The novel’s 17th-century timeline is shaped by the real historical establishment of the Hôpital de la Pitié-Salpêtrière and the medical theories of the era. Founded by an edict from King Louis XIV in 1656, the Salpêtrière was part of the Hôpital Général de Paris, a massive institution created during a period known as the “Great Confinement.” (McHugh, Timothy J. “The Hôpital Général: The Parisian elites and crown social policy during the reign of Louis XIV”, French History, September 2002.) Its purpose was to remove Paris’s outcasts—the poor, sex workers, and the mentally or physically ill—from public view. 

Salpêtrière was designated as a women’s hospital. In practice, it functioned less as a modern hospital and more as a prison and workhouse, housing thousands of women in unhygienic and often brutal conditions. This reality is depicted graphically in Skylark: The hospital Alouette enters is a dumping-ground for any woman deemed troublesome, reflecting historical attitudes toward forms of social or physical “deviancy” or non-conformity to established norms, often stigmatizing poverty and physical or mental health conditions. Alouette’s “treatment” is based on the period’s dominant humoral theory, which held that health depended on the balance of four bodily fluids: blood, phlegm, yellow bile, and black bile. (Hajar, Rachel. “Medicine from Galen to the present: A short history,” Heart Views, February 2022.)  Illness was seen as an imbalance, and physicians sought to restore equilibrium through practices like bloodletting and purging. Monsieur Moreau’s decision to bleed Alouette to cure her supposed “excess of heat in the blood” (226) is a direct application of this flawed medical logic. The novel also depicts historical medicine’s often inaccurate and misogynistic attitudes toward women’s bodies, consent, and agency, including the use of committal to protect patriarchal power, and the use of terms such as “hysteria” to medicalize female distress. (Snider, M. Hysteria, medical sexism, and gender-based inequity in Western healthcare. York University Major Research Papers. 2023.) This historical context clarifies that her torment is sanctioned by the era’s medical science, revealing how institutional power defined female defiance as a pathological condition requiring violent correction.