The Hotel Dieu in Paris is one of Europe’s oldest hospitals still operating today, dating back to around 651 CE. Like many early and medieval hospitals it was a multipurpose institution which catered for the poor and sick, offering food and shelter, as well as medical care. From 1580, however, the hospital’s regulations specified that doctors and surgeons were to visit patients twice a week. During this period the hospital often housed more than 3500 patients at the same time.
By the 1700s there were eight physicians on its medical staff, a high number for this time, and 100 surgeons. It was damaged by fire in 1772 and not fully rebuilt until the reign of Napoleon. Nevertheless it remained very overcrowded. Beds were placed in every available room, and there were sometimes up to six patients in a single bed. It became regarded as the most unhealthy and uncomfortable hospital in France, maybe even Europe.
During the French Revolution, pressure on the hospital was relieved through the creation of several new general hospitals and specialist hospitals, including those for children, venereal disease and the mentally ill. The number of beds at the Hotel Dieu remained unchanged at 1400, but the hospital took in fewer patients, so that all now had their own bed. The death rate took longer to change, and remained higher than at other hospitals. This was because most of the city’s serious accidents were admitted to the centrally located institution. The hospital was rebuilt on the opposite bank of the Seine, next to Notre Dame Cathedral, in the mid-1800s. Today it remains the first casualty centre for emergency cases in Paris, with approximately 350 beds.
The Hotel Dieu was popular among medical practitioners as it admitted interesting cases. The hospital subsequently became famous during the early 1800s for its surgeons, including Bichat and Desault, who developed clinical teaching against strong resistance. Though transformed into a scientific medical institution, its original religious nature is kept alive in its name, the ‘Hostel of God’.
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BibliographyT McHugh, ‘Establishing Medical Men at the Paris Hôtel-Dieu, 1500-1715’, Social History of Medicine, 19/2 (2006), pp 209-224
Who were the `mentally ill’? We use this phrase to reflect the historical descriptions of individuals with a variety of behaviours, mental health problems and pathologies. Historically, the concept of ‘ madness’ or ‘insanity’ was used to describe people who may have had what we would now consider psychiatric disorders. It often also included those showing symptoms of syphilis, epilepsy, depression, or in some cases merely behaviour considered to be eccentric or outside commonly accepted norms.