Book excerpt: At a time when governments are obsessed with cutting back the social network and encouraging private charities to fill the needs of the poor and the sick, Daniel Hickey provides a timely look at retrenchment strategies in local hospitals in Ancien Régime France. He explores two opposing campaigns to reform poor relief and aid to the sick: attempts by the French Crown to centralize social services by eliminating local institutions and initiatives taken by the local population to revitalize those same institutions.