Hospital Politics in Seventeenth-Century France: The Crown, Urban Elites and the Poor (review)

Tim McHugh's book offers a fresh and highly readable treatment of an important subject, taking the history of French poor relief well beyond post-Foucauldian revisionism to examine the key role of urban elites in the formation, administration, and financing of policy. The study also breaks with older longterm models of poor relief that posited the passage of responsibility for the poor from the church to the state.

After a brief historiographical introduction, the book considers theories of charity and poor relief, including Jansenist and Jesuit as well as secular approaches. Given the importance later in the book of competition between Catholics and Calvinists in Bas-Languedoc, a discussion of Calvinist views here would have been welcome.

The text centers on three case studies of institutional developments in Paris, Montpellier, and Nîmes. While the author's choice to compare the capital to provincial cities is one of the book's many strengths, McHugh does not provide a rationale of how he chose these two particular provincial cities. It is clear that the impact of the Protestant Reformation must have been a motivating factor, but it would have been interesting to have more information about the author's view of the representativeness of these two cities as cases for comparisons with the capital.

The study focuses squarely on the elites themselves and on the hospital institutions they created and reformed to care for the poor. McHugh's argument that the crown had only an indirect role in the development of poor relief in the seventeenth century is confirmed by most of the narrative, in which the crown and its various agents are held to background roles. The book has even less to say about the poor themselves, who appear mainly as objects of policies.

The composition of the elites in question, particularly in the two cities of Languedoc, changed during the seventeenth century. Medieval consulates that had combined representatives of merchants and artisans were gradually replaced by members of sovereign courts and provincial estates (in the case of Montpellier), whose vision of poor relief was shaped less by older civic models and more by a mixture of Counter-Reformation piety and family-based social ambition.

McHugh covers several well-known themes such as the role of hôpitauxgénéraux in the (re)conversion programs of the Counter-Reformation, and the religious underpinnings of the policy of enfermement (enclosure) of the poor, but with unusual and evocative detail that takes readers into the heart of poor relief institutions.

The provincial case studies also permit the author to venture into more innovative topics, including efforts by some within Nimes' Catholic and Protestant elites to hold their joint poor relief system together after the active stage of religious war had concluded. Another force for moderation in Languedoc appears in the person of Lamoignon de Bâville, Intendant, who, though a royal officer, showed great deference to the traditional authority of local elites in the management of poor relief.

One of the most fascinating subthemes of the text for this reader is the method of funding poor relief. McHugh shows that in contrast to some received opinion, poor relief in the hands of local urban elites —whether medieval or early modern —was funded not only or mainly by voluntary charity, but rather by what we might call enforced charity: direct taxes levied regularly on city populations as well as indirect taxes on foodstuffs.

Responsibility for the decline of this funding source, McHugh argues, rested in large part with the monarchy, which saw the raising of local taxes for poor relief as an increasing threat to its own insatiable need for revenue. Furthermore, the notion that Christian charity towards the poor should be purely voluntary —an idea that grew in popularity among some circles into the modern period —would have...