Tobacco smoke enema

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fumigator and a bellows

The tobacco smoke enema, an insufflation of tobacco smoke into the rectum by enema, was a medical treatment employed by European physicians for a range of ailments.

near drowning. Liquid tobacco enemas were often given to ease the symptoms of a hernia
.

During the early 19th century the practice fell into decline, when it was discovered that the principal active agent in tobacco smoke, nicotine, is poisonous.

Tobacco in medicine

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.

Before the

Columbian Exchange, tobacco was unknown in the Old World. The Native Americans, from whom the first western explorers learnt about tobacco, used the leaf for a variety of purposes, including religious worship, but Europeans soon became aware that the Americans also used tobacco for medicinal purposes. The French diplomat Jean Nicot used a tobacco poultice as an analgesic, and Nicolás Monardes advocated tobacco as a treatment for a long list of diseases, such as cancer, headaches, respiratory problems, stomach cramps, gout, intestinal worms and female diseases.[2] Contemporaneous medical science placed much weight on humorism, and for a short period tobacco became a panacea. Its use was mentioned in pharmacopoeia as a tool against cold and somnolence brought on by particular medical afflictions,[3] its effectiveness being explained by its ability to soak up moisture, to warm parts of the body, and to therefore maintain the equilibrium so important to a healthy person.[4] In an attempt to discourage disease tobacco was also used to fumigate buildings.[5]

In addition to the Native Americans' use of tobacco smoke enemas for stimulating respiration, European physicians also employed them for a range of ailments, e.g., headaches, respiratory failure, colds, hernias, abdominal cramps, typhoid fever, and cholera outbreaks.[6]

An early example of European use of this procedure was described in 1686 by

iliac passion prescribed first bleeding
, followed by a tobacco smoke enema:

Here, therefore, I conceive it most proper to bleed first in the arm, and an hour or two afterwards to throw up a strong purging glyster; and I know of none so strong and effectual as the smoke of tobacco, forced up through a large bladder into the bowels by an inverted pipe, which may be repeated after a short interval, if the former, by giving a stool, does not open a passage downwards.

— Thomas Sydenham[7]

However, emulating the Catawba, 19th-century Danish farmers reportedly used these enemas for constipated horses.[8]

Medical opinion

To physicians of the time, the appropriate treatment for "apparent death" was warmth and stimulation.

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.[9]

pipe into her rectum, covered the bowl with a piece of perforated paper, and "blew hard". The woman was apparently revived.[3]

In the 1780s the

artificial respiration.[11]

"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."

— Houlston (24 September 1774)[12]

By 1805, the use of rectally applied tobacco smoke was so established as a way to treat obstinate constrictions of the

hernias. A middle-aged man was reported in 1843 to have died following an application, performed to treat a strangulated hernia,[14] 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.[15]

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.[16] 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.[17] According to a report of 1835, tobacco enemas were used successfully to treat cholera "in the stage of collapse".[18]

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)[19]

Decline

Attacks on the theories surrounding the ability of tobacco to cure diseases had begun early in the 17th century. King

James I was scathing of its effectiveness, writing "[it] will not deigne to cure heere any other than cleanly and gentlemanly diseases." Others claimed that smoking dried out the humours, that snuff made the brain sooty, and that old people should not smoke as they were naturally dried up anyway.[20]

While certain beliefs regarding the effectiveness of tobacco smoke to protect against disease persisted until well into the 20th century,[21] the use of smoke enemas in Western medicine declined after 1811, when through animal experimentation Benjamin Brodie demonstrated that nicotine—the principal active agent in tobacco smoke—is a cardiac poison that can stop the circulation of blood.[11]

See also

References

  1. ^ Haynes, MD, Sterling (December 2012). "Special feature: Tobacco smoke enemas". BC Medical Journal. 54 (10): 496–497. Retrieved 2024-04-22.
  2. ^ Kell 1965, pp. 99–102
  3. ^ a b c d Lawrence 2002, p. 1442
  4. ^ Kell 1965, p. 103
  5. ^ Meiklejohn 1959, p. 68
  6. ^ Sterling Haynes, MD (December 2012). "Special feature: Tobacco smoke enemas". British Columbia Medical Journal. Doctors of BC. Retrieved 2019-03-29.
  7. ^ Sydenham 1809, p. 383
  8. ^ Kell 1965, p. 109
  9. ^ Hughes 1982, p. 1783
  10. ^ Price 1962, p. 67
  11. ^ a b Hurt et al. 1996, p. 120
  12. ^ Lowndes 1883, p. 1142
  13. ^ a b c Currie 1805, p. 164
  14. ^ Japiot 1844, p. 324
  15. ^ Long 1847, p. 320
  16. ^ Anon2 1811, p. 226
  17. ^ Jones 1827, p. 488
  18. ^ Anon1 1835, p. 485
  19. ^ Dick 1847, p. 276
  20. ^ Kell 1965, p. 104
  21. ^ Kell 1965, p. 106

Bibliography

External links

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