In today’s world, the phrase “blowing smoke up your ass” is a cheeky way to call out someone’s flattery or empty promises. But rewind to 18th-century England, and this expression had a far more literal—and downright bizarre—meaning. Believe it or not, blowing tobacco smoke into someone’s rectum was a legitimate medical procedure, used with surprising frequency to revive the nearly dead. Yes, you read that right: this was a real thing, and it’s as wild as it sounds.
The story begins in 1746, when a woman in England nearly drowned and was left unconscious, teetering on the edge of death. With few options available, her husband, acting on a peculiar medical suggestion, grabbed a tobacco-filled pipe, inserted the stem into her rectum, and blew smoke into her body. Astonishingly, the hot embers of the tobacco reportedly shocked her system, jolting her back to consciousness. This strange success sparked a medical trend that would soon sweep through England.
But where did this outlandish idea come from? The origins trace back to Indigenous American practices, where tobacco was used as a remedy for various ailments. English physician and botanist Nicholas Culpeper, inspired by these traditions, introduced tobacco enemas to treat conditions like colic or hernias. By the late 1700s, another physician, Richard Mead, championed the procedure, helping it gain traction as a mainstream medical practice—particularly for reviving drowning victims.
In an era when medical science was still rudimentary, the tobacco enema seemed like a stroke of genius. Doctors believed the warm smoke could stimulate the heart, kickstart breathing, and even “dry out” the waterlogged insides of drowning victims. Compared to blowing air directly into the lungs, which risked spreading diseases like cholera, the enema was seen as a cleaner, more effective delivery method. The equipment was simple: initially, a standard smoking pipe was used, though its short stem often led to unsanitary mishaps, including doctors accidentally inhaling, well, let’s just say unpleasant substances.
By the late 18th century, the practice had become so common that specialized kits—consisting of bellows and flexible tubes—were stationed along major waterways like the Thames. These kits were ready to be deployed at a moment’s notice to save drowning victims. The procedure’s popularity soared, and it wasn’t just for drowning cases. Tobacco enemas were soon prescribed for everything from typhoid to headaches to stomach cramps, touted as a near-miraculous cure.
In 1774, London doctors William Hawes and Thomas Cogan took the tobacco enema’s popularity to the next level by founding The Institution for Affording Immediate Relief to Persons Apparently Dead from Drowning. Later renamed the Royal Humane Society, this organization aimed to save lives and reward acts of bravery. Anyone who successfully revived a drowning victim—often using the tobacco enema—was awarded four guineas, equivalent to about $160 today. The Royal Humane Society, still active and now patronized by the Queen of England, remains a testament to the era’s commitment to lifesaving, however strange their methods.
The tobacco enema’s reign was short-lived. In 1811, scientists discovered that tobacco was toxic to the cardiac system, dealing a fatal blow to the procedure’s credibility. As medical knowledge advanced, the practice quickly fell out of favor, relegated to the annals of bizarre medical history. By the 19th century, blowing smoke up someone’s backside had transformed from a cutting-edge cure to a laughable footnote.
The tobacco enema may be long gone, but its legacy lives on in the colorful idiom we use today. The next time someone accuses you of “blowing smoke up their ass,” you can share the shocking truth: this phrase comes from a time when doctors quite literally did just that, in a desperate bid to save lives. It’s a reminder of how far medicine has come—and how thankful we should be for modern science.