I’ve written about the dangers of nicotine before, and particularly about my theory of nicotine playing the part of poison in the death of Game of Throne’s King Joffrey. And lately e-cigarettes, or vaporizers, have become all the rage among consumers and media alike. So of course I’ve given my two-cents about potential e-cig and nicotine dangers, too. With all of the bickering, fear mongering, and politicking over e-cigs it makes me long for the days when tobacco was simply blown up one’s arse.

Cough, cough….excuse me? Blown up one’s arse? Tobacco? Seriously?

Sure, why not? It’s really not as crazy as it sounds. Hell, I can’t lie to you . . . it is as crazy as it sounds. But it’s the fun kind of crazy. No one was hurt . . . except for the person getting the smoke blown up their arse . . . and I guess the one doing the blowing. This clearly isn’t going well, so let’s get all this sorted out.

Once upon a time in 1774 two London doctors, William Hawes and Thomas Cogan, founded “The Institution for Affording Immediate Relief to Persons Apparently Dead From Drowning”, or TIFAIRTPADFD, for short. These sorts of humane societies for the nearly drowned and dead were popular in these times, with similar chapters throughout Europe. But what set the good Drs. Hawes and Cogan apart from the rest was their unique sense of style: the tobacco smoke enema.

When an “apparently dead from drowning” person was pulled from the Thames, it was thought that two things needed to happen to successfully resuscitate them: warming of the body and stimulation. Tobacco was becoming popular in Europe thanks to its exportation from the Americas, and a well known stimulant thanks to the alkaloid nicotine. The nearly dead drowning victim can’t smoke themselves, and certainly can’t swallow anything. And since hypodermic needles weren’t to be fully-invented for another hundred years, the only logical way to administer tobacco was rectally. Plus, the warm smoke would warm the individual from the inside. Win-Win. Thus, the tobacco smoke enema was born, and devices placed all along the Thames river.

Fig 1. Tobacco smoke enema by Wellcome Images (CC BY-SA-4.0)

The tobacco enema shown above (Fig 1) is pretty self explanatory. In this early version tobacco is lit on fire in “A”, while life-saver blows air through “C”, carrying smoke down tube “D”, into rectal probe “B”, and smoke entering “E”, which is . . . what the hell is that? Is “E” the smoke itself? The colon? A beehive? Can you smoke out bees with this thing? Why is the tube so long? Is it long enough? So many questions. Instruction manuals are for chumps, but I sure could use one right now.

The big flaw in this thing is the lack of a check-valve. This simple 3-pence device  would keep material from entering “B” and traveling backwards to “C” – see what I’m saying? Enter tobacco smoke enema 2.0:

Fig 2. Tobacco smoke enema kit 2.0 by Wellcome Images (CC BY-SA-4.0)

This beauty (Fig 2) used bellows. No more inhaled fecal material! Shown is the “Deluxe” model, which could also be used to pump tobacco smoke into the lungs through the mouth or nostrils. The two pieces of ivory in the bottom right of the case? Those are the attachments for rectal administration. Nice, huh? So Dad, forget the pony . . . I want one of these beauties for Christmas.

Tobacco smoke enemas became very much in vogue, and were used to treat everything from headaches to cholera. Whether or not they worked, or if they even really afforded “immediate relief to persons apparently dead from drowning” is beyond me. And what’s more stimulating anyways, nicotine or an ivory tube up the arse. I think shoving  that thing where the sun don’t shine would give me more of a jolt than nicotine. But that’s just me. Your mileage may vary.

Sadly, tobacco smoke enemas fell out of favor in the early 1800’s when Daniel Legare demonstrated during his graduate dissertation that rectal insufflation (fancy word meaning to blow or inhale) of tobacco afforded no value in resuscitation (1). And TIFAIRTPADFD? They became the Royal Humane Society, a British charity that gives awards for acts of bravery and lifesaving, that is still in operation today. Did you know that Bram Stoker, of Dracula fame, was awarded a Bronze medal in 1882? You do now.

So the next time you have a headache, cold, or flu, ask your doctor about a tobacco smoke enema. Let me know how it turns out.

References:
(General) Lawrence, Ghislaine. “Tobacco Smoke Enemas.” The Lancet 359.9315 (2002): 1442.
(General) Haynes, Sterling. “Tobacco Smoke Enemas.” BMJ 54.10 (2012): 497-7.
1. J. Collins Warren. ‘”The ‘Pulmotor’ of the Eighteenth Century“, Ann. Med. Hist. 2 (1918): 14-20.