NAVAL HOSPITALS

The French Navy developed considerably during the latter half of XVIIth century under Louis XIV and his minister Colbert. The countless military engagements demanded increased efforts from the ports and arsenals. The health service was also very much in demand and the Naval hospitals met a necessity which was more than obvious with all the accidents, injuries, illnesses and epidemics which affected not only the staff on board but also those working on land. A hospital had already been set up in Rochefort when the port was founded in 1666, at the Priory of Saint-Eloi in Tonnay-Charente while in Saint-Mandrier the Royal Infirmary of Saint-Louis was already in operation. It was at this time that the court order of 23rd September 1673 decreed the creation of two hospitals, one in Rochefort for the West, and the other in Toulon for the East and marked the official start of hospital institutions. But it was not until May 1683 that the Rochefort hospital, known as the « Charente » hospital, adjacent to the Magasin aux Vivres (Quartermaster's Store), took over from the previous establishment while the first stone of the hospital in Brest was laid in February 1684. The hospitals in the other ports were created a little later.

The great ordinance of 13th April 1689, the true naval and military code, deals in its book XX with the hospitals of the naval forces and ports. Besides administrative regulations, the respective functions of head physician, surgeon major and the apothecary were clearly defined. To train young surgeons, a School of surgery attached to the hospital was founded in Rochefort in 1722, to be followed by those of Toulon in 1725 and Brest in 1731.





EVOLUTION OF NAVAL HOSPITALS

These naval hospitals were a hive of activity all through XVIIIth century during the War of the Austrian Succession (1744-1748), the Seven Years War (1756-1763), the American War (1778-1783) and the typhus and scurvy  epidemics imported by the squadrons of the chevalier de Piosin in 1745, those of the duc d'Anville in 1746, Admiral Dubois de Lamotte in 1757 or Admiral d'Orvilliers in 1779, not forgetting local epidemics such as those related to intermittent fevers (malaria) in Rochefort from 1778 to 1782.

The education provided in XVIII° century

These hospitals owed their reputation largely to their schools of surgery which provided a complete, theoretical education, but also one which was practical and gave a wide experience of anatomical dissections. Several rules governed the operation of these schools in 1737, 1740 and above all in 1768. The progression of pupils from one class to another was subject to an exam and to reach the grade of « entretenu » (Maintained by the King) you had to pass the formidable ordeal of the dual subjects of anatomy and surgery. Teaching was performed under the supervision of the surgeon-major for medical subjects and botany, of the surgeon-major for general operative surgery and surgery while the demonstrator supervised dissections. In 1756 each port had, apart from the medical officer, a surgeon-major assisted by an assistant-chief warrant officer and 24 king's surgeons, quite apart from the pupils. The prisons of the main ports brought a large number of subjects for dissection and sometimes also nursing staff. Naval hygiene subsequently became a major preoccupation and was the subject of specific regulations in 1765, 1780 and 1786. The naval hospitals were also provided with botanical gardens, for the supply of medicinal plants and also the education of the pupils.

Evolution in XIXth century : naval and colonial medicine

After the unhappy period of the Revolution, the contradictions of the Directoire and the grey days of the Empire, the situation of the health service gradually returned to normal under the Restoration despite the dismissal of medical assistants and a cutting-down on Bonapartist managers. The naval health service encompassed the colonial health service from 1823. There were therefore 389 health officers in the corps in 1835 of whom 80 were assigned to the colonies. The ordinance of 1835 and the decrees of 1854 and 1865 adopted measures relative to the independence of the health corps, the assimilation of its members to navy officers, their grades and promotion. The medical progress developed during the second half of XIXth century was immediately incorporated into naval hospitals. The discovery of the main pathogens, use of asepsis and anaesthesia were to create a genuine revolution in the treatment of medical diseases and above all those involving surgery. It is interesting to note that Jennerian vaccination had been adopted as early as 1817, and that quinine sulphide had been used since 1835 in the treatment of intermittent fever.

The year 1890

1890 was to see the creation of a colonial health Corps independent from the Navy health corps and also that of an Principal School of the Navy Health Service in Bordeaux which effectively relegated the naval medical schools in the ports of Rochefort, Brest and Toulon to the rank of « annex » schools in charge of preparing pupils for the entrance exam into the main school. An navy health service officer's training school was opened in Toulon naval hospital in 1896.

Current evolution

Later the reorganisation of medical studies and the merging of the various health services into a French Armed Forces Health Service led to the « annex » schools being abolished in the ports, and lessons were suspended from 1st October 1963. Rochefort naval hospital survived this for twenty years before being closed down in 1983. The hospital in Lorient closed down in 1999 and in Cherbourg in 2002. The only hospitals currently in activity are the Military officers' training hospitals in Brest and Toulon in the framework of the currently unified French Armed Forces health service.

 




ROCHEFORT NAVAL HOSPITAL

The « Charente » hospital, opened in 1683 and made up of a main building and two small wings, was capable of receiving 400 patients spread over 4 wards 10 years later. Jean Cochon-Dupuy (1674-1757), who had been physician-in-chief of the port since 1712, was soon planning the setting up of an establishment capable of teaching young surgeons and « where they could learn anatomy and how to perform surgical operations but also acquire knowledge of internal diseases and the composition of remedies ». The School of Surgery of the port of Rochefort, finally created in 1722 within the walls of the "Charente" hospital, was the first of its kind in the kingdom. The botanical gardens created near the river Charente in 1741 were extended in 1827.

Gaspard Cochon-Dupuy (1710-1788) took over from his father in 1757 as physician-in-chief and director of the School of Surgery. When he died in January 1788, he was replaced by his cousin Pierre Cochon-Duvivier (1731-1813) who did considerable work towards better hygiene. In the same year, on 9th June 1788, the new hospital designed by the engineer Toufaire, was solemnly inaugurated, and in its wake the School of surgery. This monumental building built on nearly 7 hectares of land and designed to receive 1200 patients, included a central H-shaped building whose cross-bar was approximately the same length as the longitudinal parts, which were themselves used for hospitalisation. At the front of this unit, two small wings standing on their own, housed on the one hand, Management with the salle des Actes, the salle du Conseil de santé, the library (the biggest outisde Paris) and the museum, and the other the chefferie of the hospital.

The Rochefort naval medical school was to see its heyday in XIXth century thanks to important personalities such as surgeon Jean-Baptiste Clémot, naturalists Jean-René Quoy and René-Primevère Lesson, doctor Amédée Lefèvre who eradicated lead-poisoning in the French navy, Charles Maher who compiled impressive medical statistics or Louis Tribondeau who co-authored major works on radiation with Bergonié. On the other hand, the great naval expeditions and the colonial campaigns highlighted the careers of a number of doctors and chemists due to their findings in the fields of natural science or tropical pathologies.


Naval hospital of Rochefort

In 1890, Rochefort naval medical school, which had become an « annex » school following the creation of the Ecole de Bordeaux, was to devote itself to its new vocation of preparing students for the entrance exam to the Ecole principale. Theoretical lessons, hospital internships and practical work remained the classical combination which guaranteed a serious and complete medical training. In 1910 the capacity of the naval hospital was 350 patients with a daily inpatient flow of around 220. Their annual number varied between 3 000 and 4 000. The numbers of deaths did not exceed 40, one third of those being due to tuberculosis. Malaria had all but disappeared from the region at the time. Lastly, drilling carried out within the walls of the hospital in 1865 revealed a thermal spring composed of chloro-sulfate ferruginous mineral water which was to have many therapeutical applications. This hospital bore the name of Amédée Lefèvre (1798-1869), who was responsible for the eradication of lead-poisoning from the navy and who was the author of the remarkable history of the military naval health service, published in 1867.

After the closing down of the Annex school in 1963 and that of the naval hospital in 1983, the town of Rochefort turned an important page in its history. Fortunately, the memory of this prestigious past was saved by the creation of the Museum of the Former navy school of medicine, which has been managed by the National Navy Museum since 1986. Its remarkable library with its 25 000 volumes recalls the brilliant teaching provided here while the Cabinet of medical curiosities shows a battery of medical instruments, items and anatomical preparations and the natural history cabinet exhibits a number of objects brought back from XIXth century expeditions.





NAVAL HOSPITALS IN TOULON


Naval hospital of Saint Mandrier

The infirmerie royale de Saint-Louis, built on land purchased from the priory of the peninsula of Saint-Mandrier, and which was operational from 1674 and extended in 1701, soon became a real hospital which operated at the start intermittently according to the epidemics (plague and typhus) and wars overseas, and then permanently from 1783. The priory itself, declared a national Asset, was acquired in 1790 to complete the establishment.

Founded on the spot in 1818, the new hospital was made up of three buildings laid out in a U shape open to the north, and on three levels. It was used to treat the victims of typhus and cholera epidemics and the ill and wounded of the Algerian campaign and the Crimean War. The hospital of Saint-Mandrier still rendered eminent services by taking in the wounded of the war of 1870 and the Great War. It benefited from the transfer in 1849 of the naval botanical gardens which had initially been set up in Toulon. However, the fact that it was not located in a central position posed a number of problems and it therefore ceased all activity on 20 June 1935 in favour of the hôpital Sainte-Anne.

Work on Sainte-Anne naval hospital began in 1906 after public adjudication of land located on the slopes of mount Faron, above the fortifications of the town. Built in a series of wings, it was first and foremost made up of nine big buildings with terraced roofs, large windows and very high ceilings, erected on the median part of the site. Work was finished in 1909 and the first patients arrived in 1910. Shortly afterwards, it received the wounded from World War I (which implied an increase in capacity to 1 000 beds) and later extended from 1832 to 1834 in the southern zone with the building of three new buildings of which the biggest, the Béranger-Féraud wing, in the shape of a cross of Lorraine, had 5 floors. The hospital thus extended had remarkable medical equipment for the time and high-class staff. In 1938 there were 12 500 patients with an average daily occupancy of 686 patients. Further developments were carried out during World War II and a maternity opened in 1941 in the Penard-Abelin wing (closed down in 1999). The hospital was partially occupied by the German and Italian health services after the invasion of the southern zone but returned to full operation at the end of the war with a capacity of 850 beds and a staff of 600 including 37 doctors, 4 pharmacists and 3 midwives. It became a French Armed Forces training hospital in 1967, and a number of innovations were implemented in the field of resuscitation and intensive care, cardiology, orthopaedic surgery, nuclear medicine, radiology or neuro-surgery. Its teaching vocation which began with the school of surgery and later with the Annex school of naval medicine and the l'école d'application des médecins de marine1 is still highly relevant with the training of army interns, assistants and speciality entrance exam preparation. The new hôpital Sainte-Anne, built on the other side of the boulevard on the site of the Grignan barracks for the Sainte-Anne 2000 project, this time designed as a single block, groups together the various wards and bodies of the military health service as well as the French armed forces paramedical staff school. To this can be added that the hôpital de l'Oratoire which housed a phtisiology ward before becoming a convalescent home in 1973 and later a department of physical medicine, rehabilitation and care in 2000.




BREST NAVAL HOSPITAL

From 1631 to 1684 the naval hospital assistance used existing local resources such as the hôpital Saint-Yves and the Vieil hôpital or temporary structures. The need for a permanent hospital was clear, work on the Royal Naval Hospital started in March 1684. Originally designed to receive 2 000 patients, the building was built at the top of the west bank of the Penfeld river, laid out in the shape of a U on three levels with a wing on each side. It was completed in 1690 by the building of extra wards for convalescents and patients suffering from scurvy. In the foreground a garden of simples had been planted on terraces (1694) but the garden was transferred in 1768 to a larger neighbouring site where it considerably developed under the reign of the gardeners Laurent, father and son. The school of surgery in Brest, created by an ordinance in 1731, contributed towards the fame of the hospital and its pupils had a number of subjects available for dissection during the transfer of the Marseille penal colony in 1749. After the vacuum left by the Seven Years War, the school was to find a new impetus from 1768 under the influence of physician-in-chief Chardon de Courcelles (1705-1775). It took the name of Royal naval college of surgery in 1775 before becoming Naval Health School in 1798. In November 1776 a terrible fire ravaged the hospital and the enormous damage suffered imposed the use of temporary measures. All that was left were a few « bad wards » rebuilt in a hurry but they did not allow the hospital to receive much more than 800 beds in 1794, and it was therefore necessary to use extramural temporary hospitals.

he new naval hospital, rebuilt on the site of the « burned hospital », saw its first stone laid in 1822 by the duc de Clermont-Tonnerre, minister of the navy, but it was not put in service until 1834. This infrastructure with its 200 beds, spread over 28 wards, operated in this way until World War I, without any major modifications, in spite of the increase in activity due to the 1870 war. The service was ensured by the sisters of Wisdom up to their expulsion in 1903 following the passing of the anticlerical laws whereas the naval nurses corps created by the decree of 19 March 1853 made it possible to efficiently replace the use of galley-slaves after the closing down of the penal colony in 1856. In the wake of the mobilisation of the 1914-1918 war, Brest had 4 350 beds which rose to 6 000 in 1917. The naval hospital itself provided 1 780 beds at the height of the demand for hospitalisation in 1917, others were provided by 2 temporary naval hospitals and 20 extra military hospitals and assistance companies. In May 1940 the hospital had a capacity of 1385 beds, before it was occupied by the Germans in June. Totally destroyed in 1944, Brest naval hospital of was rebuilt from 1952 and in 1968 it returned to its initial name of Clermont-Tonnerre before taking on its current name of Armed Forces Teaching Hospital. A number of improvements and modernizations carried out since that time have given it a high technical level in the service of the naval and civil population of the port. Besides physician-in-chief Chardon de Courcelles, famous names such as Keraudren, Marcellin Duval, Albert Calmette or Victor Segalen are connected to Brest naval hospital.


Brest naval hospital




THE LORIENT NAVAL HOSPITAL

The first naval hospital in the region was installed in Port-Louis around 1689 but this hôpital Saint-Louis, which had a capacity of approximately 180 beds in 1705, was closed down in 1720. It was replaced at the Revolution, still in Port-Louis, by a new hospital set up within the former walls of Les Récollets, which was also short-lived and abandoned in 1805. It was then decided that the patients would be treated in the hospital-hospice in Lorient at the end of a contract which was to be renewed up to 1865 but, in order to relieve congestion, an « ambulance » was created in the premises of the former naval hospital of Port-Louis in 1859 (270 beds in 1905) which was to remain in service up to 1936. In Lorient itself, another « ambulance » was installed in 1864 within the walls of the arsenal, soon to be completed by a wing for the wounded, a laboratory and an operating theatre. But the war of 1870 and that of 1914-1918 highlighted the insufficient capacity and in 1829 plans were afoot to build a real hospital near the cours de Chazelles. This hospital, started in 1933 and finished in 1936, was the twin of its civil counterpart, the hôpital Bodélio. This was a single building built on 4 levels in the middle of grounds, with branched wings on either side. Occupied by the German authorities in 1940 and partially destroyed by bombing in 1943, it was reinstated in 1945. It became the French Armed Forces Hospital in 1969, and in 1986 the former naval hospital of Lorient took on the name of Albert-Calmette Regional French Armed Forces hospital, from the name it had already had since 1983 in memory of the famous bacteriologist. This establishment of 235 beds underwent a series of modernizations including the operating theatre and the accidents and emergency ward. However, in the scope of the great health service reforms, this establishment was closed down on 23 July 1999. The infrastructures returned to the town to be assigned to the centre hospitalier de Bretagne sud Bodélio.




CHERBOURG NAVAL HOSPITAL

A first hospital, l'hôpital de l'Abbaye, was installed in 1793 on the edge of Equeurdreville, with a capacity of 500 patients. Later a naval artillery barracks was transformed in 1856 into a 200-bed hospital known as the « Succursale » which operated for 13 years. In February 1859 a decree was signed ordering the building of a new hospital on 10 hectares of land, rue de l'Abbaye. This was started immediately but final delivery was effective only in 1871. An isolation ward for contagious patients, a bacteriology laboratory and a radiology service were installed in 1900, and a modern operating theatre was set up in 1911. During the 1914-1918 war, the hospital received 49 000 patients or wounded. The administrative wing is a magnificent building over 200 metres long, with a triangular pediment marked with the imperial arms, on 3 floors. In front there were beautiful lawns planted with monkey-puzzle trees, and this building was connected at the back to the hospital itself by covered walkways overlooking « la rue basse » occupied by workshops, the kitchens and warehouses. The hospital building, erected on the southern part of the grounds, forms a rectangular structure surrounding a central courtyard arranged as a garden. Along the first floor a terrace runs onto which open onto the wards of the second floor, overlooked itself by a third floor.

In 1964 a new operating theatre was set up then, after the merging of the French armed forces health services, modernization was carried out on the building, from 1975 of surgery, ophthalmology, ENT and stomatology consultation services. In 1980, it became French Armed Forces medical centre and took the name of René Le Bas two years later but, was closed down by ministerial decision on 30 June 2002 in the scope of the restructuring of the French armed forces health service. Thus a history of a hundred and thirty-three years came to an end. The former hospital later became a training centre for the National Film and Television School. Among the doctors who made a name for themselves in this establishment were, besides Louis Obet (1777-1856), Jean-Baptiste Bérenger-Féraud (1832-1900) and Bernard Cunéo (1834-1901) who were both the future inspector generals of the naval health service.




OVERSEAS NAVAL HOSPITALS AND HOSPITAL-INFIRMARIES

Outside mainland France, a special place was occupied by the hôpital de Sidi-Abdallah in Bizerte, the seat of the 4th naval region. After the institution of the French protectorate on Tunisia (treaty of Bardo of 1881), an arsenal was created at the bottom of the lake of Bizerte on the Ferryville site after the drilling in 1891 of a canal between the gully and the sea. The admirably located and protected naval base developed rapidly. The building of the naval hospital was entrusted in 1899 by the commander of the naval division of Tunisia Merleau-Ponty to Medic 1st Class Georges who was both the architect and the technical designer. This hospital operated at full capacity during the 1914-1918 War, used especially as support for the Eastern army. In December 1942, the Germans took over Bizerte. The naval hospital of Sidi-Abdallah, built as a main hospital of the military zone, saw its capacity rise to 600 beds. Essentially a surgical hospital, it later saw its skills extended to other specialities including maternity and paediatrics after the liberation of the region by the allies in May 1943. Its activities increased during the events of 1961 before it was closed down during the evacuation of the base in 1963.


Sidi-Abdallah hospital

Before the setting up of the Colonial health corps in 1890, the colonial medical service was ensured by the navy. Its action was all the more necessary because of malaria, yellow fever, typhus, dysentery or cholera and typhoid which were raging in tropical regions, along with current infectious diseases including tuberculosis and even scurvy. This was the time of the naval stations, of which there were eight at the end of XIXth century, and which included the Levant, Iceland, Newfoundland, the Antilles, the south Atlantic (Brazil and La Plata stations but above all West Africa), Indochina, the Far East (China Sea, Yellow Sea and Sea of Japan) and lastly that of the Pacific (Polynesia and New Caledonia). The main developments were in Africa, in the Saint-Louis du Sénégal and Gorée centres with hospitals but also in the estuary of the river Gabon where two floating hospitals, la Caravane and La Minerve were moored. In the Antilles the naval bases with their health supports were located in Fort de France for Martinique and Pointe-à-Pitre for Guadeloupe and Cayenne in French Guiana. This group formed the « old colonies » with Reunion Island in the Indian Ocean. In Madagascar, the navy set up a naval base in Diégo Suarez at the northern end of Grande Île as early as 1885 (a colony in 1896) with an arsenal and a medical infrastructure up until its closing down in 1973. There was a hospital in Pondicherry, a trading post in India, where physician-in-chief Beaujan, the founder of the local medical school in 1863 rose to fame. In Indochina the health service was highly active during the conquest, among others in Hanoi and Saigon (with the hospital which was christened Grall in 1925 and hôpital de Choquan). In the Pacific, the ports of Papeete from 1844, Nouméa from 1853, each had their own naval hospital.

This practice of tropical pathology was to give the navy health service the unparalleled experience which was to contribute largely towards its fame in the medical world at the time.


Page publiée le 11/01/2017.