For the most part, the setting of this novel is the Hôtel de Lamballe. It was once a Paris residence of the ancien régime but by 1892, the date of the action, it is a maison de santé under the direction of the real-life alienist Dr Blanche, father of Jacques-Emile Blanche, the popular and snobbish portrait painter of the XVIth arrondissement. Three characters dominate the narrative. The eponymous Adam Gould is a failed Irish seminarian whose family problems – illegitimacy and a father who, to raise money to meet his mounting debts, abandons his common-law wife, Adam’s mother, in pursuit of a lucrative match, thus precipitating her suicide – have driven him to move to Paris and take up a job in Blanche’s clinic. 

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