Hanaoka's Magic Elixir

To make the perfect cocktail, you have to get the ratios just right. Dr. Hanaoka risked a handful of village dog's and even his wife's sight in search of that perfect proportion. In this episode, we travel to Japan to examine the origins of anesthesia.

Episode 8

Portrait of Dr. Hanaoka Seishu (1760 - 1835)

Meet Seishu 

     Seishu was born on October 23, 1760 in Kii Province, Japan, in what today would be called Wakayama Prefecture. Though little is known about his early life, we know he was born to a physician's family and started practicing at trade himself at the age of 22 in Kyoto, Japan. After completing his studies in 1785, he move back to his hometown to begin his career as a practicing surgeon at the young age of 25. 

     Seishu lived during the Edo period of Japan's history, meaning Japan was feudal society at the time and practiced the isolation policy of Sakoku. Given this, Japanese physicians had very minimal exposure to Western medicine. However, there were a handful of Dutch traders allowed to enter through Nagasaki whose medical textbooks were eventually translated and landed in the hands of Seishu. Before the introduction of Dutch Medicine called Rangaku, the standard of practice was mostly a combination of Japanese and Chinese Herbal Medicine. Surgery itself was considered sacrilegious because the Confucian philosophy that dominated at the time dictated the body to  be sacred. Any disruption of the natural flesh would irrevocably translate to the soul. There were a few Chinese doctors that deviated from this, namely Hau Tuo from 2nd Century AD. Hau Tuo's concoction, which had since been long lost, was ultimately what inspired Seishu to start working on his own general anesthetic, which he called Mafutsusan

    

Meet Hau

     Hau Tuo was born around 140 AD during the Eastern Han Dynasty in China. Born to a poor family, his father died when Hau was just 7-years-old, forcing the young boy to provide for the rest of the family. As a result, he started working in the local pharmacy where he would eventually go on to train and become a surgeon. As his notoriety grew, Hau repeated refused to be Supreme Physician in the Imperial Palace, insisting on treating common folk near his hometown. In the course of his career, Hau is believed to have created a general anesthetic called Ma Fei San:

   - Ma (麻) meaning cannabis or numbed

   - Fei (沸) meaning boiling or bubbling

   - San (散) meaning break up or powder form 

Hau would place the 'cannabis boiling powder' in wine prior to performing surgery. He was additionally a proponent of prophylaxis, encouraging his patients to exercise with Wuqinxi, which translates to 'The 5 Animal Frolics' based off of his observations of tiger, deer, ape, crane, and bear movement. Later in his life, Hau was called to cure the migraines of Cao Cao, the emperor of the Wei Kingdom. Hau is believed to have resolved the ailment through acupuncture, but only a short time later called back to attend to the emperor. This time, however, Hau told the emperor that no amount of acupuncture or herbs could resolve his issue. Surgery was the next step. Upon hearing that Hau wanted to drug him and open up his skull, Cao Cao believed this to be a blatant assassination attempt and sentenced Hau to death. Though the authenticity of this story has long since been debated, it is believed that Hau wrote all his clinical knowledge in his final days of imprisonment. It is believed that either the gaurd or Hau himself burned the papers just before the doctor's execution. In any case, Hau's knowledge was lost forever and with it the recipe for anesthesia would remain forgotten until Seishu worked to put the pieces back together once more. 

Portrait of Dr. Hau Tuo (140 AD - 208 AD)

Hanaoka's Magic Elixir Recipe

Ingredients:

8 parts of Datura alba (white angel trumpet or thorn apple) 

2 parts of Aconium japonicum (Japanese aconite)

2 parts of Angelica dahurica (Chinese angelica)

2 parts Angelica decursiva (Norwegian angelica)

2 parts of Ligusticum wallichii

2 parts Arisaema japonicum

 

Ground mixture down to a paste and boil in water. Serve warm. Bon Appétit! 

**Disclaimer: if you happen to find any of these niche ingredients at your local speciality store, do not attempt to make this at home. The active ingredients of scopolamine, hyoscyamine, atropine, aconitine and angelicotoxin serve as acetylcholine antagonists that can prove to be deadly.

Hanaoka's Surgical Casebook

Further Reading

For more information about the life of Seishu Hanoaka visit: 

https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1021&context=gibbonsocietyprofiles

https://www.ncbi.nlm.nih.gov/pubmed/15604985

To see traditional Japanese surgical drawing from his published book: 

https://ceb.nlm.nih.gov/proj/ttp/flash/hanaoka/hanaoka.html

To learn more about the scientific mechanisms of pain and anesthesia: 

1) Nociceptor (pain nerve) response at https://www.youtube.com/watch?v=fUKlpuz2VTs

2) Introduction to anesthesia at http://www.anaesthesia.med.usyd.edu.au/resources/lectures/anaesthesia_basics.html

For images on this page:

https://en.wikipedia.org/wiki/File:HanaokaSeishu.gif

https://commons.wikimedia.org/wiki/File:HuaTuo.jpg

All images are free to use and share and not under copyright protection 

Credits

Hosts: Wafik and Jessica Sedhom

Written and Produced by: Wafik and Jessica Sedhom

Edited by: Wafik Sedhom

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