Resuscitation practices of old: The Barrel method of resuscitation and tobacco smoke enemas!

Museum of the Order of St John Judi McGinley, Museum Assistant

The Barrel method of resuscitation was a medical procedure that was popular during the early to mid 1700s. This method  involved the victim being lifted up and draped over the side of a large barrel. The patient would then be  pulled back and forth alternatively via their feet, in an effort to force air in and out of his or her chest. This technique was in many ways a precursor of modern CPR.  

The Barrel method of resuscitation

 Illustrations depicting the Barrel method of resuscitation.

Image credit: Wellcome Images. Photo number: M0017194,

 http://catalogue.wellcomelibrary.org/record=b1310681. Obtained via Wikimedia Commons


The late 1700s was to witness the introduction of the tobacco smoke enema! Yes, you read it right.  This was a procedure whereby doctors literally blew tobacco smoke up into the rectums of patients who were otherwise presumed dead. It was a last-ditch attempt to bring them back to life. This mainstream procedure was originally carried out using a tobacco smoke enema device which consisted of pig’s bladder, a tobacco pipe and a nozzle.  Those who did not have access to this medical device, would resort to using a basic smoking pipe loaded with tobacco. The pipe would be lit and the stem inserted directly into the victim’s rectum, while the person administering the treatment would cover the bowl end of the pipe with his mouth and would proceed to blow smoke directly into the rectum of the patient, often with alarming results!

A Tobacco smoke enema device

Textbook drawing of an early tobacco smoke enema device, 1773. Author: Alexander Johnson.
Public domain image obtained via Wikimedia Commons.

Tobacco smoke enemas were commonly used to resuscitate drowning victims, which led to tobacco smoke resuscitation devices being located at various points of main waterways, including the Thames.  Tobacco smoke was forced into the rectum of the victim via a tube which was connected to a fumigator and a set of bellows.  Tobacco smoke would be forced into the patient’s rectum when the bellows were compressed.


Tobacco smoke enema device


Resuscitation set, Europe, 1801-1850. Image credit: Wellcome Images.


Obtained via Wikimedia Commons.



It was believed that the nicotine in the tobacco would act as a stimulant to the heart encouraging it to beat stronger and faster, thus initiating respiration. The smoke was also thought to warm the body of a hypothermic victim, while drying out his or her insides.

In 1811, English scientist Ben Brodie carried out tests on animals which confirmed that nicotine was harmful to the cardiovascular system. His findings were to sound the death knell for the tobacco smoke enema method of resuscitation, and the procedure dwindled quickly over the next few decades.


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