Hôpital de la Salpêtrière

The place, briefly

The name is the first thing to explain, because it has nothing to do with medicine. The site east of Paris, outside the walls, held the Petit Arsenal, where saltpetre — salpêtre — was manufactured for gunpowder. When Louis XIV moved that work to Vincennes, the buildings were free, and they were given to something else entirely.

On 27 April 1656 Louis XIV signed the edict creating the Hôpital Général de Paris. Its purpose was not primarily medical. It was an instrument of public order: the beggars, the poor and the various marginal people whose growing numbers were held to be disrupting the capital were to be gathered and confined. Some 33 hectares of the Salpêtrière enclosure passed into it, and the barns where saltpetre had been made were quickly judged inadequate for the numbers arriving.

For much of its first century and a half the Salpêtrière was, in effect, a place where women the state had no other plan for were put — the destitute, the old, the insane, prostitutes. That is the institution's foundation, and no account of it that skips straight to the great neurologists is telling the truth about the building.

The chapel was the grand gesture. In 1669 Louis XIV commissioned his first architect, Louis Le Vau, to design a monumental chapel dedicated to Saint Louis. Le Vau drew the plan and died in 1670; the work passed to Libéral Bruant, the architect of the Invalides, and the main structure was finished in 1678. It is built on a Greek cross — an unusual choice for a chapel of the period — with each arm running nearly 24 metres, four octagonal chapels set into the angles between them, and a choir 35 metres high at the crossing. The plan let separate categories of inmate attend the same mass without meeting each other, which tells you a good deal about how the hospital was run.

In the second half of the nineteenth century the Salpêtrière became the most famous neurological institution in the world, because of Jean-Martin Charcot. His public lectures on hysteria drew large audiences of specialists and onlookers, and included demonstrations in which he hypnotised patients — the best known of them Blanche Wittman — to produce the symptoms he was describing. The scene was painted, and the painting became one of the defining images of nineteenth-century medicine.

Charcot's teaching is where a great deal of modern neurology begins, and it is also where the study of hysteria takes the turn that runs on into psychoanalysis. The ethics of those demonstrations — women exhibited before an audience to illustrate a lecture — have been argued over ever since, and the argument is part of what the place is.

The hospital is still a working hospital, now the Pitié-Salpêtrière, one of the largest in Europe. Cléo from 5 to 7 ends here: it is where Cléo goes for the result she has spent the afternoon waiting for, and the BFI notes that the façades Varda filmed are unchanged.