The smoke of a cigarette, or more generally the one of tobacco (cigars, pipes and so on) is today recognised as very harmful for heath but up until some centuries ago it was used, even though as an alternative medicine, as a resuscitation technique for people who were about to die, especially for victims of drowning.

By the end of 1700 the tobacco smoke enema method started spreading all over Europe and especially in London. It became so much of a common medical practice that along the banks of the Thames river many devices for the complex procedure were hanging. Whoever was sailing were supposed to know the position of these live-saving instruments, some kind of ancient defibrillator. Even Venice had the equipment in all those places such as churches and pharmacies, spaces used to deliver first aid in case of need.

The smoke was blown by the doctor into the anus through a bellows and a cannula even though, since the wanted to reach the lungs from the quickest way,sometimes it was blown through mouth and nose. Most of doctors thought that the anus was still the most effective way. The nicotine contained inside the tobacco was considered as a powerful stimulant for the heart, able to accelerate the heartbeat that as a consequence would have facilitated the start of breathing one more time.  It was thought that the smoke would have “warmed up” the upper part of the body, drying up the excessive humidity.

One of the first evidences of such a practice dated back to 1746: in England a man, used to smoke tobacco with the specific tube (cigarettes as we know them today were created only in 1832), reanimated his wife, apparently dead by drowning, with the bizarre technique which he had maybe heard about.

He inserted his smoking cannula into the rectum of the woman and blew

For as odd as it may seem today, the practice was successful and the wife recovered. From then, the technique became more and more popular so that it was regularly performed and not only in cases of drowning but also for headache, typhus fever, cholera at its latest stages, and many other conditions.

The idea of utilising tobacco as a medicine came in Europe from America, where the natives were using it to treat many issues, apart from recreational purposes and religious ceremonies. All over Southern America it was, and still is in some native tribes, used the practice of “psychoactive enema” too: in that case hallucinogenic powders were employed.

The English botanist and doctor Nicholas Culpeper took to Europe the healing techniques of the native Americans, included their tobacco smoke enema as a remedy for abdominal cramping and hernia. Some years later doctor Richard Mead spread the use of it. Initially the cannula used for the technique was the short one that smokers would have too; subsequently a special instrument was developed which was avoiding for the person who was performing the enema, to “accidentally” swallow the content of the patient’s rectum.

The tobacco smoke enema was regularly utilised up until mid 18th century even though already in 1811 the English doctor Ben Brodie had warned on the danger of smoke for the cardiocirculatory system. Despite the technique fell into disuse during 1800, it seems that the practice has been employed during the epidemic of Spanish flu in 1918. That was the last attempt to recover patients about to die.

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