On offer is an excellent collection of reference letters for applicants to replace the Director of The Necker–Enfants Malades Hospital, one of France’s foremost hospitals. From the context of the letters, it appears that in 1816, the Director of the Necker Hospital, one Monsieur Mougenot, had passed away. A number of applications for his position were received. These letters speak to the applications of three doctors who are seeking appointment to the position. Each extols the virtues of the relevant applicant and offers an insight into the medical practices of the times. There are also references to “le Vicomte” or Viscount. Indeed, there are letter addressed to simply ‘Le Vicomte”. Context suggests that this could be a reference to François Alexandre Frédéric de La Rochefoucauld-Liancourt, duc de Rochefoucauld. There is no direct evidence but Rochefoucauld was a very prominent social reformer of the time. He was active in the administration and operations of medical facilities. He was one of the first promoters of vaccinations in France. He had established a dispensary in Paris and he was an active member of the central boards of administration for hospitals. Alternatively, a second possibility for the unidentified ‘Vicomte’ is Mathieu Jean Felicité de Montmorency, duc de Montmorency-Laval. Montmerency was a very close friend to Germaine de Stael, the daughter of Jacques and Suzanne Necker, Montmorency was also a senior member of the French nobility, wealthy and very well connected in Paris. Of Doctor Nysten, an unsigned letter states: Il a fait partie de la commission educale que le gouvrenment envoya dans le midi d'Espagne en 1805 pour arretez le progress de la fievre jaunes... [Translation: He was part of the educational commission that the government sent to the south of Spain in 1805 to stop the progress of the yellow fever…] Another is a note from Dr. Nysten to his father. There is evident pride in this short missive: Je veut envoi cher papa un note qui m'ete donne par un de ma collegues... [Translation: I want to send dear Papa a note that was given to me by one of my colleagues…] Another applicant, a Monsieur Trederu, submits a glowing letter of reference from the curator of the Mazarine Library. The du Bois letter is a request to an unnamed Vicomte to discuss the vacancy at Necker – Enfants Malades. Again, context suggests that the obvious unnamed Vicomte is in fact Rochefoucauld as he was deeply involved in the social and medical issues in Paris at that time. Philibert du Bois, secretaire general de l'academie de medecine de paris est venu pour avoir l'honneur de vous presenter les respects et vous prieur de vouloir bien etre favorable a la demands qu'il a presentie au confeil des hospices relativement a la place vacante a l'hopital Necker et l'hopital des enfants… [Translation: Philibert du Bois, secretary-general of the medical academy of Paris has come to have the honour to pay you his respects and to ask you to be favourable to his request to the council of hospices concerning the vacant place at the Necker hospital and the children's hospital…] History of The Necker–Enfants Malades Hospital: The Necker–Enfants Malades Hospital is a French teaching hospital It was created in 1920 by the merger of Necker Hospital (Hôpital Necker), which was founded in 1778 by Suzanne Necker, (wife of France’s Minister of Finance, Jacques Necker) and the Sick Children's Hospital located next door. The Sick Children’s Hospital is the oldest children's hospital in the Western world, founded in 1801. Jacques Necker was a leader in the movement to reform crowded hospitals by building smaller treatment centres closer to the patients' neighbourhoods. Madame Necker subsequently remodelled an old monastery into the hospital which, prior to the French Revolution, was known as the Hospice de Charité. Male and female patients were kept separate from each other, as many hospitals of the time did. Triage procedures, established all over Paris in 1802, systematically excluded pregnant women, the mentally ill, and venereal patients. Patients were divided into four categories: fever, malignant fever, surgical, and convalescent. The Hôpital des Enfants Malades (Hospital for Sick Children) was created in January 1801 to help manage the health and social structures of Paris. The newly formed Hôpital des Enfants Malades opened in June 1802. It was the first pediatric hospital in the Western world. The two physically contiguous hospitals were merged in 1920, but the Necker division continued to care for adults and Enfants Malades for children. French physician René Laennec invented the stethoscope in 1816 while he was working at the Hôpital Necker. These letters are a direct connection to the history of one of France’s great hospitals with a possible connection as well to one of France’s great noble families. They are fine pieces of primary material for a social historian of that period. They would also be an excellent addition to the personal library of a medical professional.
