Appearing in medical writings as far back as ancient Egyptian documents, enemas have been used for centuries to relieve constipation, detoxify the body, and improve general health and well-being. More recently, directions for administration of various types of enemas, including coffee enemas, were included in medical and nursing textbooks.1 Coffee enemas were mentioned in the Merck Manual of Diagnosis and Therapy, a compendium of orthodox medical treatment, through the Twelfth Edition, published in 1972.2-4 (In a letter to my late colleague Dr. Nicholas Gonzalez, an editor of the Manual commented that coffee enemas were removed primarily because of space considerations.)
Coffee enemas have been in clinical use for over a century. In a case report in the Pacific Medical and Surgical Journal in December 1866, M.A. Cachot, MD, described successful use of a coffee enema to treat a child dying from an accidental poisoning.5 Articles from the late 1800s reported that coffee enemas were helpful in post-operative care6, and in 1896, Dr. W.J. Mayo, one of the founders of the Mayo Clinic, mentioned coffee enemas as a routine part of care for patients after abdominal surgery.7 In a 1929 paper in the Archives of Internal Medicine, investigators at Lenox Hill Hospital in New York reported that rectal insertion of several different liquids caused a beneficial increase of bile flow from the liver.8
In 1938, German physician Max Gerson, MD, was licensed to practice in New York, where he successfully treated hundreds of terminal patients using coffee enemas along with diet therapy. In his book A Cancer Therapy: Results of 50 Cases, he stated “In as much as the detoxication of the body is of the greatest importance…we give coffee enemas every four hours, day and night….” (p. 190).9 In an extensive 1941 article in Uruguayan Medical, Surgical and Specialization Archives, Dr. Carlos Stajano described immediate improvement in near-terminal patients after coffee enemas, including a patient with cocaine intoxication and a patient with post-operative shock.10 Elaborating on his extensive experience with coffee enemas in post-operative management, he made a plea for their continued use.
Dr. Gonzalez believed, and I continue to believe, that coffee enemas safely stimulate the liver and gallbladder to increase the flow of bile, aiding the liver in its detoxification efforts. Some physicians claim that coffee enemas are dangerous, based on case reports of patients who reportedly developed electrolyte imbalances or infections after coffee enemas.11,12 However, close review of these cases shows that the patients in question were seriously, even terminally ill, and that the infections or electrolyte disturbances blamed on the coffee enemas could have come about simply because of the patients’ underlying disease. Whereas only a few such cases have been reported, every year in the United States thousands of people die from the side effects of medications available without a prescription, such as aspirin and ibuprofen. Dr. Gonzalez and I have instructed thousands of patients to perform coffee enemas and none have had any significant problems from them. However, I do recommend that coffee enemas only be done after consultation with a qualified medical professional.
Linda L. Isaacs, MD, received her medical degree from Vanderbilt University School of Medicine and completed her residency at New York University Medical School. Board Certified in Internal Medicine, she practices in New York City. For more than 20 years, she worked with her colleague,Nicholas J. Gonzalez, MD, using a nutritional approach for treating patients diagnosed with cancer and other degenerative diseases, and together authoring the book The Trophoblast and the Origins of Cancer . Since his untimely death in 2015, she has continued the work that they shared. For more information, visit www.DrLindai.com.
 McClain ME. The patient’s needs: Enemas. Scientific Principles in Nursing. St. Louis, MO: The C.V. Mosby Company; 1950:168.
 Bedside procedures. The Merck Manual of Diagnosis and Therapy. 9th ed. Rahway, NJ: Merck & Co, Inc; 1956:1747-1748.
 Bedside procedures. In: Lyght CE, Gibson A, Keefer CS, Richards DW, Sebrell WH, Daughenbaugh PJ, eds. The Merck Manual of Diagnosis and Therapy.10th ed. Rahway, NJ: Merck Sharp & Dohme Research Laboratories; 1961:1754-1755.
 Bedside procedures. In: Lyght CE, Keefer CS, Lukens FDW, Richards DW, Sebrell WH, Trapnell JM, eds. The Merck Manual of Diagnosis and Therapy. 11th ed. Rahway, NJ: Merck Sharp & Dohme Research Laboratories; 1966:1682-1683.
 Cachot MA. Case of Poisoning by Aconite; Enema of Coffee in the Treatment. Pac Med Surg J. 1866;9:239-240. Available at http://google.com/books?id=BkAgAQAAIAAJ
 Allison CC. Operative Technique in Appendicitis, with Cases. West Med Review. 1896;1:152-154. Available at http://google.com/books?id=tOVXAAAAMAAJ.
 Mississippi Valley Medical Association Society Proceedings. West Med Review. 1896;1:189-194. Available at http://google.com/books?id=tOVXAAAAMAAJ.
 Garbat AL, Jacobi HG. Secretion of bile in response to rectal installations. Arch Intern Med. 1929;44:455-462.
 Gerson M. A Cancer Therapy: Results of 50 Cases. Del Mar, CA: Totality, 1958.
 Stajano C. The concentrated coffee enema in the therapeutics of shock. Uruguayan Med Surg Special Arch. 1941;29:1-27.
 Eisele JW, Reay DT. Deaths related to coffee enemas. J Am Med Assoc. 1980;244:1608-1609.
 Margolin KA, Green MR. Polymicrobial enteric septicemia from coffee enemas. West J Med. 1984;140:460.
 Isaacs L. Helping the Body Detoxify. Well Being Journal, Vol. 23, No. 3, May/June 2014, March 28, 2014.