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The notion of decreasing pain in surgery stretches back thousands of years with alcohol noted as one of the first anesthetics. Natural elements including coca and opium have been used by various civilizations in anattempttomutethesearingpainofsurgery.Bythe 16th century, physicians around the world began to experiment with nitrous oxide and ether, providing the groundwork for the future of modern anesthesia. The successful application of general anesthesia in surgery was first documented in 1804 by Dr. Seishu Hanaoka (Fig. 1) in Wakayama, Japan, during a breast lumpectomy. During the case, Dr. Hanaoka served as the surgeon, anesthesiologist, and pharmacist. Although most of his worldwide contemporaries were unaware of his successes, this achievement stands as an emblematic and triumphant landmark in medicine.
Dr. Hanaoka was born on October 23, 1760, in the small village of Hirayama in Wakayama, Japan. He was the son and grandson of physicians and served as his father's apprentice until the age of 22 years when he left his small hometown to study in the then-capital and epicenter of Japanese medicine, Kyoto. He began his studies under the tutelage of Dr. Nangai Yoshimasu, a prominent practitioner of Chinese medicine. There, he learned about the basic tenets of Chinese herbal medicine and of the multitude of medicines found in nature. This knowledge greatly contributed to Hanaoka's future creation of a potent anesthetic that he called tsusensan. After studying Chinese herbal medicine, his interest in surgery drew him toward the work of Dr. Kenryu Yamato, a Japanese physician who im- plemented the Dutch surgical techniques that later became paramount to Hanaoka's career. These tech- niques were based on the burgeoning fields of surgery and...