Three centuries ago, medecine was a prestigious discipline whereas surgery not so much...
In the seventeenth century, medicine was a highly prestigious field. Doctors were leading thinkers, pillars of the university, great botanists and respected chemists, held in high regard despite the fact that their treatments were largely ineffective, limited mostly to bleeding patients and administering purgative concoctions.
The year 1686 marked a turning point. The phenomenal level of public interest in the successful operation on Louis XIV’s fistula dealt a definitive boost to the prestige of surgery as a discipline in its own right. Surgery reached its institutional height during the reign of Louis XV, with the establishment of the Royal Academy of Surgeons in 1731.
A curved ‘royal’ scalpel
The operation was performed at 8am on 18 November in the royal bedchamber at Versailles, shrouded in the utmost secrecy. In attendance were Louvois, Madame de Maintenon, the king’s confessor and his doctors. Royal Surgeon Félix de Tassy had designed a new surgical implement especially for the occasion: a curved “royal” scalpel to which he attached a sort of probe, intended to be inserted into the anal fistula (an artificial cavity created by the infection).
Before performing this delicate operation on the most illustrious of patients, Félix had “tested his hand” on a number of fistula patients in the hospitals of Paris and Versailles. Laid out along the edge of the bed, the king underwent this procedure without anaesthetic and, according to the eyewitnesses, bore the pain “as steadfastly as is possible.”
The operation proved to be a great success, and the king recovered rapidly. On the day of the operation the royal getting-up ceremony was only slightly delayed, and a few hours later he insisted upon presiding over a Council meeting from his bed, “as usual.” Félix, meanwhile, was on the path to fortune and fame. Fistula even became something of a fashionable condition at court. Pierre Dionis, another contemporary surgeon, recalls that:
“There were some people mad enough not only to boast of having the same condition, and having the same treatment as the monarch, but to actually ask surgeons to operate on them when they didn’t even have a fistula!”
La Peyronie, First Surgeon to the King
La Peyronie was a surgeon famed for his extraordinary dexterity. Trained in Montpellier and Paris, he soon caught the eye of Georges Mareschal, Royal Surgeon to King Louis XIV and later to the young Louis XV. In 1737 La Peyronie inherited his mentor’s post, and in 1742 was appointed personal physician to Louis XV, going on to become a key confidant of the king.
Kings and princes made an invaluable contribution to the advancement of science by putting their sacred bodies and royal blood at the mercy of their doctors. In doing so they served as examples and pioneers: the inoculation of the royal princes against smallpox after the death of Louis XV is a case in point.
In the seventeenth and eighteenth centuries there was still no known cure for smallpox, a highly contagious and potentially fatal disease: the pox was essentially untreatable. A forerunner to the modern science of vaccination, inoculation consisted of infecting a healthy patient with a controlled dose of pox. This method, originating in the Ottoman Empire, began to make inroads into Western Europe in the eighteenth century.
In France, inoculation was the subject of a lively controversy. By the middle of the century, with the medical establishment and theology faculties still firmly against it, inoculation had become a rebellious act, with the Duc d’Orléans as the figurehead of a new movement. In 1756 the duke requested permission from the king, his cousin, to have his family inoculated at the Palais Royal in Paris. Louis XV, still sceptical, replied that “You are master of your own children.”
It would take almost twenty years for the reigning monarch to be convinced of the merits of inoculation, by which time Louis XV had died of smallpox and the young Louis XVI had ascended to the throne with Marie-Antoinette as his queen. The latter was a firm supporter of inoculation, which had been common practice at the imperial court in Vienna for many years. On 24 June 1774, less than a month after coming to the throne, Louis XVI had himself inoculated along with his brothers, the future Louis XVIII and Charles X, at the Château de Marly. Royal doctor Joseph-Marie-François de Lassone had proposed delaying the king’s inoculation, but Louis XVI refused to see his brothers used as guinea pigs.
Meanwhile in Vienna, Holy Roman Empress Maria Theresa was worried: “As much as I support inoculation, which has saved my three sons and six grandchildren, I am concerned about the wisdom of treating all three brothers at the same time, and in this heat.”
Catherine Pégard, President of the Palace of Versailles
Laurent Salomé, Director of the museum
Thierry Gausseron, General administrator
Hélène Delalex, curator at the furniture and art object department and curator of the digital exhibition
Géraldine Bidault, in charge of the photography library and the digitization of the collections, curator of the digital exhibition
Ariane de Lestrange, Head of communication
Paul Chaine, Head of digital service
Gaëlle Bertho, coordinator of the digital exhibition