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A report on " Les Ambulances de la Ville de Faris" (Ambulances Municipales et Ambulances
Urbaines), dated June 1st, 1898, gives the following information—
The ambulance services of Paris at that date consisted of—
1. Ambulances municipales.
2. Ambulances urbaines.
The first of these is concerned with the removal of persons ill with contagious or noncontagious
complaints. The second deals with the removal to hospital of persons suffering from
accidents, and is never available for the transport of the contagious sick.
It was in 1887 that, on the initiative of Dr. Nachtel, a station for a service of the Ambulances
Urbaines was established at the Hospital of St. Louis. In 1889 the town of Paris established two
stations for the service of the Ambulances Municipales, one in the Rue de Stael, one in the
Rue Chaligny.
In 1895 the service of Ambulances Urbaines at the St. Louis Hospital was taken over by
the municipality, who shortly after decided to adopt a scheme for providing a complete ambulance
service for the removal of persons suffering from illness or from the effects of accident. After
receiving the report of a special commission on the subject, the municipality determined in favour
of the construction of new ambulance stations, the provision of additional staff and the provision of
greater facilities being given to the public for obtaining the use of the ambulances; and it was
to commence at once and to proceed with the elaboration of the scheme as quickly as possible.
The report states that it was anticipated that by January 1st, 1899, ten stations (including two special
stations), comprising four stations for the service of the Ambulances Urbaines, four for the service
of the Ambulances Municipales, and two for both services, would be in working order.
The staff at each ambulance station comprises telephone attendants, coachmen, and ambulance
assistants, the latter, in the case of the Ambulances Urbaines, being senior medical students.
As this report deals with the subject of an ambulance service for London for cases of accidents
only it will not be necessary to refer further to the Paris system, except as regards the service which
exists for bringing speedy means of removal to the scene of an accident, and for this purpose to give
here the description of it by Dr. Nachtel, which he recently forwarded to the Council, of the service
which was initiated by him in 1888 in connection with the Hospital of St. Louis, and which was taken
over by the municipality in 1894.
During the six years we were working as a private charitable society we succoured about 200
persons per month, or 2,400 per year. I should state that the area within which we operated
covered about one-sixth of Paris.* The cost of carrying on the Saint-Louis station was about
twelve hundred pounds per annum.
I planned the Paris ambulance system in a way conformable with Parisian customs. The
French place great faith in the ability of the nearest chemist to attend to victims of street
accidents. Utilising this fact, I caused a number of chemists' shops to be connected by direct
wires with the Saint-Louis Hospital. When a person is injured or taken ill in the street at any
point within the area served by the Saint-Louis station he is immediately taken to the nearest
chemist's shop; the hospital is advised by wire; the horse, which stands ready harnessed, is
attached to the ambulance; a printed form is put into the driver's hands, marked with the time
the call was received and the time at which the carriage is starting, and in a few minutes the
ambulance is at the scene of the accident. The doctor who is in the carriage makes a rapid
diagnosis of the case and applies a dressing, for which he has all the necessary appliances in the
ambulance. The vehicle then conveys the patient either to his home or to a hospital. It should
be understood that the patient is taken to the nearest hospital. If this should not be the SaintLouis
Hospital the medical attendant telephones from it to the latter for instructions, and very
often finds that a fresh call has been received and that it is necessary for the ambulance to go to
the scene of another accident. As soon as the ambulance returns to headquarters the form on
which the doctor has entered the name and address of the patient, the nature of the accident,
&c., is handed in to the hospital to be filed.
Now, it is very important that I should give a description of the ambulance. I do not
exaggerate in the least when I say that the carriage used in Paris is the outcome of several
years' reflection and experiments. It is a unique vehicle, for the New York ambulances are very
inferior to it.
In the first place, it should be borne in mind that the carriage must be built with a view to
the conveyance of an injured person. Having to serve a different purpose from those intended
for carrying sick people, it must be constructed on a different plan. It should fulfil the following
conditions—
It should be sufficiently light to be drawn by one horse.
It must be spacious enough to contain two persons, one lying down and the other seated in
such a position as to be able to attend to the first. It is also desirable that a second injured
person may be conveyed, provided he does not need to be in a reclining position.
The bed or stretcher on which the injured person is placed must admit of being put in and
taken out of the carriage without jolting the patient.
The carriage should have good springs, so as to avoid shaking.
As to the first point, the Paris ambulance is light enough to travel, when loaded, at the rate
of eight miles an hour with a single horse.
The second point calls for some brief explanations. The New York carriage is open at the
sides, the openings being fitted with curtains. This is a defect, for there is no protection from the
cold. Besides, the floor is entirely occupied by the stretcher and mattress on which the patient
is placed, so that the doctor is obliged to stand on the step, holding on by a strap. This is
another and more serious defect, seeing that, apart from the doctor's dangerous and inconvenient
position, he is practically unable to render the patient any assistance during the journey,
* Area of Paris—P,000 hectares, about 19,768 acres, say 20,000 acres, therefore one-oixth of Paris i J about 3,300 acres, or five squa: e
miles.