Hôpital Saint-Jacques is the second oldest of the seven hospitals managed by the university hospital center of the city of Nantes, France. It is located along the left bank of the Loire (Pirmil branch), in the Nantes Sud district ("Saint-Jacques-Pirmil" micro-neighborhood).
Built in the early 19th century on the site of a former priory that had become a begging depot, it was intended to replace the outdated municipal hospice Sanitat. Originally, the role of Saint-Jacques was to provide a hospice for the insane, the impoverished elderly, and orphans. Designed according to the most advanced knowledge available at the beginning of the 19th century, it underwent regular refurbishment to keep pace with the evolution of medical and sanitary techniques and the number of patients admitted. The destruction of the Hôtel-Dieu in 1943 made Saint-Jacques the largest general hospital in the Nantes area until 1967. It then returned to its original vocation, focusing on geriatrics and psychiatry.
History
Saint-Jacques de Pirmil Priory The founding period of the Benedictine Abbey of Saint-Jacques (or prieuré de Pirmil) is unknown. It probably served as a refuge for travelers on the pilgrimage to Santiago de Compostela. This priory depended on the Saint-Jouin de Marnes abbey in the Poitou region. The church built by the monks of Saint-Jacques, which serves as the priory chapel, is a blend of Romanesque and ogival styles, dating from the late 12th century.; In the 19th century, remains of a Romanesque chapel were uncovered, attesting to the fact that the church was built on top of an earlier structure.
In 1484, Thomas James, bishop of Dol and commendatory of the monastery of Saint-Jacques, had the church restored. Between 1711 and 1713, the abbey, now owned by the Benedictines of Saint-Maur (dependent on Marmoutier Abbey), was rebuilt on the ruins of the former priory buildings. The new convent, which has no cloister, comprises a central building, the longest, parallel to the church, and two perpendicular wings at either end. To these were added two pavilions adjoining the central part and a porch. In the 21st century, all that remains of this period is the building known as "de la Providence", listed as a historic monument and comprising the central building and its two wings, the pavilions having disappeared and the entrance porch having been demolished in the mid-20th century.
Only four monks remained when the French Revolution broke out, most of whom took an oath and then asked to become laymen again. The priory became bien national and was sold in 1791 to a private individual, a Nantes merchant from Port-aux-vins. The abbey chapel became a parish church the same year. It was renamed Saint-Jacques de Pirmil, and separated from the rest of the property.
After the Battle of Nantes on June 29, 1793, the Pirmil neighborhood was partly destroyed, and the homeless inhabitants found refuge in the former convent. On October 15, 1793, the departmental council decided that the buildings should be used as a hospital and that the borders of the Maison des Pénitentes, from which the nuns had been expelled in February, could be transferred there, but the operation never took place. In 1794, Saint-Jacques temporarily became a prison, housing women and children from the commune of Vue.
Begging depot In 1808, the heirs of the new owner were forced to return the site to the French state. The property was then sold to the Loire-Inférieure département, with the mission of building a begging depot to house beggars from Loire-Inférieure, Mayenne and Morbihan. In 1811, François-Jean-Baptiste Ogée (1760–1845), architect and landlord for the département and Nantes, drew up several plans, one of which was accepted. At the same time, six buildings measuring 37 meters long by 8 meters wide were added to the "Providence" building.
Operational in 1815, the depot proved too costly. The site housed 500 indigents, but the premises were deemed unsound, unhealthy, and unsuitable. Attempts to get the "boarders" to work were hampered by their lack of drive and skill, with the proceeds covering less than 7% of expenses. The depot closed in 1819, and the buildings were sold.
Saint-Jacques General Hospital
Closure of the Sanitat The Saint-Jacques General Hospital was created to replace the outdated Sanitat general hospital or hospice, located near the Quai de la Fosse (near the Notre-Dame de Bon-Port church), with a more modern facility. The Sanitat is not a hospital in the modern sense of the term: no patients are treated there. The establishment was originally a manor house designed by the municipality from 1569 onwards to keep plague sufferers away. It became the Sanitat in 1612, following the construction of new buildings, including a chapel. As epidemics became rarer, their purpose changed. After having been an occasional prison, its raison d'être was to take in beggars and vagrants, then prostitutes, lunatics (from 1676) and abandoned children or orphans. This last mission was for a time entrusted to the Hospice des orphelins, founded in 1774 by the shipowner and slave trader Guillaume Grou, but due to a lack of funds, the establishment closed in 1815.
In 1818, the Sanitat had 810 beds. The premises were dilapidated, their upkeep having been made difficult by the change of regime in France, with hospice revenues linked to taxes and privileges abolished by the Revolution. The construction of new buildings in 1826 did not solve the problems. With the insane accounting for over half of all residents, it was decided to move the Sanitat outside the city.
Design and financing of Hôpital Saint-Jacques
The approach to treating the insane evolved in the early 19th century. Philippe Pinel and his pupil Jean-Étienne Esquirol spearheaded the revival of the discipline. It was recommended that internees should no longer be allowed to lie on the floor, that the straitjacket should replace the collar and chains, and that staff should no longer use sticks or ox nerves to hit residents. A doctor is also supposed to visit each inmate once a day. The Sanitat did not allow these measures to be implemented. In 1816, plans to occupy the former orphanage were launched but abandoned two years later. In 1826, the Hospitaller Order of the Brothers of Saint John of God proposed opening a facility for the mentally ill at the Saint-Jacques begging depot, similar to those already run by the congregation. This proposal, welcomed by the prefect, was rejected by Nantes doctors. Louis-François de Tollenare, receiver then treasurer of Nantes hospitals since 1823, took up the idea. He proposed to transform the former begging depot into a hospice for the elderly, the infirm, and orphans, and to erect new buildings to accommodate the insane under the conditions then recommended by psychiatric medicine.
Tollenare was appointed director of the Sanitat by the prefect, Viscount de Villeneuve-Bargemon. The latter wished to get rid of the establishment as soon as possible, and not to commit the sums earmarked to pay for renovations. He made a secret agreement with the Order of Saint John of God, negotiated by Joseph-Xavier Tissot, a priest known as Brother Hilarion. As soon as the deal was formalized, the monks imposed an eight-year payment deadline. But Brother Hilarion's therapeutic methods gave rise to rumors, and the Prefect broke off the agreement with the cleric.
The prefect then entrusted Louis de Tollenare with managing the entire transfer of Sanitat residents. Contested by the Nantes municipality, and approved by the State, the project struggled to find financing. The operation was suspended due to the 1830 July Revolution, but then the social situation led the government of Louis-Philippe I to favor plans to open charity workshops to keep the unemployed busy. The ruling class was still reeling from the popular revolt of July 1830, and was trying to mitigate the effects of poverty to limit the risk of social upheaval. The state subsidies paid to the city of Nantes, 150,000 francs, were entirely devoted to the "charity project" of building Saint-Jacques.
In April 1832, a cholera epidemic struck Nantes, and to remedy the Hôtel-Dieu's insufficient capacity, the Sanitat, the Refuge des orphelins, and the hospice Saint-Jacques became temporary hospitals. At Saint-Jacques, women with the disease were cared for by Doctor Ange Guépin.
Mayor Ferdinand Favre delivered a speech at the laying of the foundation stone on July 28, 1832. The estimate for the construction of Saint-Jacques was 900,000 francs at the time. Additional funding was obtained from the sale of the Sanitat and its land holdings. De Tollenare obtained 600,000 francs, a good price, benefiting in the process from an increase in the value of his real estate holdings on Quai de la Fosse. The sale did, however, have the disadvantage of imposing a deadline for the move; initially scheduled for March 3, 1833, it took place in October of the same year, under pressure from the new owners of the Sanitat, who threatened legal proceedings, forcing the administration to move the residents in a hurry, into a hospice in Saint-Jacques currently under construction.
Construction
First phase, 1833-1837 Brothers Louis-Prudent and Constant Douillard, renowned Nantes architects and pupils of Mathurin Crucy, were commissioned to draw up the plans for the "Hôpital Général de Saint-Jacques", with contractor Perraudeau carrying out the work and Louis-François de Tollenare overseeing the project as master builder. The workforce was made of workers recruited from charity workshops. When, in September 1834, the Sanitat's borders had to be accommodated at Saint-Jacques, only the building for the elderly had been completed. To speed up the work, head physician Camille Bouchet (1801–1854) decided to put all patients to work, including the insane. This free labor enabled the administration to make substantial savings. For example, the insane contributed to building the cells in which they would be locked up.
During construction, rocky areas had to be leveled and other areas filled in. The marshy part of the land along the Loire was raised by 4 meters. A forge and a locksmith's shop were built, to manufacture locks, repair tools, and make 150 iron beds. The sand used for masonry and earthworks was extracted from the nearby Loire River.
The water supply is an important element, particularly for the evacuation of latrines. Another important use of water was for personal hygiene, with baths an integral part of hospital operations since the 18th century. In addition to this function, baths also played a therapeutic role. For economic reasons, Dr. Bouchet installed only one bathtub. A little later, Dr. Ferrus had a bathroom installed in each pavilion with two bathtubs. At first, the water supply was transported by hand, then pumped by hand. The Douillard brothers called on a civil engineer (apparently named M. Pervac) to install a steam-driven pumping station to bring water up from the Loire, and a rainwater collection basin. These installations were not completed until 1846.
Influenza epidemic of 1837 The winter of 1836-1837 was a late one, extending into April, with the Loire freezing over on March 26 and snow still falling on April 9. It was around that moment that an influenza epidemic hit the city. The Saint-Jacques hospital was affected in the second half of February, and by mid-March, the disease had reached practically all the hospital's patients, by which time three-quarters of Nantes' population had contracted the disease. For the city as a whole, around 260 additional deaths were attributable to the disease, while 33 influenza-related deaths were recorded at Hôpital Saint-Jacques.
Second construction phase, 1840-1845