488 THE POPULAR SCIENCE MONTHLY 



" Histoire de la Charite "" gives a list of the many drugs used, and an 

 outline of the pharmacist's duties. 



Abuses in management and the civil and religious strife following 

 the Eeformation interrupted for a time the progress of the hospital 

 movement. Eevenues were cut off and hospital organizations disestab- 

 lished, especially in England and Germany. It is true that attempts 

 were made to carry on the work by parishes and municipalities, but 

 with indifferent success. 



Luther in his letters from Italy shows that he realized the importance 

 of hospital work and he praised the Italian hospitals for their excel- 

 lence. Meanwhile, a counter-reformation within the church organiza- 

 tion was mindful of the hospital. Vives, the humanist of Bruges (1526), 

 made a plea for a census of the inhabitants of cities, the regulation of 

 vagrancy and hospital economy, whereby medical attendance was made 

 more complete and the richer institutions were obliged to share their 

 revenues with the poorer. 12 These salutary reforms were put into 

 practise in Belgium and later were extended by Charles V. to his entire 

 empire. In addition the Council of Trent passed rigid ordinances con- 

 cerning hospital management and placed hospitals under episcopal 

 supervision in order to prevent abuses and loose practises in administra- 

 tion. With these enactments improvement soon followed, and it is 

 worthy of note that in the hospital at Milan, founded by St. Charles 

 Borromeo, the rules sought to prevent malingering and obliged a strict 

 accounting of its management. 



In France the control of hospitals had passed to the king. Louis 

 XIV. founded a special hospital at Paris for invalids, convalescents and 

 incurables, as well as the great Hospital General for the poor. It was 

 at this time that St. Vincent de Paul began his work and established 

 the Sisters of Charity, a community destined to be famous for its work 

 in camp and battlefield and to exert a tremendous influence on the devel- 

 opment of nursing and the building and management of hospitals in 

 all parts of the world. An increasing number of communities of 

 women's nursing orders were formed from the sixteenth century onward 

 until to-day they practically dominate this field of endeavor. 



During the reign of Louis XVI. the Hotel Dieu showed gross mis- 

 management and a frightful mortality. Sometimes as many as 5,000 

 patients were crowded there in utter neglect and abandonment. An 

 eminent commission, including in its membership Tenon, Lavoisier and 

 Laplace, was appointed by the king to formulate plans for remedying 

 existing conditions. This board reported in 1788, recommending that 

 certain wards be abandoned and that the pavilion system as exemplified 

 in the hospital at Plymouth, England, be adopted. But the French 



u See 7, II., 225. 



12 Vives, J. L., "De subventione pauperum, " Bruges, 1526. 



