The French State and “Useful” Medical Knowledge: The Clinical Judgment of Guy-Crescent Fagon, Royal Physician to Louis XIV

My paper explores the role played by the king’s first physician (Premier médecin du roi) in organizing and evaluating a particular form of medical experimentation, namely, clinical trials of novel therapeutic substances. Although the primary responsibility of the first physician was supervising the health of the royal body, he also had a customary role in passing judgment on whether or not a given drug was safe or useful for the king’s subjects. This extended into the realm of state venality through the granting of royally-sponsored drug monopolies. As a case study, I examine the career of Louis XIV’s final first physician, Guy-Crescent Fagon (1638-1718), who organized patient trials and granted monopolies for dozens of drugs. Fagon was a graduate of the Paris Faculty of Medicine, superintendent of the Jardin du roi, and a member of the Académie des sciences, but the trials he organized were personally (rather than institutionally) assessed and occurred outside of the auspices of these bodies. I argue that Fagon’s testing practices testify to the importance of embodied expertise, personal judgment, and authoritative witnessing by trusted practitioners. They also suggest a coherent research programme, one aimed at cheap, “useful” drugs that could be used indiscriminately by large populations in order to further the goals of the French state—particularly in military contexts—but they occurred outside of the institutional spheres that historians usually associate with state-sponsored science in this period.