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Bulletin of the History of Medicine 75.4 (2001) 796-797



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Book Review

Soigner et consoler: La vie quotidienne dans un hôpital à la fin de l'Ancien Régime (Genève 1750-1820)


Micheline Louis-Courvoisier. Soigner et consoler: La vie quotidienne dans un hôpital à la fin de l'Ancien Régime (Genève 1750-1820). Bibliothèque d'histoire de la médecine et de la santé. Geneva: Éditions Georg/Médecine et Hygiène, 2000. xvi + 381 pp. Ill. Sw. Fr. 49.00; FF 200.00 (paperbound, 2-8257-0694-9).

The history of the hospital is a genre that has recently blossomed. If used imaginatively, it permits access to the life of a major municipal institution, its administration, finance, and provisioning; to the health-care professions, the hospital ministry; to clinical teaching and research; and, of course, to patients, selected diseases, and their treatments. A revised dissertation that covers the [End Page 796] Hôpital Général of Geneva during the years of the French Revolution and the Napoleonic era thus leads us to expect a detailed analysis of a municipal institution during an epoch of dramatic upheaval and change. We are indeed offered a close look at hundreds of Genevans, both the dispensers and the recipients of health care--in a Protestant, theocratic Republic.

The layout of the subject matter is at first sight surprising: four of five chapters deal with hospital admission, administration, personnel, and patient discharge. Only in chapter 4 does the patient encounter the physician. We learn that this hospital, founded in 1535, was a traditional charitable institution that catered to social as much as to medical needs: it also cared for orphans and foundlings, beggars and vagabonds--usually locked up in the "Discipline," as were the mentally ill (p. 53) and the venereal patients (p. 60). Geneva was a small city, with 27,400 inhabitants in 1790, and the Republic was tightly controlled by the Calvinist consistory. Indeed, one syndic, one councillor, eight directors, and one pastor--none of them physicians--held undisputed sway over every aspect of hospital policy: they admitted patients only if their piety matched their pain. They belonged to an oligarchy of seventy-nine families powerful in banking, justice, and politics who used a stint of hospital administration as a springboard to other public functions (pp. 89-92). Medical innovation was tried at the administrators' whim: one trustee initiated a campaign against infant mortality, another sought a cure for epilepsy, others favored secret remedies (pp. 104-7), but it appears that no physician or scientist was associated with these initiatives.

In fact, Geneva did not have a medical faculty--though the author repeatedly mentions local medical societies, she does not explain their function. Geneva boasted a number of physicians with European reputations: Samuel Tissot, Gaspard de La Rive, Louis Odier, Louis Jurine. Only Abraham Joly was deeply involved in hospital work. Genevan physicians had no admitting privileges until 1840. How, then, did they care for their indigent poor? By keeping them out of the hospital. The author informs us that the hospital employed three physicians in the eighteenth century, two of whom were assigned to make house calls, and the same applied to surgeons (p. 222). Some chronic patients, mentally ill, orphans, and foundlings were cared for in the country (pp. 252-53).

The main innovations seem to have come with the annexation of Geneva to France between 1798 and 1815. The author mentions the introduction of soup kitchens in 1800 and a welfare office in 1803 (p. 20); the opening of a preparatory school for medical students, midwives, and health officers in 1803 (p. 197); the establishment of a maternity hospital in 1808 (p. 67). For the Geneva hospital, she argues, the French intrusion was but an interlude; in 1815, the Genevans merely "blew on the embers" to revive their traditions (p. 95).

This book offers a close look at the experience of hundreds of ill Genevans, and a...

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