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Lost Writings of Hua Tuo

 Portrait of the physician Hua Tuo from a Qing Dynasty edition of The Romance of the Three Kingdoms, via  Wikimedia Commons

Portrait of the physician Hua Tuo from a Qing Dynasty edition of The Romance of the Three Kingdoms, via Wikimedia Commons

Background information

Hua Tuo (c.140-208 CEis till this day a renowned physician and a Chinese surgical pioneer. He was best known for his contributions in acupuncture, surgery and the development of anaesthetics. For anaesthetics, he boiled alcohol with cannabis to make a concoction he called “Mai Fei San”. It numbed his patients and knocked them out, allowing him to be the first Chinese doctor ever to operate on the abdomen. We chose to write about him because of his large significance and contribution to the world of medicine, being accredited as a pioneer in medicine and surgery, especially in the areas of gastroenterology, acupuncture, gynecology and neurology. Furthermore, he was praised for his benevolence, clear practicality and care for his patient, his insistence to save as many people as he could eventually made him outstanding. Four journal entries, written from his perspective based on our interpretation of how he was like, aims to give an insight into his life and the environment that pushed him to become the most famous physician in that era. However, solid information is very limited due to the subsequent and unfortunate burning of Hua Tuo’s works; the only information left about him was from Hua Tuo’s books that escaped the burning or from his apprentices. The entries would have estimated dates as there are no records of a definite timeline.

Entry 1

C.146 CE

My father died today.

Mother is mourning but she is even more worried about me as we are still living in poverty. She is now urging me to get a job in any of the fields I’ve been studying - astronomy, history, literature, geography or agriculture. However I would not feel contented. I cannot help but be distressed by the lack of competent doctors willing to treat the poor in this country. They could have prevented the death of my Father and save my Mother from grief! I do not think I would be able to properly rest until I go into the field of medicine myself and one day offer my services to anyone who needs it, regardless of social status and wealth.

I hear that the famous physician Cai currently stays in Xuzhou, just a few hundred kilometers from here. I will start walking there starting tomorrow morning to learn medicine from him. I can only hope to one day be competent enough to prevent such preventable deaths from happening again.

Hua Tuo

Entry 2

c. 160-180 CE

The civil war still rages heavily around me. I find myself treating many soldiers, maybe more than normal civilians! Upon realizing that many die via going into shock due to the intense pain of their injuries, I decided to make a concoction to help numb the pain and put them to sleep. It is a mixture of alcohol and cannabis boiled together and taken orally. I call it Ma Fei San. The effects are satisfactory! As they are asleep, they would not be able to consciously process the pain their body is in and most survive treatment.

 Japanese woodblock of Guan Yu by Utagawa Kuniyoshi (1798-1861), via  Wikimedia Commons

Japanese woodblock of Guan Yu by Utagawa Kuniyoshi (1798-1861), via Wikimedia Commons

As much as it is an effective pain reliever, some soldiers would still refuse to take the Ma Fei San as they see it as a sign of weakness. Not too long ago, General Guan Yu from Shu Han was brought to me with a poisoned arrow impaling his arm. I offered a bowl of Ma Fei San, explaining that because of the spread of poison, I had to cut the flesh around the arrow and scrape the poison from his bones. The process would be unbearably painful for any conscious person. However he just laughed at me and told me he was not afraid of the pain, insisting on playing a board game with the advisor, Ma Liang. I reluctantly carried on with the procedure, expecting him to pass out from the pain. To my surprise and respect, he did not even flinch, completely focusing on the board game through the whole process. The procedure was a success and he went straight back into war with his soldiers. He offered me a small fortune for my work which I refused. A physician’s main goal is to heal his patients and not do it for wealth and fame, but to save lives.

While I praise him for his bravery and endurance, I do hope that one day, taking substances to reduce pain would be accepted as not something that makes one weak but as a necessity. There is no weakness in preserving life.

Hua Tuo

Entry 3

C. 170-190 CE

I started using Ma Fei San for invasive surgeries. There are some diseases that I cannot seem to cure using acupuncture and herbs. My only other solution is to cut into their body and remove the cause of the disease itself for I cannot bring myself to let them die without doing more first.

It has proven to be effective. I have recently performed surgery on a patient who came to me because of excruciating pain in his abdomen despite taking medicinal herbs. I diagnosed him to have a deterioration somewhere in his abdomen and gave him a strong dose of Ma Fei San. When he was unconscious, I cut into his stomach and looked for the deterioration, which I did find. I cut the section out and sutured together the healthy gut walls before replacing it into his stomach cavity. The patient came to consciousness, surviving this procedure and recovered after 100 days with the constant intake of herbs that helped the healing process, very religiously following my instructions. Through similar procedures, I've managed to remove parasites and unnatural growths from my patients, a process that cannot be achieved by simple acupuncture. I can only hope to further understand and improve this.

I have taken in students to teach them the ways of surgery and medicine in hopes that more physicians can continue my work and reach out to more of the diseased. To Wu Pu, I imparted my knowledge of fitness, a way to keep the body strong and free from illness. By mimicking the movements of the tiger, bear, deer, monkey and egret, one can strengthen their stamina and gain inner strength. I call this the frolics of the five animals. To Fan A, I taught him all I knew about herbology and acupuncture. 

Hua Tuo

Entry 4

c. 208 ce

I write from my jail cell, awaiting execution. My fame had reached the ears of General Zao Cao, ruler of the state of Wei. He summoned me to be his personal physician to treat his recurring and chronic headaches with acupuncture. My acupuncture treatments only resulted in temporary relief from the symptoms but it did not cure the root cause of his headache. The recovery process would require long term treatments. Upon informing Zao Cao, he commanded that I serve him exclusively. I could not stand the idea of waiting hand and foot for a single man when I could be curing many more people who is in a greater need of help. I missed my home and I missed my wife. Giving the excuse that my wife was ill, I left for home and subsequently avoided all of Zao Cao’s summonings for me. I was foolish to think that I could get away with it for Zao Cao sent men to investigate if my wife was truly ill and unraveled my lie. I was thus arrested and sentenced to death. With the last few days I have in this world, I compiled all my medical knowledge into a book and begged the prison warden to help spread my knowledge into the world and save more people. Afraid of being associated with me, he rejected my plea. I have yet to decide what to do with my book. Knowing the anger Zao Cao has towards me, he would probably burn it. Maybe I’ll burn it before he does! I am heartbroken with the regret that I am unable to pass on more of what I know to this world; I cry for the people that I could have saved.

Hua Tuo



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