Now that we are all too aware of tobacco’s dangers, it’s pretty strange looking back at old cigarette adverts from the 1920s with a white-coated doctor puffing away and recommending you a specific brand of smokes. But if you thought this antiquated view of smoking tobacco was bizarre, you should see what Londoners did with it back in the 18th century.

The Wellcome Collection has recently detailed the history of smoking in Europe after it was introduced in the 16th century following colonial expeditions to the Americas. Despite its obvious phlegm-inducing side effects, tobacco was associated with medicinal benefits for centuries, all of which has now been wholly disproven by modern science.

In the 1600s, Europeans struck up the theory of how contagious diseases such as cholera or the Black Death spread from person to person, involving “miasma.” Miasma was a supposed noxious mist that contained the disease and could be identified by its foul smell. To fight off the poisonous smelly vapor, people lit up their tobacco pipes and surrounded themselves in a thick blanket of smoke.

Even surgeons in the 1800s would fill their operation theatres with tobacco smoke to prevent infections. This idea persisted across Europe and China right up until the late-19th century when it was replaced by the germ theory of disease.

However, peak tobacco-related quackery was truly achieved in the late 1700s when doctors across Europe become oddly obsessed with “tobacco smoke enemas,” the act of literally blowing smoke up one’s ass. Smoke enema kits consisted of a pipe, bellows, and a variety of tubes that could be stuck up a patient's rectum.

Smoke enemas were believed to cure anything from common colds to fatigue, respiratory failure to hernias, but their most common application was as a means to resuscitate drowning victims. In fact, the practice was so common that the River Thames was lined with tobacco smoke enema kits in case any unsuspecting victim fell into the murky waters.

“The notion of reviving victims of drowning accidents with tobacco smoke enemas seems, to say the least, a little odd. But to 18th-century physicians, this approach was entirely rational,” Ghislaine Lawrence, a medical historian from the Science Museum, London, wrote in the medical journal The Lancet in 2012.

“The mainstay of treating the “apparently dead” was warmth and stimulation. Rubbing the skin was one method of stimulation, but injecting tobacco smoke into the rectum was generally thought more powerful.”

Needless to say, very few doctors born after 1800 would ever recommend blowing tobacco up your ass. The grave health problems associated with smoking really started to become apparent by the 1920s and 1930s, eventually amounting to scientists solidly linking tobacco and cancer in the latter half of the 20th century.