Regency Doctors Threw Tobacco Up the Butt

Recently I was browsing online and discovered this highly entertaining blog by Terynn Boulton titled “When Doctors Literally Blew Smoke Up Your Arse.” Blowing tobacco smoke up a patient’s bowel was used in cases of “suspended animation” or, in other words, to revive, say, a drowning victim who had stopped breathing but might not be dead.

Here’s how it worked: the tobacco smoke was blown into the unconscious or dead person’s bowel using a small bellows. (The image at right shows the equipment used to assemble the apparatus.)

The rationale behind using a tobacco smoke enema was that tobacco contains nicotine, which acts as a stimulant. In the 18th century, this treatment was believed to stimulate the intestinal tract, which in turn stimulated the heart muscle into action. According to Boulton, the bellows apparatus was so popular that the equipment was positioned at various points along the Thames River in case someone needed to use it, much like defibrillators are available in shopping malls, schools and other public locations today.

Such use of tobacco smoke in medicine struck me as quite comical. What other uses might tobacco have that I had never heard of? Nothing would do but to go through the various books I downloaded from Google Books to see how Regency-era doctors and surgeons used tobacco to heal their patients.

Classification of Tobacco during the Regency Era

My first discovery involved terminology: the vade mecum and materia medica books of the Regency era referred to tobacco as Nicotiana tabacum, or what we call tobacco plants. In The Physician’s Vade Mecum of 1807,¹ plants with medicinal properties were categorized into classes and orders. Nicotiana was listed in these five classes:

• Class I — emetics (agents that cause vomiting)
• Class II —cathartics (sometimes called purgatives—that is, agents that empty the bowels)
• Class VI —expectorants (agents that increase the expulsion of mucus from the lungs)
• Class VII — errhina (medicines that are snuffed up the nose and cause sneezing and increased nasal discharges)
• Class VIII — sialagoga (a word I had never seen before, but which refers to agents that stimulate the flow of saliva).

The form of tobacco varied. It might be used as a fume, as when tobacco smoke was blown by bellows into a person’s rectum, or it might be chewed or inhaled (as snuff). An infusion of tobacco was intended to be used as a clyster or enema.² Infusions were prepared by adding tobacco leaves to one pint of boiling water and allowing the material to macerate for an hour in a lightly-covered vessel, after which it was strained.³

Regency-Era Uses of Tobacco in Medicine and Surgery

Tobacco smoke and tobacco clysters (enemas) were used for various medical treatments during the Regency era. Tobacco also had other unusual uses.

Reviving Persons in a State of Torpor

Mr. Samuel Cooper, late surgeon to the Forces, wrote in 1819 of the methods for reviving a person in a state of torpor or suspended animation.⁴ Heat, for example, should be gradually introduced to the person, else the part or the whole be lost to mortification (death). Friction with snow or cold water was advised, along with the administration of cordials. The fauces—the back part of the mouth—should be tickled with a feather. Likewise tobacco fumes could be introduced into the rectum … or … warm wine could be thrown up the large intestines or injected into the stomach using a hollow bougie. (I’d go for the wine.)

Mr. Cooper believed throwing tobacco fumes up the rectum was “a questionable practice,” mainly because of the plant’s well-known noxious effects.⁵ His censure was less vigorous than Mr. Thomson’s, who wrote in 1818: “the practice of employing it [a tobacco enema] in cases of suspended animation is now justly condemned.”⁶

Relieving a Toothache

Chewing tobacco to relieve a toothache was based on tobacco’s narcotic quality, which upsets the stomach and causes “considerable evacuation from the mouth and fauces.”⁷ Today we have a far greater understanding of the injurious effects of chewing tobacco on oral health and good dentistry is widely available.

Relieving Constipation and Colic

Tobacco was known to work as a purgative in clysters (enemas), which made it useful when treating “obstinate costiveness” (constipation).⁸ In clyster form, tobacco was also used in treating “obstinate colic,” proving a very effectual remedy.⁹ Interestingly, the cause of colic in infants is still not well understood, although gut microbes may be a factor. (Gut microbes seem to be responsible for everything these days.)

Eliminating Intestinal Worms

Dr. Benjamin Smith Barton was enthusiastic about the anthelmintic effects of tobacco. An anthelmintic substance is one that can destroy or eliminate parasitic worms, in particular those found in the human gut. Barton wrote: “I will only add, that it is a fact well established, that tobacco shows the anthelmintic effect, even when it is externally applied to the body.”¹⁰ (Does not that sentence remind you of Jane Austen’s famous line: “It is a truth universally acknowledged …”?) Today, the list of anthelmintics at Drugs.com does not mention tobacco as an effective treatment, which is no surprise.

Strange and Unexpected Uses of Tobacco

A Remedy for Bat Bites

Tobacco ashes were considered the best remedy for bites of the vampire or “spectre of Guiana” bat—also called the “flying dog of New Spain.”¹¹ Apparently, the bat is a monster in size but has a tiny bite no bigger than the head of a pin. It prefers to attack sleeping men and animals, in the case of humans often taking a bite out of the big toe. The author, who had been sleeping in a hammock, wrote that the surgeon who examined him in the morning estimated that some 12 or 14 ounces of blood had been sucked up during the night. Enough to fill a can of Coca-Cola!

Stuffing for Animal Specimens

Samuel Frederick Gray—a lecturer on the materia medica, pharmaceutical chemistry, and botany in the Regency era—reported that large animals being prepared as specimens were skinned and afterward stuffed with tow (a type of cotton lint), shredded tobacco, straw or a powder made from tobacco and black pepper.¹²

Tobacco Was Not Always Effective

Despite the enthusiasm for tobacco as a medical treatment, there were cases where it was tried without success. For example, its antiloimic powers—”antiloimic” refers to a substance that prevented or cured the plague—were shown to be about as effective as wine, brandy, and opium. In other words, it was not at all effective in curing people of the plague.¹³ Nor was it successful in treating cases of hernia.¹⁴ Still, in the absence of formal statistics and clinical trials, I can only admire Regency-era doctors and surgeons for trying anything and everything to help their patients recover.

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Sources:

¹Townsend, The Rev. Joseph. The Physician’s Vade Mecum; being a Compendium of Nosology and Therapeutics for the Use of Students. (London: H.D. Symonds, 10th ed., 1807).
²Powell, Richard. The Pharmacopoeia of The Royal College of Physicians of London. (London: Longman, Hurst, Rees, Orme, and Brown, 1815), p. 206 (PDF p. 267).
³Anon. A Translation of the Corrected Edition of the Pharmacopoeia. (London: Sherwood, Neely, and Jones, 1815), p. 50 (PDF p. 67).
⁴Cooper, Samuel. The First Lines of the Practice of Surgery, Vol. I. (London: Longman, Hurst, Rees, Orme, and Brown, 1819), pp. 116-120 (PDF pp. 151-155).
⁵Ibid., p. 120 (PDF p. 155).
⁶Thomson, Anthony Todd. The London Dispensatory. (London: Longman, Hurst, Rees, Orme, and Brown, 1818), p. 603 (PDF p. 748).
⁷Barton, Benjamin Smith. Professor Cullen’s Treatise of The Materia Medica, Vol. II. (London: Edward Parker, 1812), p. 197 (PDF p. 206).
⁸Ibid., p. 198 (PDF p. 207).
⁹Anon. Encyclopaedia Britannica, Vol. XII, 4th ed. (Edinburgh: Andrew Bell, 1810), p. 751 (PDF p. 762).
¹⁰Barton, Benjamin Smith. Professor Cullen’s Treatise of The Materia Medica. (Philadelphia: Edward Parker, 1812), p. 415 (PDF p. 424).
¹¹Encyclopaedia Britannica, pp. 462-463 (PDF pp. 473-474).
¹²Gray, Samuel Frederick. A Supplement to the Pharmacopoeia: Being A Treatise on Pharmacology in General. (London: Thomas and George Underwood, 1821), pp. 174-175 (PDF pp. 213-214).
¹³Barton, p. 197 (PDF p. 206).
¹⁴Grainger, Edward. Medical and Surgical Remarks. (London: Longman, Hurst, Rees, Orme, and Brown, 1815), pp. 161-170 and 161-164 (PDF pp. 167-170 and 170-173).