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The article studies the obligation of Paris surgeons to offer primary healthcare in the eighteenth century. Ordinances and police archives document what is defined as a “œpublic service of surgery,” i.e. a system which organized professional surgeons, cheap workforce, hospital and police institutions, medical technology and know-how, and payments throughout the century. This system was rooted in the domestic economy of the wealthy in charge of healthcare provided for their household. In case of emergency, surgeons’ shops or commissaires’ offices served as emergency rooms, before the injured were carried to the Hôtel-Dieu, a center of urban geography of medical emergency, or to the home of the injured. The funding of this organization was grounded in the use of surgical workforce that worked for nearly nothing— surgical students whose number greatly rose in the 18th century— and in professional deontology. Free public service was also funded by high remuneration of witness surgeons in case of criminal procedures. In addition, commissaires warranted surgeons’ healthcare payment, by litigation or threat thereof.