If someone is blowing smoke up your butt today, it probably means they are feeding your ego with insincere compliments. But a few hundred years ago people literally blew smoke up other peoples’ keisters for a variety of medicinal purposes.

This was the enlightening takeaway from a recent visit with my GI surgeon, Julius Bonello of Peoria, Illinois. Bonello wrote an article published in the December/January issue of History Magazine detailing the medical history of tobacco and an apparatus used to literally blow smoke up a patient’s derrière.

According to Bonello, rectal fumigation (also known as smoke enemas, tobacco enemas, or smoke clysters) were used during the 17th and 18th centuries to treat bowel obstruction, constipation, strangulated hernias, colic, and even to resuscitate stillborn babies.

The practice of rectal tobacco infusions during surgery for muscle relaxation was even documented in the January 1897 issue of the Boston Medical and Surgical Journal (now known as The New England Journal of Medicine). As if smoke enemas alone were not strange enough, there was an even more bizarre method put in place to prevent overdose. A cigar tied to a string was inserted into the rectum and then withdrawn once the desired effect was achieved.

Resuscitation of drowning victims was, perhaps, the most interesting use of the smoke enema, according to Bonello.

France was the first to adopt the technique, followed closely by London.

Bonello noted that nicotine has found its way back into medicine in recent decades as scientists have attempted to produce nicotine-based vaccines against HPV, HIV, rabies, Ebola, Alzheimer's, depression, obesity, and even chronic ulcerative colitis.