was a Japanese surgeon of the Edo period with a knowledge of Chinese herbal medicine, as well as Western surgical techniques he had learned through Rangaku (literally "Dutch learning", and by extension "Western learning"). Hanaoka is said to have been the first to perform surgery using general anesthesia. History Hanaoka studied medicine in Kyoto, and became a medical practitioner in Wakayama prefecture, located near Osaka, where he was born. Seishū Hanaoka learned traditional Japanese medicine as well as Dutch-imported European surgery. Due to the nation's self-imposed isolation policy of Sakoku, few foreign medical texts were permitted into Japan at that time. This limited the exposure of Hanaoka and other Japanese physicians to Western medical developments. Perhaps the most notable Japanese surgeon of the Edo period, Hanaoka was famous for combining Dutch and Japanese surgery and introducing modern surgical techniques to Japan. Hanaoka successfully operated for hydrocele, anal fistula, and even performed certain kinds of plastic surgery. He was the first surgeon in the world who used general anaesthesia in surgery and who dared to operate on cancers of the breast and oropharynx, to remove necrotic bone, and to perform amputations of the extremities in Japan. Hua Tuo and mafeisan Hua Tuo (華佗, ca. AD 145-220) was a Chinese surgeon of the 2nd century AD. According to the Records of Three Kingdoms (ca. AD 270) and the Book of the Later Han (ca. AD 430), Hua Tuo performed surgery under general anesthesia using a formula he had developed by mixing wine with a mixture of herbal extracts he called mafeisan (麻沸散). Hua Tuo reportedly used mafeisan to perform even major operations such as resection of gangrenous intestines. Before the surgery, he administered an oral anesthetic potion, probably dissolved in wine, in order to induce a state of unconsciousness and partial neuromuscular blockade. The exact composition of mafeisan, similar to all of Hua Tuo's clinical knowledge, was lost when he burned his manuscripts, just before his death. The composition of the anesthetic powder was not mentioned in either the Records of Three Kingdoms or the Book of the Later Han. Because Confucian teachings regarded the body as sacred and surgery was considered a form of body mutilation, surgery was strongly discouraged in ancient China. Because of this, despite Hua Tuo's reported success with general anesthesia, the practice of surgery in ancient China ended with his death. The name mafeisan combines ma (麻,