Local Hospitals in Ancien Régime France: Rationalization, Resistance, Renewal, 1530-1789

Leonard Adams is a professor of French Studies at the University of
Guelph.

This study of eight hospitals in France (two each in the provinces of
Brittany, Normandy, Dauphiné, and Provence) examines the factors
responsible for their survival over more than

200 years despite repeated efforts by the crown aimed at rationalizing
and reforming such

institutions.

In his painstaking investigation of archival material, Daniel Hickey
highlights the complex political, economic, medical, and social factors
that were to determine the administrative orientation health care took,
not only in the selected regions but in the entire country. Over the
period, an absolute monarchy resorted to expediency and coercion in its
attempt to deal with urban centres vying with rural districts for the
spoils of expropriation and for subsidies from the royal treasury.
Caregiving institutions were always an expensive component of social
governance.

In the process, responsibility shifted between the central government,
provincial authorities, local notables, and the Church. Inspired by the
new thinking of the Catholic Reformation, the diocesan clergy played a
major role, sharing in the creation of new charitable orders that
increased the participation of women at all levels of the welfare and
hospital care system. Even Enlightenment thought played a part in
resisting centralization and in implementing municipalization measures
that, in the end, ensured the survival of a number of local hospitals.

Summations solidly based on careful analysis and collation of a wealth
of primary sources are evident throughout Hickey’s work. His choice of
institutions proves to be a varied and comprehensive sample; his
analysis of the data presented reinforces the validity of his arguments
and justifies their applicability.

An informative glossary, pertinent statistical maps and tables, and a
detailed index enhance the usefulness of this book, which has much to
offer social and cultural historians. Editorial oversights that have
crept into the text appear insignificant in comparison with the
thoroughness and scholarly organization that characterize this important
contribution to 18th-century studies.