Anal Fistulas
An anal fistula is an opening between the anal canal and external skin, typically in the perineal area. Prior to the 17th century, no one considered operating on anal fistulas. The risks were too great, and pain too intense. That change in 1686, when Louis XIV, the Sun King, developed an anal fistula. While the King tried to hide the effects of the fistula, he was in great pain and all attempted treatments, including compresses and enemas failed.
In the 17th century, physicians did not perform operations; these were the work of barber-surgeons. A barber-surgeon, Charles Francois Felix was called in to perform the surgery. Felix requested a period of six months to prepare for the delicate operation. He designed two new surgical tools, which still exist today, a retractor and a curved scapula and was provided with some 75 healthy test subjects on which to practice, primarily convicts. He operated on three to four of these men each week, and some survived the operation.
On November 18, 1686, the king stoically endured the operation. It is said that he made no sound at all during the procedure, performed, of course, without anesthesia. Within a month, he was able to sit up in bed, and over time, he recovered fully.
Monsieur Felix taught others to perform the operation, but more importantly, he changed the status of surgeons. Before his operation on the king, barber-surgeons were thought of with little respect. He became the surgeon to the king, and many in the court feigned fistulas of their own in an attempt to follow the king’s example.