SURGERY

11 May

In contrast  to India,  surgery generally remained  outside the domain  of China’s  scholarly,  elite medicine.  Presumably,  reluctance  to  mutilate the body  and  the lack of dissection-based  anatomy  inhibited  the dev- elopment  of surgery  in China,  but  such  obstacles  are  not  necessarily insurmountable. Indeed, forensic medicine reached a high level of sophistication in China,  as indicated  by a text known  as The Washing Away of Wrongs (1247), which is considered the world’s first treatise on forensic medicine.

When   confronted  with   their   apparent  failure   to   establish   a respected  surgical  tradition, Chinese  scholars  contended  that  the  effi- cacy  of  their  preventive  and  therapeutic medicine  obviated  the  need for   surgical   interventions.   Nevertheless,   Chinese   history   provides accounts  of  physicians  who  performed  miraculous  operations. Inter- actions between China  and India  during the transmission of Buddhism may have inspired such stories, although  they did not lead to the inte- gration  of surgery into classical Chinese medical traditions.

The  most  famous  Chinese  surgeon,  Hua  T’o (ca. 145–208), was credited with the invention of anesthetic drugs, medicinal baths, hydrotherapy,  and  medical gymnastics.  Master  of acupuncture and  a brilliant  diagnostician, Hua  T’o could  reputedly  cure  migraine  head- aches  with  one  acupuncture needle.  One  of  his  most  unusual  cases involved  a  patient  suffering  from  a  painful  tumor  between  the  eyes. When Hua  T’o skillfully opened  the tumor,  a canary  flew out  and the patient  was completely cured. Although  canary-filled  tumors  may be a rarity  in medical  practice,  headaches  and  chronic  pains  are  not,  and Hua T’o usually cured such disorders with acupuncture. Unfortunately, when consulted by the Emperor  Ts’ao Ts’ao, the surgeon recommended trepanation as a treatment for his intractable headaches. Suspecting that such drastic surgery might be part of an assassination plot, Ts’ao Ts’ao ordered  Hua  T’o’s execution.  Unable  to  smuggle his writings  out  of prison,  Hua  T’o  took  the  secrets  of  his  great  discoveries  with  him. The   lost  secrets  of  Hua   T’o  supposedly   included   ointments   that prevented  and cured infection as well as miraculous  anesthetics.

According to tradition, of all the operations invented by Hua T’o, the only one to survive and enjoy considerable  usage was his technique for castration. This operation provided  the eunuchs  employed  as civil servants  and palace attendants. Descriptions of castration as practiced in 1929 note that  despite the crudeness  of the operation most patients healed  in about  a hundred  days,  although  about  two percent  died as the result of hemorrhage  or infection.

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