The one who operated on Louis XIV for an anal fistula

Charles-François Tassy is known to have been King Louis XIV’s first surgeon. The doctor notably distinguished himself with the operation of an anal fistula, one of the many ailments from which the king would have suffered, on November 18, 1686.

A king victim of many evils

Louis XIV did not have what is called iron health. The Sun King is said to have suffered from multiple boils, gout, recurring headaches and diabetes-like symptoms. Son lack of hygiene probably didn’t help (he would have taken only one or two baths in his entire life under the advice of his doctors). Remember, however, that the representation of cleanliness was absolutely not thought of in the same way at that time. Nevertheless, according to a Russian emissary to his court, the king “stank like a wild animal”.

That being said, in January 1685, Louis XIV began to complain of pain in his anus. Upon inspection, there is indeed swelling. Over time, this swelling develops into an abscess and then a fistula. As a reminder, a fistula is an abnormal connection between two parts of the body (between the rectum and the skin for example).

The king is first treated with enemas, lotions, with a red-hot poker and even bloodletting. None of the treatments work and the king continues to suffer, to the point of being unable to sit up properly. Very quickly, the pus also invites itself to the party, forcing Louis XIV to change regularly.

Then comes Charles-François Félix, surgeon (and barber), chosen to operate on the king.

Charles-François Félix de Tassy (1635-1703), first surgeon to King Louis XIV.

Fistula fashion

The surgeon, who plays his career, then trains on many poor people from Paris gathered at the hospice of Versailles. Over the months he perfected the operation, performing it on about seventy-five healthy men.

We do not know how many subjects died during these operations – during which the lack of surgical hygiene was so badly known – but these allowed Charles-François Félix to develop a specific instrument, a “royal scalpel curved line extended by a stylus. The cutting edge is also covered with a silver cap so as not to injure when inserting it into the anus.

On the day of the operation, Louis XIV is lying facing the window, while two apothecaries hold his legs apart. The intervention, which lasts three hours, goes well. The king then feels much better. Two similar operations will nevertheless be carried out later in his life.

The consequences of this operation extended far beyond the king’s anus. For a time, a fashion spread among the courtiers at Versailles to have their fistula operated on in the manner of the king. More importantly, the surgery gained a better reputation. At the time, operators were indeed less reported than doctors. Many people from all over Europe then travel to France to take advantage of their surgical skills.

This is how the anus of a king advanced the science of the 17th century.

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