History of Europe

Louis XIV's anal fistula:the "operation" of the century

The conquering king, the stoic king, the brave, strong and courageous king… From the years 1680/90, the Sun King is also and above all a great sick body. Fever, gout, diarrhoea, dizziness, he is very often unwell. At 45, he already has only a few snags left. The King's entourage admires his courage and his capacity for resistance , he who remains silent in the face of the most unbearable pain.

This is undoubtedly the story of the anal fistula of Louis XIV , operated in 1686, which struck contemporaries the most. It also confirms the intelligence of the monarch, capable of transforming a physical failure into a communication tool at the service of his policy.

The incompetence of doctors

In the 17th century, the causes of anal fistulas (infection of a gland located inside the anus) were not lacking. The most serious is the regular practice of enemas advocated by doctors whose ignorance is mocked by Molière. Administered with non-sterilized instruments, they can have disastrous consequences. The immoderate practice of horse riding and the ingestion of excess fatty meats do not help.

At the beginning of 1686, Louis XIV was 47 years old. An anal tumor appears. It does not take long to degenerate into a fistula. The King's first physician, Antoine d'Aquin , and its first surgeon, Félix de Tassy , are arguing about the treatment to be adopted. Since surgery is still underestimated in favor of medicine, it is first of all the remedies recommended by Antoine d'Aquin that prevail. And what remedies!

We welcome in Versailles all the charlatans who offer so-called “miraculous” decoctions. D'Aquin himself applied various plasters and suppuratives to shrink the abscess. In vain. It's just that the doctor doesn't know what he's doing. A note written after the operation testifies to his embarrassment:

It is quite difficult to fully know the cause of the hard and glandular tumor which occurred to Her Majesty and which gave birth to this annoying fistula that lasted a whole year, without having been able to give in to iron and fire.

Months pass, and the king plans to go down to the south of France to take the waters of Barèges , which succeeded so well for his son the Duke of Maine in 1675, and for his minister Louvois who suffered from a broken leg in 1680. But such an expedition, undertaken in a context of political crisis (the European princes, worried about the omnipotence of the King of France, begin to get agitated) seems quite inconsiderate. The monarch renounces it.fistul andLouis XIV

The king's fistula:a state secret

All options are soon exhausted. We have to face the facts:the operation must take place. D'Acquin gives way to Félix. For two months, the monarch hardly leaves his apartments except to go to mass, while the surgeon prepares his intervention in the greatest secrecy.

Indeed, since July a large part of Europe has allied itself against Louis XIV, forming the League of Augsburg . The king is not fooled:Versailles is crawling with spies and nothing must filter concerning the operation in the Foreign Courts, in order to avoid rumors around his state of health. It would not be a question of discouraging the few allies he has left!

A heavy responsibility weighs on Félix de Tassy. To put the odds on his side (he still plays his career, even his life…) the surgeon invents a special scalpel with curved blade, called "à la royal". He tries his instrument on many fistula patients at the Versailles hospital. With Louis XIV, he will have no room for error. The operation is extremely delicate at this time. The outcome can be fatal due to the risk of infection , and Felix has no desire to be the cause of the king's death!

After ten months of suffering, the monarch therefore resolves to undergo "the great operation". The day of the intervention is set for November 18 , with only witnesses Monseigneur the Grand Dauphin, Madame de Maintenon, the Minister of War Louvois, the father of La Chaise, the king's confessor, the first doctor and the first surgeon.fistul andLouis XIV

"The Great Operation" of the fistula of Louis XIV

The great operation took place on November 18, 1686, at seven o'clock in the morning, in the royal chamber . Louis XIV is placed on the edge of his bed, a bolster under his stomach and his legs raised, firmly held by servants to avoid any sudden movement.

The operation, obviously performed without anesthesia , is related by Aquinas who observes:“Mr. Félix (…) introduced a probe at the end of a scalpel made on purpose, all along the fistula into the gut, which he joined with the finger of his right hand, and, withdrawing it at the bottom, opened the fistula with easy enough, and then having introduced scissors into the foundation through the wound, he cut the intestine a little above the opening, and cut off all the clamps that were in the intestine; which the king maintained with all possible constancy .

The ordeal was terrible, but Louis XIV hardly let nothing show of his suffering . He holds back his cries, and only exclaims, at the height of the pain:“My God! My God! ". When the wound had to be incised again, he would have simply said:

– Is it done, gentlemen? Finish it off, and don't treat me like a king. I want to heal as if I were a peasant.

The operation succeeds. The Court is immediately informed of this success. Everyone is amazed. The Marquis de Dangeau noted in his Diary:"This resolution surprised everyone ". That same evening, the King presided over the Council from the depths of his bed, and the next day there he was, giving audience to the ambassadors and ministers of foreign princes, in possession of all his means. However, an informed observer like the Abbé de Choisy does not fail to point out:

Yet you could see the pain painted on his face. His forehead was almost always sweaty, from sheer weakness; and yet he gave his orders and made him account for everything. He ate in public in his bed and allowed himself to be seen twice a day by the least of his courtiers.fistul andLouis XIV

A widely exploited cure

More than the operation itself, it is its consequences that are of interest. The surgeon's performance is unanimously recognized.

For Felix, it's fortune and glory, and the success of the big operation definitely enhances the prestige of the French surgery.

The Court takes a keen interest in this discipline and scrambles to attend the public dissection sessions . It is said that Félix still retained a tremor in his hand from this particularly intense moment in his life!

The exploitation of the happy outcome of the operation by Louis XIV for political purposes is remarkable. For any other monarch than him, this intervention would have remained an inglorious episode on which not to dwell. But the king transforms it into irrefutable proof of his omnipotence.

As an expert in staging, he hastens to communicate the happy news to his people. The Abbé de Choisy noted in his Memoirs the excitement that gripped the population , literally amazed:

One ​​cannot express the effect produced in the minds of Parisians by such surprising news. Everyone felt at that moment how precious the life of a good king is, everyone thought they were in the same danger in which they were. Fear, horror, pity were painted on all faces. The least of the people left their work to say or to say again:"We have just performed the great operation for the king." The churches fill up to pray to God to grant the king a speedy recovery.

Many festivities are organized across the kingdom to celebrate the king's recovery. Te Deums are composed in his honour. These unifying celebrations timely, reinforcing the unity of the kingdom in the delicate context of the revocation of the Edict of Nantes, proclaimed the previous year.

Of course, we do not hesitate to let the European courts know of the admirable courage shown by the sovereign, his iron will in the face of danger. Let the League of Augsburg take it for granted:nothing makes the King of France bend, not even illness!

Detail which has its importance, it is to support Louis XIV in this difficult moment that Madame de Maintenon had composed by Lully a hymn whose text is written by Madame de Brinon , superior of the Royal House of Saint-Louis:God Save The King . The young ladies of Saint-Cyr sing this song during the operation and then perform it each time the king visits. Several theories clash on how he would then have crossed the Channel:the fact remains that he became for the English the world famous God Save The Queen !fistula andLouis XIV

A long recovery

What we are careful not to make public, on the other hand, is that the operation is not a success the first time... Indeed, it is necessary to again incise many times over the following months. Interventions even more painful than the first. Madame de Maintenon is distressed about it on December 4 in a letter to Madame de Brinon, lady at Saint-Cyr:

The king's evil never ends; those who deal with it make me die of grief:they find it one day at will, and the next day just the opposite. M. Fagon had a conversation with me this morning which wrung my heart for the whole day. A moment later, he came to assure me that the wound was doing well; tonight it will be something else. I did not put my trust in them, but I am not mistress of the sensitivity of my heart. Nothing needs to be said about all this. Keep praying and making others pray for him.

She wrote to him again on December 11:

The king suffered today for seven hours as if on the wheel, and I'm afraid his pains won't start again tomorrow.

The next day, the Marquis de Dangeau confirms that Louis XIV is not yet at the end of his troubles:

The king is still in great pain and has this morning dismissed his council; but he held it in the evening and saw the courtiers at his supper.

Finally, on December 25, Madame de Maintenon can let her relief burst :

We hardly put anything on the wound, it is healed. Everyone is overjoyed to see him come out.

After a few relapses in January and February 1687, the monarch was finally out of the woods in March. Surgery and Politics Successful! fistula andLouis XIV