First edition of this highly significant document on the state of Parisian hospitals at the end of Louis XVI's reign, written by Jacques Tenon (1724–1816), surgeon at the Salpêtrière, which remained an influential reference for French hospital policy through to the Third Republic.
The work is complete with its 17 folding plates (including 2 tables and 14 architectural plans and elevations of hospitals).
Some light foxing; the copy appears to have been rebound in this later binding.
Contemporary pastiche binding in half Havana sheep, flat spine with gilt fillets and the gilt cipher and arms of the Chodron de Courcel family, green paper-covered boards, marbled endpapers and pastedowns.
The composition of this text took place within the framework of a public debate on the future of the Hôtel-Dieu hospital in Paris.
In the 18th century, the Hôtel-Dieu was notoriously overcrowded, unsanitary, and prone to fires. It was used almost exclusively by the destitute who had no other care options, and it had gained a reputation as a "death trap" due to its dire conditions and high mortality rate. Two major fires had occurred in 1737 and 1772, the latter destroying much of the complex. In this context, the Baron de Breteuil, Secretary of the King’s Household, commissioned the Académie des sciences to investigate; Tenon's report was the outcome of that consultation. The text comprises five memoranda:
- General overview of Parisian hospitals
- Architecture, organization, and outcomes of the major hospitals in Paris
- Location, surface area, and optimal sites
- Description and organization of the Hôtel-Dieu in Paris
- Architecture and organization of a hospital intended to replace the Hôtel-Dieu. Tenon counted 48 hospitals in Paris, excluding the smallest institutions: 22 hospitals for the sick, 20 for able-bodied paupers, and 6 for the indigent (sick or otherwise). He also mentions a hospital specifically for Protestants. Their legal status was complex: some were what we would now call public (under the authority of the King, the City Hall, the Archbishop...), others private (run by religious congregations or funded by lay donations for orphans and the needy). Tenon finally proposes the creation of a purpose-built hospital—what he calls a “healing machine”—a measurable structure subject to management and evaluation. It would be based on principles such as visibility (patients should be distributed so that they can be seen, distinguished, evaluated, and compared), and adequacy and appropriateness in terms of rest space, air circulation, and separation of patients and diseases (isolation of the contagious).