Taboos

Usefully transgressive research

In 1686 surgeon Charles-Français Felix de Tassy broke a taboo. After preparing for months, first on cadavers exhumed without permission and then on destitute patients without consent or anesthesia, he successfully operated on King Louis XIV of France’s anal fistula in front of a small audience and described his experience in a report the following day. His transgression? Writing a scientific report about surgery, which was considered a low-value trade and not worthy of serious study. King Louis’s subsequent decision to elevate Felix’s status and create permanent teaching positions in surgery led, after Louis’s death, to the establishment of the French Royal Academy of Surgery. This in turn was a major step on the road to the equality and eventual unification of surgery and medicine and major improvements to both during and after The Enlightenment.

We find three good reminders in this story.

First, taboos change over time. What would cause a reader in 2025 to recoil (stolen cadavers! no consent! no anesthesia! leaking anuses!) was commonplace in 1686 while the social transgression of surgeons acting above their station eventually led to them being violently assaulted by the physicians of Paris.

Second, extensive scientific progress sprung from breaking down the taboo against serious study of surgery. There are scientific taboos today as well. Some of them are severe enough that we dare not write about them here. Nevertheless we expect that several are standing in the way of major advances and will make us the laughingstock of future generations.

Finally, privacy and resources are the main ingredients needed for usefully transgressive research. Louis XIV’s wealth and status created an opportunity for Felix to work outside the purview of the medical establishment for as long as it took for him to perfect his operation, thus protecting him from the taboos of the time until he was able to deliver an unquestionable result. Today it is very rare for scientists to have both of these elements at once and even when they do we are much better at preventing their work from entering the mainstream. Not only do we need to let them cook, we need to be ready to be proven wrong when they come back with a right answer we don’t like.