In the 1970's, my brother got a 3-speed thingy that replaced the front sprocket on his bike. Someone used one on one of the bike buildoffs here, I believe. It had a small front front sprocket and big round case with the gears in it.
There's also the Schlumph Mountain Drive and Speed Drive setups that you bang with your foot to change gears. The Pashley Guv'nor Plus 4 uses a similar type of BB with a Sachs Duomatic hub for 4 speeds with no cables. See the link for a video on how to change gears.