CCHA Study Sessions, 41(1974), 53-64

The Hôtel-Dieu of Quebec

The First Hospital North of The Rio Grande
under its First Two Superiors

by Loretta LA PALM

    The history of Canadian hospitals began in New France. When Louis XV signed away his vast American colony to George III in 1763, the first hospital north of the Rio Grande became the fifth in the British Empire. ⁽¹⁾ At that time the Hôtel-Dieu of Québec had stood on its lofty cliff for one hundred and twenty-four years.

    The origins of the hospital go back to 1635 when Father Paul Le Jeune, Superior of the Jesuit Missions had asked for women to help in the evangelization of the Indians through a hospital and a girls' school. ⁽²⁾ He thought that the close contact that nuns could establish would give them many opportunities to win souls for God. Four years later, on May 4, 1639, three sailing vessels left the port of Dieppe, France, for Canada. Aboard the flagship, the St. Joseph, were the world's first women missionaries. Nine women had answered the appeal of Father Le Jeune, six nuns and three lay women.

    Funds for the hospital were provided by the Duchess of Aiguillon, niece of Cardinal Richelieu. She was a devout widow of 35, a disciple of Vincent de Paul, one of those who sparked a great religious revival in seventeenth century France. She offered to provide a foundation of 44,400 livres with the capital to be invested in France to produce an annual income of 3,000 livres. ⁽³⁾ The Duchess had invited the Augustinians ⁽⁴⁾ of Dieppe to conduct the new Hôtel-Dieu of Quebec. Their order had been nursing in the little seaport since about the year 1200; they had an excellent reputation. Although all volunteered to go, the community elected three by vote. Mother St. Ignace Guenet, 29, was chosen superior. Her health was not robust but she had great qualities of leadership. Her companions were Mother St. Bernard Lecointre, 28, a shy, faithful worker, and young Mother St. Bonaventure Forestier, 22, beautiful, kindly, and gifted with a glorious voice. The Indians loved her at once and called her "la belle, la bonne, la gentille." Catherine Chevalier, a sturdy servant girl of 25 offered her services for ten years if she were then given the habit of a lay nun.

    Also on board the same ship were three Ursulines, together with two lay companions: Marie of the Incarnation, 39, the superior; Mother St. Joseph, 23, from Tours; Mother Ste. Cecile, from Dieppe; their foundress, Mme de la Peltrie, a widow of 36 and her companion, Charlotte Barre, 19, who planned to become an Ursuline. These five women had come to begin the first girls' school in New France, for both Indian and French children, with Mme de la Peltrie providing the finances.

    On August 1, 1639, after a voyage of three months, a boat carrying the missionaries approached the shore beneath the Fort which Champlain had built on the great rock of Quebec. An artist has painted the scene; Mother St. Ignace in her graceful white wool habit stepped ashore first, then Mother Marie of the Incarnation, wearing the black of the Ursuline Order, then the other nuns, and the lay women. They knelt to kiss the soil of Canada before greeting Governor Montmagny, Father Le Jeune, and the other Jesuits. Most of the town's 200 citizens had gathered at the water's edge to welcome them, for the women missionaries had been eagerly awaited in a country where few women had preceded them. ⁽⁵⁾

    The newcomers were led up the steep path to the small wooden church which Champlain had built. They were invited to the Governor's residence for lunch, then taken to the new warehouse loaned to them by the Company of One Hundred Associates. ⁽⁶⁾ At once the Hospitalières began to set up their Hôtel-Dieu in their temporary quarters. The two-story house had two large rooms and a small 'cabinet' on each floor.

    Today the Hôtel-Dieu, a fifteen-story stone building, stands on the same spot that, in 1637, the Duchess had sent men to clear. The site for the Hôtel-Dieu, 71/2 arpents on Ste. Genevieve's Hill, had been donated by the Company. On their arrival Mother St. Ignace and her two Hospitalières walked down a rocky path through the woods to inspect their future hospital and monastery. Great was their disappointment after they reached it through a pathless tangle of stumps, dry branches, and brush. Only the foundation had been laid and not a drop of water was to be found on this high promontory which overlooked the junction of the St. Charles and St. Lawrence Rivers. Yet, though they turned doubtfully away in 1639, Mother St. Ignace and Mother St. Bonaventure were the first two superiors whose faith and determination raised on these foundations the hospital which grew through the centuries into the modern institution we see today.

    The first beds had just been set up in their temporary hospital's one ward, when a severe epidemic of smallpox broke out among the Indians, most of them Algonquins and Montagnais from around Sillery. The ward was soon filled and the workmen erected a circle of bark cabins around the building. The nuns cared for ten, twenty, even thirty patients at a time in the ward. During the epidemic, over a hundred were treated in the hospital and about 200 stayed in the cabins, some for only a few days. Twenty-four patients died and of these twenty were baptized.

    Supplies planned for two years were exhausted in a few months. Sheets and blankets were cut in two and sometimes into three; all the linen, even the guimps and bands of the hospital mothers were used for dressings. All three Hospitalières nursed all day and washed linens at night. At last they became ill of exhaustion, leaving their duties temporarily to the Jesuits. These took over as best they could, which apparently was not too good. When the first Hospitalière returned, she found "a man's house, disorderly and full of rubbish, with soiled linen rotting on every side." ⁽⁷⁾

    So many Indians had died that the survivors fled from "the house of death." But, when they found that other tribes had died in even greater numbers they came back to ask Mother St. Ignace to move her hospital to Sillery where a number of them lived. The Jesuits had built a fine stone house and chapel there and had made an attempt to settle these nomadic tribes, Algonquins and Montagnais. ⁽⁸⁾ Thus the Jesuits, too, favoured moving the hospital to Sillery, hoping that it would further induce the Indians to return there from their hunting expeditions and stay there instead of moving elsewhere.

    As yet, only about 250 immigrants had settled in the colony, divided over Quebec, Beauport, and Trois Rivières. Mother St. Ignace decided to accept the move and to build a large hospital at Sillery among the native people whom they had come to serve; they expected to live among them for many years to come. The corner stone of their fine stone monastery, 100 X 30 feet, which had two stories, plus a fine mansard attic, was laid in July 1640. When they moved in on November 30, snow covered the ground but the building was not yet finished.

    Handsome as it may have been with its fifteen windows along the side and six across the end when completed, their suffering in the unfinished house that winter was indescribable. No amount of fuel in the huge chimneys could heat the part of the building so hastily enclosed for this winter. Wind and snow blew in around ill-fitted doors and windows. The north-west gable, which felt the force of the worst storms, was stuffed with straw and boards. Food was poor and scanty. Fat pork, peas, bread, and a little rice was all they had to give the two who were in bed with chest infections. Mother St. Ignace was spitting blood and Mother Ste. Marie, one of the two who had arrived in September, died in March. She was only 28.

    About this time, the Algonquins moved their cabins to encircle the large strong Hôtel-Dieu which was only about sixty paces away, but out of sight over a steep hill. The Montagnais stayed near the Jesuit house. This tribal division remained; fear of the Iroquois caused the Algonquins to choose the stronger building. Already during this first winter the Indians left their old and infirm behind in the cabins which they had built around the Hôtel-Dieu before going on their winter hunt. Formerly, they sometimes had to kill the very feeble through compassion. The Augustinians shared their scarce food with these helpless ones who came to look upon them as 'mothers' indeed.

    With the return of the warm weather, Mother St. Ignace recovered from her illness. With her usual efficiency she had their beautiful building completed before the winter of 1642. At that time it was the largest building in New France; it had a large ward, a fine chapel, and plenty of room for individual cells. They even took boarders, Mme Giffard, wife of the first doctor of the Hôtel-Dieu and their two daughters. ⁽⁹⁾ One of these became the first Canadian nun.

    The years at Sillery were happy for the hospital mothers. They learned Algonquin, taught the children, and cared for the old and the sick. This wilderness became a gentler place through their presence. In 1640 the Duchess sent eight small paintings by Rubens for their chapel. ⁽¹⁰⁾ In 1643 they received from a wealthy cousin of Mother Marie two large wall tapestries in her memory. Already, beauty had its place in the chapel where they knelt before their Eucharistic Lord. The rich gifts of tabernacles, sanctuary lamps, chalices, ciboria, and candlesticks became models for the fine Canadian artists such as goldsmiths Ranvoyzé and Lambert whose works are now displayed in our museums.

    In 1642, M^lle Jeanne Mance, the future foundress of the Montreal General Hospital, spent the winter in a house near Sillery. When the Hospitalières learned that her sponsor, Mme de Bullion, had sent her to establish a hospital in Montreal as the Duchess had done in Quebec, they gave her the only nurse's training she ever was to receive. Also that same year, Marie Irwin, a young Scottish girl of only 16, came to Canada as a postulant. She was so wretched and lonely that Mother St. Ignace kept her as a boarder until the next spring at which time she wisely sent her back to Dieppe. During this year the nuns cared for about three hundred patients, chiefly using the cabins built within the hospital stockade. The Sisters' attractive white woolen robes became soiled so often from the smoke and grease in the tepees that they used native bark to dye them. Some wept to see the drab brown result; begga''s robes they said. They kept this color until they returned to Quebec. In 1643, two more Hospitalières arrived from France. Now there were five choir nuns, a lay sister, and their servant Catherine. ⁽¹¹⁾

    During the same year, Iroquois attacks came closer to Quebec; more Indian families and even a French family from upstream moved into the Hôtel-Dieu enclosure. Fear kept the Algonquins from hunting and since the hospital depended upon that, food became scarce. It was from this time that legend reports a miraculous multiplication of food: a cask of peas, from which they took several measures a day, lasted more than three months.

    Father Jogues, who had come to warn them that the Iroquois had threatened to carry off ""les filles blanches" as they called the Augustinians, was himself captured on his way to Huronia. Then Governor Montmagny insisted that the Hôtel-Dieu be moved back to Quebec and to the protection of the fort.

    Mother St. Ignace was without money; it had all been used on the splendid monastery now standing empty at Sillery. However, encouraged by the Jesuits and the Governor to borrow money, she ordered work to resume on the site above the River St. Charles. They bought two more arpents of land from a neighbour. This brought a stream of water to the hospital. During that summer of 1644 the hospital mothers worked as day labourers, using wheelbarrows, winches and planes. Late in November, enough of the building was enclosed to give them shelter in a few draughty, cold rooms where the chimneys smoked, and where the sick ward was reached by going out into snow, rain or icy winds; no covered walk had yet been built.

    Mother St. Ignace, exhausted by her efforts to prepare the new Hôtel-Dieu spent the winter of 1644-45 in bed, frequently coughing blood. In 1645 her second three-year superiorship was completed, and the constitution of the small community confirmed. Now Mother St. Bonaventure, at 28 the youngest of their community, was elected superior. She it was who, with the counsel of the former superior, had to cope with the endless troubles which kept this building in a constant state of reconstruction for two summers.

    For the summer of 1646, the whole community moved into the sick ward, a separate building, while chimneys were rebuilt and low walls raised. There Mother St. Ignace died of tuberculosis after the last ship left for France; thus her mother would not learn of her death until the next summer. Although she was only thirty-six she had built two hospitals during her seven years in Canada. She herself was the first to cross the threshold of the completed Hôtel-Dieu when she was carried into the chapel for her funeral Mass. One of the Algonquins pronounced a funeral oration, expressing the gratitude of his people to her for her loving kindness. Of seven Augustinians who had come to Canada she was the second to die.

    The winter of 1647 was one of hardship for Mother St. Bonaventure. The sick were cared for in the ever-present cabins which again surrounded the hospital. The building was still cold, some chimneys smoked, that of the kitchen being unusable. There were twenty-eight persons to feed: five nuns, a servant, a chaplain, four boarders, seven workmen, plus a cabin of ten Indians. They cared for eighty patients that winter, some for several months. The Relation for that year says that there is no one who does not bless a thousand times their foundress and the charitable people whose gifts help them to care for the poor and the sick.

    Three more nuns came in 1648, among them Catherine of St. Augustine, a girl of sixteen who had just made her vows. ⁽¹²⁾ Warmhearted Mother St. Bonaventure received this ardent youngster, who soon won the whole community, with open arms. In that same year the first Canadian girl, Françoise Giffard, daughter of Dr. Giffard, entered as a novice, taking the name St. Ignace in honor of the first superior who had inspired her vocation. Thus, they now had eight choir nuns, and a novice, as well as Catherine Chevalier, who became a lay nun the following year.

    The hospital had few patients that summer when the ships from France brought the colonists. The Augustinians provided a hostel for these new "Canadians" while their homes were being prepared. They taught them "the ways of the country." New meats, such as moose, bear, and beaver, as well as many wild fowl, geese, ducks, and pigeons (tourtres, the origin of the popular French-Canadian tourtière, a meat pie served after midnight Mass) had become part of the food of Canadians, as had Indian corn and blueberries, dried for winter use just as the French dried prunes. Most important was the preparation of homes and clothing for the fierce cold of the long winter.

    1650 was a year to test the missionaries. The martyrdom of Jesuits Brébeuf and Lalement in 1649 and the destruction of the Huron mission shocked New France. Grief mingled with joy in the heroism of their sacrifice among the Hospitalières, most of whom had known Father Brébeuf personally. Mother St. Bonaventure, in a letter to Sebastien Cramoisy, their agent in Paris, says that 400 Huron refugees, led to Quebec by Father Ragueneau, were camped at the door of the hospital, completely destitute. She noted: "I never saw anything so poor and so devout." The three religious orders tried to provide food for them but it was almost a famine year and the colonists could give little help. At times the Hospitalières themselves went hungry. The Hôtel-Dieu established a schedule of devotions for these new Christians to make them feel a part of the French community. That year, too, two sisters returned to France, one mentally ill, the other unable to adjust to the hardships of life in Canada.

    Lively and capable, Mother St. Bonaventure, who was superior as often as the constitution allowed, planned in 1653 to replace the wretched building, long, narrow, low, and dark, which Mother Catherine said looked more like a little hut than an Hôtel-Dieu. They planned a ward, a church, and a choir for the community. The Duchess and her friends sent three ships laden with supplies. All three were lost; the first crushed in the ice, the others captured by the Spanish and the English. The nuns now had to borrow and use their dowries to continue the work.

    A Hospitalière of exceptional gifts arrived in 1655, Mother of the Nativity de Boulic. She had been well-educated by her godmother la Marquise de Cournouaille, had a pension of 150 livres, linen and clothing worth 400 livres. At 24 her qualities of leadership gave community an alternate superior and Mother St. Bonaventure much needed relief.

Mother St. Bonaventure saw the dedication of the first stone Hôtel-Dieu on the present site in 1658. She laughed at her own pride in their building. They held "open house" that day so that the whole town could view it. She wrote:

It seemed so beautiful to us at the time and to all who came to see it that, although we had seen well-built and spacious hospitals in France, we were charmed with our own. It consisted, however, of only one ward, now the women's ward..., yet we thought we were in a Louvre; we placed the beds on either side in the French manner and there we practiced our profession joyfully.

There were now thirteen choir nuns and two lay sisters to practice their noble profession. Meanwhile, in 1656 and again in 1660, the Iroquois threatened Quebec and when this happened for the first time the Hôtel-Dieu had guards on duty all night. In 1660 they had to leave their monastery at dusk for a building in the Jesuit compound, near the Fort, for three weeks. That year, Dollard and his 16 men turned back 700 Iroquois who were coming down the Ottawa to attack Montreal and Quebec. Also during this time, in 1659, the first bishop of Québec, Bishop Laval, arrived. He stayed at the Hôtel-Dieu for three weeks until his residence was ready. He saw exhausting routine of the hospital nuns and ordered relaxation of some of their rules of fasting. He remained a firm friend of the hospital during his long life. In 1660, when the ships brought many sick to Quebec, Bishop Laval himself served as an orderly in the ward to help the overworked nuns.

The hospital which grew and developed under the wise leadership of this "unworthy superior" as she signed herself, was surprisingly modern to judge by the orders sent to their agent in Paris. The order of 1663 included many drugs, chiefly emetics, purgatives, and ointments for healing wounds. Many of the remedies were compounded by the nun-pharmacist using mortar and pestle. A dozen lancets and opium were probably used for surgery. Among the vessels for ward use were two padded ones of tin for slipping under patients. The order for 36 bowls, 36 sauce dishes, 24 cups and 48 spoons suggests about twenty-five beds. Shirts were provided for men and women, and mob-caps, lined, woolen caps and thick cloth for making dressing gowns were ordered.

    In 1664, Mother St. Bonaventure, again superior, saw the great design of the Duchess in jeopardy. In that year the hospital had provided 4,400 days care, most of it free. The community had gone into debt as the population increased but their income from France did not increase. The Community now asked the Bishop to divide the patrimony of the Duchess between the poor, whom the Duchess wished to help, and the community. The Bishop decided that the poor should have one-third and the Augustinians two-thirds for the maintainence of the hospital. All gifts henceforth were divided accordingly. Thus the nuns were somewhat taken aback when, later on, they received a gift of rich draperies for the chapel; the Bishop valued them and the community had to pay one-third of this sum into the treasury of the poor.

    With the coming of Royal Government and the Carignan-Salières Regiment, the role of the hospital changed. Military men and colonists soon outnumbered Indian patients. In 1665, one hundred and thirty-six men were brought from the troop ships in one day. Talon, who had brought out six hundred and fifty colonists that year, endowed the hospital with a second ward, a laundry, and a water system which provided hot water to both wards. In 1672 he added another ward, bringing the average daily occupancy to thirty-one. Also, the Hospitalières of this Hôtel-Dieu were becoming a Canadian community. ⁽¹³⁾ Fourteen had come from France, but after 1671 only Canadians were accepted. One Huron girl received the habit on her death bed, being then not quite sixteen, the only native girl to become a nun during the French regime.

    In 1672, the Augustinians lost their dear foundress, the Duchess of Aiguillion, whom they regarded as a benevolent mother. Although she had not increased her foundation, she had canvassed her wealthy friends on their behalf, sent them rich gifts, and encouraging letters. They had a funeral Mass of the greatest solemnity to which they invited as many as their church could hold.

    Mother St. Bonaventure was 66 and very tired when she was relieved of the office of superior for the last time. She had carried this burden for 21 years of her life. A young nun, who had entered in 1664, a granddaughter of Dr. Giffard, and a niece of the first Canadian nun, became superior. She had taken the name St. Ignace, which her aunt wished her to have. ⁽¹⁴⁾ Abbé Casgrain in his book, Histoire de l'Hôtel-Dieu de Québec, has called her "la femme forte." She was the spirit of the hospital for the next thirty years as Mother St. Bonaventure had been for the past thirty-seven years. In 1683 she was superior of 26 Hospitalières; she succeeded in attracting novices, because by 1695 there were 40 sisters.

    Although Mother St. Bonaventure took less demanding offices, she was always there to advise. She now had time to do what her daughters had often urged, to write down all the things she had often told them about the first years in Quebec. She now completed her "petits cahiers" in which she recorded her memories of people and events in the Hôtel-Dieu and in Canada during her lifetime. She still had many years to live and witnessed most of the events of seventeenth century Quebec .

    In 1685 the ships from France brought the new bishop, St. Vallier, and so many sick from fever and scurvy that 300 were brought to the hospital, filling the church, attics, sheds, and even tents. When the hospital mothers became exhausted, priests and brothers replaced them. A new treatment, vouched for as a sure cure for fever was bleeding at the temple. Twenty died, but not one thus bled. With their large ovens and kettles the Sisters fed the militia of some 500 young men, when Phips attacked Quebec, cared for the few wounded, and thanked God when the enemy sailed away.

    Mother St. Bonaventure died in 1698, at the age of 82, after sixty years in Canada. The Hôtel-Dieu still serving so many was built largely through her faith and work. She loved and was loved by the Indians. She won young girls to the community by her affection and gaiety. The Annals say, "She fell into a second childhood in her last years, but the habit of obedience was so strong that if she wanted something unsuitable one only had to say 'Our Mother does not wish it.' Even in extreme old age, she was still beautiful." ⁽¹⁵⁾

    Today the Hôtel-Dieu has 700 beds, 140 Hospitalières and ten daughter communities. The Augustinians brought to Canada the best of French Catholic civilization and planted it firmly in the New World. The successors of the first "mothers" are conscious of their heritage which their museum recalls. The motto of the Province of Quebec, Je me souviens, might well have been chosen by the Augustinian Hospitalières of Quebec. They remember.

1. Cortez established a hospital in Mexico City in 1524. Four English hospitals pre-dated the Hôtel-Dieu of Quebec: St. Thomas and St. Bartholemew's, London; a hospital in Chatham, and one in Bath. (SAUNDERS, History of Medicine, 1929, p. 304).