Early Modern Burgundian Hospitals as Catalysts of Independent Political Activity Among Women: Lay Nurses and Electoral Empowerment, 1630-1750
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This essay investigates the largest secular healthcare network in early modern Europe in which lay women took vital roles as professional nurses, pharmacists of renown, and powerful, highly conscientious administrators. By 1750, this organization encompassed at least fifty-five municipal and charity hospitals of varying size located in towns throughout eastern France and western Switzerland. These hospitals were all direct outgrowths of the remarkable Hôtel-Dieu (les hospices civils) in the Burgundian town of Beaune and its institutional satellites. At each site, patient care, nurse training, pharmacology, and many aspects of internal governance became the responsibility of an extensive, closely bound consorority of lay women trained under and showing enduring fidelity for centuries to the secular governing rules of the mother-house in Beaune.
My study is a comparative one. It relates notable confrontations between lay female nurses and potent external antagonists at the highest echelons of the French clergy. The hospitals involved are the civil hospital of Chalon-sur-Saône (also known as the Hôpital de St. Laurent) and the Hôtel-Dieu of Dole in the adjoining province of Franche-Comté. At both sites, the nurses and their internal, secular protocols of politics and governance drawn from Beaune became the targets of senior Catholic prelates intent on remaking and controlling the nurses' vocation. These churchmen both misunderstood the lay status of the nurses and entirely underestimated their resolute, resourceful defense of their ancient electoral and administrative liberties. This defense was anchored by long, eloquent affidavits from the nurses themselves wherein they articulated the service values they held dear and their principled, political objections to outside efforts at controlling them. Such power-political testimonies from early modern French women are quite rare and especially informative. In this contest, misinformed and presumptuous prelates lost every legal challenge they mounted against the nurses' cherished rights of self-governance and medical service. These episodes of complex contest between healers of souls and healers of bodies illuminate the local dynamics of the French Counter-Reformation. They also offer new perspectives on the history of hospitals, women, and women's political agency in the formation of a public sphere in early modern France.
The magnificent Hôtel-Dieu of Beaune was founded in 1443 as a hospital for the sick poor by the august chancellor of the Burgundian state, Nicolas Rolin. Rolin lavishly endowed this institution with fertile fields, forest tracts, prime vineyards, and 1,000 livres in annual rents on the Salins salt works. He assiduously bought contiguous building plots within Beaune for his hospital and paid the entire cost of its construction. The hospital was his masterwork of charity intended to expiate in perpetuity the myriad crimes and misdemeanors he had ruthlessly committed in unswervingly loyal service to his prince, the duke of Burgundy. By 1451, the institution was in full operation, taking in up to fifty indigent patients at a time.
Rolin also lavished attention on organizing and reorganizing the internal staff and operations of his hospital. He originally entrusted patient care in Beaune to a group of beguines imported from Flanders. Outraged by the misbehavior of an audacious and sadistic mother superior, Rolin soon dismissed the entire company. In 1459, to a team of three notaries, he personally dictated the highly detailed new internal operating statutes of the hospital. Rolin stipulated that the entire organization was to be overseen by a board of directors drawn from the échevinage of Beaune, with the mayor as chief executive. Rolin entrusted medical care and pharmacy development to a cadre of lay nurses whom he specifically prohibited from ever taking holy orders or becoming nuns. Rolin accorded these women the right to elect their headmistress and her second-in-command by secret ballot. Once elected, the headmistress was to serve for life. Rolin assured the headmistress a place and a deliberative voice on the executive council of the hospital. She alone was responsible for the recruitment, admission, evaluation, and dismissal, if necessary, of all nursing candidates. Postulants to the nursing staff were expected to swear allegiance to the operating statutes, obedience to the headmistress and executive council, chastity during their time of service, and devotion to the humble care of the sick poor above all else. In return, they received lodging, meals, a nominal annual salary, and clothing suitable to their vocation at the hospital. This habit was blue in winter and white in summer accompanied by an elaborate white kerchief, an ensemble to which the nurses gave special, enduring attention. This distinctive dress undoubtedly contributed to their very strong esprit de corps. Their similar social origins reinforced this sense of solidarity; candidates for the nursing staff came principally from notable local families anchored in the middle to upper-middle ranks of Burgundian society. The fathers and kinsmen of nursing recruits included skilled artisans, wine merchants, notaries, lawyers, and civic and parliamentary office holders. Investiture ceremonies for new nurses became public holidays at Beaune, and a woman's dutiful service to the hospital redounded to the great honor and esteem of her family.
Enrolled lay nurses in Beaune's hospital retained full rights to hold and dispose of external property. They owed no fees or dowry to the institution. They were also permitted to leave the institution at will after giving suitable notice. Rolin accorded the nurses a chaplain/confessor to be drawn from the local clergy of Beaune. No other priest could perform the office of the dead or administer the sacraments within the Hôtel-Dieu. This chaplain served at the pleasure of the executive council, and Rolin made certain that no senior clerics could ever meddle in the selection or service of the chaplain except in cases of moral turpitude or dereliction of duty. At great cost, Rolin obtained multiple privileges directly from the pope in Rome exempting the Hôtel-Dieu in perpetuity from the jurisdiction of local bishops and regional archbishops. Collectively, these arrangements were known as the "rule" of Beaune's hospital, and all employees swore to uphold it. All members of this charitable house ultimately answered to Rolin personally, and the chancellor appointed his senior male heir in perpetuity as patron and supreme governor of the charitable institution.
Beaune's nurses quickly gained repute throughout the region for their kindness, self-abnegating Christian charity, competence as healers, and expertise in assembling and dispensing a growing pharmacopoeia. Even decades after successful treatment by Beaune's nurses, lowly vignerons and poor peasant women in the area remembered them and the hospital in their simple wills, giving humble donations in recompense for what one formerly destitute patient called "the kindest consideration I have ever received in my life." Such public veneration of the Hôtel-Dieu and its lay, female working staff strengthened the nurses' solidarity and enhanced their sense of guardianship over patient care and the functioning of the institution as a whole.
As Beaune's hospital grew in stature, the nurses there were able to assert their authority and autonomy. In 1639, Beaune's nurses successfully took legal action locally and through the Parlement of Paris to block the attempt of their nominal patron Louis de Pernes, count d'Epinac, a descendant and heir by marriage of Nicolas Rolin, to move in and use the Hôtel-Dieu as his primary residence in Burgundy. Thirteen years later, Beaune's nurses sued and thwarted de Pernes' son who tried to abrogate the nurses' electoral privileges and claimed the right to appoint at will headmistresses of the nursing staff. In both cases, the nurses prevailed by asserting that the presence and malfeasance of aristocratic patrons would destroy the hospital's "public reputation" (honnêteté publique). The nurses of the Hôtel-Dieu presented themselves as defenders of an honorable, caring institution that benefited immensely from Burgundians' respect, trust, and charitable support predicated on this veneration of the hospital. They construed the Hôtel-Dieu as a public trust and themselves as vital trustees of the hospital by virtue of their work experience and exemplary care in the wards. This trustee status legitimated their legal combat against their nominal patrons. The capacity of early modern French urban charities publicly thus to empower female members of their personnel should be counted among the most significant aspects of their socio-political and socio-cultural histories. Nurses from Beaune carried with them far and wide a remarkable aptitude for successful legal defense of their own working rules and the integrity of the hospitals they represented.
The growing renown and resourcefulness of Beaune's nurses induced the city fathers of numerous other Burgundian towns to petition the Hôtel-Dieu's executive council for either the loan or permanent transfer of nurses to institute or to take over and reform medical services and administration at other hospitals. This was the case in Chalon-sur-Saône, on the river south of Beaune, in 1632 when city fathers requested nurses from Beaune to take over the dysfunctional local civic hospital of St. Laurent. In anticipation of the arrival of the expert Beaune nurses, the governors of Chalon fired the entire aging, irresponsible, and incompetent staff of their own hospital. They begged the council of Beaune's hospital to advise the nurses there of Chalon's crying need for help. The Beaune council did so but left final adjudication of the matter for the nurses themselves to decide. Ultimately, after much internal debate and soul-searching, two nurses and three probationary staff (novices) from Beaune volunteered for service in Chalon on the condition that they could bring Nicolas Rolin's complete rule with them and conduct patient care in their new hospital on that model. While city fathers in Chalon retained supreme administrative authority over the hospital of St. Laurent, they worked to accommodate the nurses' wishes and readily assented to their conditions. They noted with relief that they could now count on the arriving nurses ("these dear women") to establish quickly the good order, competent management, and cleanliness that assured the wide fame of Beaune's own Hôtel-Dieu. Nursing staff at Chalon grew to twelve in 1640 and to sixteen in 1662 as the nurses from Beaune settled in, won new recruits, and enlarged charitable donations for the hospital from the notable families of Chalon. Chalon's new nurses all maintained close ties of affection and regular correspondence with colleagues in Beaune. They shared a commensurate devotion to trusteeship and Rolin's rule, which was now more than two hundred years old but still integral to the nurses' sense of communal identity and public medical service.
In 1661, the presence of esteemed lay nurses in Chalon apparently disconcerted the city's new bishop, Jean de Meaupou, formerly chief almoner to Louis XIV. Tangling with Chalon's city fathers over who possessed the right to control ecclesiastical appointments within the Hospital of St. Laurent, Meaupou asserted in a letter that he exercised supreme administrative authority over all "monastic congragations" existing within his diocese, one of which he contended was the hospital in Chalon. His supervisory rights here, he argued, also derived from the papal bull of 30 June 1622 by which Pope Gregory XV ascribed governance of all hospital nuns (religieuses hospitalières) in France to local bishops.
These assertions of episcopal authority over Chalon's hospital met with immediate counter-blasts from members of the city council and the nurses themselves, adept political parties now working in tandem and equally convinced that Meaupou sought to treat the nurses as religious sisters "bound by vows to a rule" (liées par des voeux réguliers). While Chalon's échevins sued Meaupou in the Parlement of Dijon to restrict his authority over the hospital, Chalon's nurses employed the local procureur of the bailliage, kinsman to one of them, as an emissary directly to Colbert and the queen mother in Paris. They equipped their representative with a letter for Colbert signed by eleven of the nurses that asserted their lay status – they were never nuns – and their historic exemption from episcopal government according to Beaune's rule. They artfully appealed to Colbert as "the poor daughters of the hospital" (pauvres filles de l'hopital), seeking asylum and protection from a bishop too zealous in expanding his powers that would trammel their "exemption from episcopal jurisdiction." They asked Colbert to intercede to spare them from injustice, so that "we may no longer be troubled in the jurisdiction of the almoner appointed by Messieurs the mayors and échevins." Failure to restrict the bishop, they feared, would "cause divisions among us and grave affronts to our conscience."
This letter is remarkable for several reasons. First, it shows the nurses' determination to secure protectors at the very highest levels of the French royal state. Second, it displays the nurses' acute awareness of jurisdictional boundaries and disputes; they repeat the word "jurisdiction" three times and emphasize that any innovations therein would be seriously disruptive and legitimate causes for the nurses' anguish. Third, it manifests the nurses' adroit political maneuvering, allying themselves with civic officials and local royal magistrates to thwart the ambitions of senior local prelates. There, the nurses and their allies succeeded brilliantly. In February 1665, the nurses' procureur returned to Chalon carrying letters from the queen for the intendant of Burgundy and the bishop of Chalon himself. The queen's letters ordered the bishop to desist from all meddling in the hospital's internal affairs and commanded the intendant to certify that this order was followed. At a public assembly held at Chalon's hospital in the company of the current mayor and three former mayors of the city, the headmistress of the nurses took the floor and triumphantly read out in detail the contents of the queen's letters. At Chalon, the French Counter-Reformation from above did not pass through the city's main hospital.
Fourteen years later, in 1679, the nurses and magistrates of Chalon relied on this precedent to make common cause again. Now they completely stymied a new bishop's presumptuous demand for a seat on the hospital's administrative board. The political symbiosis between town council and hospital nurses endured at Chalon. It was reinforced by the council's solemn presence at and endorsement of elections of headmistresses at the hospital in 1692, 1717, and 1732. Civic magistrates took special care to document the proper conduct of these elections, stipulating the names of all sisters involved in the polling and scrupulously noting that the tradition of secret, written balloting continued unabated. All parties concerned apparently appreciated such elections as central to the good order and integrity of the hospital and the civic community at large. Fidelity to these deliberative protocols further restricted the much more authoritarian ambitions of senior churchmen within the city.
Similar tensions arose between like antagonists at Dole in 1697-1698, over two centuries after Rolin dictated his hospital rule so empowering to lay nurses. Here in Dole, amidst the war-torn frontier province of Franche-Comté, city councilmen faced ill-disciplined regular French and Spanish troops, roving bands of mercenary brigands, citizens racked by multiple communicable diseases, and peasants starved by recurrent subsistence crises. Dole's own Hôtel-Dieu desperately needed an infusion of highly competent administrative and medical personnel. Thus, in 1663, fifteen years before the surrounding province itself became nominally French, Dole's magistrates appealed to the Hôtel-Dieu in Beaune for a long-term loan of as many sisters and novices as could be spared. Again at Beaune the nursing staff carefully debated deputizing sisters for so perilous a mission across an ill-defined international frontier and into a bleak, devastated foreign province. Eventually, six nurses and a new headmistress-elect from Beaune chose to emigrate, arriving in Dole on 21 November 1663. They brought Rolin's rule with them and accordingly re-energized Dole's hospital, which grew to a community of twelve nurses and numerous novices by the 1690s.
Ceded to France from Spain by the Treaty of Nijmegen in 1678, Franche-Comté became a demonstration site for the French Counter-Reformation. The zealously pro-French Antoine-Pierre de Grammont, secretly consecrated archbishop of Besançon in 1662, labored diligently at this task. Grammont showed special concern for much closer clerical governance of all hospitals within his archdiocese, including that of Dole. For years, he and his agents assiduously gathered information on the form and operating statutes of all hospitals in his domain. In the mid-1690s he personally composed and then ordered his diocesan print shop to publish his Règlement de la conduite des hôpitaux du diocèse de Besançon et des religieuses qui y servent les pauvres et les malades (1697). In this 132-page tract, Grammont made his ambitions very clear. He sought to impose new rules for the reception and treatment of the sick poor, for the behavior of nurses both inside and outside all of his hospitals, and for clerical supervision and control of all hospital administrative matters. He continually referred to the nursing staff of his hospitals as nuns (religieuses) and specifically intended that all nurses take perpetual holy vows, become nuns, and accordingly adopt veiled habits. Headmistresses were to lose all control over the admission of sick patients and aspiring nurse candidates. Moreover, the archbishop sought to curtail all headmistresses' terms of service, reducing the post to a maximum triennial tenure and making each headmistress dependent on annual re-elections. Under Grammont's regime, ordinary nurses under Rolin's rule at Dole would lose completely their freedom to hold personal and familial property, leave the hospital with notice at will, and wear their own traditional working garb.
Such sweeping proposed alterations in the governance of Dole's Hôtel-Dieu immediately elicited strong opposition from Rolin's nurses who had already been working in Dole over thirty years. The mayor and city councilmen, alarmed at the prospect of seeing their most talented lay nurses driven from the community at a time of great public need, made common cause with them, encouraging each nurse to sign depositions of protest. After close consultation with the entire nursing staff, the headmistress, Jeanne-Marie Gombeau, declared that she found it impossible to abandon any part of the rule from Beaune. She refused outright to "submit" to a triennial term of office, stoutly rejected annual re-elections, and dismissed any changes at all in the dress of working nurses. She would quit Dole at once, she asserted, abandon the Hôtel-Dieu, and return to Beaune rather than accept any of the archbishop's detestable plans. Such action, she contended, would be entirely preferable to obeying the archbishop and thus breaking the contract (traité) formerly agreed to between the administrative council of the hospital in Dole and the Hôtel-Dieu in Beaune. In her reiterations of the nurses' contractual obligations to Dole and its hospital, Gombeau set the tone for her nursing sisters' complete rejection of the archbishop's plans.
Gombeau's nurses followed the headmistress' lead. Nurse Marie Derriey asserted that she could never consent to acceptance of the new archepiscopal rules. They would only harm proper care of the sick poor and foment "disunion" among the nursing staff. Derriey and several of her sister nurses apparently became convinced that their external opponents especially sought to undermine the integrity of the staff from within, break the nurses' mutual trust, and factionalize them by means of perpetual annual elections imposed from outside. Nurse Catherine Conte would never consent to the new rules. She would leave Dole rather than submit, "having never imagined upon her admission that she would ever be subjected to obey in spiritual or temporal matters anyone other than the council of the hospital, the headmistress, or the nurses' confessor." She was convinced that the archbishop's plans for a headmistress annually re-elected to a limited triennial term would only foment factions among the nurses and their kin. This situation would destroy forever the close union the nurses had previously enjoyed and would entirely undercut the authority of headmistresses based upon long experience of patient care. Nurse Marguerite Sigaud also stated that she would quit the hospital and Dole rather than "subject herself" to any rule other than that of Beaune. Nurse Catherine Regnier declared that she would "persist forever" in her devotion to the rule of Beaune and could never consent to any change in the internal governing protocols or in the dress that "distinguished her as one of the sisters of the hospital of Beaune." In matters of internal hospital governance, she announced that her allegiance would go only to a headmistress freely elected by the sisters themselves.  Nurse Ursule Guigne "wouldn't hesitate a moment to quit the hospital if she were obliged to follow the new rules, never having consented to subject herself to anything but the rule of Beaune."
Although Dole's nurses from Beaune persistently reminded the archbishop that they were not and never had been nuns, they did not limit their rebuke of his pretensions to the issue of his non-existent jurisdiction. Their vocabulary of protest boldly reiterated no submission, no subjection, and no violation of conscience through renunciation of the contracts to which they had consented and for which they had voted. Manifest here were the nurses' exceptionally strong professional ethos and self-perception, individual and collective, as the real trustees of Dole's hospital. They expressly grounded both attributes in effective service to the sick poor and complete fidelity to Rolin's emancipatory, unifying rule.
The nurses' steely refusals to submit utterly shocked Archbishop Grammont. He bombarded the sisters with ever angrier fulminations to obey. In a series of letters sent at very short intervals from Besançon to Dole, Grammont persistently addressed the nurses as "our" or "my very dear daughters" (Nos / mes très chères filles) – note the possessives and the clearly monastic tone of these salutations. He could in no way comprehend the nurses' "repugnance" for his rule, and he castigated them for ever attributing to themselves the authority to administer Dole's hospital without deference to clerical instruction. Grammont sought to establish complete "uniformity" in regulation for all the hospitals in his charge, and he would not allow female nurses to impede this progress. Their insubordination in this matter was astounding, especially because he clearly conceived of the nurses as nuns duty bound to effect his wishes. Unimpressed with these rebukes, Dole's nurses from Beaune flatly refused to give in and abandon the political prerogatives of their secular rule.
Archbishop Grammont died, aged eighty-four, on 1 May 1698. He was immediately succeeded by his nephew, Pierre-Joseph de Grammont, named by the king. Perhaps the new church dignitary held the nurses of Dole entirely responsible for the old man's fatal apoplexy. Whatever the cause, Pierre-Joseph swiftly demanded that the nurses in Dole submit entirely to his late uncle's plan for all the regional hospitals. The nurses once again completely refused and appealed for relief to the parlement now operating in Besançon. At considerable cost, both sides in the mounting dispute sent emissaries to Rome to check on the fifteenth-century papal bulls by which Nicolas Rolin had initially exempted his hospital and his lay nurses from the meddling of local ecclesiastics. Oddly enough, these documents proved entirely authentic, and papal secretaries could not be suborned to alter the originals. In letters, Pierre-Joseph de Grammont's Roman agent complained continually of his penury, the exorbitant cost of research in the Eternal City, and the steep bribes he often could not afford that were necessary even to gain access to archival secretaries at the Vatican.
In a futile effort to intimidate the nurses, the new Grammont archbishop resorted to a lettre de cachet against the insubordinate headmistress in Dole, Marie Gombeau, ordering her sequestration in the Hôtel-Dieu of Besançon. She quickly fled to the mother house hospital in Beaune, safe at last. Advocates for the hospital in Dole decided to appeal directly to the king's council in hopes that a definitive royal opinion would defuse the entire matter which had now grown extremely poisonous. Aided and abetted by influential Franc-comtois nobles at court, representatives of Dole's Hôtel-Dieu won their case. They secured a royal decree of 6 July 1701 restoring Gombeau as headmistress at Dole, conveying the king's praise for the nurses' "wisdom" and effective medical service, and permitting them to operate in full accord with Nicolas Rolin's still vibrant rule. Archbishop Grammont got the message to busy himself with other ecclesiastical matters that were more pressing in a slowly recovering frontier province. Yet again, agents of a centralizing and authoritarian Catholic Reform could not check lay female nurses carrying forward a professional rule of service perceived widely as integral to their success as healers.
Although surveyed all too briefly here, these events show how lay French women, sharing and propagating an identity as professed nurses and pharmacists endowed with self-governing liberties, set very firm limits to the authority of seventeenth-century clerics. In defense of their vocational liberties, self-determined, contractual obligations, and essential freedom of conscience, lay female nurses in several important provincial cities forged strong, enduring political alliances with local civic magistrates also intent on limiting the prerogatives of clerics. Such public-private partnerships today are considered essential for the sustenance and propagation of civil society. In the early modern French cases surveyed here, many municipal hospitals, staffed and defended by highly competent and self-governing female nurses with long experience of electoral politics, helped to foster the development of a prototypical public/professional sphere. Within that emerging sphere, animated by many French hospitals and their female lay nurses, the protocols of effective, consensual public service trumped the dogmas of religion. These disputes reveal the highly variegated and problematic history of the French Counter-Reformation. More importantly, these episodes involving the widely active lay nurses of Beaune indicate how even the most "absolute" of French monarchs acknowledged the utility of women's liberties that assured the effective and humane care of a society's most humble and needy members.
See Abbé Boudrot, L'Hôtel-Dieu de Beaune, 1443-1880 (Beaune: Batault-Morot, 1881). This is the only comprehensive history of Beaune's charity hospital ever written. The documentary evidence that Boudrot presents is precious, but his narrative account offers no analysis of the institution's broader cultural history, nor does it pay any attention to the extraordinary expansion of its lay nursing service to other hospitals in the region and beyond.
The rule of the house exists in multiple manuscript copies within the Archives of the Hôtel-Dieu in Beaune [hereafter AHDB] and was printed at least once in the seventeenth century and broadly disseminated.
For a more detailed analysis of these legal conflicts see my article "Patrimony, Trust, and Trusteeship: The Practice and Control of Burgundian Philanthropy at Beaune's Hôtel-Dieu, c. 1630," in The Impact of Hospitals 300-2000, ed. John Henderson, Peregrine Horden, and Alessandro Pastore (New York: Peter Lang, 2007), 77-92.
AHDB, Minutes of the Executive Council, 13-14 Nov. 1632. See also Henri Batault, Notice Historique sur les hopitaux de Chalon-sur-Saône avant 1789 (Chalon: L. Marceau, 1884), 126-7. Batault's analyses are based on his careful reading of the original archives of the Hospital of St. Laurent, especially Series A-D previously conserved in the Archives Hospitalières Chalon [hereafter AHC].
Batault, Notice historique, 171-2, is apparently based upon AHC, Série C1-C9, "Matières ecclésiastiques," to which the author had access in the later nineteenth century. This series is listed and partially described in the 1914 manuscript catalogue of the Archives de l'Hôpital de Chalon now in the AHC (Hospital of St. Laurent) in Chalon. However, the location of the entire Série C from this archive is unknown as of fall 2006.
Antoine-Pierre de Grammont, Règlement de la conduite des hôpitaux du diocèse de Besançon et des religieuses qui y servent les pauvres et les malades (Besançon: Rigoine, 1697). This rare duodecimo text is in the Bibliothèque Municipale de Besançon, Bureau d'étude, Réserve Comtoise, cote 230456.
Archives Municipales Dole [hereafter AMD], Archives Hospitalières, Cote 40, no. 9, 10 Jan. 1698. All of the nurses working in Dole signed very clearly and firmly their depositions of protest to the archbishop. Coupled with their voluminous manuscript correspondence, such evidence clearly indicates a very high degree of literacy among these servants of the sick poor.
See AMD, Archives Hospitalières, Cote 40, nos. 4-8 for the letters from Rome of Le Prieur Beuque, Grammont's agent charged with inspection of all surviving papal dossiers concerning Nicolas Rolin and the privileges Rolin obtained from fifteenth-century popes for the Hôtel-Dieu in Beaune.
For details on this continuing conflict see Eric le Bas de Bouclans, Les soeurs de Sainte-Marthe aux XVIIe et XVIIIe siècles: de l'Hôtel-Dieu de Dole à la Franche-Comté (Mémoire de maîtrise, Université de Besançon, 1999), 112-22.