Tulane University School of Medicine - T Wave Yearbook (New Orleans, LA)

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Charity Hospital circa 1835. ularly Germany and Ireland, were treated at Charity, and by 1858 foreigners outnum- bered US natives by a ratio of six to one. To provide additional financial aid to Char- ity, taxes were placed on all concerts and Carnival Balls. In addition, all theatres in New Orleans were required to give four benefit performances annually. Although an official gambling act would not go into effect until 1923, a tax on gaming halls was instituted for the benefit of the hospital as early as 1815. Further amended in 1832, this law increased the number of gaming halls and raised the tax to S7,500, three- quarters of which was designated for Char- ity Hospital. However, it was the 1842 Passenger Tax paid by all persons arriving in New Orleans from foreign ports that ensured the hospital ' s financial stability during this period. Five years after the great fire, the square roughly corresponding to the location of the current Fairmont Hotel on Canal Street, was sold by the city to the Administrators of Charity to build a new hospital. Work was begun in 1815, and when completed in the same year, the new facilities were described as vast and commodious, capable of caring for 120 patients. honor of King Charles III of Spain. Almonester died in 1798, probably feeling that most of Charity ' s administrative prob- lems had been solved. Yet the problems only worsened later! In the early 1800s, the mayor of New Orleans pleaded before the Louisiana legis- lature to Look at the Charity Hospital and examine the state of abandonment and dep- rivation to which this institution is reduced. The poor man preyed upon by maladies seeks asylum and finds only a grave. Another catastrophic event occurrred Fri- day, September 23, 1809, when a kitchen fire quickly spread to the wooden shingled roof and burned the entire hospital to the ground. The indigent sick suffered intense hardship after this fire, and many were housed on the upper gallery of the Cabildo, which served as City Hall. Louisiana became a state on April 30, 1812, and assumed full responsibility for Charity Hospital on March 17, 1813. Immigrants from dozens of European countries, partic- An open word of the early 1800 ' s. M Mh i sz r ' ' S jL«W» History of Charity Hospital T-WavS=JSC

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Charity Hospital of New Orleans: A Rich History a Poor State of Affairs by John E. Salvaggio, MD Henderson Professor of Medicine Charity Hospital embraces an intriguing and colorful past, and has served a real pur- pose. It is steeped in Louisiana history, and has survived difficult times and some of the worst political squabbles and patronage problems in the country, enduring for over 250 years primarily because it was needed. Its charter dates to January 1736, when Jean Louis, a French sailor formerly employed by the Company of the Indies who worked in New Orleans as a boat builder, bequeathed his estate of approxi- mately 10,000 livres (about $2,500 today) to the founding and furnishing of Charity Hospital in early French colonial Louisiana. This makes it the oldest continually operat- ing hospital in what is now United States territory. (Bellevue Hospital in New York City is also the same age, but was estab- lished two months after Charity.) Perhaps it was the abandonment of the poor, who could not be cared for at the French military or Royal Hospital, that induced Jean Louis to be so generous. Ini- tially called the Hospital of St. John or Le Hopital des Pauvres de la Charite (Hospital for the Poor), its charter came into effect upon Louis ' death. In his wisdom, Louis appointed the Reve- rend Father Philippe, Parish Cure and pas- tor of St. Louis Cathedral, to work with Councilman Raguet in disbursing his legacy and running the Hospital. Sunday collec- tions were taken in the cathedral to support Don Andres Almonester y Roxas, Early ► Charity Hospital Benefactor. it. In addition, several local individuals made donations of property in their wills. On March 10, 1736, a house at Chartres and Bienville Streets became the first quar- ters for the Hospital. Patients must have been admitted immediately, because only a month after its opening the house proved to be too small and by 1743 it became neces- sary to replace it. A governmental land grant at the ship-turn at the end of a canal and fronting on the cemetery was provided to build the new Hospital. This location was advantageous since supplies could be unloaded from the ships as well as patients transferred to or received at the Hospital. Its proximity to a cemetery was also of obvious advantage. After Louisiana was ceded to Spain in 1763, the French were allowed to admin- ister Charity for six more years. With the arrival of Governor O ' Reilly in late 1769, however, Charity came under control of church authorities and the Spanish govern- ment, as was the custom of such hospitals in Madrid and other Spanish cities. In 1779, a great hurricane wreaked havoc upon New Orleans, reducing Charity Hos- pital to ruins. Only the kitchen and store- house escaped its fury. This destruction resulted in much consternation and suffer- ing, leaving homeless patients to perish upon the streets or in some obscure cor- ner. Nonetheless, the Hospital survived. During this terrible time, Don Andres Almonester y Roxas, a former war clerk, civil notary, and noble gentleman born in Andalusa, Spain, came to Louisiana and rescued the Hospital. He was a leading citi- zen of the colony and made a modest for- tune as an owner of retail stores adjacent to Jackson Barracks. He was described by some as a selfless benefactor and by oth- ers as an opportunistic land speculator. Almonester offered the huge amount of $114,000 to rebuild the hurricane-ravaged Hospital. It was completed in October 1785, and named the Charity Hospital of St. Charles (the San Carlos Hospital) in

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Charity Hospital circa 1900. ► Note the addition of satellite buildings around the main structure pictured on the previous page. A great flood inundated the city the next year and led to the creation of a medical licensing board (The Committee-Medical) to deal with the subsequent terrible sanitary conditions and medical problems. Indeed, the narrative of a young Boston minister who had visited New Orleans in that year described the hospital as a deep disgrace to any civilized or Christian country. A group of citizens visiting Charity in 1818 were horrified by the condition of patients, and complained to the governor and Hos- pital administrators. They noted the Hospital ' s filthy condition, and the total inadequacy of attendants. They also stated that patients had to sleep on mattresses upon which were visible marks of the putrid discharges of those who had died on them of the most pestilential diseases. Chickens roosted in the hospital rooms, and their offal covered the furniture in every direction. They further reported that brick dust was used to absorb the filth on the hospital floors, and that it arose in clouds and choked patients on the few occasions when the floors were swept! It is important to note here that many epidemics struck the city and killed thousands from early French colonial days through the 20th Century. The deterioration of the San Carlos Hospital combined with a marked increase in the local population made it apparent that new facilities were again needed. Completed in 1833 at a cost of $149,570, the fourth version of Charity undoubtedly marked a milestone in its history. Records show the lower story was occupied in part by the Medical College, indicating that when formed in 1834, the new Medical College of Louisiana (now Tulane Univer- sity School of Medicine) was located within the hospital. During busy times in the early 1900 ' s, two (or even three) patients were forced to share a bed. With the arrival of the Daughters of Charity, in combination with the above- mentioned items, the overall medical atmosphere in New Orleans was excellent, and the entire medical complex was, at that time, very likely one of the best of its kind in the world. After the Civil War commenced in April 1861, its chaos made little difference to Charity Hospital. Following a series of re- signations in February 1862, Ernest Lewis, a young student intern, was appointed of 21. Lewis refused to treat General Benjamin Butler ' s soldiers when Butler captured New Orleans with his flotilla and 15,000 man garrison. The General was extremely lenient with young Lewis even though Butler later learned that Charity was housing Confederate soldiers trans- ferred from the old marine hospital when its supplies were cut off following the city ' s surrender. Lewis finally agreed to accept the federal soldiers, and actually convinced Butler that additional physicians were needed to care for them. During the post-war period, lottery tickets were again sold to support the Hospital through the Louisiana State Lottery Com- pany formed in 1868. The government finally outlawed this company around 1900, but until then, it provided — at least on paper — major support for Charity. The old Ship Passenger Tax that had helped greatly in the late 1840s and 50s, was di- verted to the Bureau of Agriculture and Immigration. Thus the Hospital ' s debts rose markedly. At this time, large numbers of blacks were admitted to the hospital. Prior to the War, most blacks had been treated by private physicians on the plantations where they had worked as slaves. When they became emancipated, more and more of them re- quired the services of Charity. The Charity Board enacted a policy forbidding discrimi- nation founded on race, color, or previous ;;T Wave History of Charity Hospitai W0( lm L