The Hôtel-Dieu (; "God Shelter") is a public hospital located on the Île de la Cité in the 4th arrondissement of Paris, on the parvis of Notre-Dame. Tradition has it that the hospital was founded by Saint Landry in 651 AD, but the first official records date it to 829, making it the oldest in France and possibly the oldest continuously operating hospital in the world. The Hôtel-Dieu was the only hospital in the city until the beginning of the 17th century.
The original Hôtel-Dieu stood on the banks of the Seine on the southern side of the Île de la Cité. It was ravaged by fire several times and was rebuilt for the last time at its present location on the north side of the parvis of Notre Dame between 1867 and 1878, as part of Haussmann's renovation of Paris.
Nowadays operated by Assistance publique – Hôpitaux de Paris (AP-HP), the Hôtel-Dieu is a teaching hospital associated with the Faculté de Médecine Paris-Descartes.
History
Overview
Originally, the Hôtel-Dieu admitted a wide range of people: not only the sick and injured, but also needy travellers and pilgrims, and indigents. Run by the Catholic Church for many centuries, the hospital's original mission was to provide "Christian charity dedicated to the shelter, spiritual comfort and treatment of the ailing poor.":44 An 18th century essayist, Louis Rondonneau de la Motte, wrote in his Essai Historique sur l'Hôtel-Dieu (1787): "the citizen and the foreigner, the Christian and the Turk, the Jew and the Idolater are all equally welcome."
This broad, charitable mission was to dominate until the end of the Ancien Régime. By 1789, the Age of Enlightenment -- with its focus on the pursuit of knowledge via reason and evidence and on ideals such as progress, fraternity, and government dedicated to the well-being of the people -- had left its mark on the agenda for hospital reform. This ushered in a more scientific approach to hospital design that was to influence medical practice and management for more than a century. During this process, the role of the Catholic Church was diminished and then eliminated and the Hôtel-Dieu became a publicly run institution.
Middle Ages
Although tradition dates the founding of the Hôtel-Dieu back to Saint Landry, 28th bishop of Paris around 650, the first official records of an institution whose mission was to care for the destitute, infirm and sick date to 829. In 1157, letters patent mention a "Hôtel-Dieu-Saint-Christophe", referring to a chapel dedicated to this saint. Shortly thereafter, in 1165, Maurice de Sully, bishop of Paris, undertook the reconstruction of this hospital: the old buildings were destroyed in 1195 and the new constructions were completed in 1255. At that time, the buildings of the Hotel Dieu occupied the south side of the Ile de la Cité near Notre Dame.
In its first several hundred years, the Hôtel-Dieu functioned as a general purpose charitable institution operated by religious orders — it offered food and shelter in addition to medical care to needy people. This mixed social mission characterised its services for many centuries and was imitated by many other cities (for example, the Hôtel-Dieu de Beaune, founded in 1443).. However, by the 16th century, admission to the hospital was available only to the sick and injured and to pregnant women.
From the time of Louis IX onwards, the Hôtel-Dieu often housed more patients than it was designed to hold, leading to serious problems of overcrowding that would hamper the effectiveness of the hospital for centuries. From the 15th to the 16th centuries, it went from 303 beds to about 500, but the number of patients would regularly hover around 700 and would often exceed 1500 during times of conflict, food shortages or epidemics. It is estimated that the number of admissions was 25,000 per year during the 16th century.