The Hôtel-Dieu de Paris (ɔtɛl djø də paʁi) is regarded as the oldest hospital in the city of Paris

Paris

Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...

, France

France

The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

, and is the most central of the Assistance publique - hôpitaux de Paris

Assistance publique - Hôpitaux de Paris

The Assistance publique – Hôpitaux de Paris is the public hospital system of the city of Paris and its suburbs...

 (AP-HP) hospitals. The hospital is linked to the Faculté de Médecine Paris-Descartes. It still resides on the left bank of the Île de la Cité

Île de la Cité

The Île de la Cité is one of two remaining natural islands in the Seine within the city of Paris . It is the centre of Paris and the location where the medieval city was refounded....

, next to Notre-Dame where the facility was originally built between the 7th and 17th centuries, with two buildings being linked by the pont au Double

Pont au Double

-Location:The bridge links the 4th and 5th arrondissements of Paris, from the Île de la Cité to the quai de Montebello.Bridge location on the Seine:Downstream: Petit PontUpstream: Pont de l'Archevêché- History :...

. Although the facility has been ravaged by disastrous fires on several occasions, the hospital remains in existence today (the current architecture dates back to 1877). As a symbol of charity

Charity (virtue)

In Christian theology charity, or love , means an unlimited loving-kindness toward all others.The term should not be confused with the more restricted modern use of the word charity to mean benevolent giving.- Caritas: altruistic love :...

 and hospitality

Hospitality

Hospitality is the relationship between guest and host, or the act or practice of being hospitable. Specifically, this includes the reception and entertainment of guests, visitors, or strangers, resorts, membership clubs, conventions, attractions, special events, and other services for travelers...

, it was the first hospital in Paris until the Renaissance

Renaissance

The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Italy in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historical era, but since the changes of the Renaissance were not...

.

History

The Hôtel-Dieu was founded by Saint Landry

Landry of Paris

Saint Landry of Paris was a bishop of Paris and saint. Consecrated bishop of Paris in 650, he built the first major hospital in the city, dedicating it to Saint Christopher, which is now the Hôtel-Dieu...

 in 651, and is considered to be the first hospital in the city.

The history of Parisian hospitals dates from the Middle Ages

Middle Ages

The Middle Ages is a periodization of European history from the 5th century to the 15th century. The Middle Ages follows the fall of the Western Roman Empire in 476 and precedes the Early Modern Era. It is the middle period of a three-period division of Western history: Classic, Medieval and Modern...

. Poverty was widespread during that period, and the Hôtel-Dieu became an opportunity for many of the bourgeois and nobility

Nobility

Nobility is a social class which possesses more acknowledged privileges or eminence than members of most other classes in a society, membership therein typically being hereditary. The privileges associated with nobility may constitute substantial advantages over or relative to non-nobles, or may be...

 to redeem their sins by coming to its aid. Their efforts allowed the construction of the Hôpital de la Charité

Hôpital de la Charité

Hôpital de la Charité was a hospital in Paris founded in the 17th century and closed in 1935.-History:In 1606, Marie de Médicis invited the Brothers Hospitallers of St. John of God to come to France. The Abbot of Saint-Germain-des-Prés granted them the use of its former Saint-Père chapel, which...

, 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. 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: the Presidents of Parliament, the Chambre des Comptes, the Cour des Aides and the Prévot des Marchants. 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

Jacques Necker

Jacques Necker was a French statesman of Swiss birth and finance minister of Louis XVI, a post he held in the lead-up to the French Revolution in 1789.-Early life:...

, who created the roles of Inspecteur general des hôpitaux civils et maison de forces (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. They became socially dangerous, because they were marginal. In order to control them, the 17th century elite brandished moral arguments to create establishments allowing them to confine the poor. The hospital therefore became a place of confinement, allowing them to clean up the urban world at the same time. 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

Suzanne Curchod

Suzanne Curchod was a French-Swiss salonist and writer. She hosted one of the most celebrated salons of the Ancien Régime. She was the wife of Jacques Necker, and is often referenced in historical documents as Madame Necker....

 progressively modified the symbolism of hospitals: from charity to benevolence. In addition, the ideas advocated by the Siècle des Lumières

Age of Enlightenment

The Age of Enlightenment was an elite cultural movement of intellectuals in 18th century Europe that sought to mobilize the power of reason in order to reform society and advance knowledge. It promoted intellectual interchange and opposed intolerance and abuses in church and state...

 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. It was nevertheless not until the 19th century that hospitals became a place of practicing medicine and science, but also, a place for teaching and medical research.

In 1772 a fire destroyed a large part of the Hôtel-Dieu which was not rebuilt until the reign of Napoleon

Napoleon I of France

Napoleon Bonaparte was a French military and political leader during the latter stages of the French Revolution.As Napoleon I, he was Emperor of the French from 1804 to 1815...

. 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 hospice

Hospice

Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...

s). This willingness to improve management brought about the creation of new services: the bureau d'admission (Admissions office) and the Pharmacie centrale (Central Pharmacy).

Secondly, during this period, the Hôtel-Dieu advocated the practice of vaccination

Vaccination

Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

. The Duc de La Rochefoucauld-Liancourt

François Alexandre Frédéric, duc de la Rochefoucauld-Liancourt

François Alexandre Frédéric, duc de la Rochefoucauld-Liancourt was a French social reformer.-Early life:...

 was a fervent supporter of this. Similarly, the discoveries of René-Théophile-Hyacinthe Laennec

René Laennec

René-Théophile-Hyacinthe Laennec was a French physician. He invented the stethoscope in 1816, while working at the Hôpital Necker and pioneered its use in diagnosing various chest conditions....

 permitted the refinement of methods of diagnosis

Diagnosis

Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

, osculation, and aetiology of illnesses.

Faced with this development of medicine, the Hôtel-Dieu was unable to cope. It was for this reason that new Parisian hospitals appeared, each specialising in one or several clinical specialties. The Hôpital Saint-Louis

Hôpital Saint-Louis

Hôpital Saint-Louis is a hospital in Paris, France. It is part of the Assistance publique - Hôpitaux de Paris hospital system, and it is located at 1 avenue Claude-Vellefaux, in the 10th arrondissement, near the metro station: Goncourt.-External links:*...

 became a large centre for the study and treatment of dermatology

Dermatology

Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....

 and the Hôpital Pitié-Salpêtrière

Pitié-Salpêtrière Hospital

The Pitié-Salpêtrière Hospital is a teaching hospital located in Paris, France. Part of the Assistance publique - Hôpitaux de Paris, it is one of Europe's largest hospitals...

 became a centre for the study and treatment of the central nervous system

Central nervous system

The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

 and geriatrics

Geriatrics

Geriatrics is a sub-specialty of internal medicine and family medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or...

. Progressively, each hospital developed its own centre of paediatrics

Pediatrics

Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...

.

It was not until 1908 that the Augustinian nuns

Augustinian nuns

Augustinian nuns are the most ancient and continuous segment of the Roman Catholic Augustinian religious order under the canons of contemporary historical method. The Augustinian nuns, named after Saint Augustine of Hippo , are several Roman Catholic enclosed monastic orders of women living...

 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 arrondissement

Arrondissement

Arrondissement is any of various administrative divisions of France, certain other Francophone countries, and the Netherlands.-France:The 101 French departments are divided into 342 arrondissements, which may be translated into English as districts. The capital of an arrondissement is called a...

s and being the local centre for the first four.

For the last 50 years 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

Diabetes mellitus

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

. It is also a referral service for hypoglycemia

Hypoglycemia

Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...

. Oriented towards informating 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 insulin

Insulin

Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....

s and new drugs, effects of nutrition, external and implanted pumps, glucose

Glucose

Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate...

 sensors and artificial pancreas

Artificial pancreas

The artificial pancreas is a technology in development to help people with diabetes automatically control their blood glucose level by providing the substitute endocrine functionality of a healthy pancreas....

.

More recently, a major department for ophthalmology

Ophthalmology

Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

 (emergencies, surgery and research) has been developed at the Hôtel-Dieu, under the supervision of Yves Pouliquen

Yves Pouliquen

Yves Pouliquen was born 17 February 1931 in Mortain, France. A doctor by profession, his work has been dedicated to the pathology of the cornea. In 1994 he was awarded the Prix mondial Cino Del Duca and on 29 November 2001 he was elected to the Académie française...

.

Notable figures

Notable physicians, researchers, and surgeons who practised at the hospital include Bichat

Marie François Xavier Bichat

Marie François Xavier Bichat , French anatomist and physiologist, was born at Thoirette .Bichat is best remembered as the father of modern histology and pathology. Despite the fact that he worked without a microscope he was able to advance greatly the understanding of the human body...

, Dupuytren

Guillaume Dupuytren

Guillaume Dupuytren, Baron was a French anatomist and military surgeon. Although he gained much esteem for treating Napoleon Bonaparte's hemorrhoids, he is best known today for Dupuytren's contracture which is named after him and which he described in 1831.- Birth and education :Guillaume...

, Hartmann

Henri Albert Hartmann

Henri Albert Hartmann was a French surgeon. He wrote numerous papers on a wide variety of subjects, ranging from war injuries to shoulder dislocations to gastrointestinal cancer...

, Desault

Pierre-Joseph Desault

Pierre-Joseph Desault was a French anatomist and surgeon.He was destined for a career in the Church, but his own inclination was towards the study of medicine; after learning something from the barber-surgeon of his native village, he was settled as an apprentice in the military hospital of...

, Récamier

Joseph Récamier

Joseph-Claude-Anthelme Récamier was a French gynecologist.He was born in Cressin-Rochefort, Ain. For much of his professional career he was associated with the Hôtel-Dieu de Paris, where in 1806 he became chief physician...

, Cholmen, Dieulafoy

Paul Georges Dieulafoy

Paul Georges Dieulafoy was a French physician and surgeon. He is best known for his study of acute appendicitis and his description of Dieulafoy's lesion, a rare cause of gastric bleeding.-Life, studies, and career:...

, Trousseau

Armand Trousseau

Armand Trousseau was a French internist. His contributions to medicine include Trousseau sign of malignancy, Trousseau sign of latent tetany, Trousseau-Lallemand bodies , and the truism, "use new drugs quickly, while they still work."-Biography:A native of Tours, Indre-et-Loire, Armand Trousseau...

, Ambroise Paré

Ambroise Paré

Ambroise Paré was a French surgeon. He was the great official royal surgeon for kings Henry II, Francis II, Charles IX and Henry III and is considered as one of the fathers of surgery and modern forensic pathology. He was a leader in surgical techniques and battlefield medicine, especially the...

, Marc Tiffeneau

Marc Tiffeneau

Marc Émile Pierre Adolphe Tiffeneau was a French chemist who discovered the Tiffeneau-Demjanov rearrangement.Tiffeneau received his Ph.D in science in 1907 and his Ph.D in medicine in 1910....

, among other notable figures.

External links

• Official site (in French)