Surgery under general anesthesia in second-century China: The legend of Hwa Tuo

Nai-shin CHU
Department of Neurology, Chang Gung Medical College and Memorial Hospital, Taipei, Taiwan

In traditional Chinese medicine, Hwa Tuo (110? - 208 A.D.) is one of the most famous doctors. In medical treatment, he used only few herbs or few points in acupuncture and achieved excellent results. His ultimate fame came from his remarkable skills as surgeon and his discovery of the use of general anesthesia.

According to the Annals of the Later Han Dynasty (ca. 430 A.D.) and the Chronicle of the Three Kingdoms (ca. 270 A.D.), Hwa Tuo performed operations under general anesthesia and the operations even included major ones such as dissection of gangrenous intestines. Before the surgery, he gave patient a narcotic wine to drink to become drunk, numb and insensible. The anesthetic which was called "numbing effervescing powder" was dissolved in the wine.

Unfortunately, the exact composition of the anesthetic powder was not described in his or other Chinese medical writings. The herb has been thought to be datura flower which contains atropine and scopolamine, aconite root, or rhododendron flower.

Confucian teachings regarded the body sacred and surgery as a form of body mutilation was not encouraged or even became a taboo. Despite his great achievement, practice of surgery could hardly take off and the death of Hwa Tuo marked the end of Chinese surgery.

In Western medicine, the first operation under ether general anesthesia was performed by Morton in 1846. How could Hwa Tuo accomplish such scientific achievement in the second century has remained a mystery. Even so, it is quite remarkable that Hwa Tuo had come up with the idea of performing surgery under general anesthesia of narcotic wine.

Session IX -- Early Neuroscience: Chinese, Arabic and Islamic Medicine
Wednesday, 5 June 2002, 8:30 am

Seventh Annual Meeting of the International Society for the History of the Neurosciences (ISHN)

Los Angeles, California, USA