Louis XIV ruled France for 72 years, built Versailles and loved ballet, painting and beautiful things. His people called him the Sun King. He'd also earned a less flattering nickname, the Enema King: his physicians recorded three or more enemas a day, more than 2,000 in all, and the most glamorous court in Europe copied him.
Blame the ibis
The enema is far older than Louis. The Roman historian Pliny the Elder credited ancient Egypt, where people supposedly got the idea from the ibis, a long-legged wading bird sacred to Thoth, the god of magic, justice and the judgment of the dead. Pliny wrote that the bird "washes the inside of its body by introducing water with its beak into the channel by which the residue of our food should leave."
The Egyptians believed human waste held whdw, a four-letter word with no vowels (call it "wuhud"). It was the element that made things rot, and rot brought disease, so the healthy thing to do was flush it out often. Herodotus described Egyptians giving themselves ritual enemas three times a month. Pharaohs had a servant just for the job, with the title "shepherd or guardian of the anus." According to the Ebers Papyrus, a 68-foot-long encyclopedia of Egyptian medicine, this servant stirred herbs and honey into about a pint of diluted salt water, milk, wine or beer and delivered it through a thin golden tube. When a pharaoh died, these servants were sometimes put to death so they could keep serving him forever.
After that the practice spread everywhere. The Mongols used it to feed people, pouring broth into an animal bladder fitted with a cow's horn. The Greeks used it to rebalance the four humors, the bodily fluids they believed controlled health. The Romans, whose doctors needed no training at all, made enema syringes out of solid bronze. Medieval doctors used a greased tube tied to a pig's bladder and sometimes filled it with vinegar or the diluted bile of a dead boar. People put up with that because the other remedies were worse. Hemorrhoid sufferers prayed at St. Fiakor's stone, and Hippocrates advised yanking hemorrhoids off with the fingernails. For the worst cases there was a red-hot rectal cautery iron.
Paris goes mad for the clyster
In 17th-century France, a new home kit took the enema, or clyster, out of the doctor's office and into people's homes. The word comes from a Greek word meaning to wash out. One model had a bent nozzle so you could do it yourself. For modest ladies there was a shield that covered everything except the anus. Word got around that regular purging made your skin glow, and aristocrats started having clysters three or more times a day. They scented the fluid with orange blossoms and rose petals, and for a while tinted fluid was in fashion, which only makes sense if someone is watching.
Sometimes someone was. The court chronicler Saint-Simon described the Duchess of Bourgogne chatting with the king at a crowded party when her lady's maid dropped to her knees and vanished under the duchess's huge skirts. The duchess kept right on talking while the maid gave her an enema in the middle of the ballroom.
A body at war with itself
The man behind the fad had a rough life. Louis became king in 1643, a few months before his fifth birthday. His mother mostly ignored him, he nearly drowned in a palace fountain, and at nine he lived through a noble rebellion that left him with a lifelong grudge against Paris. Smallpox scarred him at eight. Measles came next, then gonorrhea at 16. When he got typhoid, one of his doctors' teas had him racing to the chamber pot more than a dozen times a day. He picked up parasites too, including a liver fluke from contaminated watercress. His doctors bled him at least once a month and recorded every meal, bowel movement and nightmare in the Journal of the Health of the King.
In his mid-forties, his doctors pulled all his teeth, hoping it would help his rheumatism. It left a hole between his mouth and nose, so any liquid he drank sprayed into his nose. They sealed it with a hot iron and no anesthesia.
The most powerful king in Europe was so widely imitated that his courtiers copied more than his daily enemas. Many bragged they had his agonizing anal fistula too, and dozens demanded surgery before being sent home.
The fistula everyone wanted
In 1686 Louis developed an anal fistula, an abnormal tunnel that runs from inside the anus out to the skin. It swelled up, oozed pus and cost him control of his bowels. His courtiers were so devoted that many bragged they had one too. Dozens demanded surgery and were told they were fine and should go home.
Louis did need the operation, and his surgeon, Félix de Tassy, had never done it. So de Tassy practiced on hospital patients in Paris. Rumor said the ones who died were carried out at night and buried at dawn. Then, in the king's bedchamber, he used a curved scalpel with a probe at the tip that he'd designed for the job. Louis had no anesthesia. He recovered, and within hours he was running a council meeting. De Tassy became the toast of Versailles and spent his time turning away courtiers who wanted the same surgery.
Kings die like other men
Louis ate enormously. The Duchess of Orleans wrote that "He could eat four plates of soup, a whole pheasant, a partridge, a large plate of salad, two slices of ham, mutton au jus with garlic, a plate of pastry, all followed by fruit and hard-boiled eggs." Gout followed, then fevers, boils and constant pain in his mouth. The bleeding and purging went on.
In the end, gangrene killed him. His doctors mistook the pain in his leg for sciatica and bled him. Black marks soon spread across his skin: senile gangrene, tissue death caused by poor blood flow. He took to his bed on August 25, 1715, and died a week later, four days short of his 77th birthday. Before he died he told his five-year-old grandson, "Remember this, kings die like other men."
The enema outlived him. In 2022, Americans spent $45 million on enema products.
