Peter Ratiu: The way I read it, it seems to me that "clystère de Tchékhov" is a twisted-mirror image of "violon d'Ingres". Nabokov seemed to have held the view that Chekhov's dabbling in medicine was by and large akin to Ingres' ambitions in playing the violin, instead of sticking to what he was already great at, namely painting. Nabokov made a remark to the effect of Chekhov being an unremarkable physician (in SO, I suppose).
Jansy Mello: Don B. Johnson's interpretation is slightly different. He writes (27 Mar 2002) Incidentally, is that "clystere de Tchekhov" a set phrase in Russian or VN's "translation of the French "violin 'Ingres"? i.e., a secondary skill that is itself of great brilliance? And why is the "spy" motif introduced here?;4e582feb.0203 *  Instead of diminishing Chekhov's abilities or vocation as a physician ("dabbling in medicine"), he considers it as a reference to "a secondary skill" that may be equally brilliant. The theme of finding a "hobby" substitute for one's art was also broached upon in DBJ's message.
Matt Roth** brought up a limerick from VN's correspondence with Edmund Wilson and referred to the well-known painting by Ingres focusing on the shapely back of a lady (suggesting a violin). In my loose associations it is this painting that I envisage, too, when Van Veen writes about his erotic reaction to Ada's lyre.***
When I googled to find an illustration of Ingres's feminine torso, surprise!. Here is wiki (in French) on Man Ray's photographs: "Le Violon d'Ingres est une célèbre photographie réalisée par l'artiste américain Man Ray en 1924. Elle représente une femme, en l'occurrence Kiki de Montparnasse, avec, en surimpression sur son dos nu, les ouïes d'un violon. Sa coiffe, un turban, évoque les tableaux orientalistes du peintre français Jean-Auguste-Dominique Ingres, duquel le photographe était un admirateur et auquel le cliché rend hommage. De fait, son titre reprend une expression de la langue française faisant de la passion qu'Ingres entretenait pour le violon, lorsqu'il abandonnait ses pinceaux, l'archétype du hobby. Il suggère que les femmes, et en particulier le modèle de sa photographie, étaient pour Man Ray, lorsqu'il délaissait son art, son propre passe-temps de substitution." 
btw All these female torsoes and the choice of the word "clystère," as I see it, remain oriented towards "anal penetration," which is even more strongly suggested than in Van and Ada possible conjunction "a tergo" .    
* DB Johnson commentary about The Violon d'Ingres was brought up by me again in Sept.7 2013: 
0245612013-09-0713:29432RLSK, LATH and a double monster
** Matth Roth also contributed in the past (1 Mar 2010): 
Then there is a limerick, "Le Violon D'Ingres De Sirine," which reads:
Our perverse old [Russian epithet I can't transcribe] Vladimir
Was stroking a butterfly's femur.
"I prefer this," he said,
"To a lady in bed,
Or even a velvet-eyed lemur."
*** "and then bent over to insert the bronze chained plug; it got sucked in by itself, however, while he steadied her lovely lyre and next moment was at the suede-soft root, was gripped, was deep between the familiar, incomparable, crimson-lined lips. She caught at the twin cock crosses, thus involuntarily increasing the sympathetic volume of the water’s noise.."
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