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Tobacco smoke enema: Wikis


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A 1776 textbook drawing of a tobacco smoke enema device, consisting of a nozzle, a fumigator and a bellows
A simpler, more portable device.
A: Pig's bladder.
FG: Smoking pipe.
D: Mouthpiece to which the pipe is attached.
E: Tap.
K: Cone for rectal insertion.

The tobacco smoke enema, an insufflation of tobacco smoke into the rectum by enema, was a medical treatment employed by 18th-century European physicians for resuscitating drowning victims and other purposes.

The stimulation of respiration through the introduction of tobacco smoke by a rectal tube was first practiced by the North American Indians.[1] In 1745, Richard Mead was among the first Western scholars to recommend tobacco smoke enemas to resuscitate victims of drowning.[2] One of the earliest reports of resuscitation by rectally applied tobacco smoke dates from 1746, when a seemingly drowned woman is reported as being successfully revived after, on the advice of a passing sailor, the stem of the sailor's pipe was inserted into her rectum and air was blown into the pipe's bowl through a piece of perforated paper.[2]

To physicians of the time, the appropriate treatment for "apparent death" was warmth and stimulation. For this purpose, artificial respiration and the blowing of smoke into the lungs or the rectum were thought to be interchangeably useful. The smoke enema was considered the most potent method, however, due to the warming and stimulating properties associated with tobacco in the pharmacopoeia of the period.[2] At 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.[1] In the 1780s, the Royal Humane Society installed resuscitation kits, including smoke enemas, at various points along the Thames.[2]

Smoke enemas were also used to treat various other afflictions. An 1827 report in a medical journal tells of a woman treated against constipation with repeated smoke enemas, with little apparent success.[3] According to another report of 1835, tobacco enemas were used successfully to treat cholera "in the stage of collapse".[4] In 1811, a medical writer noted that "[t]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.[5]

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.[6] 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.[6] 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.[6]

The use of smoke enemas in Western medicine began to cease after 1811. In that year, Benjamin Brodie showed through animal experimentation that nicotine, the principal active agent in tobacco smoke, was a cardiac poison prone to stopping the circulation of blood.[1]

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