Surgeon Developed General Anesthesia in Edo Japan
Hanaoka Seishu is the first person on record to have performed a successful surgery under general anesthesia. Seishu was born on October 23, 1760, near Wakayama, in Japan. The time period in which he was born is known as the Edo period. Japan was a feudal society, led by a military dictatorship called the Tokugawa shogunate. The leader of the shogunate was a military ruler with the title of “shogun”. Due to the government’s isolationist policies, foreigners were banished from Japan and the country was cut off from contact with all other nations except the Netherlands. Dutch traders, who were only allowed to enter into Nagasaki, were responsible for introducing the practice of surgery to Japan. In fact, western medicine was one of many subjects that made up the areas of study called “Rangaku,” meaning “Dutch Studies” or “Dutch Learning”. From the age of 22 to 25 Seishu studied medicine in the city of Kyoto, and began his profession as a surgeon in 1785, in his hometown of Wakayama.
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Although he studied western medicine while in Kyoto, traditional Chinese medicine inspired the anesthesia he would become famous for using. During Seishu’s life, Chinese medicine was more popular than Western medicine. In his studies of Chinese medicine, Seishu encountered legends about a famous Chinese surgeon called Houa T’o, who was believed to have used an anesthetic in his surgeries. Inspired by such stories, Seishu worked hard at developing his own anesthesia, which came to be called Tsusensan, and was administered orally, as a hot drink. The drink worked like a narcotic and it placed his patients into a very deep sleep that could last for an entire day.
Developing the anesthetic is what allowed Seishu to treat a wide range of ailments and perform more serious surgeries than previously possible. Tomio Ogata has written that Seishu was able to tend to "wounds, trauma, inflammation, ulcers, malformations, and tumors, including cancer." In addition, he performed plastic surgeries and amputations. But his career is particularly noted because of his surgeries to remove breast cancer, of which he supposedly accomplished around 150, though it is questionable whether or not they were all really cancer (p. 650). The first time he performed cancer surgery was in 1805 when he removed a cancerous tumor from a sixty year-old woman. The surgery was a success and the woman is said to have recovered completely, thereby giving him proven results that he would use as proof of success when suggesting future surgeries. Many of his procedures, including the breast cancer, can be seen through illustrations in Seishu’s case book.
Hanaoka Seishu’s ground-breaking surgical procedures brought him fame in Japan. Seishu became such a renowned surgeon that he drew the attention and admiration of other prominent medical practitioners of his time, such as Genpaku Sugita, “the pioneer and founder of Dutch learning and Western medicine in Japan…” Seishu kept the knowledge of how to perform his procedures a secret, only passing them on to his students. Despite this, his reputation spread, particularly after the Meji Restoration of 1868 when knowledge of his practices were made widely known. Although later variations of anesthesia would be created, Hanaoka Seishu was an innovator in the field. His development of a general anesthesia preceded the more familiar ether anesthesia invented in the United States 41 years later.
First posted 11/5/2014
Hanaoka Seishu’s surgical casebook. The National Library of Medicine
Gordon E. Mestler, "A galaxy of old Japanese medical books with miscellaneous notes on early medicine in Japan. Part III.: urology, syphilology and dermatology; surgery and pathology,” Bulletin of the Medical Library Association, 44/2 (1956): 125–59.
Tomio Ogata, “Seishu Hanaoka and his anaesthesiology and surgery,” Anaesthesia, 28 (1973): 645–652. (Extracted from the Wiley Online Library; PDF available through link)
Koichi Watanbe, “Seishu Hanaoka (1760-1835),” Biomedicine International, 4 (2013): 1-2.
Seishu Hanaoka, with his mother (left) and wife
International Museum of Surgical Science