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La santé des populations civiles et militaires

Élisabeth Belmas
Serenella Nonnis-Vigilante


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Emmanuel Pénicaut. Archives of ministère de la Défense for history of military health department and hospitals (XVIIth-First half of XXth century)

1Archives of military health department are now contained into three main warehouses: the Service des archives médicales hospitalières des armées in Limoges, where are mainly kept invalids individual dossiers and medical archives of hospitals; museum of Val-de-Grâce in Paris, where are stocked incomplete archives and papers collections on Health military department during XIXth century and at the beginning of XXth century; the Service historique de la Défense in Vincennes, where can be found archives of the Hotel des Invalides, individual dossiers of military physicians and archives of Health Military department during XIXth and XXth centuries.

Joël Coste. Hospital admission registries, valuable source documents for historical epidemiology of modern period. Lessons from the study of admission register of the Hôtel royal des Invalides (1670-1791)

2Historical epidemiology deals with the study of the distribution and determinants of disease in human populations of the past by means of statistical methods. This paper focuses on the interest and limits of one of the main sources for the historical epidemiology of modern era: hospital admission registers. Structure, content and methods of analysis of these registers are successively considered and conditions of their use are defined, in order to determine the frequency and the determinants of diseases and health statuses in ancient populations and to analyze their consequences in terms of survival and handicap. The admission register of the Hôtel royal des Invalides (1670-1791) serves as a main example to study a particular occupational population, the reformed soldiers of armies of kings Louis XIV, Louis XV and Louis XVI.

Élisabeth Belmas. The admission conditions in the Hôtel royal des Invalides: social and demographic observations (1670-1791)

3The admission conditions in the Hôtel royal des Invalides are studied through a sample of 11 528 soldiers, extracted from a 10% random poll carried out about 110 000 registrations of soldiers from 1670 to 1791, at the moment of their reception into the famous institution, founded by king Louis the XIVth and devoted to old soldiers and war crippled. Huge success of the Hôtel royal des Invalides forced successive monarchs to increase number of years asked for entering the Hôtel and to externalise boarders, more and more numerous, any time they were still spry enough: they were allowed to take long vacations, they were sent «en détachement», to keep fortresses on boarders and inside country. After 1764, lots of them received a pension of military disability, which was replaced in 1776 by a pension of military reward. The analyze of the 11 528 registrations sample by descriptive statistic methods reveals that typical boarder was a little less than 50 years old, born in France, catholic, bachelor and particularly handicapped by wounds received during wars.

Docteur Michel. Sardet Medical activity and statistics of Naval hospital of Rochefort in the XIXth century

4The navy hospital in the port of Rochefort, a model since 1683, reached its peak in the XIXth century, when the navy medical corps served also in colonies. Doctors and surgeons were renowned for their experience and their works. Among them, Charles-Adolphe Maher drew up during fourteen years, from 1854 to 1867, many statistics about the population in the city and in the hospital. So, the mortality appeared not higher than in the others military ports. The hospital statistics are particularly interesting. If the intermittent fevers (paludism) are 28,5% of the admissions, only 0,11% drive to death, thanks to sulfate de quinine administered in the hospital since 1825. These statistics are a precious picture of medical demography in a maritime city in the second part of the XIXth century.

Claire Fredj. Doctor-patient relations in the French Army during the Second Empire: The case of overseas expeditions

5The Second Empire Army gives us a particularly interesting view on the relations between doctors and their patients: weaponry had changed, several long-distance expeditions brought new physical constraints to the Army, and troops were now recruited among much more diverse populations, with soldiers from Algeria, Senegal, Darfur and Cochinchina. Those groups developed very different attitudes toward «official» medicine – embodied by the army physician – that got imposed on them during their service. The constant sanitary monitoring of soldiers, aimed at assuring a level of health condition to the armed forces, familiarized large groups to «official» medicine. By its administrative duties and the large number of patients under their rule, army physicians thus occupied an intermediate position between a generalizing clinical medicine and a personalized approach to treatment.

Bertrand Thaite. Native medical practitioners in Algeria, 1860-1905

6This article investigates the social and professional status of native medical practitioners whose careers originated in the crises that shook Algeria at the end of the Second Empire, in particular the demographic crisis of the final years of the military rule in the French colony. These life stories illustrate the difficulty of combining knowledge based status and race based identity. The doctors promoted by the governor Chanzy have complex and difficult careers while those promoted by the charities of the Catholic Church are often incapable of returning to Algeria. Far from being neutral, medicine and medical practitioners were at the heart of colonial conflicts.

Gersende Piernas. Introduction to history of military thermal hospitals in France (XVIIIth-XIXth century)

7French military curing, heritage from Antiquity, begins really from the XVIIIth century through a rational organization on the all country, independent of civil curing and reaching gold age during the XIXth century. Hospitals and military rooms in civil hospitals constitute a geographical net, they have their own very expert seasonal medical staff who practises a specific thermal medicine with mixed results but who set an example for civil thermal medicine in France and for civil and military medicines abroad.

Docteur Jean-Jacques Arzalier. The Army Medical Departments in the Crimean War (1854-1856). A Comparative Study on British and French Health Support in the East

8The Crimean War (1854-1856) was the result of the protection offered to Turkey by United Kingdom and France. Casualties and suffering experienced by the soldiers mobilized public opinion, especially in England. Disparity among French and British health services fails to explain the losses which were mostly illness rather than fighting related. Logistical deficiencies during the first winter (1854-1855) reduced the British Army to one third of its nominal strenght. The following winter, although all fighting has resumed, typhus fever striked the French Army confounded by overcrowded camps and deficient sanitation. With the public opinion acting as a catalyst, the Parliament and Royal Commission moved the War Department towards required reforms. As the French lack their ally capacity to openly examine their own mistakes, the subsequent Second Empire military campaigns will bear the consequences of this flaw…

Stanis Perez. Court physicians and cinchona during XVIIth and XVIIIth centuries

9Known and used in Europe since the XVIth century, cinchona is a drug which fantastic spread is basically linked with the court physicians and its network. After a perilous beginning and many controversies about its real powers, the «Jesuits powder» enters finally at court and quickly wins a royal guarantee: after the recovery of the king, this one became the best protector of the peruvian drug.

10The king physicians took the opportunity to advertise for an expensive remedy but rather efficient… even if forgeries were numerous! Under Louis XV, cinchona rise carries on and succeed in becoming the febrifuge par excellence. Always expensive, it becomes very interesting as the Crown biopolitical policy was growing.

Isabelle Robin-Romero Étienne-François Geoffroy (1672-1731): A phisician between Académie royale des sciences and practical of medicine

11É.-F. Geoffroy, entered in 1699, whereas he was still medical student, to the Académie royale des sciences in Paris as an élève of Guillaume Homberg, the Chemist. Once installed as doctor, he chose the Academy and teaching to the Collège royal and to the Jardin Royal rather than a career at the court. One will wonder how these activities of scientist and physician could influenced one on the other. The bonds between science, diffusion of the knowledge and practical of medicine will be examined by showing how Geoffroy formed part of the networks of scientific exchanges, in and out of the Academy, and how his studies and readings could influence his daily practice of doctor.

Claire Barillé. Hospital in working class areas in Paris

12French hospitals display a significant evolution at the end of the XIXth century. While still held in bad esteem, their registers of entries show a contrario a huge attendance in poor districts, where new hospitals are built such as the Lariboisière hospital in the 10th arrondissement, or the Tenon hospital in the 20th arrondissement, or even the new Hotel-Dieu rebuilt in the center of Paris in 1877.

13The increasing number of patients matches the demographic growth of Paris but can also be explained by rather easy and free admissions as well as the settlement of the hospital in close vicinity. The dwellings of the patients utterly outlines the hospital as institution of proximity.

14Gender and age lead to different uses of the institution: men are mainly concerned by breath or traumatic affections while women come not only for breath affections but for maternity issues as well. Death rates prove that health condition worsens for men admitted to hospital when compared to females figures. Age of patients accounts for an overrepresentation of the 20-30 year-old, whose respiratory diseases and traumatic accidents mean manual and dangerous jobs.

15Paris hospitals get more specialized and welcome various audiences for betterknown pathologies and shorter cure duration, depicting medicalization as a thorough process in urban societies at the end of the XIXth century.

Chiara Devoti. Archives sources and architectural designs for hospitals of the Ordine Mauriziano (XVIIIth-XIXth century)

16The paper analyzes the importance of the Ordine Mauriziano, a knightly order offering hospital services in an important pre-unitary state in Italy, ruled by the Savoy monarchy, and controlling the assistance in main cities, like the capital, Turin, and some strategic towns (Aosta, Lanzo, Valenza, Luserna San Giovanni and Sanremo). Archive sources help to define the role of the internal rules and the relationships with architectural designs to provide a modern assistance and to manage the quest for an hospital that meets the patient’s needs.

Serenella Nonnis-Vigilante. Complaints and demands, a source for history of doctor-patient relations in France during XIXth and XXth centuries

17From the XIXth century onwards the ancient hospital world was modified in depth by the rise of clinical medicine and the consequences of germ theory. New laws opened the doors not only to pauper patients but also to paying ones. Thus as secular medical staff asserted their demands for social and scientific recognition, the patients themselves demanded to be respected as sufferers and patients as well as individuals with rights to free treatments. Their complaints and demands are a unique source to explore the complex emotions running through the hospital world and the emergence of less unequal power relations between medical staff and patients.

Olivier Faure. Foundation and development of private hospitals in France from XVIIIth to XXth century

18Quite ignored, the history of private hospital is older than one could imagine. In fact, the first private institutions were founded at the end of the XVIIIth and the beginning of the XIXth. They were devoted to the people who were not received in the public hospitals for different reasons (lack of places, attempt to expel chronic and incurable diseases from the wards). The second generation was formed of confessional hospitals which, for ideological causes, made concurrence to the public institutions. The third generation (end of the XIXth) was made up of medical or surgical clinics technically efficient but very expensive. For sick people who were too proud to go to the poor hospital but too poor to pay the clinics the friendly societies opened half a dozen of specific hospitals.

© Presses universitaires du Septentrion, 2010

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