I recently delved into the bowels of coffee enemas.

I knew that Gwyneth Paltrow and GOOP were happy to shill for Big Wellness and sell over-priced, harmful coffee enema kits and of course there are many “integrative” doctors firmly on the groundless coffee enemabandwagon, but honestly I really thought coffee enemas were something people spoke about but never used or perhaps tried once and then their rectum sat them down for a little conversation.

Was I naive! There is a Facebook group, Bottoms Up, dedicated to the devotees of coffee enemas…

…and they came out to support poor Gwyneth Paltrow.

Don’t listen to that mean old Dr. Gunter!

Several coffee enemas aficionados were not shy about passing their superior knowledge on to me via Facebook and Twitter, claiming “coffee enemas were used in WW2 for pain management because of lack of supplies for injured soldiers.”

Right, the morphine couldn’t get through to the front, but the coffee could?

And that “coffee enemas stimulate the vagus nerve which helps the body made gluthione [sic].”

I’m guessing they mean glutathione?

Sigh. That’s not really how it works. That’s not how any of it works, but never mind.

Was this rumor based in fact? I had to know. I’m fascinated at the lengths people will go to justify their clearly biologically implausible yet harmful therapies. Also, Trump’s been President for a year and I needed a distraction.

For those of you who don’t know, coffee enemas were mainstreamed by Dr. Max Gerson in the 1920s. His original “regimen” (and I use that term lightly) involved a vegetarian diet, weird supplements, raw calf’s liver, hourly glasses of fruit and vegetable juice for 13 hours a day, and an enema fetish. This is supposed to “detoxify” the body. It doesn’t. His regimen has never been evaluated and is, of course, stupid.

It wouldn’t be surprising that a quasi-medical therapy made it’s way into military medicine (or any of medicine) in the 1930s or 40s. There were no ethics review boards, studies were not performed as they are today, and of course we really had a very basic understanding of physiology compared with what we know today. Treatments were also very limited. The first dose of penicillin wasn’t administered until 1940. Enemas were recommended for many things.

Did they work (apart from treating constipation)? No. Did they stop people from coming back to the doctor and thus producing the illusion of a cure? Probably.

I contacted Adam Montgomery, a military historian. He found no mention in several sources, but contacted the U.K. Association for the History of Nursing and apparently one historian of nursing recalled coffee enemas being used as a stimulant in patients with shock, to boost circulation until they were re-hydrated. Nothing in writing though.

I then reached out to The Museum of Military Medicine in the U.K. and the Assistant Curator was kind enough to reply! I hear my e-mail brightened up their day! The RAMC training manual from 1911s fails to mention coffee enemas, however, coffee enemas are mentioned in the World War II 1944 RAMC training manual.

I was so excited. I don’t know why, but I was!

Coffee enemas were considered stimulant enemas, apparently as a treatment for shock and also for poisoning.

The coffee was mixed with brandy and heated to 105 degrees F. 

This is a very bad therapy. First of all, six ounces of fluid even if it were all absorbed (doubtful) isn’t going to treat anyone’s low blood pressure. Secondly, coffee is not going to counteract any poisoning. Might it wake you up? I suppose some caffeine might be absorbed, but that isn’t going to really do much in the way of reversing an impending coma brought on by a poison or a toxin. It is true whole bowel irrigation has been recommended in some types of overdoses, specifically to remove undigested delayed-release tablets in cases where no other antidote is available, but that is copious fluid and not coffee. 

There are a whole host of treatments that we used in the 40s that we now know are useless, or worse, barbaric. Obviously the frontal lobotomy, which shared the Nobel Prize in Medicine in 1949, is a classic and tragic example. 

So yes, coffee enemas were in a World War II medical manual, but not as pain relief but rather as undoubtedly ineffective treatment for shock and poisoning. 

And as for the Merck Manual? Yes, coffee enemas were removed in the 1970s and not because of a Big Pharma conspiracy but because they don’t work. I mean honestly people. What drug sales were coffee enemas actually killing?

So please, keep your coffee well away from your rectum and in your cup.

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  1. Just for fun I looked at my Merck’s 1899 Manual ( available on line ) and could find no reference to coffee enemas. There is a notation on Page 103 for constipation where “Coffee: sometimes purges.”

  2. I never understood how Gwyneth Paltrow became a self proclaimed nutrition guru. I am a registered dietitian, and have clients who follow her and get very confused about nutrition practices because of her.

  3. I know nothing about coffee enemas personally, professionally or historically.
    But I do know an unscientifically argued article when I read one. It’s full of snide inuendo and personal attacks, in place of the evidence, insight or compassion befitting the medical profession. Cheap shots are easy, and probably fun to write, but they’re also beneath the author and the publication that linked to it.

    1. @JBrecher – this article is about whether or not coffee enemas were used during WW2 for treating pain or not. That question was answered through research (although not exhaustive). This is a blog, although a respected one, not a journal of medicine.

  4. you failed to mention the addition of the 1 oz of brandy . i think the idea may be that the poison may make the victim unable to drink the coffee and brandy . it sounds as bad as drinking the coffee made from excreted beans of the cevit cat

  5. Hey, Jen, I wonder if the coffee came with or without the sugar and cream and it was shaken or just gently stirred. Amazing how much influence society can impose on each other based purely on the power of suggestion and the peer pressure of support from the likes of Paltrow and Oz
    I am QUITE satisfied that after being in surgery for over 3 decades and with close to 15 years of direct education that over time we are pretty safe in our refutation of such nonsensical schemes by laypeople with microphones and keyboards. Funny when the rubber finally hits the road and people are truly sick they don’t call Gwen or Oz for actual help they call US and then bitch about what we charge
    Dr Dave

  6. Over 30 years ago I was Director of Public Health Laboratory in East Texas. A lady was convinced she had intestinal parasites and submitted several specimens that were all negative. Very little formed stool but loaded with what appeared to be epithelial cells. I finally interviewed her even though I wasn’t a clinician with the approval of my medical director. She finally revealed she started her morning with her coffee enema. A new one on me. I suggested maybe she leave that off. We found a cure for her problem.
    Jimmy L. Conner, PA-C, M. S. Specialist Microbiologist (NRM)

  7. Please contact the American Association for the History of Nursing of the Nursing History Centers at UPENN or UVA Schools of Nursing for more information on health practices of the past. There are excellent historian scholar nurses at all these places and could have directed you to resources. As an aside, enemas were not administered by physicians, only ‘ordered’, in the last 100 yes. Only nurses administered enemas. Physicians wouldn’t know an enema bag from a fleets.

  8. I have an old copy of the NATO Emergency War Surgery manual, from (approximately) that era. I’ll see if I can dig it up and have a look for anything remotely similar.

    1. Finally dug it up! The index has no entries for coffee or for enemas. A section that addresses pain interestingly recommends a triage step to sort casualties who are merely restless from those in severe pain before administering morphine. I won’t claim to have read every word of every chapter, but I was unable to find any reference to coffee enemas in any chapter that seemed even remotely relevant.

  9. I think there’s a Facebook group for EVERYTHING! Dr. Gunter, can you PLEASE do an article about worms? There is another group on, you guessed it, Facebook that is suggesting some seriously crazy and sometimes dangerous things to do if you have worms. Reading some of the comments in their feed, I think some of the members are suffering from some mental health issues. So asking them to do daily enemas with coffee and other things, plus using something called a ZAPPER, seems really dangerous. I saw one member using a ZAPPER on her child! They need some serious education!

  10. In The Good Soldier Schweik, the Czechs who are unfit for service in the Austro-Hungarian army are put in the hospital, where they receive one enema and one stomach-pump per day, until they declare themselves fit for service. A medical miracle!

  11. “a vegetarian diet, weird supplements, raw calf’s liver, hourly glasses of fruit and vegetable juice for 13 hours a day”

    On that diet how could you possibly need an enena ….that’s gotta clean you out anyway!

  12. My father was a surgeon in a field hospital in the South Pacific during WWII. As kids we loved to go through his US Army issue surgical kit. Retractors, scissors, needles, but nothing to put up your butt for enemas. I think they were too busy sewing up and amputating to do enemas. Besides, it would have been a waste of coffee.

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