麻沸散
Mafeisan / Hua Tuo's Surgical Anaesthetic
The world's first recorded general anesthetic — a powdered herbal compound dissolved in wine, administered orally to render patients unconscious for surgery. Hua Tuo (c.140-208 CE) predates Western ether anesthesia (1846) by over 1600 years.
Scientific Principle
Multi-alkaloid synergistic anesthesia: scopolamine (M-cholinergic receptor antagonist → sedation + amnesia + gland suppression) from Datura/mandrake; aconitine (Na⁺ channel modulator → initial excitation then nerve conduction block → analgesia) from Aconitum; cannabinoids (sedation) from Cannabis. The three work synergistically: anticholinergic + Na⁺ channel block + cannabinoid sedation → unconsciousness + pain loss + muscle relaxation. The exact formula was lost when Hua Tuo's manuscripts were burned, but the pharmacological profile of the candidate plants supports the historical account. Zhao et al. (2018, J Anesth Hist, PMID:30217390) confirmed the historical validity of Mafeisan as the world's first general anesthetic.