The General Hospital of Paris () was an Ancien Régime institution intended as a place of confinement of the poor. Formed by a royal edict during the reign of Louis XIV, it aimed to address the recurring problem of begging and the Cour des miracles, as well as to house invalids. The General Hospital's authority stretched beyond its premises to include all the poor in Paris.
The hospital serves as a major point of analysis in philosopher Michel Foucault's seminal work, Madness and Civilization.
Founding
Like the other western European states, France dealt with an increase in mendicancy beginning in the sixteenth century. This increase fueled anxiety about maintaining social stability and motivated the creation of more severe penalties for begging, such as branding, whipping, and forced labor. In the years prior to the establishment of the General Hospital, the devastation of the Fronde resulted in a particularly large influx of beggars into Paris. The growing population of beggars was approximately 40,000 people, many of whom were refugees impoverished during the wars. This amount would have constituted roughly 10% of the Parisian population.
To alleviate such destitution, in 1652 the Company of the Blessed Sacrament, an active French Catholic secret society, started relief efforts centered around the development of a charitable storehouse. However, after the wars' conclusion, the company decided to advocate for a policy of confinement, a more long-term solution to the city's poverty and mendicancy. The company had taken an interest in confining the Parisian poor ever since 1633, impressed by apparent successes of the first General Hospital in Lyon. However, this proposed solution also had precedents within the city itself. For instance, from 1612 to 1618, the Hôpital des Pauvres Enfermés—an early attempt at building a Parisian general hospital—locked up local beggars and subjected them to a system of forced labor. However, this effort was short-lived due to financial difficulties, political conflicts, and a sharp increase in the refugee population, among other challenges. Later on, in 1632, the Parliament of Paris again began to apprehend beggars, this time using them as forced laborers for the city sewers.
Consequently, the idea of confinement had already been introduced when Christophe du Plessis-Montbard, a devoted member of the Company of the Blessed Sacrament, began to work with the Parliament in 1653 on developing plans for a new Parisian general hospital. Also instrumental in shaping these plans were Les Dames de la Charité, an organization of wealthy lay women led at the time by Marie Madeleine d’Aiguillon. The General Hospital of Paris was ultimately established three years later in 1656 by a royal edict of Louis XIV. The hospital was endowed not just with authority on its own premises, but also with jurisdiction over all the poor residents of the city.
Michel Foucault identifies the founding of the Parisian General Hospital as a key moment in the continent-wide trend towards confining the poor. Similar establishments were founded during the same time period in modern-day Switzerland, United Kingdom, Poland, Germany, Russia, and Ireland.
Operations
Facilities
The Parisian General Hospital was structured as a consolidation of a number of existing institutions under shared mission and management. These establishments initially included the Maison de Saint-Louis de Salpêtrière, Maison de Saint-Jean de Bicêtre, Notre Dame de La Pitié, La Savonnerie, and Scipion. However, Maison du Saint-Esprit and the Enfants-Trouvés were soon added and Savonnerie dropped. In 1670, a royal edict also added the Foundling Hospital, to house abandoned children. By 1680, the General Hospital had expanded to encompass a total of nine different institutions. Many of the hospital's constituent institutions had previously served as charities for different indigent groups.
Although the General Hospital was not a medical facility, a resident physician was hired to make regular visits to the various constituent institutions. Eventually, beginning in 1780, physician Jean Colombier began to introduce a substantial expansion to the hospital's medical apparatus in his capacity as the royally-appointed inspector of hospitals and prisons. He created facilities staffed with medical personnel at Salpêtrière and Bicêtre. Beginning at an earlier time, the General Hospital also contributed to medical research by a confidential arrangement whereby dead prisoners from Salpêtrière could by used by researchers at the Royal Garden of the Medicinal Plants as cadavers (French: Jardin royal des plantes médicinales).