- 期刊
Legendary Hwa Tuo's Surgery under General Anesthesia in the Second Century China
華佗首創全身麻醉開刀的探究
摘要
華佗是中國傳統醫學的一代名醫，醫術高超，精通各科，尤其以外科成就最輝煌，被尊稱為外科之神。華佗的外科成就，包括開刀技術高明，能做各種高難度手術，還發明瞭全身麻醉藥「麻沸散」，讓病人喝了（可能泡酒服用），「須臾便如醉死，無所知」，可以安心進行「破腹割背」的手術，甚至做腫瘤摘除和胃腸縫合的大手術，傷口四五天內愈合，病在一月左右復原。 「麻沸散」的成分，因爲文獻未記載而失傳。專家們推想，可能是洋金花（曼陀羅），烏頭，羊躑躅（鬧羊花），或茉莉根。根據「本草綱目」記載，這些藥物皆可浸酒做全身麻醉。 華佗的事迹，主要根據「三國志」和「後漢書」的華佗傳。這些記載，多根據傳說所說，可能有誇大，甚至神化的地方。另外，華佗用全身麻醉開刀的文獻記載，也相當簡略，不但「麻沸散」的成分未說明，開刀方法也沒有詳細記錄。更遺憾的是，華佗沒有把這項偉大的醫學創舉，薪傳後代。華佗的去世，不止是麻醉閉刀方法的失傳，也導致中國外科醫學的沒落。因此，華佗全身麻醉閉刀的事迹，仍須進一步考證。
並列摘要
In traditional Chinese medicine, Hwa Tuo (110?-208 A.D.) is one of the most famous doctors. He used only few herbs in drug treatment or applied few points in acupuncture, and achieved excellent results. His ultimate fame came from his remarkable surgical skills and his discovery of general anesthesia. According to the Chronicle of the Three Kingdoms (ca. 270 A.D.) and the Annals of the Later Han Dynasty (ca. 430 A.D.), Hwa Tuo performed operations under general anesthesia and the operations even included major ones such as dissection of gangrenous intestines. Before the surgery, he gave patient an anesthetic to drink to become drunk, numb and insensible. The anesthetic was called ”foamy narcotic powder” and probably dissolved in wine. Because Confucian teachings regarded the body sacred, surgery as a form of body mutilation was not encouraged, or even became a taboo. Despite his great achievement, practice of surgery could hardly take off and the death of Hwa Tuo marked the end of Chinese surgery. Unfortunately, the composition of the anesthetic powder was not mentioned in those two books or other Chinese medical writings. The herb has been thought to be datura flower, aconite root, rhododendron flower, or jasmine root. Furthermore, Hwa Tuo's operations under general anesthesia were not described in details. Therefore, his remarkable achievement needs to be further documented. In Western medicine, the first operation under general anesthesia occurred at the Massachusetts General Hospital in 1846 when William Morton demonstrated the effectiveness of ether. How could Hwa Tuo accomplish such scientific achievement in the second century has remained a mystery. Even so, it seems quite remarkable that Hwa Tuo had come up with the idea of performing surgery under general anesthesia using the ”foamy narcotic powder”.