Enema fumosum: the contribution of the North American first nations to drowning resuscitation - A historical review.
Resuscitation plus · 2026-05-20 · Other / unclear
Abstract
Rectal insufflation of tobacco smoke was the most used resuscitation method for drowning accidents in the second half of the 18th century. Probably practised for centuries by the indigenous tribes of Canadian Acadia, knowledge of this form of treatment reached England from the New World already at the beginning of the 17th century. The East India Company's fleet surgeon, John Woodall, was the first to describe the method in his textbook, published in its second edition in 1639, entitled "The Surgeons Mate" and referred to it as "Enema fumosum". Within a few decades, this treatment spread throughout Europe, initially being used primarily to treat severe abdominal complaints. Then in 1740, at the behest of Louis XIV the French polymath René-Antoine Ferchault de Réaumur recommended tobacco smoke enemas as the most effective method of resuscitation for drowning victims. The rescue organisations that emerged shortly thereafter in many European countries, such as the Dutch "Maatschappij tot Redding van Drenkelingen", founded in 1767, adopted Réaumur's recommendation. Emergency literature of the time contains hundreds of examples of successful resuscitation after using this method. The first doubts about its effectiveness were expressed in 1776 by the famous English surgeon John Hunter, followed shortly afterwards by the physicians Charles Kite and James Curry. The method fell increasingly into disrepute. By the middle of the 19th century, it had been definitively replaced by Marshall Hall's "Ready Method" and other new resuscitation methods. What remains of it today are memories of a form of therapy that seems curious, but whose implementation undoubtedly saved the lives of a large number of people threatened with drowning as many reports on successful drowning resuscitations demonstrate.