About the middle of the seventeenth century, under the reign of Louis XIV., a hospital prison, named the Salpétrière, was established for the reception of prostitutes; but, by a strange inconsistency, in 1658 it was closed to women suffering from syphilis (femmes gatées), and physicians were directed to examine all women “who showed symptoms of syphilis on the face.” A few years’ experience showed the fallacy of this system. Diseased women were confined in the place; should they not be treated there? The physicians thought they should, and accordingly, though in violation of the rules of the establishment, a small room was appropriated to this class of patients. It appears that at this time a prostitute found some difficulty in obtaining admission to the Salpétrière; it being not unusual for unfortunate creatures to have themselves arrested for vagabondage, and to submit voluntarily to the whipping which the ethics of the day required in the case of females as well as males, in order to obtain medical treatment. It will be seen that our New York system can not claim the merit of originality. Prostitutes, in fact, flocked to the Salpétrière in such numbers that the room furnished by the connivance of the authorities was soon far too small to accommodate them. The hospital managers declared to the royal government that medical treatment was out of the question in so crowded an apartment, and that a putrid fever might be expected if better accommodations were not provided. In reply, the government placed at their disposal a ward in the hospital of Bicêtre.
This was in 1691. For nearly a hundred years afterward the severe cases of venereal disease were sent to Bicêtre, the milder ones kept at Salpétrière. Both establishments were a disgrace to humanity. The patients were cheated of the food allowed them, and supplied with cheap broth and cheese in its stead. No baths, and but few medicines were at their command. Their ward was filthy, close, and in ruin. Patients were often obliged to wait so long for medical attendance that their maladies became incurable. The air in which they lived was pestiferous, and no one could visit the hospital without being shocked at its aspect.[205] Medical men who saw the place expressed amazement that so many persons should exist in so small a room. Eight women slept in a bed, and in the room appropriated to those whose turn for treatment had not come, the patients slept by gangs, one half sleeping from 8 P.M. to 1 A.M., and the remainder from 1 A.M. to 7 A.M. The floor was covered with dirt and filth, and the windows were nailed down, for fear of their being broken if opened. There was but little linen, and that was in rags, and abominably dirty. One hundred persons only were treated at a time, fifty men and fifty women. A new batch was admitted to treatment every two months, and, as the hospital always contained from three to four hundred sufferers, some cases remained six or eight months without any treatment whatever. Many died before they reached the hands of the doctors. The diet was the same for all. Those who had not been admitted to treatment were supplied with coarse bread, cheese, rancid butter, and (very seldom) a little meat. The surgeons of Bicêtre usually made fortunes in a short time.[206]
If any thing farther were needed to characterize the hospital of Bicêtre in the eighteenth century, it would be the rules in virtue of which no diseased person could claim admission until a complete year had elapsed from the time of their first application, and every diseased person was turned out, whether ill or well, after six weeks’ treatment. It was stated to M. Parent-Duchatelet that the average mortality was one hundred women and sixty men per annum.[207]
In 1787, Dr. Cullerier was appointed surgeon in charge of syphilitic cases at Bicêtre. He commenced his administration by denouncing the state of things he found there, and it is mainly from the memoires he addressed to the government that the preceding facts have been obtained. His representations seem to have met with but little success. In 1789, however, the bulk of the prisoners at Bicêtre were set free, and he immediately availed himself of the increased room to accommodate his patients.
The reform was so slight, or rather so vast a reform was needed, that the moment the attention of the republican government was drawn to the subject, it removed the syphilitic cases from the hospital of Bicêtre to the hospital of the Capuchins. That establishment was enlarged, and named the Hospital of the South (l’Hôpital du Midi). Gardens and baths were provided; ample wards permitted the classification of diseases; the food was of the best kind, and sufficient in quantity. This immense step was the work of the republican authorities.
It was, however, only the first of a series of reforms. Originally, men and women of all grades were admitted promiscuously. This led to grave inconveniences. The decorum of the hospital was frequently disturbed by the conduct of some of the men with regard to the prostitutes in the adjoining wards. To obviate this, a new hospital was set apart, under the reign of Charles X., for the reception of male patients only. It is the Hospital de Lourcine.
A still more serious trouble arose from the mixture of prostitutes with other women who, from the infidelity of their husbands, hereditary disease, or other causes, found themselves infected with syphilis. For some time complaints had been made on this head, but an accident, which occurred in 1828, compelled the authorities to act. The daughter of a professional nurse, residing in the vicinity of Paris, caught syphilis from a child her mother was nursing, who had inherited the disease. It took the shape of a virulent chancre on the palate, and the girl was sent to the Hospital du Midi for treatment. She found herself thrust among the vilest prostitutes, whose language and sentiments shocked her so terribly that she insisted on leaving the hospital at once. The physician on duty declined to grant her request, whereupon the poor girl contrived to get into the yard, and threw herself into a well. She was drowned, and on an autopsy of her corpse it appeared that she was a virgin. This dreadful incident aroused the public mind. Hitherto the disposal of the prostitutes had been a subject of dispute between the administration of the hospital and that of the city, each wishing to thrust them upon the other. The government now interfered, and special accommodation was provided for prostitutes at the prison of Saint Lazare. The Hospital du Midi was devoted exclusively to such women as were not inscribed on the rolls of the police.
Before these distributions took place, when men and women were indiscriminately received at the Hospital du Midi, the average annual admissions, from 1804 to 1814, were 2700; from 1822 to 1828 it exceeded an average of 3100. Twenty years ago the mortality was said to be less than two per cent.; it was ten per cent. at Bicêtre.
At the Hospital du Midi, diseased persons who do not desire admission to the hospital are treated outside, all the medicines they require being furnished them free of charge.
It would appear, from stray allusions in various old ordinances, that some sort of medical office had been established in the eighteenth century by the government, for the purpose of affording gratuitous advice to prostitutes, and denouncing those who were diseased; but there exists no positive evidence of any such establishment or office. It was not till 1803 that a regulation was made by the prefect of police, requiring all public women to submit to be visited by a physician appointed by him. The plan was a bad one, as the physician was paid by fees which he was authorized to exact; and it was rendered worse in practice by the dishonesty of the man chosen for the office, one Coulon. This individual made money and neglected his duties. The system was altered in 1810, and a dispensary established, with a strong medical staff, who were directed to visit all the prostitutes in Paris. This institution is still in existence; it will be further noticed in the next chapter.