At last, the man at the center of a rape trial that has shocked France and drawn attention around world spoke in court.

Dominique Pelicot explained how his wife had saved him from a childhood haunted by a sexual assault he said he had suffered in a hospital at the age of 9, and a gang rape he witnessed while working as an apprentice electrician on a construction site as a teen.

“She didn’t deserve this, I recognize that,” he said in tears from the stand, his voice so weak the court strained to hear him.

Mr. Pelicot, 71, is accused of drugging Gisèle Pelicot, his wife of 50 years, over almost a decade in order to rape her while she was comatose. Then, the police say, he invited dozens of men to come into their house and join him in raping her.

Some 51 men, including Mr. Pelicot, are on trial together, mostly on charges of the aggravated rape of Ms. Pelicot. One has pleaded guilty for similarly drugging his own wife to rape her and inviting Mr. Pelicot to their home to rape her while she was drugged.

His appearance on Tuesday came as a surprise. Just one week into the trial, Mr. Pelicot fell so ill that he missed four days of court, until the head judge finally postponed the hearing. Mr. Pelicot was diagnosed with kidney stones, a kidney infection and prostate problems.