You are here:

Smoke Up Your Arse – Strange, Historic First Aid Practices

First Aid Time Travel

Read for some first aid time travel? Just pop a few coins in the Time Machine and off we go. A few more than that? Oh, well, I suppose that will have to do. Hang on tight, off we go! What might you have expected if you needed first aid? Let me warn you now: you may soon be missing many of our modern-day comforts….

Smoke Up Your Arse – First Aid for Drowning

Murky underwater image of female figure, her dress billowing back from the knees, face unseen. This drowned female will need first aid.

A drowned female in need of first aid. Photo by Nick Russill on Unsplash

If you were unlucky enough to fall into a river and drown in the 1700s, you might be pulled out of the water, chilled and sodden, but your indignities wouldn’t end there. A presumably well-meaning doctor or first aider would literally blow smoke up your arse. Yes, really.

The smoke enema was conducted using a pipe. Later, bellows were added to prevent the first aider from inhaling a rather toxic blowback. Revival kits were supplied along the Thames just in case. It was just one of many exciting treatments from the relatively new wonder drug, tobacco.

Did it work? Well, it got the victims turned into a sort of (!) first aid recovery position which may have allowed water to be coughed out. It certainly gave the doctors something to do while they were engaged in some dubious ‘watchful waiting’.

Will we be teaching the technique on our next First Aid Course? Nope.

Let It All Out – Bloodletting

If you were feeling a bit out of sorts in ancient or medieval times, you might head down to your local barber-surgeon for a bit of bloodletting. Something about balancing the Humours, though it might have used up any good humour you had to begin with! At least, if it didn’t make you feel better, you could always ask for a Low Skin Fade Pompadour!

Bloodletting was a hugely popular first aid treatment up until the 19th century. Epilepsy, stab wounds, asthma, stroke, heart attack… you name it.

Photo of a bloody hand suggests that blood-letting is taking place, a first aid practice of sorts in early times.

Bloodletting is not part of our first aid courses. Photo by Max Muselmann on Unsplash

Lacking the ability to call 999, but with blades and bowls a-plenty, the barber-surgeon knew just what to do. This has largely fallen out of popularity. However, remarkably it is still used today, but rather more sparingly and only in blood conditions where iron or red blood cells are wildly out of balance.

We will show you how to manage a bleed on our first aid courses, but we’ll leave blood-letting to the history books.

Suck it Up – Leeches

You may have heard of this one – leeches. Not unlike bloodletting, it supposedly cured anything and everything. If you can get your head past the ‘ew’ factor, it hurts much less. This is thanks to the anaesthetic that the leech produces in the hope that you won’t realise what it’s up to while it has a decent drink of your blood.

Interestingly, the leech has made a medical comeback. Because leeches release something that stops your blood from clotting, they have been successfully used when reattaching a limb. We promise that there are no leeches in our First Aid kits!

Holy Moly – First Aid Surgery

So another practice that goes back into time immemorial is that of trepanning/ trephining. This was the art of releasing bad spirits in a very literal way, by making a nice, round incision into the skull. This involved drilling or otherwise making a round incision into the skull itself. Now, you might think that you need this like you need a hole in the head (ha!) and you’d be quite right. But those spirits aren’t going to disappear without a bit of help, are they?

A human skull looks back. This unfortunate soul may have once been given first aid in the form of trephination. However, the angle is not clear enough to determine if this is so.

A skull. First aid no longer required. Photo by Michael Förtsch on Unsplash

It’s a bit tricky to say whether the reasons for trephining has changed over the millennia as we can see the distinctive holes in skulls from before there was any kind of written record  – as early as the Mesolithic period. We can also see the tell-tale sign that some recovered from this treatment as the hole smoothed over. Having survived the ordeal, they then presumably went on to live a good life.

It’s possible that those who agreed to have a bit of skull surgery in days gone by were suffering from severe migraines, pre-eclampsia, epilepsy or severe mental health problems. Whatever the exact reasons, it was a surprisingly popular treatment – with 25% of skulls in one area (France) showing signs of having had a bit of skull removed. Elsewhere, 1 in 10 was typical.

Fortunately, today we have medication and psychotherapy. Holes are still made in skulls – as part of brain surgery and occasionally when pressure cannot be released from the brain or sinuses in any other way.

Brain surgery of any sort is definitely not on the curriculum of our first aid courses. 

Cigarettes for Asthma – Dangerous First Aid

A woman from the early 20th century looks down. The entire image has been fractured by an overlay of smoke.

Cigarettes are no longer recommended for asthma attacks. Photo by Unseen Histories on Unsplash

In the 1920s, cigarettes were being promoted as a way to help asthma. This is pretty shocking when we realise how smoke from tobacco can cause serious lung disease, the last thing that anyone with asthma needs. Tobacco companies did have a growing awareness that cigarettes were bad for you, but there just weren’t the same kind of legislation around advertising.

We know that a serious asthma attack can be life-threatening and these days a first aider might help them to move away from any irritant or allergen and encourage them to use their reliever inhaler. Remember to get them to breathe OUT first and then slowly inhale and hold the ‘puff’.  Keep an eye on them and be ready to get help if they are struggling to breathe.

Whale Carcass for Rheumatoid Arthritis

Rheumatoid Arthritis can be incredibly painful. But if you happen to be in Australia in 1899, you might well be able to direct your patient to the nearest Whale Hotel. When a whale died, the blubber was cut open and patients could be rowed out to the whale and float inside the slowly rotting carcass.

The cool whale fat was a wonderful balm for the person’s inflammatory pain. What’s not to love? Just look out for birds that might want to pick at the whale carcass, watch out for weather changes and assess the risk of smothering. PS Your new friend may desire a bath afterwards and a change of clothes. Also, please do leave the whales alone. They don’t need any more bother.

Milk Transfusions –  A Hopeful Experiment

There was a brief wave of enthusiasm for milk transfusions in the late 19th Century in Canada and the United States. While injecting cow’s, goat’s or sheep’s milk intravenously seems like an odd choice to us today, they were experimenting because blood transfusions didn’t always work. The main reason for this was because blood types hadn’t been discovered yet. Karl Landsteiner did so in 1901.

Did it work? The theory was that the fat would transform into white blood cells. This was unfortunately not possible. Occasionally someone survived the ordeal, but mostly it resulted in death.

We do not encourage milk transfusions on our first aid course. Or, come to think of it, blood transfusions. If you believe that someone has lost enough blood to require a transfusion, make sure you tell the 999 operator.

Back to the Future

As we return to the present day, you can give thanks that these practices are largely confined to the history books and that First Aid knowledge has moved on so much.

It is fair to say that there have been quite a few breakthroughs over the years that have changed medicine forever. We have a multitude of medical tools and practices which would surprise and confuse our great-grandfathers. Robotic surgery, donor egg IVF, talking defibrillators…

What did you miss most? General Anaesthetic? Ambulances? Vaccines? Antibiotics?

Who knows what discoveries may await us in the coming years? Perhaps future generations will be appalled by something that is a regular part of our practice.