Abstract We draw on Colin Jones’ framing of the Sisters of Charity as medical practitioners rather than charitable carers (1989) to centre the entrepreneurialism of Marie Grand and Marie Fiansons’ medical practice in eighteenth-century Lyon. Although historians recognize the significance of early modern European women’s (medical) work, they often assume such work existed in the shadows of the medical marketplace. Archival erasures and gendered narratives obscure the flexibility of women’s medical practices. Grand and Fiansons’ documents, analysed alongside adverts for local medical services, elucidate working women’s medical practices. As silk-workers and self-defined ‘chymists’ and herbalists, Grand and Fiansons were at the centre of healthcare and medicine. The breadth of their practice and networks emerges through the exceptional survival of their ‘counter-archive’ in the consular court archives. Their story reveals the fluidity and porousness of boundaries between domestic and occupational medicine, precarity and commodified care work, and charity and entrepreneurialism.