The Montreal General Hospital began as a community initiative driven by the Female Benevolent Society of Montreal, a charity formed by a group of Protestant women who recognized the urgent need for care on behalf of growing waves of indigent immigrants arriving in the city from across the Atlantic. The MGH was the first general public hospital open to all creeds to serve the needs of the Montreal community, and has remained faithful to this principle of service for over two centuries. Its unofficial first location was a modest, four-bed shelter opened in the Recollet suburb in 1818.

Prior to the creation of Lower Canada in 1791, Montreal was a small French colony with limited resources for medical care. In 1645, Jeanne Mance created Hôtel Dieu, Montreal’s first hospital. By the early 19th century, Hôtel Dieu was the only hospital serving Montreal’s citizens, and there were just twenty-one licensed physicians for a city of twenty thousand. Individual doctors would perform house calls, but there was no single institution operating with an inclusive open-door policy in the city that could cater to an increasingly English-speaking, Protestant population. The Montreal General Hospital changed this reality.

Sir Thomas George Roddick was a McGill-trained physician and surgeon whose career began at the Montreal General Hospital. As an early adopter of germ theory, Roddick learned of a new surgical antiseptic technique developed by Joseph Lister. He visited the doctor in Edinburgh (1872) and again in London (1877) where he was able to secure one of Lister’s carbolic acid diffusers and bring it back to Montreal. The first of its kind in North America, Roddick consistently used the diffuser in the operating room and published his findings supporting its use. With the introduction of antisepsis, surgical mortality rates at the hospital dropped from 80% to less than 4%, forever changing the practice of surgery.

The introduction of antisepsis was so successful in lowering the mortality rate of surgeries that for the first time in history surgery began to branch out as a category separate from medicine. Renowned MGH surgeon Francis Shepherd recalls that after 1877 “no region was sacred to the surgeon’s knife,” since with lower risks came the viability of accessing the brain, spinal cord, abdominal cavity, and vital organs. In 1882 Roddick declared he would only practice surgery, effectively separating medical and surgical disciplines at the hospital for the first time. This decision would anticipate the flourishing of medical specialties to come. By the eve of the First World War, the hospital had transitioned away from a service that was mainly custodial to a place of healing.

While at the MGH, Roddick served as the chief surgeon of the Canadian Forces for the North West Rebellion. After he left the MGH, he continued to distinguish himself by playing an instrumental role in the creation of the Medical Council of Canada, championing public health issues, especially tuberculosis prevention, and founding the Alexandra Hospital for Infectious Diseases. He also served as the Dean of Medicine at McGill from 1901 to 1907.

As Montreal rapidly industrialized, it grew into a city of over three hundred thousand inhabitants by the end of the nineteenth century. The MGH adapted to these changes with the expansion of its services as it endeavored to meet the demands of a newly urban population and its health problems. Infectious diseases and sanitary problems remained rampant, and the infant mortality rate was shockingly high – one in four children did not survive infancy – largely due to slum conditions in the city’s working class areas, alongside contaminated water and milk supplies.

The Social Service department was established at the MGH in 1911 through the efforts of Reverend John Lochhead of the Melville Presbyterian Church in Westmount. Inspired by Richard Cabot at the Massachusetts General Hospital, who pioneered hospital-based social service programs, Lochhead raised funds for the salary of a full time social worker, Emma J. Foulis, who was hired in 1912 and did a two-week apprenticeship at the Massachusetts General.

Though ignored at first by hospital staff, the department – with the help of twelve volunteers – identified charitable agencies that could provide services to the poor and homeless, and arranged for transfers of convalescing and chronically ill patients to other institutions at a time when the hospital’s shortage of chronic care beds desperately needed addressing. The Melville Church congregation also purchased a residence on the summit of Westmount Hill for the MGH to use as a convalescent home, a precursor to the Montreal Convalescent Hospital.