Biography (SGZ): Hua Tuo (Yuanhua)

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Hua Tuo (Yuanhua) A
華佗 (元化)
(AD 110-207) B

Sanguozhi Officer Biography
translated by jiuwan (Giao Chau)

Hua Tuo style Yuan Hua was a man from Qiao in the state of Pei. Fu () was another name (1). He was a well-educated man and was familiar with the classics. The Chancellor (xiang) of Pei, Chen Gui recommended him for a prestigious post; the Grand Commandant (tai wei) Huang Wan offered him a position in his ranks as well, but Hua Tuo accepted neither position. He was skilled in the technique for nourishing one’s nature. The people in his era all thought he was around a hundred years old, yet he still looked quite young and rugged. He was highly skilled in prescribing medicines and curing illness. In preparing remedies, he required very little ingredients. He didn’t need to weigh the various herbs to mix for the remedy. In his mind he knew the exact proportions to add and mix. It was ready to drink as soon as the broth was finished boiling. After the patient was instructed on how to take the medicine, Hua Tuo would leave. Afterwards the patients’ condition would vastly improve. In cauterizations, he would burn in one or two places; and in each place there are no more than seven or eight separate cauterizations. The disease would then be eliminated. In acupuncture, it would also be in one or two places. He would instruct the patient: “I’m going to guide the needle to a certain spot. Let me know when I reach the spot.” The needle would then be removed as soon as the patient told him he had reached the spot. The sickness would then go away. If the illness was internal, where the effects of acupuncture and medicines were useless, Hua Tuo would then perform surgery. The patient would then drink a solution of ma fei.C Immediately after drinking, the patient would then become intoxicated as if they were dead and completely unaware. Hua Tuo would then make the necessary incision to remove the infected tissues. If the disease was inside the intestines, he would sever them and wash it out. The abdomen area would then be sewed up and an ointment would be applied on it. The pain would cease after four or five days. The patient would gradually regain his health. In about a month’s time, the patient would be back to normal.

The Chancellor (xiang) of Gan Ling’s wife was six months into pregnancy, her abdomen caused her pain and discomfort. Hua Tuo examined her pulseD and thus replied: “The fetus has already died.” He had someone assisted him in manipulating her abdomen to discover the position of the fetus. If the fetus was on the left, then it would be a boy; if it were on the right, then it would be a girl. The person replied: “It’s on the left.” Some medicine broth was made to bring about the abortion of the dead fetus. Indeed it was a male. The lady recovered afterwards.

The county magistrate (xiang li), Yin Shi, was troubled by sufferings in his four limbs (his arms and legs). His mouth was parched, other people’s voices bothered him, and urination wasn’t simple for him either. Hua Tuo spoke: “Try eating something hot. If you break into sweat, then you can recover; if you don’t sweat, then after three days, you’ll surely die.” Immediately after consuming the hot food, Yin Shi didn’t sweat at all. Hua Tuo then remarked: “The vital breath within has already been severed, it is finished.” Indeed it was as Hua Tuo said. Yin Shi died.

Er Xun and Li Yan, two ‘fu li’ personnel both came. Both experienced the exact same symptoms - headaches and a fever. Hua Tuo prescribed the two men with different medicines. He was questioned why, to which he replied, “Er Xun is suffering externally while Li Yan is suffering from within, it is fitting their treatment is different.” So each men was prescribed with the appropriate medicines. The next day both was cured.

Yan Xin of Yan Du and some other people were waiting for Hua Tuo. Upon returning Hua Tuo asked Yan Xin, “How is this gentleman’s health?” To which Yan Xin replied thus: “It is as normal.” Hua Tuo then explained: “You sir, have a sever illness in your face that I can see right now. You better not drink so much wine anymore.” They sat for awhile. Afterwards everyone returned to their respected homes. After going several li, Yan Xin felt dizzy and disoriented in his head, thus he fell out of his cart. Someone had to help him back up and returned him home. He then died.

The Postal Controller (du you),E Dun Zi Xian, was sick. After reading his pulse, Hua Tuo told him, “You’re still weak and depleted, you won’t be able to recover just yet. Relax and don’t over-exert yourself, do it not - and you shall die. At the moment of death, your tongue will hang out several inches.” His wife heard that he was getting over his sickness and traveled from over a hundred li to see him. They engaged in intercourse that night. Within three days Dun Zi Xian suffered from a relapse. Exactly as Hua Tuo had said.

Hua Tuo went in to see the sick Postal Controller (du you), Xu Yi. Xu Yi told Hua Tuo, “I was treated by acupuncture last night. After insertion of acupuncture I suffered a little from coughing, but I could not relax afterwards.” “The needles shouldn’t have been inserted in the stomachic duct because they have mistakenly pricked the liver by accident. Your appetite will decrease, and in five days you are beyond saving,” was the response from Hua Tuo. The illness transpired just as Hua Tuo said it would.

Chen Shu Shan of Dong Yang had a boy of two years old who had taken ill. At first the boy would cry. Afterwards he became weakened. Chen Shu Shan asked Hua Tuo as to what caused this. To which was the reply, “During pregnancy, the mother’s vital ‘yang’ breath was being directed towards the fetus’ nourishment. Her breast milk was cold and devoid. This passed on to the child (the condition acquired from the mother), it would be hard to cure right away.” Hua Tuo then prescribed some ‘si wu nu wan’ pills for the child. After about ten days, the child’s sickness was eradicated.

A woman of Peng Cheng was using the toilet at night where she was bitten and poisoned by a scorpion. It was so unbearable that all she could do was groan. Hua Tuo soaked her hand in a bucket of warm solution, in which she was finally able to get some sleep. But several attendants had to keep changing the solution to preserve that a constant warmth maintained. She recovered afterwards.

The magistrate of an army, Mei Ping, who had taken ill, got a discharge and returned home to Guang Ling. Still over two hundred ‘li’ away [from home] he stopped off at a relative’s home. In a moment, Hua Tuo also arrived to visit [that relative]. The home owner [the relative of Mei Ping] asked Hua Tuo to check out Mei Ping. Afterwards Hua Tuo replied: “If this gentleman had seen me earlier, then there would no need to come here. This sickness of yours has finalized, so hurry home and see your family. For in five days you’ll be dead.” Mei Ping hurried home posthaste. Hua Tuo was indeed correct again.

Hua Tuo was walking down the road when he saw a man with a blocked pharynx. That man had a weakness for eating, but when he ate something it wouldn’t go down [his throat]. His family members were taking him to see a doctor on a cart. Upon hearing the man’s moans and groans, Hua Tuo stopped to examine the sick man. “Down the road, there is a man who sells biscuits on the side of the road. He has some vinegar and garlic, which if you drink it, your sickness will vanish on its own.” It was as Hua Tuo said, the man coughed up a snake-like parasite and felt relieved. The parasite was then hung onto the side of the cart. The patient then proceeded to go thank Hua Tuo. But Hua Tuo had not returned home yet. His children were playing in front of the gate of the house. Upon seeing the man in the cart arrive, they said to each other, “He must’ve met our father, you can tell by looking at the side of his cart.” The patient went in to sit inside. There he saw on the wall about ten snake-like parasites just like his.

There was a sick administrator of a commandery (unnamed) that Hua Tuo visited. He knew if he could get the patient really angry then the man would be cured. Many payments and gifts were accepted but Hua Tuo did nothing to help the patient. Hua Tuo then abandoned the man, leaving behind a letter cursing the man! Upon reading the letter, the patient flew into a great rage. He ordered the pursuit to catch and execute Hua Tuo. The son of the governor understood what Hua Tuo intended and told the pursuing men to halt. The governor was able to recover because in his anger he vomited out some black blood.

In another instance there was this gentleman that wasn’t feeling well. Hua Tuo told him: “You, sir, have a illness which is deep rooted. Therefore I have to operate on your abdomen to remove it. But you won’t live any more then ten years. Your sickness will not kill you either, if you can endure the pain for ten years then your lifespan will be reached. So it’s not worth the operation.” The patient couldn’t bear the pain any longer, so he insisted to have the illness removed. After Hua Tuo operated on the patient, the pain was quickly alleviated, but after the ten years the patient died.

The Grand Administrator of Guang Ling, Chen Deng had gotten sick where he felt discomfort in his chest, his face flushed red and he had no appetite. Examing his pulse, Hua Tuo said, “Your honour, inside your stomach lies many parasites. If not rid of, then you’ll develop an ulcer. This was caused by eating raw or uncooked meats.” Immediately a medicinal broth was prepared. It was taken in two parts, half first then the remaining half. Chen Deng then vomited three pints or so of parasites with red heads and still wriggling. Half of their bodies were like minced fish meat. All pain suffered by the patient disappeared afterwards. Hua Tuo then warned him: “You will suffer a relapse of this illness in three years. If you have a good doctor nearby you, then you can be saved.” Indeed after the three years, Chen Deng did suffer from a relapse. At the time Hua Tuo wasn’t in the area; nor was there any good doctors in the area so Chen Deng died.

The High Ancestor [Cao Cao] had heard of Hua Tuo and summoned him to court. Henceforth Hua Tuo was often in attendance. [Cao Cao] suffered from constant headaches. Each time it occurred his heart would in chaos, his vision dazed. Hua Tuo would treat Cao Cao with acupuncture to stop the pain (2).F

General Li’s wife was quite sick and moaning. After reading her pulse, Hua Tuo told the general that, “She was injured during pregnancy but the fetus hasn’t died yet.” General Li retorted: “I heard during pregnancy when she suffered injury the fetus was miscarried.” Hua Tuo then answered firmly, “The reading of her pulse indicates the fetus has not miscarried.” The general believed that Hua Tuo was wrong, so he left. The lady improved slightly, but after about one hundred days she suffered a relapse. Hua Tuo was called upon once more. Hua Tuo again said, “The indications of her pulse does indeed say that there is still a fetus inside her. Initially she had twins, the first one came out first [the one that was miscarried], but she lost a lot of blood. The second one couldn’t been born because she lost too much blood. The mother herself didn’t notice this, others were unaware as well. Therefore the unborn fetus stayed inside the mother’s wombs unborn and died. Her pulse didn’t return to normal. And the dead fetus was causing the mother much distress in the spine. I will make a solution broth for her and then apply acupuncture to force the dead fetus out.” After the lady had taken the broth and received the acupuncture, she experienced pain as if she was in labor. Hua Tuo then warned: “This dead fetus has decayed enough that it won’t come out on its own. Someone will have to probe for it.” Indeed when the fetus came out, they discovered it was a dead baby boy. The arms and legs were completely formed, it was blackish in color and about a foot in length.

Hua Tuo was indeed highly skilled in his medicinal practice, but he was originally a scholar. Although he was skilled at healing people, he often regretted he was looked upon as a doctor by profession. Later on, when [Cao Cao] had taken personal control [of the affairs of the state], his illness became more severe and intensified. So he had Hua Tuo attend to him exclusively. “This condition is hard to heal in the short term, it requires a long term treatment to heal,” replied Hua Tuo. Hua Tuo was away from home for a long time and desired to return home. Telling Cao Cao, “I have received a letter from home, I wish to return temporarily.” Upon returning home, Hua Tuo delayed his return based on his wife’s sickness. Several extensions were added to his leave yet he did not return. [Cao Cao] wrote letters calling for his return. He even dispatched an imperial decree to the local authorities to send Hua Tuo back. Hua Tuo found it distasteful waiting on others for a living, he was proud of his abilities. So he delayed his departure back to Cao Cao. [Cao Cao] in his anger dispatched men to investigate. If indeed his wife was ill, he would bestowed upon them forty bushels of ‘xiao dou’ and be lenient on his return date. If it was false excuse in delaying return, then Hua Tuo was to be apprehended and brought back. Hua Tuo was then thrown in prison, confessing his fault. Xun Yu (one of Cao Cao’s advisors) petitioned on Hua Tuo’s behalf saying to Cao Cao: “His skills are truly effective, many lives depend on him. Spare him on this account.” [Cao Cao] answered back, “Don’t worry, you think there are no other rats like him All under Heaven?” Hua Tuo was then sentenced to death. Upon his execution, he presented a scroll to the jailer. “This can save lives,” said Hua Tuo. The jailer fearful of the law didn’t accept the scroll. Nor did Hua Tuo force it upon him. Instead he inquired for a fire to burn the scroll. After Hua Tuo’s death, [Cao Cao’s] headaches were not healed. [Cao Cao] sighed, “Hua Tuo could have healed me. That rascal didn’t so that he could enhance his own importance on me. Even if I didn’t kill him, he wouldn’t have healed me and rid me of this source of pain.” Afterwards, Cao Cao’s beloved son, Cang ShuG died of illness. [Cao Cao] in anguished cried out: “I regret putting Hua Tuo to death. In doing so I have condemned my son to death!”

Initially, an army personnel Li Cheng was suffering from a cough. It caused him sleepless days and nights. From time to time he would cough up blood and pus. He questioned Hua Tuo about this. Hua Tuo told him: “Sir, you’re suffering from your intestines swelling. What you are coughing up is not from your lungs. I will give you two tenths of a certain powder. Upon swallowing it should eradicate the coughing. You’ll feel relieved and see some small improvements in a month. If you can take care of yourself well, in a year you’ll be healthy again. A minor relapse will occur again in eighteen years. Take this powder again and you’ll feel better. If you can not obtain this medicine, then you’ll die.” Another two tenths of powder was given to him. After receiving the medicine, about five or six years went by, a relative of Li Cheng’s had the same illness as him before. His relative said: “You’re strong and healthy now. I’m dying here. How can you bear to save the medicine when you’re situation is not as critical?” (3) “First lend it to me, and when I get better, I’ll get some more from Hua Tuo.” Thus Li Cheng gave away his medicine to his relative and set out for Qiao. But upon arriving to see Hua Tuo, he could not request the needed medicine because Hua Tuo was imprisoned. Since there was no medicine for Li Cheng, he suffered a relapse after eighteen years and died (4).

Wu Pu of Guang Ling and Fan Ah of Peng Cheng were two students who learned from Hua Tuo. Wu Pu following Hua Tuo’s guidance was able to bring relief to others in his treatments. Hua Tuo had instructed Wu Pu: “The human body needs constant movement, but it shouldn’t be stressed to the limit. Movement allows the vital air to disperse freely, the blood to flow freely in the arteries thus preventing the illness to manifest in the first place. It’s like the hinge on a door of a house that doesn’t decay due to the constant opening/closing. It was as the ancients have done in the past. They’ve stretched their necks like that of a horned owl; they stretched their waists; moving around their joints, all in efforts to delay aging. I have this technique called ‘movements of the five animals’.H The first is called ‘the tiger’; the second is called ‘the deer’; third is ‘the bear’; fourth is ‘the ape’; and the fifth is ‘the bird’; useful in preventing illnesses, beneficial to the limbs because they are a form of stretching. If your body experiences some discomfort, simply perform one of the animal exercises. Upon sweating, sprinkle some powder on yourself and your body will feel relaxed. Giving you a healthy appetite.” Wu Pu followed this instructions and lived to be more than ninety years of age. His ears and eyes were still sharp as ever, his teeth all held firm and strong. Fan Ah was skilled at acupuncture. Ordinary doctors advised that on the chest and back regions - one should not carelessly insert needles. If they did, then it would not be more than fourth tenth of an inch. Fan Ah would insert the needle in the back one to two inches; in the chest region he would stick the needle in five to six inches deep immediately relieving the patient of his ailments. Fan Ah once asked Hua Tuo for a medicine that would benefit one’s health. Hua Tuo told him how to make a powder from varnish leaves and ‘qian nian’. When the varnished leaves were fragmented; the ‘qing nian’ split into fourteen parts it would be ready. When taken for a long period of time: it would rid one of the ‘three worms’I; benefit the five viscera, lighten the body [making it nimble and agile]; and prevent your hair turning white. Fan Ah followed this advice and lived over a hundred years. In the cities of Pei, Peng Cheng, and Chao Ge it is said that varnish leaves and ‘qing nian’ grows plentiful and abundant (5).

(1) Pei Song Zhi's notes: The ancient word ‘fu’ () and the modern word ‘zhuan’ () are similar. Writers often can’t differentiate the difference. Searching for Hua Tuo style Yuan Hua’s name, Fu was another name of his. <return>

(2) According to Hua Tuo Bei Zhuan (Records of Hua Tuo): There was once a man with two lame legs didn’t allow him to walk properly. When Hua Tuo saw this he said to the man: “If it’s pricked enough with an acupuncture needle and proper medicine taken, then there shouldn’t be any veins showing.” The man was then instructed to undress. Needles were inserted in his back in ten different locations, either one inch deep or five inch deep depending on the location. Being possessed is different for each person. The appropriate locations were then determined. The more treatments that were applied, the easier it was for him to walk. Afterwards another needle was inserted into the spinal cord region (just behind the head, in the lower cranial area). Proper movement in the upper and lower body was restored. Thus the man was able to walk normally again.F <return>

(3) Pei Song Zhi’s notes: The Ancient language says to conceal it away. <return>

(4) According to Hua Tuo Bei Zhuan (Records of Hua Tuo): People in the region of Qing Long Zhong (Green Dragon Central) have seen sightings of the Shan Yang Grand Administrator (shan yang tai shou) of Guang Ling, Liu Jing Zong. Liu Jing Zong says that in the days of peace, he would often see Hua Tuo. After viewing the patient’s pulse in the arms, [Hua Tuo’s] examination was that of the gods.

The governor of He Nei, had a daughter about twenty years old. In her left knee she had a tumor. Although it itched, it didn’t cause her any pain. The tumor would arise about every ten days. This has went on for about seven to eight years. Liu Xun of Lang Ye, on behalf of the governor, brought in Hua Tuo to examine her. Upon examination, Hua Tuo finally said: “It’s easy to remedy. All that is needed is the head of a yellow colored ‘dao kang’ dog and two fine horses.” A rope was tied around the dog’s head on one end, and fastened to the horses on the other. The horses were then lead out with the dog trailing behind. Calculating that if the horse went about thirty li, the dog wouldn’t be able to keep up. A person was then needed to help the exhausted dog along for another fifty li. Then it would be ready to be used as a remedy for the governor’s daughter. The daughter was then to be laid down not knowing anything. A big butcher knife was brought out to cut the dog up. A cut was to be made near the stomach region, just in front of the hind legs. The newly cut location of the dog was then faced towards the tumor’s opening [on the girl’s knee] about two to three inches away. Stopping [in front of the tumor] for a moment was necessary. In a while, from the center of the tumor, out came a snake like creature. It looked like it had a firm lateral head. When it wiggled enough inside the tumor it would stop. At this moment it was pulled out. It was about three foot in length. Clearly like that of a snake, but it’s eyes were irregular and it had scaly ears. An ointment was rubbed onto the center of the tumor. After seven days the governor’s daughter recovered

In another case, there was a person who was suffering from headaches. He could hardly raise his head, his vision was blurred. This accumulated over the year. Hua Tuo asked him to remove his clothes for examination. Then asked him to tilt his head towards the ground one to two inches. A damp cloth was then wiped on the body, circling the whole circumference. A pulse was then taken in several places, producing the five shades. Hua Tuo then instructed several of his pupils to obtain a beryllium knife to cut at some veins. The five shades were then depleted after seeing the red blood. An ointment was applied to the open wound. The man proceeded to sweat afterwards. Some powdered ‘ting li quan xie’ was given to him to drink. He recovered immediately.

There was this instance where a married woman was sick for a year. Her sickness had symptoms of a fever and the chills. In the winter, middle of the eleventh month (December), Hua Tuo had her sit in a stone manger. The manger was then filled with cold water, in which she sat in for about a hundred days. It was filled with about seven to eight ‘guan’ [of the cold water], anymore and it would cause death. [After the hundred days of soaking in cold water she then soaked in hot water]. Her illness was being expelled using steam [from the hot waters], this raised about two to three inches. After enough soaking, Hua Tuo placed a warm fire near her couch, with a thick blanket on her. Some powder was applied to her when she started to perspire (sweat). When her perspiration had stopped, she recovered shortly.

There was this person who was experiencing pain in the stomach. In about ten days or so the hair on the patient’s eyebrows would fall off. Hua Tuo told the patient, “The spleen is partially decaying and it may affect the stomach in the rear.” Instructing the patient to lie down, Hua Tuo administered some medicine. Cutting open the stomach, upon closer observation Hua Tuo had found out that the spleen was indeed decaying. Hua Tuo then proceeded to cut away the infected flesh. After the surgery was done, an ointment was applied to the wound. The patient recovered fully after a hundred days of taking further medication given by Hua Tuo after the surgery. <return>

(5) According to Hua Tuo Bei Zhuan (Records of Hua Tuo): Other names for ‘qing nian’ was ‘di jie’ and also ‘huang zhi’. It helped manage the five viscera and was beneficial for one's essence. It was originally found inside the mountains. A Taoist person told of the whereabouts of it to Hua Tuo. Hua Tuo was delighted at this, and also told this to Fan Ah who in turn kept it a secret. The fellow villagers of Fan Ah saw that it was his birthday. They thought that it was peculiar that he was still strong and healthy. They had made him many clothes [for his birthday]. [I have omitted the rest of this passage due to length and it's Fan Ah’s bio]. <return>

Translator Notes
(A) Hua Tuo was many hundred years ahead of his time in terms of medical knowledge and practice. The exact source for his knowledge remains to be investigated. It may be possible that he made his own discoveries and advancement on his own without any teacher to instruct him. There is a legend of Hua Tuo at the age of seven lost his father. Living in poverty his mother sent him to learn under a famous physician named Cai. <return>

(B) The traditional dates given to his life span. His exact date of death wasn’t specified (in Sanguozhi). However we do know that Cao Chong died in the 13th year of Jian An (AD 208). Hua Tuo’s death was before Cao Chong as stated in his bio, so Hua Tuo couldn’t have lived past the year AD 208. Also Cao Chong’s death wasn’t specified when (the month) in 208 that he died. A possible scenario would be that Cao Chong died early in the year of AD 208, while Hua Tuo died in the late stages of the year AD 207. Nevertheless, most historians would agree, that traditionally Hua Tuo died in the year AD 207. <return>

(C) In modern terms this would be morphine. Although morphine was not chemically isolated and identified until about 1805 by the German scientist, Frieddrich W. A. Serturner, it is however a naturally occurring substance. The ma fei, used by Hua Tuo, has anesthetic properties – causing an entire or partial loss of the feeling of pain to the patient; thus allowing Hua Tuo to perform surgery without the patient feeling the pain. This suggests how far-advanced Hua Tuo’s skills were compared to his contemporaries. <return>

(D) Although in this passage Hua Tuo took Gan Ling’s wife’s pulse he did not touch her on the abdomen to discover the position of the fetus. Instead he had someone else do it for him. Most likely one of the handmaids nearby. Back then, it wasn’t proper etiquette for the physician to touch the woman in that area. The conventional rules of conduct in ‘polite’ society forbade this. Instead the physician would merely point to the spot on a model or drawing. It wasn’t until many centuries later that this was dropped and allowed physicians to touch their patients where ever necessary. <return>

(E) The Postal Controller under the Han dynasty was a prefecture-based appointment. As the name implies, the Postal Controller was responsible for the mailing system in the prefecture. Other duties include: deputy inspector of other counties within the prefecture; odd jobs of catching thieves and collecting rent. <return>

(F) A popular belief in China in the ancient days: was that when a person that had taken ill in where they lose control or movement in certain body parts; that it was due to one being possessed by a spirit. Although modern science disproves this theory, nevertheless, the ancients ‘cured’ this ailment by acupuncture therapy. This is what Hua Tuo did exactly. Because of the belief of possession of spirits was different for each person, the remedy would thus be different as well. Therefore, although acupuncture is applied, a difference of depth would be applied to as to how each needle should be placed. This leads to many possible combinations of the ten needles that Hua Tuo applied on the man. So before applying the needles, Hua Tuo had to consider carefully how deep he would prick each needle in and in which location. <return>

(G) From Cao Chong’s SGZ bio (Sanguozhi: Scroll 20:Book of Wei 20) : Cao Chong styled Cang Shu, was one of Cao Cao most loved child out of his 25 sons and 7 daughters. After Hua Tuo’s death, Cao Chong died of illness in the 13th year of Jiang An (AD 208) at the young age of 13. Further details can be found in Cao Chong’s own SGZ bio. <return>

(H) This refers to as what we know today as ‘yoga’. <return>

(I) Different types of parasites that can eat away the five viscera. <return>

Copyright © 2003 jiuwan (Giao Chau)
Translated from Chen Shou’s Sanguozhi