Tobacco Smoke Enema - Medical Opinion

Medical Opinion

To physicians of the time, the appropriate treatment for "apparent death" was warmth and stimulation. Anne Greene, a woman sentenced to death and hanged in 1650 for the supposed murder of her stillborn child, was found by anatomists to be still alive. They revived her by pouring hot cordial down her throat, rubbing her limbs and extremities, bleeding her, applying heating plasters and a "heating odoriferous Clyster to be cast up in her body, to give heat and warmth to her bowels." After placing her in a warm bed with another woman, to keep her warm, she recovered fully and was pardoned. Artificial respiration and the blowing of smoke into the lungs or the rectum were thought to be interchangeably useful, however, the smoke enema was considered the most potent method, due to its supposed warming and stimulating properties. The Dutch experimented with methods of inflating the lungs, as a treatment for those who had fallen into their canals and apparently drowned. Patients were also given rectal infusions of tobacco smoke, as a respiratory stimulant. Richard Mead was among the first Western scholars to recommend tobacco smoke enemas to resuscitate victims of drowning, when in 1745 he recommended tobacco glysters to treat iatrogenic drowning caused by immersion therapy. His name was cited in one of the earliest documented cases of resuscitation by rectally applied tobacco smoke, from 1746, when a seemingly drowned woman was treated. On the advice of a passing sailor, the woman's husband inserted the stem of the sailor's pipe into her rectum, covered the bowl with a piece of perforated paper, and "blew hard". The woman was apparently revived. In the 1780s the Royal Humane Society installed resuscitation kits, including smoke enemas, at various points along the River Thames, and by the turn of the 19th century, tobacco smoke enemas had become an established practice in Western medicine, considered by Humane Societies to be as important as artificial respiration.

"Tobacco glyster, breath and bleed.
Keep warm and rub till you succeed.
And spare no pains for what you do;
May one day be repaid to you." —Dr. Houlston (24 September 1774)

By 1805, the use of rectally applied tobacco smoke was so established as a way to treat obstinate constrictions of the alimentary canal that doctors began experimenting with other delivery mechanisms. In one experiment, a decoction of half a drachm of tobacco in four ounces of water was used as an enema in a patient suffering from general convulsion where there was no expected recovery. The decoction worked as a powerful agent to penetrate and "roused the sensibility" of the patient to end the convulsions, although the decoction resulted in excited sickness, vomiting, and profuse perspiration. Such enemas were often used to treat hernias. A middle-aged man was reported in 1843 to have died following an application, performed to treat a strangulated hernia, and in a similar case in 1847 a woman was given a liquid tobacco enema, supplemented with a chicken broth enema, and pills of opium and calomel (taken orally). The woman later recovered.

In 1811, a medical writer noted that "he powers of the Tobacco Enema are so remarkable, that they have arrested the attention of practitioners in a remarkable manner. Of the effects and the method of exhibiting the smoke of Tobacco per anum, much has been written", providing a list of European publications on the subject. Smoke enemas were also used to treat various other afflictions. An 1827 report in a medical journal tells of a woman treated for constipation with repeated smoke enemas, with little apparent success. According to a report of 1835, tobacco enemas were used successfully to treat cholera "in the stage of collapse".

I may observe, that before I was called to this case, stercoraceous vomiting had decidedly set in. My object in ordering the tobacco infusion and smoke enemata was to favour the reduction of any obscure hernia or muscular spasm of the bowel which might exist. I also directed that the attendants of the girl should, after she had taken the crude mercury, frequently raise her up in bed, (she was too feeble to raise herself,) to alter her position from one side to the other, from the back to the belly, and vice versa, with the view of favouring the gravitation of the mercury to the lower bowels. —Robert Dick, M.D. (1847)