The health of Louis XIV was a matter of paramount importance to the nation. So much so that a daily record of his physical condition was kept, from his childhood until his death at the age of 77. The journal was the responsibility of Louis’s First Physician, a position held successively by three men, Dr. Vallot, Dr. L’Aquin, and Dr. Fagon.
It’s due to the diligence of the Royal Physicians that we know the exact date on which Louis noticed a swelling in his anal area — January 15, 1685. By February 18th an abscess had formed, and by May 2nd a fistula had appeared. His doctors tried to treat him, unsuccessfully, with enemas and poultices. Eventually, Charles-Francois Felix was sent for, a surgeon.
Surgeons were not considered as respectable in those days as physicians. Most of them were also barbers, and some of them had little training. Physicians had received more training, but had been forbidden, since the early days of the Church, to cut into a living human body. For that matter, the Church didn’t want them cutting into dead bodies, either.
The cause of King Louis’s problems was attributed to his many years of excessive horseback riding, often wearing heavy armour. Some whispered that his sexual practices may have also figured into it. No one seemed to think there might be a connection to his hygiene — a discipline at which Louis was notoriously lax. He seemed to be aware of his body odor, frequently opening a window when he came into a room, so that his couriers would not be overcome. In all the years that his health journal was kept for him, it was only recorded once that he had taken a bath. There are accounts of some 2,000 enemas, however.
Felix recommended surgery, and Louis agreed to it. Felix, however, requested six months to prepare himself to perform the surgery. He had never done such an operation before, and he needed to practice. He performed the operation on 75 peasants, men who didn’t actually need the operation. Not all of them lived.
On November 18th, 1686, at 7 o’clock in the morning, Felix operated on the king. Standing by were Madame de Maintenon, Louis’s wife or mistress (the king is believed to have secretly married her around this time), his son, the Dauphin, his confessor, his physicians, and his MInister of State, whose presence was necessary in order to make sure Felix went through with the operation. The king was calm, but the surgeon was terrified.
The operation was performed without anesthetic. Felix had devised a special curved scalpel and special retractor. You can see pictures of both on this website. They’re really quite frightening.
The operation was a great success. King Louis was able to sit up in bed within a month, and another three months he was able to ride again. Word of his great courage during the operation spread throughout the court, and some of the nobles took to wearing bandages on their buttocks in the king’s honor. The procedure became known as “the Royal”, and at least thirty nobles asked Felix to perform the same operation on them. They were greatly disappointed when he told them that they didn’t need it.
In gratitude for his services, Felix was given a large sum of money, a title, and an estate. The status of surgeons was greatly improved by the event, and in 1731 Louis XV, Louis XIV’s grandson, would establish the Royal Academy of Surgeons. As for Charles-Francois Felix, he was apparently greatly shaken by his experience. He never touched a scalpel again.
Sources: “Scalpel and Retractor”, Sciences and curiosities at the Court of Versailles; Guiseppe Dodi and Robert J. Spencer, Outpatient Proctology, 1996; “France: From the anal fistula of Louis XIV to modern surgery!”, History of Africa Otherwise; “The History of Medicine in America”, Wellness Directory of Minnesota; “New Publications: Journal of the Health of Louis XIV, Written by Drs. Vallot, L’Aquin, and Fagon, all three, successively, his First Physicians”, The New York Times, July 27, 1862.