THE PARIS HOSPITALS.
The Place du Parvis--The Parvis of Notre Dame--The Hôtel-Dieu--Mercier's
Criticisms.
In the matter of police administration and of civic government
generally; the Hôtel de Ville is to the whole of Paris what the Mansion
House and the Guildhall are to that part of London known specially as
the City. The Hôtel de Ville has charge, moreover, of all the Paris
hospitals and benevolent institutions. The general administration of
the hospitals is entrusted to a Director, under the surveillance of a
Consultative Committee.
The most ancient and most celebrated of all the Paris hospitals is the
Hôtel-Dieu, occupying a space which is bounded on the north by the Quai
aux Fleurs, on the south by the Place du Parvis, on the west by the Rue
de la Cité, and on the east by the Rue d'Arcole.
The Place du Parvis deserves a word of mention to itself. The word
"Parvis" has several derivations, the most popular of which is from the
Latin _paradisus_. The ancient form of the French word was _paraïs_ or
_paravis_, contracted into _parvis_; and it was applied to the open
space in front of a church because, in the days of the "mysteries,"
it was here that the paradise of the play was located. According to
another derivation, the "parvis" is the ground outside a church which
"_pare_" or "guards" the principal door--_huis_ in the ancient French.
In this sense the word is used to denote, in the Jewish Temple, the
space around the tabernacle. _Parvis céleste_ is a phrase employed by
French poets to signify heaven or the firmament; which does not at all
prove--indeed seems to disprove--that _parvis_ means, or ever did mean,
the same thing as _paradisus_. The _parvis_ of the old churches was,
in any case, used as a place of penance for those who had scandalised
the town by some offence against good morals; and it was there that on
certain occasions holy relics were brought for exhibition to the people.
The temples of Greece and Rome were surrounded by enclosures, as if to
separate them from the public thoroughfare; and the first Christian
churches had enclosures in front of the principal entrance, where tombs,
crosses, statues, and sometimes fountains were to be seen. After the
twelfth century the _parvis_ ceased to be enclosed; though so late as
the sixteenth century the Parvis of Notre Dame appears, by exception, to
have been shut in by a wall not more than three feet high, through which
there were three different gateways.
The Parvis of Notre Dame served in ancient days the most varied
purposes. Here, before the establishment of the University of Paris,
public schools were held. It was a place of punishment, moreover; and
it was on a scaffold erected in the Parvis of Notre Dame that Jacques
de Molay and the Templars heard the sentence read which was afterwards
executed upon them (March 18, 1314) in the Île aux Vaches, as the little
island was anciently called where now stands the statue of Henri IV.
Here, too, under Francis I., Huguenots were given to the flames.
Jacques de Molay, the last grand master of the Templars, was born in
Burgundy, and entered the order in 1265. He distinguished himself in
Palestine, in the wars against the Mussulmans. Elected grand master in
1298, he was preparing to avenge the defeats which the Christian arms
had recently sustained, when in 1305 he was recalled to France by Pope
Clement V. The pretext for this summons was a projected union of the
order of Templars with that of the Hospitallers. But the true object
of Philip the Fair, for whom the Pope had acted only as instrument,
was the destruction of the order, whose immense wealth had excited the
monarch's covetousness. On the 13th of October, 1307, all the Templars
were arrested at the same hour throughout France; and a process was
instituted against them in which every form of justice was violated.
Thirty-six knights expired under torture, and several owned to the
crimes and the shameful immorality of which they were falsely accused.
Molay himself, in the agony of torture, allowed some words to escape
him; but before dying nearly all the victims retracted the utterances
wrung from them by pain. The Pope, throughout this tragic affair,
followed the directions of the French king, to whom he owed his tiara.
To go back from history to legend, it was in the open space afterwards
to become the Parvis of Notre Dame that in 464 Artus, King of Great
Britain, son of Uther, surnamed Pendragon pitched his camp when invading
Gaul and ravaging the country. Gaul was at that time governed for the
Emperor Leo by the Tribune Flollo, who retired to Paris and there
fortified himself. Artus now defied Flollo to single combat. The Tribune
accepted, and the duel took place on the eastern point of the Île de la
Cité, with lance and hatchet. Blinded by the blood which flowed from a
wound he had received in the head, Artus invoked the Virgin Mary, who,
it is said, appeared to him in presence of everyone, and covered him
with her cloak, which was "lined with ermine." Dazzled at this miracle,
Flollo lost his sight, and Artus had now no trouble in despatching
him. In memory of the Virgin's interposition, Artus adopted ermine for
his coat-of-arms; which for a long time afterwards was retained by the
kings and princes of Britain. He wished at the same time to consecrate
the memory of his triumph, and accordingly erected on the very ground
where the combat had taken place a chapel in honour of the Virgin,
which at last became the cathedral church of Paris. Then Artus (or
Arthur) returned to his British island, and there founded the Order of
the Knights of that Round Table which is still preserved in Winchester
Cathedral.
[Illustration: A GENDARME.]
Until the Revolution the Parvis of Notre Dame was shut in north and
south by populous districts through which ran narrow, ill-built streets,
and which contained several buildings of importance. Since then a clean
sweep has been made of all the tumble-down buildings in the ancient
Cité, between the two banks of the Seine north and south, between the
Cathedral on the east and the barracks of the Republican Guard on the
west. The southern part of the Parvis has been transformed into a sort
of English garden, in the centre of which stands an equestrian statue
of Charlemagne by the sculptor Rochet.
In old French, the second of two substantives joined together did duty
as genitive; so that Hôtel-Dieu signified the hotel (or house) of God,
just as in some ancient French towns _Mère-Dieu_, as the sign of an
hotel, meant not, as is sometimes ignorantly supposed, "God the Mother,"
but "The Mother of God." The Hôtel-Dieu or Hôtel de Dieu (a house, that
is to say, in which the poor and suffering were received and attended
in the name of God and under His auspices) was founded about 660, in
the time of Clovis II., son of Dagobert, by Saint Landri, twenty-eighth
bishop of Paris. Here he was accustomed to receive, at his own expense,
not only sick people, but also beggars and pilgrims. _Medicus et
Hospes_, such was the motto of the bishop, who might justly claim the
double title of physician and host. In the course of centuries the good
work begun by Saint Landri was continued on a large scale by the French
kings, with Philip Augustus, Saint Louis, and Henri IV. prominent among
them. Among the benefactors of the Hôtel-Dieu must also be mentioned the
Chancellor du Prat, and the first President, Pomponne de Bellièvre.
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
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
carried off. This is known and heard of with the most indifferent
composure!"
[Illustration: PRINCIPAL COURT OF THE HÔTEL-DIEU.]
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
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."
[Illustration: RUE DE RIVOLI.]