Hua Tuo and the “Mafeisan” Anesthetic

Hua Tuo, courtesy name Yuanhua, from Qiao county in the state of Pei (present-day Bozhou, Anhui), was an outstanding physician of the late Eastern Han, ranked with Dong Feng and Zhang Zhongjing as one of the “three divine doctors of the Jian'an era.” He was skilled in internal medicine, surgery, gynecology, pediatrics and acupuncture, especially surgery, and is honored as the “founder of surgery.” Hua Tuo invented “mafeisan”: the patient took it with wine and, once unconscious, underwent surgery such as opening the abdomen; afterward the wound was sewn and dressed with ointment, and healed in about a month. This is an early record of general anesthesia, over a thousand years before Western surgery used anesthetics. Unfortunately the formula is lost. Hua Tuo also valued disease prevention. He held that the body needs proper exercise, as a door hinge that turns often does not rot: “With movement the grain energy is dispersed, the blood flows, and illness cannot arise.” Imitating the movements of the tiger, deer, bear, ape and bird, he devised the exercises known as the “Five Animals' Frolic” to strengthen the body. According to the Book of the Later Han, “Biography of Hua Tuo,” his disciple Wu Pu practiced them for years and in his nineties still had sharp hearing and sight and firm, intact teeth. He practiced across today's Jiangsu, Shandong, Henan and Anhui, leaving many legendary tales. He cared nothing for office; when Cao Cao, suffering from headaches, summoned him as attending physician, Hua Tuo went home claiming his wife was ill and would not return, and Cao Cao had him jailed and executed. His medical writings were thereby lost. “Hua Tuo reborn” is still used to praise a skilled doctor, and the Five Animals' Frolic survives as a traditional form of exercise.