Hôtel-Dieu of Québec when Estienne arrived in Nouvelle France

Understanding the beginning of the XVIIIth century hospital
In Nouvelle France the hospital has nearly nothing to do with the XXth or XXIst century’s. Just to get a better understanding, one must go back to the origin of the word which is the same as for the words host, hotel or hospitality. In the colony, the hospital takes in, comforts, nourrishes; it gives plants medicines that comes from ancient knowledges, but it does not try to heal the body -only the soul. It takes care of the body and of the soul.

But the hospital-that-does-not-cure is a bit more complicated than what I tell you. There are two types of hospitals: the general hospital and the hotel-Dieu (God’s house). «The hospital takes in the poor, while the hotel-Dieu takes in the sick (Lebrun 82, free translation).» Both comes from the need for Christians to be a living example of charity, mercy, compassion, François Rousseau tells us in a beautiful book, La croix et le scalpel (The Cross and the Scapel - not translated in English). Hence the general hospital and the hotel-Dieu shares the goal to take in all the destitutes, the first society’s destitutes, the last health’s destitute. General hospital takes in powerless, paupers, travellers. Hotel-Dieu takes in anyone provided they are sick. Both greets each and everyone as if he was a living, suffering representative of Christ.

In France and in the colony, in the beginning of the XVIIIth century, the general hospital changed surreptitiously its goal. With time, with growing hardships, with life ordeals and great pauperty without any relief in sight, the destitutes give up hope and stop trying to make ends meet. Their growing number is a direct menace for public morality and for law and order. Less and less they are useful as the good conscience of the rich who were able to show they were good christians (even though they demanded in return the poors and the religious pray for them each day). So general hospital becomes an institution where to lock away the destitutes of all sorts (like La Salpêtrière in France). Out of sight they are no more a menace for the social body. In the general hospital those who can work are incited to do so while all the others are hidden (Lebrun 82).

The hotel-Dieu keeps taking care of the sick even though with time the sick will have to pay a share of the financial burden. Thus, the army will have to pay for his soldiers, the captain of the vessel for his seamen, the employer for his employees and his servants, the congregation for its priests and its nuns. All of the others will give what they can and what they think is a fair share.

Finally the hotel-Dieu does not have a lot of beds; it can only take in forty people or so, but many more during a time of epidemic. During the smallpox epidemic of 1702, the hotel-Dieu would take in about fifty people each day (Rousseau). The sick themselves are about 25 years old - just like Estienne-, four out of five are men (Rousseau 80). During an epidemic they lay two or three in a bed and the gravely ill, those that vomit and have diarrhea get to lay together on the straw: it is easier to throw away and replace straw than it is with a mattress filled with sheep wool. Those laying there "are constantly exposed to have relapse or catch a new variety of disease after the one that was cured (Lebrun 84)." This is also the place where they place those who are dying.

In his book, François Rousseau does not talk about those straw «beds» neither of this practice during the epidemics. However François Lebrun develops many pages on the topic. It seems evident with such a limited number of beds that more than one sick occupies one bed when the number of the sick surpass the number of the beds: "our hospital was so filled with sick people that it was impossible to take them all in, impossible to take them all in in a heated place, hence we had to put them in the choir [of the chapel]."

Image source :

Text sources :
François Rousseau, La croix et le scalpel, Histoire des Augustines et de l'Hôtel-Dieu de Québec, Tome I : 1639-1892, Sillery, Septentrion, 1989,
François Lebrun, Se soigner autrefois; Médecins, saints et sorciers aux XVIIe et XVIIIe siècles, Paris, Seuil, coll. Points Histoire, # H 193, 1995.
Georges Vigarello, Le propre et le sale, L'Hygiène du corps depuis le Moyen Age, Paris, Seuil, Points coll. Histoire, # H92, 1985.

Abbé Henri-Raymond Casgrain, Histoire de l'Hôtel-Dieu de Québec, Québec, Louis Brousseau, imprimeur-libraire, 1878.

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