Paris, From the Earliest Period to the Present Day; Volume 2

by William Walton

The liberality of Mazarin, of the king, and of some of the wealthier citizens provided the administration of this great institution with its principal resources; the cardinal gave it at one time a hundred thousand livres, and left it sixty thousand francs in his will. It was exempted from numerous taxes and imposts, it was entitled to a third of all the confiscations awarded the king; to those fines imposed in the city, the faubourgs, and the jurisdiction of the prévôt of Paris which were not otherwise applied, to the duty on wine entering the city, to five sous on each minot [three bushels] of salt sold in the granaries of Paris, to a quarter of the fines from the departments of streams and forests, to a tax on the admissions to theatres, etc. Later, the Hôpital-Général was authorized to open the first mont-de-piété, or pawnbroking establishment, in France.

In addition to all their other functions, the Bicêtre and the Salpêtrière were created, by the regulation of April 20, 1684, maisons de correction for children of good families, of both sexes. The bureau of the Hôpital-Général ordered the arrest of idle, disobedient, or dissipated children, at the request of fathers or mothers, tutors or guardians, or of the nearest relatives, and even, in case of the death of the parents, on the complaint of the curés of their parishes. "Although originally created principally as a philanthropic institution, the Hôpital-Général was assuming more and more a penitentiary character; the regulation of 1680 had already added to the list of its criminals 'vagabond individuals, whom idleness leads to an infinite number of irregularities,' and had directed its officers to imprison them in a special prison, either for a determinate period or for life; there, they were to be given only the amount of food actually necessary to sustain life, and were employed at the hardest labor that their strength would permit. It does not appear that this frightful severity produced any result, for, from year to year, new edicts were constantly appearing, redoubling these rigorous measures against the mendicants."

As organized at present, the Bicêtre contains three thousand one hundred and fifty-three beds, and the Salpêtrière three thousand eight hundred and eleven. The latter includes also a clinic for nervous diseases, with consultations for out-door patients, the former clinic of Doctor Charcot, and one service of electro-therapeutics, for both in-door and out-door patients, which attracts many from outside. There is a very curious medical museum; and the institution itself claims to be one of the great centres of scientific research.

An interesting feature of the general administration of the Parisian hospitals is the arrangement made by the internes, the graduates in medicine and pharmacy in the in-door service of the institution, for providing themselves with the necessary meals. These young men are paid by the Assistance Publique the modest sums of from six hundred to a thousand francs a year, from the first to their fourth year, out of which they have to provide for themselves until they are de permanence. They therefore make provisions for dining in common, and their salles de garde are cheerful and very informal gathering-places, gay and hospitable, liberally adorned with inscriptions, engravings, and paintings, permeated with the souvenirs and traditions of the institution to which they are attached. At the Hôtel-Dieu, owing to the size of the hospital and the number of clinics, the number of internes and externes, bénévoles and provisoires, and their friends, is so great that the social character of the salle de garde naturally suffers; each one dines hastily, occupies himself only with his invited guest, and, after coffee, if his duties do not claim him, goes off in search of some shady promenade, which the cloisters of the Hôtel-Dieu—unlike the green courts of the Bicêtre and Salpêtrière—do not offer him. Consequently, the gastronomical qualities of the repast assume a considerable importance, and the duties of the économe become proportionally heavy.

This very useful official is a comrade endowed with the necessary domestic and executive qualities, who assumes the onerous task of directing this refectory. He must be a gourmet, of course, this is indispensable; he must have imagination and experience in order to prepare and to suitably vary the ménus; he must be economical, orderly, judicial, and discriminating, so as to know which rebellions and protests are to be heeded and which ignored, and to preserve suitable relations with his cantinière. The interne on duty alone has a right to have his repasts served by the Assistance Publique; as these are constantly changed, the administration furnishes the equivalent of what it owes in provisions, which are turned into the common stock. It also furnishes the necessary utensils and cooking apparatus. The cantinière must have given proof of her worth either as a cook in the hospital or as a cordon bleu in the city. She must also be provided with a husband or some other connection capable of serving at table. At the end of each repast, the économe marks on a list of his subscribers a cross opposite the name of each participant, or two or more crosses if he has had guests. At the end of the month, the permanent expenses are added up, wages, etc., which sum is divided into as many parts as there are internes. This is a fixed amount, the proportionate share of which must be paid whether the subscriber has dined only once, or not at all. Then the cost of the number of meals actually consumed is added up and divided by the number of crosses. This cost of each meal varies greatly in the different hospitals, those outside the city walls being able to provide more cheaply. Thus, in 1893, it was one franc seventy-five centimes at the Hôpital de la Charité, and only eighty-five centimes at the Bicêtre. The presence of the monthly fixed charges which have to be met brings about the apparent anomaly that the more meals the young doctor eats in his messroom the less proportionally do they cost him.

As a recompense for his labors in the general service, the économe has the privilege of presiding in the centre of the table, of carving, and of sitting as umpire on all the manifestations. When any one of the habitués of the common table has passed an examination, assisted his master in some difficult operation, or otherwise had a chance to distinguish himself, it is in order for him to celebrate the great occasion by discreet libations in which his friends may share. As it sometimes happens that these fortunate ones—entirely through timidity and modesty—omit to mention their professional successes at the hospitable board, the custom has arisen of proclaiming their virtues for them and thus causing them to "manifest" themselves. "But, as the examinations are rare, and the flasks of Chartreuse small, some one is called upon to manifest, on the slightest provocation, for the promulgation of an unseasonable political opinion, for a bad pun, for anything you please. The manifesteur is made aware of the fate which menaces him by a clinking of bottles and plates, by a hammering with the backs of knives;—however, his condemnation is not definite until the économe has pronounced judgment upon it. He is careful to see that it is not always the same culprit who is executed."

As a contrast to the Hôtel-Dieu, the Hôpital Cochin, in the Faubourg Saint-Jacques, has one of the smallest salles de garde in Paris. In recompense, its diners have under their feet an immense city, with streets, open places, and many inhabitants, a city cool in summer and warm in winter, and which, for a long period of time, the internes of this hospital had been in the habit of considering as an annex to their dining-room. It is not every one who would take this view of the catacombs; but the practice of medicine and surgery does not lend itself to the cultivation of squeamishness. Every evening, accordingly, exploring parties were organized to visit these subterranean streets; underneath the hospital itself is a large open square, from which radiate, in every direction, lanes and avenues. These the internes at first explored by means of a compass, but, as a result of some judicious meditation before the commemorative slab recording the death by starvation of Philibert Aspaut, concierge of the Val-de-Grâce, lost in the catacombs in 1793, they took the trouble to unearth an old plan in the Musée Carnavalet and draw up a new one, probably now one of the best in existence. In consequence of this prudent conduct, they have never had any losses to deplore; but the frequency of these unprofessional rambles finally aroused the administration to action, and the hospital entrance to the underground city was closed. Since then, the disconsolate diners have had to seek other distractions;—it is said that they are greatly given to equitation, but as they have no horses in their salle de garde, they paint them by squadrons on the walls, as illustrated on page 259.