Faced with drowning in the 18th century, physicians and laymen were not deprived of choices: innumerable resuscitation methods of variable efficiency existed (Table 1). One method, however, surpasses all the others: the anal insufflation of tobacco smoke. Propagated by scholars like the physicist and naturalist Réaumur, it was intended as a means against the burial of individuals falsely diagnosed as dead: «But what is best, perhaps, is to blow the smoke of a pipe into the intestines. One of our Academicians has witnessed the swift and happy effect of this smoke on a drowned man. A broken pipe may supply the pipe or blow-torch by which the smoke that is drawn from the whole pipe will be blown into the body».
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The unusual method is somewhat comparable to legendary and mythical stories of undertakers inserting silver needles in the nail bed of the big toe before any burial.Table 1List of all resuscitation methods for drowning victims in 18th century.
| Hanging by the feet |
| Roll in a barrel (open at both ends) |
| Vomiting caused by a feather introduced into the oesophagus |
| Undress wet clothes and warm with pre-heated sheets and blankets (or in a hot water bath) |
| Turn the body in all directions in a bed |
| Pour hot urine into the mouth |
| Pour a decoction of pepper and vinegar into the mouth |
| Irritate the inside of the nose (with a feather, alcohol, tobacco, etc.) |
| Blow hot air with a cannula or a pipe into the mouth |
| Cover the body with manure |
| Lay the victim between two naked living people |
| Make a hot intra-rectal enema |
| Bleeding (mainly jugular) |
| Tracheotomy |
| Blow the tobacco smoke of a pipe into the anus |
These “hurried burials” were indeed one of the most important fears of the modern West: a book published in 1742 — a best-seller at the time, written by Jacques-Jean Bruhier d’Ablaincourt, the Dissertation On the Uncertainty of the Signs of Death compiles anecdotes of living buried subjects. The subject became so fashionable that it created an unprecedented anguish among the living (…who are the future dead).
The success of this method of anal insufflation was such that an apothecary (Philip Nicolas Pla) installed about twenty “fumigation boxes” along the banks of the Seine River in Paris. Inside each box was a printed manual, an iron spoon to open the jaws, salts of ammonia to rub under the nostrils, a woollen garment for warmth, and an enema to insufflate tobacco smoke into the anus. Fascinated by such resuscitation kits, all European capitals followed suit after its popularity in Paris and Lyon.
Considering the method patho-physiologically, the pain caused by the introduction of tobacco smoke into the anus could activate the mechanism to pull the unconscious patients out of their torpor by adrenergic stimulation. It must be noted that painful stimulation is also a modality for assessing the depth of coma.
Even if one easily understands the use of tobacco (it is considered as an irritant, and therefore a stimulant), the question still remains as to why the anus was the preferred site for insufflation? For some, the origin is more symbolic than pragmatic: perhaps the answers lie in the legendary stories of the storks that hibernate under the water of the lakes, immobile, each having their beak driven into the anus of another … or in popular beliefs related to the burlesque resurrections of the medieval Carnival celebrations and the Commedia del’arte.
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Conflict of interest
None for any author related to the subject of this historical publication.
References
- Avis pour donner du secours à ceux que l’on croit noyés.Unknown printer, Paris1740
- Du tabac pour le mort. Une histoire de la réanimation.Champ Vallon, Paris2018
Article info
Publication history
Published online: July 05, 2019
Received:
June 26,
2019
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© 2019 Elsevier B.V. All rights reserved.
