“It is a general truism of this world that anything long divided will surely unite, and anything long united will surely divide.” – Luo Ghuanzhong, 1300s, CE
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The following blog was written by Curatorial Volunteer Mary Catherine Shea.
In 1846, New England dentist, William T.G. Morton, demonstrated to medical students that anaesthesia de-sensitized patients to pain during surgery and minimized the risk of death from shock. Although his demonstration is considered a pivotal moment in the history of anaesthesiology, Morton’s biography forms only one chapter in the history of individuals who have used anaesthesia to successfully perform surgeries.
Approximately 1600 years before the Boston demonstration, Chinese physician, Hua Tuo, (statuette at left), invented an anaesthetic that he called mafeisan and applied this substance to patients undergoing abdominal surgery. Rising to fame as a surgeon within the Eastern Han dynasty of 25-220 CE, Hua Tuo had access to the pharmaecopia texts and philosophical traditions of Taoism, Buddhism and Confucianism that still circulated during the end of the Han dynasty’s golden age. Hua also witnessed the peasant rebellions, the shanghan epidemic and the military offensives that characterized the beginning of the dynasty’s decline. Some censuses show a population loss of 34 million between the Eastern Han and the Western Jin dynasties, as warfare and mass migration depleted the population.
Working on the frontlines of war, Hua Tuo gained more experience in surgery, performing procedures that did not align with state-endorsed Confucianism. Like contemporaneous Greek and Roman scholars, Confucian authorities treated the human body as sacred and prohibited human dissection. Surgery was therefore regarded as a low-grade medical technique and a treatment of last resort. By operating on the soldiers and peasants that were victim to the military turbulence that characterized the decline of China’s golden age of power, Hua Tuo was able to use his anaesthesia to perform resections of gangrenous intestines, anastomoses and laparotomies. Hua Tuo’s abdominal operations were all the more remarkable as they were situated well outside of the Western surgical canon for more than a thousand years.
Surprisingly, Hua Tuo’s life and his surgical expertise figure as prominently in China’s literary landscape as within its historical chronicles. Luo Ghuanzhong immortalizes Hua Tuo within his 14th century literary masterpiece, The Romance of the Three Kingdoms, depicting Hua as a philanthropic healer whose personality and interests contrasted with the novel’s main political actor and arch-villain, Cao Cao—one of the three generals who divided the Han empire into separate kingdoms. Cao Cao reportedly summoned Hua Tuo to alleviate his migraines and when Hua Tuo recommended brain surgery (trepanation) as an appropriate course of treatment, Cao Cao suspected Hua Tuo of plotting to assassinate him and ordered Hua Tuo executed. Hua Tuo’s surgical and anaesthetic diagnosis and surgical skill were situated at the apex of political and historical intrigue. While the exact events of Hua Tuo’s downfall are unclear, his techniques were likely lost because they fell out of favour with prevailing religious ideologies.
Hua Tuo’s contributions to acupuncture and pharmacology were carefully chronicled within China’s historical annals and his name was also given to contemporary acupuncture needles. China’s philosophical and cultural practices allowed his holistic treatment methods, such as Tai Chi and acupuncture, to flourish.
Prevalent political forces of the late Han dynasty obscured Hua’s original surgery techniques and developments in anaesthesiology. It was another 1600 years before the surgical use for anaesthetic was ‘discovered’, or rather, it resurfaced, within the 19th century hospital amphitheatres, where students emphasized empirical knowledge as a basis for understanding human anatomy and physiology.