ninth in the London hospitals, and a thirtieth in those of Versailles. In the great and celebrated hospital of Lyons, which has long been one of the best conducted in Europe, the average mortality has been found to be only one-fifteenth. It has been often proposed to divide the Hôtel Dieu of Paris into smaller establishments better situated, more airy, and salubrious, but money has been wanting to carry the plan into execution.

Curtae nescio quid semper abest rei.

Money is always to be found when men are to be sent to the frontiers to be destroyed, but when the object is to preserve them it is no longer so. Yet the Hôtel Dieu of Paris has a revenue amounting to more than a million (forty thousand pounds), and every day increasing, and the Parisians have rivalled each other in their endowments of it.

We cannot help remarking in this place that Germain Brice, in his "Description of Paris," speaking of some legacies bequeathed by the first president, Bellievre, to the hall of the Hôtel Dieu, named St. Charles, says: "Every one ought to read the beautiful inscription, engraved in letters of gold on a grand marble tablet, and composed by Oliver Patru, one of the choicest spirits of his time, some of whose pleadings are extant and in very high esteem.

"Whoever thou art that enterest this sacred place thou wilt almost everywhere behold traces of the charity of the great Pomponne. The gold and silver tapestry and the exquisite furniture which formerly adorned his apartments are now, by a happy metamorphosis, made to minister to the necessities of the sick. That divine man, who was the ornament and delight of his age, even in his conflict with death, considered how he might relieve the afflicted. The blood of Bellievre was manifested in every action of his life. The glory of his embassies is full well known," etc.

The useful Chamousset did better than Germain Brice, or than Oliver Patru, "one of the choicest spirits of his time." He offered to undertake at his own expense, backed by a responsible company, the following contract:

The administrators of the Hôtel Dieu estimated the cost of every patient, whether killed or cured, at fifty livres. M. Chamousset and the company offered to undertake the business, on receiving fifty livres on recovery only. The deaths were to be thrown out of the account, of which the expenses were to be borne by himself.

The proposal was so very advantageous that it was not accepted. It was feared that he would not be able to accomplish it. Every abuse attempted to be reformed is the patrimony of those who have more influence than the reformers.