By Christoph Renninger
In January 1686, a tumor formed on the Sun King’s buttocks. His personal physician Antoine Daquin describes the tumor as a small lump, two finger widths away from the anus, not painful, reddened or pulsating. The lump was probably triggered by an inflamed gland, as this was common in the 17th century.
The doctors of Ludwig began the treatment, among other things with sugar, various herbs or with roses cooked in red wine. When a perianal abscess developed from the node, they punctured it to drain pus. They filled the resulting cavity with various substances, which caused the king considerable pain.
Louis XIVbecame increasingly angry as abscess and pus continued to torment him and he had to change clothes 2-3 times a day. His complaints lasted for months, the pain even increased. Every time he felt better, the court doctors made it worse with enemas and laxatives. . Regular treatments with red-hot iron had increased the dimensions even more.
After months of pain and other ailments, the ruler realized that his doctors were powerless and decided to have surgery. Until then, he sullenly isolated himself in his private chambers at Versailles. At court he was seldom to be seen, he had to give up riding; in the gardens he stayed in a palanquin.
The prelude to the operation
At that time, surgeons were considered «craftsmen» and not doctors.And no surgeon should dare to lay hands on the king without mastering the procedure perfectly. The operation was planned in detail and top secret. Apart from the king’s doctors, only his mistress and secret wife Madame de Maintenon and his confessor Pére La Chaise were informed.
The royal surgeon Charles-François Félix (junior) (1635 – 1703) had never performed such an operation before, but was allowed to gain experimental experience on patients from the hospitals in Versailles. Historians have tried unsuccessfully to learn more about their fate. Rumor has it that the victims of the experiments were secretly buried at sunrise.
The day of the operation
The day before the procedure, the king walked through his gardens, had dinner with the family. Due to the severe pain, he finally decided to postpone the operation for another day at short notice.On November 18, 1686, at 7 o’clock in the morning, the time had come.
In order not to arouse suspicion, the royal doctors and surgeons, as well as four pharmacists, had arrived in the early morning hours by different routes in the antechamber of the royal bedchamber. After an enema, the king showed great interest in the instruments to be used, and seemed to have his nerves well under control.
Louis XIV now lay on his stomach on a bed, with a pillow under his stomach and his legs spread wide. The three-hour operation was performed without anesthesia. Allegedly, the king did not complain of pain and only shouted «Mon Dieu» twice, although the pain must have been excruciating.
The procedure was a success. Later, two more similar interventions were necessary. But the Sun King was convinced of the operation, News of the healing quickly spread throughout the palace.The king held court from his bed, singing and in high spirits. Just two days later, Louis XIV was back on his feet.
A place in the history books?
It was probably the most famous operation of the 17th century, but in the king’s personal medical records it appears only with a half-page sentence. The operating Surgeon was, of course, interested in a detailed description and wrote an 18-page document the next day. Little is known about the whereabouts of this report. In 2007, it is said to have resurfaced and been auctioned for 4000 euros.
The consequences of the operation
The surgeons were rewarded with titles of nobility, palaces and riches. Every person who suffered from an fistula now had hope of healing through the operation.And like everything the Sun King did, surgery became fashionable at court. Nobles queued up to be operated on like the king, with or without fistulas.
Not only the king was very courageous in the operation, but also the surgeons. A failed operation or even the death of the king would have had serious consequences. The news about the successful operation found its way all over Europe; many people came to France to be operated on by the experienced surgeons. Paris was the center of anatomy and surgery. Previously eclipsed by doctors, surgeons were now in the spotlight.
Louis XIV also needed surgical help on other occasions, for example after a riding accident in 1683 and due to an abscess on his neck. His future court surgeon Georges Mareschal (1686-1736) was also known throughout Europe for his skills in the operation of bladder stones.
The death of Louis XIV.in 1715 was also caused by medical errors. His doctors opposed surgical intervention and mistakenly considered incipient gangrene to be sciatic. The king begged his surgeons to amputate his leg, but it was already too late. The king died in extreme pain, even though his life could have been saved by an early amputation.
The development of French surgery
Through the power and influence of the Sun King, surgery established itself as a medical discipline. He himself appointed surgical chairs at Le Jardin du Roi (now Jardin des Plantes), often in dispute with the powerful medical faculty. The university viewed the royal doctors with suspicion and was skeptical of the rise of surgeons. The faculty was known to be reactionary and hostile to the new ideas of the Enlightenment, and there were even physical altercations.
After the death of Louis XIV.The next royal chief surgeons carried out a series of reforms, such as the reorganisation of surgical training with the help of experienced surgeons. The first official courses were held in 1724. The medical school tried unsuccessfully to gain control over it.
An important step was the establishment of l’Academie Royale de Chirurgie in 1731 with the support of Louis XV. The establishment of the academy was an immediate success and was quickly respected in the professional world. It existed for 62 years and produced a large number of well-known surgeons.
Voltaire (1694-1778) describes the progress in surgery as so rapid and astounding that people from all parts of the world came to Paris for surgery. France not only had excellent surgeons, but was the only country to have the necessary instruments.
With the revolution of 1789, the Royal Academy also came to an end. In the following turbulent years with changing republics, emperors and kingdoms, there was little academic development in the field of surgery.A new professional society was not created until 1843 in Paris.
Under the influence of the work of the author and philosopher Denis Diderot (1713-1784), internal medicine and surgery were combined in medical studies. Medical facilities in Paris, Montpellier and Strasbourg are replacing purely surgical training centres.
Napoleon Bonaparte (1769-1821) prevented a renewed split in the medical disciplines by banning an independent organization of surgeons. In 1808 the universities were reorganized, medical faculties were rebuilt, with equal existence of the important medical specialties.
This article was originally published by Coliquio.de.
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