Hua Tuo

Hua Tuo

Hua Tuo (d. 208) was a renowned physician during the Eastern Han Dynasty and Three Kingdoms era of China. He was described as looking like "an immortal who had passed the gates of this life" and "a man with the complexion of a youth and a snowy beard". The Book of Later Han records Hua Tuo as the first person in China to use anesthesia during surgery. He used a general anesthetic combining wine with an herbal concoction called mafeisan (麻沸散 lit. "cannabis boil powder").

Historical accounts

Hua Tuo came from Qiao in the State of Pei (modern-day Bozhou, Anhui). Besides being one of the most respected physicians in Chinese history, Hua Tuo also devised techniques to enhance health. He developed the Wuqinxi (五禽戲 "Frolics of the Five Animals"), a series of exercises based on movements of the tiger, deer, bear, ape, and crane.

He was well known for being able to diagnose miscarriages by examining a woman's pulse and to tell whether the dead fetus was male or female depending on the position of the fetus. He was also famous for ridding people of parasites that had gotten into their bodies from ingesting uncooked meat. One account was about a snake-like parasite that blocked a man's pharynx and another was about "wriggling red headed" parasites that could cause ulcers. Dong Xi, who had heard of Hua Tuo, introduced him to Sun Ce. Hua Tuo healed general Zhou Tai who had been gravely injured in rescuing Sun Ce's brother, Sun Quan. Hua Tuo used drugs that healed Zhou Tai's wounds within a month, and Sun Ce rewarded him richly.

Cao Cao heard about Hua Tuo and summoned him to his court. Henceforth Hua Tuo was often in attendance. Cao Cao suffered from chronic headaches (which many today believe was a brain tumor) and Hua Tuo would treat Cao Cao with acupuncture to stop the pain. Later when Cao Cao had taken personal control of the affairs of the state, his pain became worse and more frequent. Hua Tuo told Cao Cao that this kind of illness would need long term treatments and thus Hua Tuo came to treat Cao Cao exclusively. Having been away from home for a long time, Hua Tuo desired to temporarily return and Cao Cao allowed this. Upon arriving however, Hua Tuo delayed his return to Cao Cao and made excuses to extend his stay citing that his wife was ill. Cao Cao sent many letters requesting for Hua Tuo to return, but Hua found it distasteful waiting hand and foot on others for a living. So he delayed his departure back to Cao Cao. Cao Cao sent agents to investigate the situation and if indeed Hua Tuo was telling the truth and his wife was truly ill, he would bestowed upon them forty bushels of 'xiao dou' and be lenient on his return date. If he was lying and making false excuses in order to delay his return, then he was to be apprehended and brought back by force. Hua Tuo was then thrown in prison, confessing his fault.

Xun Yu, an advisor of Cao Cao petitioned on behalf of Hua Tuo asking Cao Cao to spare him because his skills could save many lives. Cao Cao would pay no heed and ordered for Hua Tuo to be executed. Upon his execution, Hua Tuo presented a scroll, Qing Nang Shu (青囊書 "medical practice book"), to the jailer saying "This can save lives". But the jailer, who was fearful of the law declined to accept it, nor did Hua Tuo force it on him. Instead Hua Tuo requested for a fire and burned the scroll. This loss to traditional Chinese medicine was irreplaceable. Veith (1966:3) notes that, "Unfortunately, Hua T'o's works were destroyed; his surgical practices fell into disuse, with the exception of his method of castration, which continued to be practiced."

Even after Hua Tuo's execution, Cao Cao's pain did not go away. Cao Cao cursed "Hua Tuo could have healed me. That rascal didn’t so that he could enhance his own importance on me. Even if I hadn’t killed him, he wouldn’t have healed me and rid me of this source of pain." Soon afterwards, Cao Cao's favorite son Cao Chong fell ill and died. Cao Cao in anguished cried out "I regret putting Hua Tuo to death. In doing so I have condemned my son to death!".

Hua Tuo's exact date of death was not specified in Records of Three Kingdoms, but since Cao Chong died in 208 AD, Hua Tuo could not have lived past that year.

In later times, a set of 34 paravertebral acupuncture points was named the "Hua Tuo Jiaji" (華佗夹脊) in his honor. Hua is considered a shenyi (神醫 "divine doctor") and is worshipped as a medicinal god or immortal in Daoist temples. "Hua Tuo zaishi" (華佗再世 "Hua Tuo reincarnated") is a term of respect for a highly skilled doctor.

Fictional accounts

In the historical novel Romance of the Three Kingdoms, Hua Tuo supposedly healed the Shu Han general, Guan Yu, who had been struck with a poisoned arrow during his Battle of Fancheng. Hua Tuo offered to anesthetize Guan Yu, but he simply laughed that he was not afraid of pain. Hua Tuo used a knife to cut the flesh from Guan Yu's arm and scrape the poison from the bone, and the sounds chilled all those who heard them. During this excruciating treatment, Guan Yu continued to play the board game Go with Ma Liang, without flinching from pain. When later asked by Ma Liang, Guan Yu said that he feigned being unhurt to keep the morale of the army high. After Hua Tuo's successful operation, Guan Yu allegedly rewarded him with a sumptuous banquet, and offered a present of 100 ounces of gold, but he refused, saying that a doctor's duty was curing patients, not making profits. Despite the historical fact that Hua Tuo died in 208, a decade before Guan Yu fought the 219 Battle of Fancheng, this storied operation is a popular artistic theme.

Hua Tuo was later called upon to cure a chronic excruciating pain in Cao Cao's head, which turned out to be a brain tumor. Hua Tuo told Cao Cao that in order to remove the tumor, it would be necessary to open up his skull. However, Cao Cao suspected the doctor intended murder, and ordered that Hua Tuo be jailed and executed. This was because Ji Ben, a former royal surgeon, had participated in Dong Cheng's assassination plot on Cao Cao (this assassination attempt by Ji Ben however did historically happen).

Legend has it that Hua Tuo gave his Qing Nang Shu, which recorded techniques for treating patients, to a prison official before his execution. However, this official, or in some versions of the story his wife, burned the book to avoid being implicated. In another version of the story, Cao Cao ordered all of the written medical works of Hua Tuo be burned. Either way, many of Hua Tuo's medical methods were lost forever.

See also


  • Fan, K.W. 2004. "On Hua Tuo's Position in the History of Chinese Medicine," The American Journal of Chinese Medicine, 32.2:313-320.
  • Veith, Ilza. 1966. Huang Ti Nei Ching Su Wen; The Yellow Emperor's Classic of Internal Medicine. University of California Press.

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