Until last month I had assumed that the phrase “blowing smoke up your behind” was figurative (meaning insincere compliments) rather than literal. Then on the new books shelf at my friendly local public library I found a book by Lydia King and Nate Pedersen titled Quackery: A brief history of the worst ways to cure everything. On pages 88 and 89 was a section titled Blowing Smoke Up Your Arse which described how in 18th century London tobacco smoke enemas were used to try and resuscitate drowned people. The article was illustrated by a photograph of a kit from the Wellcome Collection (with a bellows as shown above) and a captioned diagram showing the parts and how they were assembled. I have added another Wellcome Collection illustration of the assembled device (which coyly omits the nozzle). There was an organization known as The Institution for Affording Immediate Relief to Persons Apparently Dead from Drowning (which later became the Royal Humane Society). There even is a four-minute YouTube video titled Tobacco resuscitation kit: a smoke enema to save your life? It describes the theoretical basis of four humours.
There also was a magazine article by Sterling Haynes on Tobacco Smoke Enemas in the December 2012 issue of the BC Medical Journal (on pages 496 and 497). He said that in 1811 English scientist Ben Brodie discovered that nicotine was toxic to the heart, so smoke enemas soon became unfashionable. Via PubMed I found another article titled A history of the medicinal use of tobacco 1492 – 1860 by Grace G. Stewart in the July 1967 issue of Medical History (pages 228 to 268) with a better description (page 244) of how blowing smoke went from literal to figurative:
“Dr. (Daniel) Legare put the final touch upon the practice of injecting smoke into a patient’s intestinal canal to resuscitate the apparently drowned, when he presented his inaugural dissertation at the University of Pennsylvania in 1805, recording the results of his experiments upon animals with the rectal insufflation of tobacco smoke and demonstrating thereby that this mode of procedure was of no value as a means of resuscitation. The discontinuance of the practice of using tobacco smoke for this particular purpose did not mean that physicians abandoned the practice for other purposes, however, for it was continued until 1860 and possibly later.”