Intensive Care Unit and Department of Anesthesiology, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan,
J Anesth. 2015 Feb;29(1):96-101. doi: 10.1007/s00540-014-1868-9. Epub 2014 Jun 27.
Seishu Hanaoka (1760-1835) left behind no books that he himself had written. This is why many aspects of Hanaoka-style general anesthesia using a mixture of herbal extracts, which he called mafutsu-san, remain unknown. We are able to learn about this technique today because there are several descriptions of it in books written by his students, such as Mafutsuto-Ron ("Treatise on Mafutsuto") by Gendai Kamata (1794-1854) and Yohka-Hiroku ("Secret Records of Surgery") by Gencho Homma (1804-1872). On the other hand, Geka-Kihai-Zufu ("Illustrations of Surgical Cases"), a surgical textbook, by Gendai Kamata, containing one of the oldest illustrations of general anesthesia published in 1840, was recently rediscovered (2011). For the first time, this book revealed, in the form of a picture image, the actual circumstances of Hanaoka-style general anesthesia.
We therefore compared the descriptions of general anesthesia featured in these three documents, and thereby investigated the actual anesthetic management and the procedures used.
We found that the circumstances under which Hanaoka-style general anesthesia, using fabrics and futon mattresses, as well as blindfolding and constraining the patient's body during surgery, were exactly as described in Mafutsuto-Ron and Yohka-Hiroku. In addition, besides a surgeon conducting an operation, there was a physician who observed the patient's general condition. Gendai Kamata, the author of Geka-Kihai-Zufu, is believed to have recognized the importance of anesthetic care of surgical patients.
花冈清（1760-1835）没有留下自己撰写的书籍，因此，他所使用的草药提取物混合而成的和汉麻醉法（被他称为麻沸散）的许多方面仍然不为人知。我们今天能够了解这种技术，是因为他的学生所著的几本书中都有对其的描述，如现代·金山（1794-1854 年）所著的《麻沸散论》和本庄·元（1804-1872 年）所著的《外科秘录》。另一方面，现代·金山的外科教科书《外科例证绘谱》（1840 年出版的最早的全身麻醉插图之一）最近（2011 年）被重新发现。这本书首次以图片的形式揭示了花冈式全身麻醉的实际情况。
因此，我们比较了这三本书中全身麻醉的描述，从而研究了实际的麻醉管理和使用的程序。
我们发现，使用织物和被褥床垫以及在手术中对患者进行蒙眼和约束的花冈式全身麻醉情况，与《麻沸散论》和《外科秘录》中的描述完全一致。此外，除了外科医生进行手术外，还有一名医生观察患者的一般情况。《外科例证绘谱》的作者现代·金山，被认为认识到了对手术患者进行麻醉护理的重要性。
