title: Management of patients under general anesthesia with mafutsu-san in Hanaoka-style surgery: comparisons of illustrations from Geka-Kihai-Zufu with descriptions from Mafutsuto-Ron and Yohka-Hiroku.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We therefore compared the descriptions of general anesthesia featured in these three documents, and thereby investigated the actual anesthetic management and the procedures used.
  
  
  CONCLUSIONS
  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.
authors: Intensive Care Unit and Department of Anesthesiology, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan, dotek@m.ehime-u.ac.jp.
authors: Kentaro
authors: K
authors: Dote
authors: Tosihiro
authors: T
authors: Yorozuya
authors: Keizo
authors: K
authors: Ikemune
authors: Yoko
authors: Y
authors: Desaki
mesh_terms: D000768:Anesthesia, General / Q000266:history*; D000776:Anesthesiology / Q000266:history*; D005260:Female; D013502:General Surgery / Q000266:history; D049671:History, 18th Century; D049672:History, 19th Century; D006801:Humans; D010361:Patients; D013782:Textbooks as Topic / Q000266:history