At No. 42 in the Rue de Sèvres stood the hospital or asylum (hospice) for incurable women, founded by the charity of Marguerite Roulié, assisted by Cardinal de la Rochefoucauld, Grand Almoner of France. But the institution has now been transferred to Ivry in a large building, where incurable men are also received. The house in which the original hospital for incurables was established is now occupied by the Laennec Asylum, containing upwards of 300 beds, of which nearly fifty are for surgical cases. Then there are charitable houses for sick and for convalescent children. In the Rue de Sèvres (Nos. 93 to 95) is the monastery of the priests of the mission of St. Lazare, which, since 1816, has occupied the mansion of the Duc de l’Orges.

The chapel dedicated to St. Vincent de Paul, founder of the Lazarists, contains the relics of the saint, which were transferred to their present abode on the 29th of April, 1830. Seventeen bishops, with all the clergy of Paris and of the diocese, took part in the ceremony. The brothers of the Christian schools, also the sisters of Charity and of the Foundlings, assisted; in all upwards of 10,000 persons. This was for the{196} Parisians the great event of the spring of the year 1830, which, however, in the month of July was to witness a manifestation of a very different character: the Revolution that brought Louis Philippe to the throne.

At the right corner of the Avenue of the Invalides stood, up to the time of the Revolution of 1789, a country house belonging to the sculptor Pigalle. The congregation of Notre Dame des Chanoinesses Régulières de Ste. Augustine, founded there towards 1820 a house of education, which has remained celebrated under the name of the Convent of the Birds. Beyond the Boulevard Montparnasse, which branches off at this point towards the Boulevard des Invalides, is the House of the Infant Jesus, founded in 1751 by the zeal of the Abbé Languet, Curé of St. Sulpice, by the liberality of the Marquise de Lassay, and under the patronage of Queen Marie Lesczinska, in favour of thirty poor and noble young ladies; to become in 1802 a hospital for sick children. Here the mortality is at the rate of two out of eleven, which is almost twice the average mortality in the hospitals for adults. “The idea of creating a special hospital for children,” said Professor Bouchardat, “excellent at first sight, is fatal for the unhappy ones who are admitted.” Contagious diseases spread, as a matter of fact, with particular rapidity among children. To counteract this evil the Hospice des Enfants Malades has been provided with a garden, 31,000 square metres in extent, so as to permit as much as possible the isolation of the little patients.

Besides the inmates of the Paris hospitals a great number of out-patients receive treatment within their walls.

An important institution in Paris, to which we have practically no counterpart in England, is one for the nursing of the indigent poor at their homes. It is admirably organised, and has done a great deal of inestimable work; and Dr. Le Fort is as proud of it as he seems ashamed of the Paris hospitals.{197}

On the 25th of May, 1791, the municipality of Paris was charged by the administration with the distribution amongst the different parishes of the funds raised for the poor. On the 5th of August a municipal “Commission of Benevolence” was formed to consider the best method of administering aid to the indigent; and it is to this commission that the creation of the “offices of benevolence” is due. At the present time these offices relieve some twenty Paris mayoralties, besides freeing the hands of the hospital administration. Each office consists of the mayor of the arrondissement, as president; two assistants, twelve administrators, an unlimited number of commissionaires and sisters of charity, and a secretarial treasurer. Attached to each office are physicians and surgeons, midwives, etc. The scheme comprises, in each arrondissement, two or three “houses of assistance” where the poor come to seek aid for their sick friends, and where patients inscribed on the list of the indigent may have gratuitous consultations, medicine, and so forth. Fifty-three such houses are distributed over the capital.

Any poor or necessitous person wishing to be nursed at home through this organisation applies in person or by deputy to the office in his particular arrondissement, and if his case proves to be one requiring medical aid, the doctor attached to his section is instructed to visit him.

Dr. Le Fort draws a very strong contrast indeed between the Paris hospitals and the “houses of assistance.” The former institutions he declares to be, as a whole, the “most defective and murderous in Europe”; the latter, a “title to glory” for the city of Paris. He attributes the difference to the fact that the medical element is eliminated from the direct administration of the hospitals, but allowed its proper sway in the “benevolence” system. Certainly, one advantage{198} of this system is that it strengthens those family ties which a long residence in hospital relaxes and too often breaks.

In connection with the hospitals and relief institutions of Paris must be mentioned the National Institution for Blind Children, founded just after the Revolution by Louis XVI., before the Republican form of government had been definitely adopted. Its initiator was Valentine Hauy, the mineralogist, to whom a statue has been erected in the principal courtyard. The Institution for Blind Children is one of the ten general establishments of benevolence conducted under the immediate authority of the Minister of the Interior by a responsible director, assisted by a consultative commission. The instruction given is (according to a writer on the subject who evidently does not set too high a value on music) “technological, musical, and intellectual.” Employment is found for the children on the completion of their studies.

The house of the strangely named Quinze Vingts is designed for the reception of 300 blind persons of both sexes, each with his own private apartments for himself, or himself and family, together with many other advantages as well in money as in kind. Attached, moreover, to this institution are 1,300 outside pensioners in all parts of the country, receiving assistance in money according to the class to which they have been assigned: 200 francs, 150 francs, and 100 francs.

The origin of the Quinze-Vingts, or Fifteen-Twenties, is lost in obscurity. Hence all sorts of contradictory stories and conjectures without foundation, substituted for positive documents. According to some authors St. Louis, on his return from Palestine, founded the establishment of the Fifteen-Twenties for 300 knights—the sad remains of his army.

But the writers of the time make no mention of this alleged fact, and the ordinances of St.{199} Louis contain no sort of reference to it. The legend of the 300 knights must therefore be regarded as a fable. It is certain meanwhile that the blind asylum dates from an epoch anterior to the reign of St. Louis, though it is quite true that this pious monarch, by his patronage and his liberality, became the real founder of the house.

The Fifteen-Twenties forming a mendicant corporation, subsisting by alms, and belonging body and soul to their own Order, were first established in the Rue St. Honoré, not far from the Tuileries. They remained there under the constant patronage of numerous and powerful protectors until 1779, in which year Louis XVI. transferred the asylum to the ancient residence of the Black Musketeers in the Rue de Charenton. Its revenues already amounted to more than 370,000 livres (i.e. francs). The constitution of the hospital was then modified, collections in the churches were forbidden, and mendicancy in the streets likewise. At the same time regular pensions were introduced.

Towards the gate of a modest edifice situated in the Rue St. Jacques, near the Luxemburg Garden, may daily be seen visitors attracted to this point from all quarters of France and even of the globe. The building they wish to enter was, until 1794, the seat of the minor seminary of St. Magloire, belonging to the Archbishop of Paris. In this year he ceded the house to the deaf and dumb institution, which, founded in 1760 by the Abbé de l’Épée in his own domicile, Rue des Moulins, was, just after the Revolution, raised to the dignity of a national establishment and transferred to the ancient monastery of the Célestins near the Arsenal. The national institution of the Rue St. Jacques, which still exists and which is under the direction of the Minister of the Interior, contains some 210 pupils of from seven to fourteen years. The school comprised, until lately, two divisions entirely separate and distinct, one for boys, the other for girls, when suddenly the girls of the Paris institution were sent to the institution of Bordeaux, and the boys of the Bordeaux school to that of Paris, so that at present, wherever they may have been born, the deaf and dumb boys are all at Paris, while the deaf and dumb girls are all at Bordeaux. Professor Ferdinand Berthier, of the Paris deaf and dumb school, himself deaf and dumb, maintained, in an article published some five-and-twenty years ago, that this pretended reform was no amelioration whatever; the deaf and dumb children studying perfectly well when the boys and girls were educated together under the same professors. At that time{200} the Paris institution was administered by a director with the use of speech, assisted by an examiner of studies, similarly gifted, and a body of professors, some of whom spoke, while others were deaf and dumb.

One of the best private deaf and dumb institutions in France is at Lyons. It contains a good number of pupils of both sexes, and its director is, or was until recently, M. Claudius Forestier, a very distinguished deaf-mute; his wife, a highly educated person—the speech-endowed daughter of the deaf-mute founder of the school—acting as directress.

The number of deaf-mutes in France has been approximately estimated at 25,000; and here, as in nearly all countries where statistics are published, it is found that the male sufferers are decidedly more numerous than the female.

To each establishment, public or private, workrooms are attached, conducted by competent instructors, and in which all the pupils, poor or rich, serve an apprenticeship to some profession, art, or trade which will one day enable them to{201} earn a subsistence. No longer, therefore, is the community encumbered by deaf and dumb idlers; the men and women thus afflicted leading active lives as shoemakers, dressmakers, tailors, sempstresses, locksmiths, compositors and even painters and sculptors.

It has been complained that the deaf and dumb institutions of France—about fifty in number—are insufficient for the instruction of 25,000 deaf-mutes, many of whom must consequently be deprived of instruction in those employments for which they are generally as apt as their neighbours who can speak and hear.

The question of the hereditary nature of muteness has been a good deal discussed by French experts. “Dumbness,” says Ferdinand Berthier, “far from being a necessary result of deafness, simply follows the latter by reason of a natural sequence. Whether deaf-muteness dates from birth or from some accident, it has been proved in the present day that the vocal apparatus of the deaf-mute and that of a speaking person are with rare exceptions equally well organised. A prejudice still too widely spread in the world, and worthy of every effort towards its destruction, is that deaf-muteness is infallibly transmitted from father or mother to child; when on all sides we see deaf-mutes, married between themselves or to speaking spouses, constantly producing children who both hear and speak, and{202} in no way share the parental infirmity. Those arts which have enabled the sublimest efforts of genius to dazzle the world do not, in our opinion, merit greater attention from scholars and philosophers than the method which shall open to the deaf-mutes a road leading to intellectual labour and to the full enjoyment of civil and political rights.”

Looking back to antiquity, this excellent writer points out that the ancients regarded the education of deaf-mutes as an impossibility both physical and moral.

It was the custom at Sparta to allow children suffering from this double infirmity to die of hunger and thirst in the desert, where they were for that purpose exposed; and the laws of Solon were on this point no less severe. Aristotle, if he did not precisely justify the rigour of such laws, at least endorsed the moral prescription. In the fourth book of his History of Animals he unhesitatingly relegates deaf-mutes to the rank of idiots, declaring them hopelessly beyond all tuition. The Republic of Rome did not show itself more humane. It was in vain that intelligence beamed in the face of these unhappy victims: if their tongue could produce no sound they were condemned to be flung into the Tiber.

One of the earliest agents in the removal of this weight of infamy from the fraternity of deaf-mutes was, curiously enough, the stage. Lucian eulogises the pantomime of the dumb-show actors of his epoch, and the admirable influence they exercised in raising the deaf and speechless above general contempt. The Egyptians and Persians, more civilised and enlightened in this respect than Sparta, Athens, or Rome, showed for their deaf-mutes a solicitude which approached devotion.

In centuries less remote many efforts have from time to time been made by philosophers and philanthropists to invent an effectual method of instructing deaf-mutes. The sign method of the Abbé de l’Épée was one of the first great steps in this direction. The abbé held that the old-fashioned dactylology was insufficient, and that signs were essential to those who could neither hear nor speak. Starting from the incontestable principle that the bond existing between ideas and sounds which strike the ear is not more intimate, more natural, than the bond between ideas and traced characters which strike the eye, he found it by no means difficult to demonstrate the possibility of fully replacing speech, in the case of a deaf-mute, by mimicry.

As regards this mimicry, M. Berthier cautions people against the common mistake of confounding it with dactylology, or the language of the fingers. Dactylology is confined to the servile reproduction of the letters of the alphabet of any particular language, one by one, syllable by syllable, word by word, or in no matter what other conventional manner. Mimicry, a faithful picture of human thought, paints ideas and sentiments in a living language—the innate language of all nations—the language of humanity. By means of it thoughts are exchanged more quickly than by speech or writing—not to mention dactylology, which lags so far behind.

In the midst of his brilliant triumphs the Abbé de l’Épée had frequently to engage in conflict with two classes of powerful adversaries: the philosophers and the theologians; the former regarding words as the only vehicle for imparting metaphysical ideas, the latter regarding them as the sole means of inculcating supernatural religious truths.

Louis XVI. had granted the abbé out of his own privy purse an annual pension of 6,000 francs, in addition to his official appointment at the Célestins. Hitherto the school had, for twelve years, been maintained entirely at the cost of the founder, aided by such occasional alms as he received for the purpose. It was at the Célestins in 1789 that he expired, amid the weeping of his pupils and with the delightful thought that his work would not perish with him.

Amongst the disciples of the Abbé de l’Épée must be mentioned the Abbé Sicard, canon of Bordeaux, whom the archbishop of that town sent to Paris, where he had founded a deaf-mute institution, in order that he might study under de l’Épée that method of which there was so much talk. The high talents of this young priest soon enabled him to divine, comprehend, and complete the thought of his master in exciting the warm sympathies of the public towards those unfortunate persons whose tongue was tied and whose ear was stopped.

On the death of de l’Épée, Sicard competed for and was unanimously awarded the management of the abbé’s institution. Having already written not a little on the subject of deaf-muteness, he now published other works, “A Deaf-mute’s Course of Instruction,” among others, which only served to increase his renown; though in this treatise there was indeed one highly objectionable assertion concerning the condition of a deaf-mute which the author found it necessary to retract in his “Theory of Signs.{203}”

During the Revolution of 1793 the Abbé Sicard did not escape persecution. Flung into prison after the eventful 10th of August, he was lucky enough to keep his head on his shoulders during the massacres of September. He had scarcely been set at liberty when, as editor of the Catholic Annals, he was condemned to transportation to Cayenne; and he passed the next two years of his life in flight far from his beloved institution, of which he did not resume the direction till after the Revolution of the 18th “Brumaire.” He died in 1822.

Among the professors whom he formed must be mentioned a speech-endowed one named Bébian, who in his turn trained several deaf-mute professors. His works are still consulted with advantage both in France and abroad by those who wish to devote themselves to this arduous method of instruction. The object he kept before him in writing was, as he himself expressed it at the commencement of one of his books, “to simplify the method and render it so easy that the mother of a family can teach her deaf-mute child to read just as she teaches the others to speak.”

Oblivion had already seemed too long to have overspread the remains of the Abbé de l’Épée when, in 1837, on the initiative of M. Berthier, a numerous and distinguished committee was formed for the purpose of raising to the clerical philanthropist a monument worthy of him in that chapel of the church of St. Roch which belonged to his family, and in which he was accustomed to celebrate mass, assisted by deaf-mutes. It was here indeed that his ashes lay. An admirable sculptor, M. August Préault, was unanimously chosen to interpret the homage which so many famous deaf-mutes and others wished to pay to the abbé’s memory, and he worthily carried out the intentions both of committee and subscribers. Eight years afterwards, in 1845, a crown of laurels in bronze was placed beside the monument with this simple inscription: “To the Abbé de l’Épée, from the Swedish deaf-mutes.” This crown, beautifully executed, was likewise the work of Préault. The year previously the same sculptor had testified his own admiration of the abbé by contributing to the Hôtel de Ville a fine statue of him. The town of Versailles, which was proud of being the birthplace of the great founder of the deaf-mute institution, could not do less than follow the example set by Paris in voting to his memory a statue, which was confided to the chisel of M. Michant. The same artist was subsequently commissioned by the Count de Montalivet, then intendant-general of the civil list, to execute a bust of the abbé for the historic gallery of Versailles.

The Paris hospitals are not, like ours, supported{204} by voluntary contributions. Many of them have from the beginning been richly endowed. Others depend on grants from the State or from the Municipality; while a few are maintained from mixed sources. None of them, however, depend, as in England, on subscriptions and donations received periodically from charitable persons. Consequently, applicants for relief or advice need neither letters of recommendation nor introductions of any kind. Medical succour is given at certain hours to all who choose to ask for it. Patients seeking admission and regular attendance have sometimes to wait for their turn. But there are, in proportion to the population, quite as many beds at the service of the sick in Paris as in London.

Of the most ancient and most famous of all the French hospitals—the Hôtel Dieu—mention has already been made. Scarcely less celebrated, in view of the important services they have rendered and of the many physicians and surgeons of eminence who have lectured, operated, and prescribed within their walls, are the two hospitals named after those divine qualities Charity and Pity.

The Hospital of La Charité is the principal one on the left bank of the Seine; nor is its position likely to be forgotten by those who have heard of the famous professor of surgery—Lisfranc—and his attacks upon the illustrious Dupuytren, head of the Hôtel Dieu, whom Lisfranc, in his highly polemical lectures, used habitually to describe as “ce brigand de l’autre côté de l’eau.” Lisfranc had doubtless differed with his eminent rival on some slight theoretical point, for which reason he accused him, with a vehemence which Molière’s own doctors might have envied, of mental perturbations and moral offences in no way attributable to him.

No less than three benevolent institutions have been founded in Paris under the name of Charity—the Hôpital de la Charité Chrétienne, endowed and opened by Marguerite de Provence, widow of Louis IX., but destined in the course of{205} ages to disappear; the Maison de la Charité, founded by the town of Paris at the beginning of the sixteenth century, with the aid of Francis I., against epidemics, afterwards to become known as the Maison de la Santé; and finally, the Hôpital de la Charité, already referred to, which remains one of the first medical and surgical institutions in Paris.

The origin of La Charité and its history up to the time of the Revolution are sufficiently curious. A hospital was founded at Grenada in 1540 by St. John of God, who became the chief of a religious order which occupied itself specially with the care of the sick. This congregation of hospitallers spread rapidly throughout Europe, and a certain number of its members being, in 1602, at Paris, Marguerite de Valois, the divorced wife of Henry the Fourth, who in her old age, when her passions had somewhat subsided, became religious, enabled them to establish a hospital, to which the name of La Charité was given. The brothers of the Order of St. John of God had already a place of their own, which they gave up in order to take possession of the larger premises placed at their disposal by Queen Marguerite. A capacious house, surrounded by vast gardens, was the first home of La Charité. Here patients were received and treated by the brethren, who, besides religion, had studied medicine, surgery, and pharmacy. Their vows did not allow them to admit women, and their utility seems to have been further limited by insufficient knowledge of the art of healing; and this notwithstanding the fact that several of{206} the brethren made themselves a great name as surgeons and physicians. In the early part of the eighteenth century they joined to their staff medical men from the ranks of the laity; compelled to this step by an edict from the Parliament of Paris which ordered them to admit, without salary, a surgeon-apprentice to help them in dressing wounds, and a master-surgeon to share their labours generally. Throughout the eighteenth century they found themselves constantly exposed to attacks from the members of the various medical and surgical guilds, who claimed the sole right of attending the sick and wounded.

In 1792, three years after the outbreak of the Revolution, the different religious congregations were broken up, and the Hospital of La Charité was placed under the direction of the Municipality of Paris. The very title was abolished, and instead of Hôpital de la Charité—beautiful and suggestive name!—it was now called, without the least significance, Hôpital de l’Unité. Under the Restoration, however, its old name was given back to it; and since then, under many changes of government, it has retained its original appellation.

Among the other hospitals of Paris the most important are those of La Pitié and of St. Louis, to which may be added L’Hôpital du Midi, and a number of special hospitals, such as the one known as La Maternité, founded in 1795, which is at once a school for the instruction of wet-nurses, and a maison d’accouchement, or lying-in hospital.{207}

CHAPTER XXIX.

LUNATIC ASYLUMS AND MIXED INSTITUTIONS.

III. The period of torture.—Though no longer subject to death punishment by fire, lunatics were almost as badly off in the eighteenth and at the beginning of the nineteenth century as at an earlier time. Such asylums as existed in France and other countries up to the present century were entirely of a monastic kind; and it was not, as before mentioned, until the reign of Louis Philippe that any regular secular institution for the treatment of the insane was founded. The unhappy lunatics were probably happiest in those countries where least notice was taken of them; for not a century ago they were liable, when “cared for,” to copious bleeding, shower-baths, sudden frights, and rigid coercion. In some places they were chained and flogged at the changes of the moon, or they were placed under the charge of criminals, who set dogs on them and tortured them to death. The doctors, instead of checking these barbarities, encouraged them; and from time to time invented new ones. They it was who introduced the “circular swing” and “bath of surprise.” One torture, diabolically devised, was to lower the patient into a well, chain him there, and allow the water to rise gradually to his mouth in order to give a shock to his nerves. An unhappy man named Norris{208} was in England, at the so-called Hospital of Bethlem, fixed to the wall by the neck and waist so that he could not move a foot or raise his arms; and, thus attached, he remained for twelve years.

“At an epoch not far distant from our own,” says Dr. Linas in a paper on lunatic asylums in France, “demented persons were, with the exception of those who found an asylum in the monasteries, treated as vagabonds and even criminals.”

The first attempts to improve the condition of the unhappy lunatic were made by Dr. Tenon, and by a member of the Constituent Assembly, M. Rochefoucauld-Liancourt, in 1791. A year later Pinel, equally estimable for his philanthropic and for his scientific spirit, introduced at Bicêtre the reforms which, in common with the two excellent men before named, he had long been meditating. For the First Revolution, then, with all its mad excesses, must be claimed the honour of having introduced in modern times the humane treatment of the insane. The Revolution, indeed, opened not only a “career to talent,” but a path to very useful reform. The mad patients were now taken from the Hôtel Dieu and other hospitals to be placed at Charenton, Bicêtre, and La Salpêtrière (1802-1807). From that time these asylums, placed under the direction of eminent medical men, changed their character. The employment of force or coercion with lunacy was at an end; and the new establishments, thanks to the intelligence and zeal of Esquirol, Ferrus, and their disciples, gained the highest reputation throughout Europe. The study of mental maladies was now for the first time followed.

It was not, however, until 1838 that Charenton became a lunatic asylum and nothing else. Bicêtre and La Salpêtrière remained hybrid institutions, half hospitals, half asylums; receptacles alike for madness and old age. The inmates of Charenton are treated with the greatest kindness. Cases of insubordination must of course be dealt with; and they are treated by the withdrawal of some favour or (less humanely, as it would seem to the lay reader) by the shower-bath. A strait-jacket, with long sewn-up sleeves, is the only means of coercion employed with violent and dangerous madmen, so as to preserve them against the excesses of their own fury and to render it impossible for them to injure their companions. The wards of the unruly patients—broad and lofty, well lighted, well ventilated, with waxed floors—present no resemblance whatever to the cages of former days.

All patients without exception, peaceful or unruly, are in the enjoyment of fresh air, sunlight, space, and as much liberty as can be prudently allowed them. They correspond with their relatives and receive visits from their family and their friends. Once a month they are officially visited by a magistrate, whose duty it is to question them and listen to their complaints. For the men there are workshops of all kinds, for the women workrooms. The dormitories are well kept, the dining rooms are exquisitely clean, and for the recreation of the patients there are billiard rooms, drawing rooms, and libraries. Music, too, and drawing may be cultivated. During the summer there are excursions to the country, during the winter evening parties,{209} concerts, and dramatic representations. Among the inmates persons of every age, every rank, and every profession are to be found: some of them monomaniacs, harmless dreamers after an impossible chimera or vain hope; or it may be obstinately attached to some wild idea which they cannot refer to without expressions of violence. The liberal professions are largely represented at Charenton, and, due numerical proportion being observed, furnish more lunatics than any other class. “Paris,” says Dr. Linas, “the great rendezvous of every kind of ambition, every kind of vanity, every presumption, every passion, every pleasure, and every form of misery, furnishes a larger contingent than any other part of France.” While the proportion of lunatics for the other departments is one to from 1,500 to 2,000 inhabitants, it is in the ratio of one to 500 for the department of the Seine. In 1801 this department had 946 lunatics to support, in 1845 2,595, in 1851 3,060, and in 1865 4,388. Happily, however, largely as the numbers will be seen to have swelled, a great many cures are yearly effected. In the year last-named 389 patients (154 men and 224 women) were discharged sane from Bicêtre and the Salpêtrière.

There are two modes of admission to these asylums. The Prefect of the Seine authorises the admission of harmless patients on the demand of those patients’ friends; but lunatics who are considered dangerous to the community—and these form by far the greater proportion—are shut up by order of the Prefect of Police.

Let us take a leisurely glance at the two great French lunatic asylums. To begin with La Salpêtrière. It is situated on the 13th arrondissement, almost at the entrance to the Boulevard de l’Hôpital, and not far from the Jardin des Plantes and the Bridge of Austerlitz. On the pediment of its portal is this inscription: “Hospital for old age—Women.” Such has been the official title of the institution since 1823, but the more ancient and popular name, that of La Salpêtrière, has prevailed in common use.

At the spot which is occupied by this madhouse there stood in the reign of Louis XIII. a little arsenal called La Salpêtrière, on account of the saltpetre which was made within its walls. In 1656 appeared an edict of Louis XIV. ordering the establishment at this point of a general hospital for the “poor mendicants of the town and suburbs of Paris.” Thanks to the royal munificence, to the liberality and generous co-operation of Cardinal Mazarin, of the Duchess d’Aiguillon, and several notable citizens, to the pious zeal of Vincent de Paul, and to the active direction of the architects Levau, Bruant, Duval, and Le Muet, the various buildings of the arsenal were happily converted into a retreat for the poor, two new blocks, those of Mazarin and St. Claire, being added to the original structures. From the 7th to the 13th of May, 1657, the hospital opened its doors to 628 poor women, blind, mad, and imbecile, infirm, invalid, deaf, or otherwise afflicted, as well as to 192 children of from two to seven years of age, who, born in many cases out of wedlock, had been exposed and abandoned.{210}

In 1669 the church was built by the king’s orders. Towards 1684 was constructed in the centre of the hospital the prison of La Force, where women of irregular life were incarcerated. In 1756 the Marchioness de Lassay caused to be constructed at her own expense the superb building which bears her name, and which forms a pendant to that of Mazarin.

At the period last mentioned La Salpêtrière still contained, as at its origin, the most strangely mixed population that could be conceived. At the end of the last century, and more particularly at the beginning of the present, efforts were made to transform this “frightful sewer,” as Camus called it. From 1801 to 1804 La Force was evacuated. Its feminine inhabitants transferred to Lourcine, the children went to the Orphelins; the insane were separated from the infirm and placed in a special quarter. From 1815 to 1823, in virtue of a very strong report drawn up by M. de Pastoret, the dungeons of La Salpêtrière were destroyed, the sanitation improved, the dormitories enlarged and well ventilated, the furniture renewed, and the diet improved. Finally, as if to efface all memory of the past, the asylum received the name of Hospital for Old Age. Other subsequent ameliorations, notably those effected in 1836, 1845, 1848, and 1851, have contributed to render La Salpêtrière what it certainly is in the present day—the finest institution of the kind in France.

The total population of the establishment is no less than 5,000, comprising as it does some 800 employés, 1,500 lunatics, and nearly 3,600 patients, old or infirm. The annual expenses amount to nearly two million francs. Within the precincts of La Salpêtrière the visitor might fancy himself in a small town. There is a church, a letter box, a tobacco shop, a butcher’s shop, warehouses, wash-houses, and a market, or rather bazaar, where all sorts of goods are retailed, such as fruit, vegetables, sweetmeats, and pastry; there are streets named after the establishments to which they lead—Laundry Street, Kitchen Street, Church Street, and so on; there are large promenades and pretty gardens, together with courts, squares, and “places” bearing the illustrious name of a founder, a benefactress, a physician, or a saint immortalised by charity.

This vast community of indigence and madness is under the control of the general administration of Public Assistance. The local management is in the hands of a director, assisted by a steward and eleven clerks. The medical officers are seven in number, five for the insane and two for the infirm; not to mention a surgeon, a dispensing chemist, and other medical assistants. The religious services are conducted according both to the Catholic and the Protestant ritual. The staff of female attendants is divided up into superintendents, under-superintendents, household servants, etc. The superintendents and under-superintendents wear a black uniform, severe but in good taste. They are women carefully chosen, able, devoted, of tried zeal, benevolent character, and not infrequently of mental culture.

Before the principal entrance to La Salpêtrière, looking towards the Boulevard de l’Hôpital, is a more or less triangular open space, which, almost deserted during five days of the week, is animated and noisy like a fair every Thursday and Sunday between the hours of twelve and four; for the public is then admitted to see the inmates, and the wandering dealers have assembled in order to sell presents for the unfortunate patients. The two porters of the establishment have on these days enough to do, since the number of visitors averages from 1,200 to 3,000.

Before entering the hospital the church is worthy of observation. Louis XIV. ordered it to be built in December, 1669, and it was constructed by the celebrated architect, Levau. It is of octagonal form, and like the ancient basilicas, of which the model is preserved by the Greek Church in Russia and elsewhere, it is surmounted by five cupolas: a central one, beneath which stands the high altar, and four lateral ones covering an equal number of chapels.

Under the portico are two allegorical groups by the famous sculptor, Etex. The interior of the church is adorned with ancient organs, statues of Christ and of the twelve apostles, and a number of pictures belonging to the eighteenth century, some of which should not hastily be passed by. Every Sunday nearly three hundred demented women assist with the greatest devotion at the celebration of mass. On the buildings and wings to the right and left of the church are engraved the names of the most illustrious and most generous benefactors of the Salpêtrière: Mazarin, Bellièvre, Fouquet, and Lassay.

Administratively and medically the Salpêtrière is divided into five compartments, which are subdivided into quarters or sections. The old people, the incurables, the infirm, form three separate classes. The principal wards bear the names of Mazarin, Lassay, St. Jacques, St. Léon,{211} and Ste. Claire. There are smaller wards which are dedicated to the Virgin, to St. Vincent de Paul, the guardian angel, and St. Magdalen.

The patients are allowed three meals a day: between seven and eight a breakfast of bread and milk; between eleven and twelve, soup and boiled beef; between four and five, a plate of vegetables and then dessert. Those who are well enough, to the number of 850, take their meals in the refectory; the others, upwards of 1,700, are served in the dormitories. The annual mortality among the indigent inmates averages 23 per cent. At the time Dr. Linas wrote his paper on La Salpêtrière there were several examples of longevity in the institution, including a certain Madame Mercier, who was well and lively at 104.

The department which occupies the southern extremity of La Salpêtrière is the one specially devoted to lunatics. Placed at the head of the establishment in 1795, Pinel introduced at this hospital the same beneficent reforms with which he had already endowed Bicêtre. He at once did away with the chains, fetters, and irons with which, until his time, the patients were loaded, and he filled up the subterranean dungeons in which unhappy women, half naked, had often had their feet gnawed by rats, or frozen by the cold of winter. From 1818 to 1836 Esquirol, pupil, disciple, and friend of Pinel, introduced new modifications to soften the lot of the deranged.

Connected with La Salpêtrière are many interesting traditions. During its earliest days St. Vincent de Paul ministered constantly to the patients. Here Bossuet, on the 29th of June, 1657, pronounced his panegyric on St. Paul, one of the masterpieces of Christian eloquence. Here was confined in 1788 the mysterious personage calling herself Madame de Donhault, whose identity has never been established, and who is known in judicial annals as the “WOMAN WITHOUT A NAME,” or “THE SHAM MARCHIONESS.” Here, too, was shut up the widow and accomplice of the famous poisoner, Desrues, massacred with thirty-five other prisoners on the 4th of September, 1792. Two other women who played in the world two very different parts died at La Salpêtrière: Théroigne de Méricourt, at the age of fifty-seven, after eighteen years of wild illusions, and Mdlle. Quino.

The Salpêtrière has been the cradle of important physical and psychological studies in connection with brain diseases. These have sometimes taken a slightly fantastic form, as when Esquirol and his nephew, Dr. Miture, endeavoured to cure madness by the most agreeable remedies—the former prescribing music, the latter champagne. Rostan and Georget in 1822 made at La Salpêtrière experiments in animal magnetism, which attracted much attention in the scientific world, especially as regards two subjects, now well known in the history of somnabulism: the young Petronilla, and the widow Brouillard, nicknamed Braquette, whose clairvoyance was some years later put to a delicate test by three mischievous house surgeons, MM. Dechambre, Diday, and Debrou. A number of interesting and very important experiments in the new science (or old science under a new name) of hypnotism have been made by Charcot and his pupils at this institution. Here, too, a close examination and analysis of the cerebral manifestations of the insane led some subtle anatomist to the conclusion that genius was but a form of insanity. There was one physician of La Salpêtrière, M. Lélut, member of the Chamber of Deputies, and of the Institute, who, in two remarkable works, endeavoured to prove that in the minds of Socrates and of Pascal there was, at least, a touch of madness. Another learned physician, attached during the Louis Philippe period to the Salpêtrière, M. Trélat—described by Dr. Linas as “an excellent man, ex-minister, and not a member of the Legion of Honour”—wrote a book, which may be classed with the one just named, on “Lucid Madness.”

Bicêtre, an asylum of the same character as La Salpêtrière, derives its name from the familiar Winchester. On the site of Bicêtre, in the year of grace 1284, Jean de Pontoise, Bishop of Winchester, built near Paris a manor house, which, after the name of his see, he called Winchester, soon corrupted into Wicester, which, by a further process of corruption, became successively Bicestre and Bicêtre. After going through various hands, and at last passing into the king’s possession, Bicêtre was given in 1656 by Louis XIV. to be turned into a hospital for old men above the age of seventy, lame and incurable children, the blind, the paralytic, the imbecile, and the epileptic, together with women of dissolute life, who were to be received only on condition of being corrected, whipped, and fed on bread and water.

At the period of the Revolution Bicêtre was at once a hospital, an asylum, a prison, and a house of correction, until, in 1791, it became at the same time a madhouse. The lunatics were at first mixed up with the criminals, or confined in horrible dungeons, but at length the{212} intelligent and benevolent Pinel broke their chains. It was only in 1812, however, that the lunatics were placed in a special compartment, separate at once from the criminals and from the patients. Bicêtre continued to be a prison until 1836, when it became simply a hospital. At present the dungeons of former days are used as store-rooms for provisions and drugs.