Sunday, March 05, 2006

The deity and the drains

Two hundred years ago, the Hotel-Dieu in Paris was perhaps the best hospital in the world, catering to several thousand patients. Over a door of the hospital were inscribed these words: C'est icy la Maison de Dieu, et la Porte du Ciel, "This is the House of God, and the door to heaven."

The door to heaven, indeed! The death rate at the Hotel-Dieu was one in four. Three patients to a bed was the rule; the middle patient's head lay between the feet of the patients to either side.

Sheets were washed once a month by novice nuns, who soaked the laundry in the polluted waters of the Seine, then banged out the crusted soil with a kind of spade.

Physicians and nursing staff at the Hotel-Dieu served their patients bravely and unselfishly, but matters of life and death were thought to be in the hands of God. Prayers and processions were the primary regimen for effecting cures. Not much changed in this regard until Florence Nightingale began her hospital reforms in the 19th century, emphasizing separation of wards, cleanliness and ventilation.

The English writer Lytton Strachey said of Nightingale that she seemed "hardly to distinguish between the Deity and the Drains," that is, between religious faith and scrupulous elimination of agents of infection. Only when the Drains -- scientific medicine -- became paramount did hospitals enter the modern era.

See this week's Musing.