In 1974, Dr. Henry Heimlich was a successful thoracic surgeon in his mid-fifties. He had been one of the first doctors to perform an operation that fixed damaged esophagi, and had become head of surgery at Cincinnati's Jewish Hospital. But Heimlich wanted to do more. In looking for a simple method that would save the lives of people who were choking, he and his team started experimenting with beagles. He realized that when he pushed upward on the dog’s diaphragm, compressing its lungs, a tube in the dog’s throat became dislodged, allowing it to breathe normally again.

How the Heimlich Maneuver Became Popular

Because he knew a peer-reviewed study in an established medical journal would take too long to get published, Heimlich got creative and crowd-sourced his research. For the June 1974 issue of the journal Emergency Medicine, he wrote an article called “Pop Goes The Café Coronary,” explaining how to do his method and asking people to try it if they encountered anyone choking on food. The Chicago Daily News then ran an article on it, and people around the U.S. reported that it worked.

In its August 1974 issue, the Journal of the American Medical Association coined the phrase “Heimlich maneuver” (though the journal can neither confirm nor deny this report), but the American Red Cross—a well-respected authority on health and safety issues, and a primary education provider for life-saving procedures such as CPR—didn’t see enough evidence to replace their official anti-choking recommendation of back blows with Heimlich's new procedure. Angry that the Red Cross wouldn’t recommend his method, Heimlich tried to spread awareness of it to save as many lives as possible. He became a celebrity doctor, appearing on The Tonight Show in 1979 (with Johnny Carson demonstrating his maneuver on actress Angie Dickinson), and selling posters and shirts.

“I have known from the time I began conducting my research on the Heimlich Maneuver that back slaps are ineffective in expelling an object from the windpipe of a choking victim,” Heimlich told Mental Floss in an exclusive statement. “But back slaps are also potentially dangerous. It’s been scientifically proven that hitting a choking person on the back can drive an object that is partially blocking the airway more deeply into the throat.” A 1982 study (partially funded by Heimlich [PDF]) backed up his assertions, and in 1985, the Surgeon General announced that the Heimlich maneuver was the only method that could save victims of choking. After 11 years, the Red Cross finally agreed.

The Controversies Around Henry Heimlich

Despite this win, Heimlich's medical reputation wasn't invincible. Starting in the 1980s, he attracted negative attention for arguing that the Heimlich maneuver should also be used on drowning victims. After hearing anecdotes that it saved people from drowning by forcing the water out, he unsuccessfully tried to convince the Red Cross and American Heart Association to replace CPR with the Heimlich maneuver for these types of emergencies, as well as for those with asthma. But the Red Cross and a majority of doctors view the Heimlich maneuver as dangerous for those with that much water in their system (since it can cause the victim to vomit) and not helpful for asthma sufferers (since the maneuver doesn't treat the underlying cause—chronic inflammation).

The medical community also criticized Heimlich for his malariotherapy studies in China and Africa, in which he and his team infected AIDS patients with malaria, hoping that the increased body temperatures caused by the disease would jump-start the immune system on a cellular level, thus curing their AIDS. (A similar treatment of curing syphilis with malaria won a Nobel Prize in 1927, but doctors have stopped using it because of the danger and the better treatments which have since emerged.) Doctors argued that his studies were dangerous, not rooted in scientific fact, and a violation of human rights. But Heimlich, during the height of the AIDS epidemic, was able to use his Hollywood connections to fundraise (Jack Nicholson donated $25,000 at one point) and advocate to a broader base. There was even a 1995 episode of Chicago Hope dedicated to the topic.

Henry Heimlich's Legacy

Heimlich, who died in May 2016 at age 96, believed that cancer, Lyme disease, and AIDS could be cured by malariotherapy. In the early 2000s, his younger son, Peter Heimlich (using a pseudonym) began sending letters to media outlets and medical journals accusing his father of falsifying studies. Peter continues to run a website dedicated to warning the public about the dangers of using the Heimlich maneuver on drowning victims and of malariotherapy. Heimlich did not publicly discuss his son’s actions, and he attributed professional jealousy as the reason that the medical community rejected his ideas.

In 2006, the Red Cross updated its official guidelines, instructing people to do five back blows on choking victims, and only try the Heimlich if the back blows didn’t work [PDF]. At Heimlich's request, they also removed the phrase “Heimlich maneuver” from all their literature and training materials and replaced it with the phrase “abdominal thrust” instead. Heimlich disagreed with the two-part recommendation, and didn't want his name attached to anything that suggested hitting a choking victim on the back. “I have no desire to diminish the good work that the American Red Cross has done, such as in times of natural disasters,” Heimlich told Mental Floss, “but telling people to hit a choking person on the back could potentially lead to death. The Red Cross should do what the American Heart Association does—recommend the Heimlich Maneuver as the sole method for saving the lives of choking victims.”

Ultimately, choking still remains a hazard (in 2017, it was the fourth leading cause of injury death), and it’s not entirely clear if back blows or abdominal thrusts are more effective at saving a choking victim. It can depend on many factors (such as what kind of item is lodged in the person’s throat, how big and how deep the item is), but the Red Cross’s current recommendation is still to perform five back blows, and move on to abdominal thrusts only if the back blows are not effective, repeating the process until the victim coughs up that errant piece of hot dog.

This story was originally published in 2015; it has been updated for 2021.