Hôtel-Dieu de Paris

Hôtel-Dieu de Paris
AP-HP
Main entrance of the Hôtel-Dieu, in 2007
Geography
Location	Paris, France
Organisation
Care system	Public
Services
Emergency department	Yes
Beds	349
Links
Website	http://www.aphp.fr
Lists	Hospitals in France

Episodes from the Life of a Bishop-Saint, by the Master of Saint Giles (ca. 1500), showing the Gothic buildings of the Hotel Dieu at right. These survived until the 18th century

The Hôtel-Dieu de Paris (French pronunciation: ​[ɔtɛl djø də paʁi]) is regarded as the oldest hospital in the city of Paris, France, and is the most central of the Assistance publique - hôpitaux de Paris (AP-HP) hospitals. The hospital is associated with the Faculté de Médecine Paris-Descartes. It still resides on the bank of the Île de la Cité, next to Notre-Dame, connected to the "Rive Gauche" by the pont au Double. Although the facility had been ravaged by disastrous fires on several occasions (the current architecture dates back to 1877). The two buildings of the facility were originally built in the 7th and 17th centuries. It was built as a symbol of charity and hospitality. It was the only hospital in Paris until the Renaissance.

History

The Hôtel-Dieu was founded by Saint Landry in 651,^[1] and is considered to be the first hospital in the city^[2] and the oldest worldwide still operating.

The history of Parisian hospitals dates from the Middle Ages. Poverty was widespread during that period, and the Hôtel-Dieu became an opportunity for many of the bourgeois and nobility to come to its aid. Their efforts allowed the construction of the Hôpital de la Charité, which linked piety and medical care. Like many hospitals of that era, it started as a general institution catering for the poor and sick, offering food and shelter in addition to medical care.^[1][3] The creation of the Hôtel-Dieu continued this tradition of charity up until the 19th century, despite being called into question during the centuries which followed.

In the 16th century the Hôtel-Dieu faced a financial crisis, as it was only financed by help, subsidies or privileges. This brought about the creation in 1505 of a council of laymen governors:^[2] the Presidents of Parliament, the Chambre des Comptes, the Cour des Aides and the Prévôt des Marchands. The state progressively intervened, firstly by the intermediary of the Lieutenant Général de Police, member of the Bureau de l’Hôtel-Dieu de Paris (Bureau for the Hôtel-Dieu in Paris) in 1690, then by the intermediary of Jacques Necker, who created the roles of Inspecteur général des hôpitaux civils et des maisons de force (General Inspector for civil hospitals and jails) and Commissaire du roi pour tout ce qui a trait aux hôpitaux (Royal Commissioner for all that relates to hospitals).

During this period, the image of the poor changed. The 17th century elite created establishments to house the poor. Hospitals thus took the name of "Hôpital Général" (General hospital) or "Hôpital d'enfermement" (Asylum), of which the Hôtel-Dieu was one.

In parallel to her husband's work on the management of hospitals, Madame Necker progressively modified the symbolism of hospitals: from charity to benevolence. In addition, the ideas advocated by the Siècle des Lumières allowed reflection on hospitals. However it was not until the end of the 18th century that hospitals became a "curing machine", where the patient is treated and leaves cured. In the 19th century hospitals became places of teaching and medical research in addition to practicing medicine.

In 1772 a fire destroyed a large part of the Hôtel-Dieu which was not rebuilt until the reign of Napoléon.^[1] Other designs were built and numerous modifications made.

In 1801, the Parisian hospitals adopted a new administrative framework: the Conseil général des hôpitaux et hospices civils de Paris (General Council for Parisian hospitals and civil hospices). This willingness to improve management brought about the creation of new services: the Bureau d'admission (Admissions office) and the Pharmacie centrale (Central Pharmacy).

Also during this period, the Hôtel-Dieu advocated the practice of vaccination. The Duc de La Rochefoucauld-Liancourt was a fervent supporter of this. Similarly, the discoveries of René-Théophile-Hyacinthe Laennec permitted the refinement of methods of diagnosis, auscultation, and aetiology of illnesses.

Faced with this development of medicine, the Hôtel-Dieu was unable to compete. It was for this reason that new Parisian hospitals appeared, each specialising in one or several clinical specialties. The Hôpital Saint-Louis became a large centre for the study and treatment of dermatology and the Hôpital Pitié-Salpêtrière became a centre for the study and treatment of the central nervous system and geriatrics. Progressively, each hospital developed its own centre of paediatrics.

It was not until 1908 that the Augustinian nuns left the Hôtel-Dieu for good.

Role within the Parisian healthcare system

The Hôtel-Dieu is the top casualty centre to deal with emergency cases, being the only emergency centre for the first nine arrondissements and being the local centre for the first four.^[1][4]

For the last 50 years it has been home to the diabetes and endocrine illnesses clinical department. It deals almost exclusively with the screening, treatment and prevention of the complications associated with diabetes mellitus. It is also a referral service for hypoglycemia. Oriented towards informing the patient (therapeutic education) and technological innovation, it offers a large choice of care facilities for all levels of complications. It is also at the forefront of research in diabetes in areas such as new insulins and new drugs, effects of nutrition, external and implanted pumps, glucose sensors and artificial pancreas.

More recently, a major department for ophthalmology (emergencies, surgery and research) has been developed at the Hôtel-Dieu, under the supervision of Yves Pouliquen.

Notable figures

Notable physicians, researchers, and surgeons who practised at the hospital include Forlenze, Bichat, Dupuytren, Hartmann, Desault, Récamier, Cholmen, Dieulafoy, Trousseau, Ambroise Paré, Marc Tiffeneau, among other notable figures.

References

1. "Hotel Dieu". London Science Museum. Retrieved 2009-09-14.
2. Radcliff, Walter. Milestones in Midwifery and the Secret Instrument. Norman Publishing.
3. Fosseyeux, Marcel. "L'Hôtel-Dieu de Paris au XVII et au XVIIIe siècle" (in French). Berger-Levrault.
4. "AP-HP Hôtel-Dieu official site" (in French).

External links

• Official site (in French)
• Hotel Hospital Dieu concepção artística do East Villa Graphics Jun. 2012

Coordinates: 48°51′17″N 2°20′56″E / 48.854665°N 2.348808°E