Daily Life During the French Revolution (25 page)

HOSPITALS

Of the 2,000 or so hospitals in France under the old
regime, some consisted of only one room staffed by a couple of nuns in a rural
village. Others were large public institutions like the
Hôtel-Dieu
in
Paris. By 1789, most major cities were equipped with a general hospital that
could attend to routine illnesses, as well as care for the elderly. Bordeaux
had seven hospitals of varying size and efficiency, and the facility in Paris
comprised a number of buildings. For many people, with no resources, these
disease-infested places, dreaded as the ultimate refuge, amounted to a dingy
and pathetic place to die.

Poor hygienic conditions and the failure to segregate those
with contagious diseases from people suffering from broken bones (although the
wealthy could obtain a separate room, since their good treatment augured well
for charitable donations) were the result of both lack of financial resources
and power struggles within the institutions.

Poor sanitary conditions were often aggravated by the fact
that many hospitals were situated on the edge of town next to cemeteries,
refuse dumps, and the municipal abattoir or close to fetid rivers and streams,
giving rise to humid and overpowering odors.

Daily life in the hospital often involved stormy sessions
between doctors and the nursing sisters. For instance, in 1785, at the
Hôtel-Dieu
in Montpellier, the royal inspector of hospitals and prisons, Jean
Colombier, insisted on the subordination of the sisters to the medical staff,
who accused the sisters, among other things, of overfeeding the patients. The
Mother Superior resigned because the doctors were given more sway than the
sisters in the internal affairs of the hospital. Championing better hygiene,
the doctors clashed with the sisters, and the struggle for supremacy became one
of traditional sympathy and consolation versus scientific and therapeutic
treatment. The management and the sisters both insisted that the hospital
should be a charitable institution, rather than a medical one. The
administration (made up of the city’s elite) preferred to see medical care
administered in the home and believed that the emphasis in the hospital should
be put on the spiritual and material wellbeing of the patients.

The buildings themselves were often in a sorry state of
disrepair. Frequently, the walls were crumbling, the roofs leaked, and broken
windows precariously adhered to rotting frames. The money for upkeep was not
always there, and the shortage grew worse throughout the eighteenth century.
The straw beds were breeding places for lice, fleas, and germs, and in summer
months, beds crawling with vermin became unbearable. Further, ventilation was
often poor, and the stench of urine and excretion was sometimes overwhelming.
Lack of hygiene in overcrowded rooms constituted an extreme health hazard in
many hospitals. Sometimes two or three people, each with different diseases,
might occupy the same bed, and straw was distributed around the floor for those
without a mattress to lie on. On occasion, a patient entered a hospital with
one ailment and contracted another there, one that could be fatal. Smallpox ran
through the children’s wards and led to many deaths. Tinea and scabies were
often endemic, typhus and dysentery were sometimes introduced, often by sick
soldiers, and gangrene, too, was a problem.

In winter, heat was precious, and lack of hot-water
bottles, foot warmers, and braziers meant that elderly patients developed
hypothermia and pneumonia. For young children and the elderly, the hospital was
too often the gateway to the grave.

As some progress was made in the understanding and control
of disease, most doctors became aware that good food and hygienic conditions,
as well as the isolation of patients with contagious diseases, played a part in
health. Such measures, however, were often sporadic, incomplete, and not
economically viable.

Conflict arose over the use of corpses for anatomical
research on the workings of the human body. This, along with teaching, was
firmly opposed by the sisters and the administration. When teaching was
allowed, procedural regulations were strict so as not to offend the sensitivity
of the nurses, who also felt that the sick and poor should not be molested by
students asking questions and trying to examine them.

The medical profession’s demands eventually convinced
hospital staff to allow some dissection of bodies, but, apart from executed
criminals, few bodies were procurable. In some instances, doctors, surgeons,
and medical students in private schools took liberties such as raiding
graveyards, often treating the remains in a cavalier manner once they had
finished their dissection. Body parts were dumped outside the cities in heaps
or thrown into a river, where bits might wind up at a public washing site.

As a result of the contentious situation, doctors vied with
one another to acquire posts in military garrisons, prisons, and the new
Protestant hospital in Montpellier, where they had direct access to the sick
without the obstructive influence of nursing sisters and administrators.

Whenever possible, people, even of modest means, avoided
hospitals; hospital admissions were usually not confidential, and the
experience was humiliating. Those who were desperate enough to enter the
General Hospital in Montpellier, for example, had to appear before the full
administration board of the institution, headed by the bishop, and a committee
of the city’s prestigious nobles. There, as often as not in rags, they pleaded
their case for acceptance. If they were admitted, their effects were
confiscated, their clothes taken to be washed and rid of fleas, while the
patient was examined by a student surgeon to ascertain if the illness was
genuine and that the patient was not suffering from any of the diseases that
were barred from the institution. If all was in order, the patient received a
kind of uniform from the nursing sister and was then sent to the hospital
chaplain for confession. Finally, the patient was ushered to a bed. With
thousands of dying old men and old women, babies, orphans, and handicapped and
deformed people, the hospitals gave an impression of a scene from hell.

By 1789, Paris was being cleaned up, and in the process the
establishment began to realize that mortality in cities was greater than that
in the country because the urban environment was so deleterious for its
inhabitants. Doctors agreed that a serious health risk was present because
people were forced to breathe air infected with the odor of bodies decaying in
the cemeteries, where they were often not properly buried, and by the open
sewers in the streets. Many houses still had chamber pots for toilets, and
these were emptied into the streets at night, giving the neighborhood an
insalubrious and disagreeable ambiance.

New graveyards were created outside the walls of the city,
but this met with opposition from those who wanted their loved ones buried
close by, and, in the end, burials continued in town for some time to come.

During the late eighteenth century, proper nourishing food
began to be a subject of discussion, along with the quality of the air. At
least for the wealthy, wholesome food and clean air were becoming priorities.
Concern was also expressed over the
Hôtel-Dieu
in Paris, whose humid and
airless interior gave rise to perpetual pestilence. Enlightened campaigns
advocated opening windows both in hospitals and in private homes to let fresh
air circulate.

Preoccupation with cleanliness within the city slowly began
to extend to concern for the cleanliness of the body; doctors started
encouraging people to wash themselves more frequently. Up to this time, little
or no attention had been paid to washing even excrement off the body.

Since the nuns were also in the business of making good
Christians out of the patients, many hospitals had chapels of their own or
altars in the rooms. Salaried priests kept track of death records and led the
sick in prayer, helped draw up wills, buried the dead, administered the
sacraments, catechized children, confessed new entrants, and said Masses for
benefactors. Sisters also watched over the patients at mealtimes to ensure that
there was no trafficking in food, no blasphemy, boasting, or inappropriate
conversation that reflected poorly on the hospital and the Catholic religion.
Sisters could impose rebukes and mild punishments, such as reducing rations or
short imprisonment. Serious matters of insubordination or discipline were taken
up by the administration board, and retribution could include corporal
punishment or banishment from the hospital.

Up to the middle of the eighteenth century, if a patient
under a doctor’s care died (as frequently happened), the cause was put down to
God’s will. Once the doctors were put in charge, however, they increasingly saw
disease as part of nature, unrelated to sin and God, and insisted on a secular
medical program set apart from the spiritual explanations of the church.

Surgical equipment ca. 1770, showing a wound compress
comprising a hooked leather strap, leg binding, and several other items.

Surgical supports ca. 1770, including arm restraints
and an adjustable reclining seat, with diagrams of its various parts.

QUACKS AND CHARLATANS

The common people, superstitious and with a faith in
panaceas, were often beguiled by medical charlatans. The elixirs these
itinerant vendors offered might have been made of harmless vegetable juices and
herbs, but all were touted as a cure for most ailments.

Peddlers gathered crowds on street corners, extolling the
virtues of their product. Some, to attract people’s attention, supplied
entertainment: acrobats, jugglers, firework displays, dancers, musicians, and
tightrope walkers beckoned the curious. Markets, festivals, and fairs drew the
dissembling healer to put on his show and sell his concoctions. In one case,
Alexandre Cosne, son of a Parisian building worker, appeared with a huge pool
complete with mermaid, who answered questions from the crowd. Cosne would turn
up in cities claiming to be a magical healer whose potion would cure eye
ailments, skin disease, stomach problems, halitosis, and syphilis. It was also
touted as particularly effective for dyeing hair!

In Paris, the Pont Neuf, which spans the river Seine, was a
primary gathering point for swindlers, thieves, beggars, entertainers, and
other sundry people. Here there was someone to pull a rotten tooth, make
eyeglasses, or fit an ex-soldier with a wooden leg. There were those who sold
powdered gems guaranteed to beautify the face, drive away wrinkles, and add to
longevity.

MIDWIVES

An integral component in the lives of the French were the
midwives who assisted in the delivery of children. They generally lacked any
formal education, especially in rural areas, but as good Catholics they could
be relied on by the state and the church under the old regime to record the
births and to report those to unmarried mothers. Midwives were usually
middle-aged and often widowed women who used their skills in childbirth to help
make ends meet by charging a small fee. In the 1780s, they began to receive a
little technical training at state expense in a number of dioceses, and they
could receive a diploma of competence from their local guild of surgeons after
a six-month course at the
Hospice de la Maternité
in Paris. Few attended
these classes, however. After the revolution, the government attempted to
extend its control over midwives when the medical establishment complained that
they were very ignorant and illiterate and in many cases did not understand the
French language. Government agents weeded out the most incompetent but realized
that to ban all who were unqualified would essentially eliminate their
function. Those who had won the confidence of local inhabitants were allowed to
carry on.