Last week, Monte dei Paschi completed a sale of shares valued at €3 billion and replenished its capital. But the bank is gasping under a pile of bad loans and has effectively put itself up for sale, which could mean moving its headquarters away from Siena. Fabrizio Viola, the bank’s chief executive, said that Monte dei Paschi will continue to support Siena as a bank, though not as a benefactor. “We are ready to support the economy with good credit at the right price,” he said.

Siena is slowly adjusting to life with a greatly diminished Monte dei Paschi.

Some of the changes have been small. The Misericordia di Siena, which provides ambulance service and other health care services, is making up the lost funds by renting out real estate and collecting more money from members and other private sources.

“Had we survived only with the foundation’s money, we’d have gone belly up,” said Mario Marzucchi, president of the Misericordia, which has been operating for more than seven centuries.

Other activities financed by the foundation were less essential, like a club for the spouses of doctors, and the colorful costumes that members of the city’s Contrada, ancient neighborhood associations, wore in processions that preceded the Palio races.

“There was too much money. Everything was easy,” Marcello Clarich, the president of the Monte dei Paschi Foundation, said in his office overlooking the Piazza del Campo. “Now we are going back to normality.”

A broader economic overhaul will take longer.

As Siena looks to reinvent itself, the city, in part, is looking to that past. With a large and well-preserved medieval center, Siena is crowded with tourists in the summer but is often underbooked the rest of the year.