Remedy for all the inconveniences of lifeBMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8637 (Published 27 December 2012) Cite this as: BMJ 2012;345:e8637
- Wendy Moore, freelance writer and author, London
Poverty was widespread, unemployment rising, and ill health spiralling out of control. But in the face of overwhelming odds and establishment opposition, one man came up with a visionary idea: free medical care for all in need. The time was early 17th century France; the pioneer was a physician named Théophraste Renaudot.⇑
Born in Loudun to Protestant parents, Renaudot (1586-1653) gained his medical degree at Montpellier in 1606. As a physician he was well placed to grow rich by dosing wealthy clients with the customary toxic potions and purges. But Renaudot disdained Galenic theory in favour of the new chemical medicines and supplemented his university education by studying the lowly art of surgery. Returning to Loudun he dedicated himself to treating the poor and impressed the region’s powerful Cardinal Richelieu. After shrewdly converting to Catholicism, Renaudot brought his reforming zeal to Paris.
Supported by Richelieu and Louis XIII, Renaudot was appointed Commissioner for the Poor and during the 1630s he launched a series of bold schemes to combat poverty and sickness. In Paris, he founded the Bureau d’Adresse, which operated as a prototype welfare state.
The bureau acted as an information hub—a 17th century version of the internet—for housing, work, healthcare, and even missing persons. As the jobless were put in touch with employers seeking workers, so needy patients were referred to apothecaries, surgeons, and physicians willing to treat them without a fee. The bureau ran daily drop-in clinics and produced medicines that it dispensed for free. To help the poor make ends meet, Renaudot set up pawn shops offering low interest loans. To silence his critics—not least physicians outraged at the threat to their monopoly—he founded a national newspaper, La Gazette. Renaudot even created a system for self-diagnostic medical consultations—a form of telemedicine—called La présence des absens. Patients in the provinces could buy a booklet in which they selected their symptoms from a list and pinpointed their problems on a diagram of the body. They posted the details to the bureau, which returned a diagnosis and treatment plan.
According to Renaudot, it was possible through the bureau to “sell, buy, rent, exchange, let, borrow, learn (or) teach practically whatever one wanted.” His aim was simply to remedy “all the inconveniences of life.”
Perhaps most innovative of all, Renaudot ran weekly conferences where experts and amateurs alike met to discuss burning issues of the day and he published the proceedings in five volumes. Participants aired their views on science, ethics, the occult, and medicine. Topics ranged from remedies for gout, leprosy, and epilepsy to quests for perpetual motion and the philosopher’s stone.
Sadly this golden age was not to last. After Richelieu and Louis XIII died, in 1643 the Faculty of Medicine sued Renaudot for illegal practice and succeeded in shutting down the bureau and ending all his welfare initiatives. As Renaudot might have said, plus ça change.
Cite this as: BMJ 2012;345:e8637
Sources: Renaudot T, ed. Havers G, trans. A general collection of discourses of the virtuosi of France. Thomas Dring and John Starkey, 1664; Wellman K. Making science social: the conferences of Théophraste Renaudot, 1633-1642, University of Oklahoma Press, 2003; Solomon HM. Public welfare, science, and propaganda in seventeenth century France: the innovations of Théophraste Renaudot. Princeton University Press, 1972.