Archaeologists in China have uncovered rare physical evidence that surgeons in the Ming Dynasty were using sophisticated anaesthetic compounds more than 600 years ago. By analysing microscopic residues left on iron surgical tools, researchers identified traces of aconitine — a highly toxic substance derived from monkshood plants that was carefully processed and applied to reduce pain during operations.
The discovery offers a remarkable glimpse into medieval Chinese medicine, revealing not only advanced surgical knowledge but also refined methods for handling dangerous drugs safely.
The study, published in the journal Antiquity, focused on a pair of iron scissors and tweezers excavated from the tomb of the physician Xia Quan (1348–1411), whose burial was uncovered in Jiangyin, Jiangsu Province, in 1974. The instruments are now held by the Jiangyin Museum.
Detecting ancient medicine
SRS microscopic imaging results for residue particle 2 taken from the scissors (left) and tweezers (right) – photo courtesy Antiquity
Researchers used an advanced technique known as Stimulated Raman Scattering (SRS) microscopy to study tiny red residues trapped on the tools. The method allowed them to identify chemical traces without significantly damaging the artefacts.
“Stimulated Raman scattering (SRS) microscopic imaging is an advanced optical technique that can be used to accurately identify material compositions and map component distribution, effectively overcoming the key challenges in residue research of minimal sample availability and the need to preserve archaeological material,” explained Congcang Zhao, a professor at Northwest University in China and one of the lead authors of the article.
The team removed just two milligrams of residue from each instrument under a microscope. Even with such tiny samples, the researchers identified chemical signatures associated with aconitine, an alkaloid found in Aconitum plants such as wolfsbane and monkshood.
These plants are notoriously poisonous. In sufficient doses, aconitine can affect the nervous system and heart, making careful preparation essential. Yet medieval Chinese physicians had already developed methods to reduce its toxicity.
By the Ming Dynasty, practitioners were processing aconite through techniques such as vinegar boiling, soaking in black soybean decoctions, detoxifying with mung beans, and removing the outer skin of the root. The resulting compound, often called Caowu San, functioned as an anaesthetic intended to make patients insensitive to pain during surgery.
Medieval surgical instruments in China
The scissors and tweezers, along with their residue. Photo courtesy Antiquity
The study sheds new light on the sophistication of Ming-era surgery. Historical records indicate that physicians used a surprisingly diverse range of instruments, including scalpels, scissors, needles and tweezers.
The researchers note that the excavated scissors resemble modern straight operating scissors used for precise cutting, while the tweezers resemble modern tissue forceps designed for gripping soft tissue.
The tools themselves also reveal the technological capabilities of the period. Analysis showed that both instruments contained over 95 percent iron, reflecting the advanced iron-smelting industry of Ming China. During the fourteenth and fifteenth centuries, both state-run and private iron production flourished in China. This allowed craftsmen to produce durable surgical tools capable of handling difficult procedures.
A medieval topical anaesthetic
One of the most intriguing aspects of the study is the evidence that the anaesthetic was likely applied directly to the patient’s skin. The residue was concentrated in concealed functional areas near the handles of the instruments, suggesting medicinal liquid had splashed into difficult-to-clean spaces during surgery.
Historical medical texts from the Ming Dynasty support this interpretation. According to Standards for Diagnosis and Treatment: Ulcer Treatment, surgeons would “first apply a numbing agent to the area, then use the scissors to trim away the outer layer of skin.”
The same texts describe wound-sealing medicines used for horrific injuries including slit throats, severed ears, ruptured abdomens, broken scrotums, and missing lips.
The article also catalogues numerous anaesthetic recipes preserved in medieval Chinese medical literature. These included ingredients such as datura, rhododendron, pepper, scorpion, mugwort, and even toad venom. Aconitum species appear repeatedly throughout these formulae.
“Combined with records of anaesthetic prescriptions in Ming Dynasty medical texts, the study confirms that Aconitum was employed as a topical anaesthetic, safely and precisely applied during surgical procedures,” Zhao said. “Ming physicians used iron surgical instruments and controlled the toxicity of aconitine through topical application, compound prescriptions and strict procedural controls, demonstrating a practical ability to balance drug potency with patient safety.”
NEW Microscopic analysis of 14th century CE Chinese surgical instruments reveals traces of a highly toxic chemical used as anaesthetic, highlighting the sophisticated medicine of Ming China.
The researchers argue that this is the first direct chemical evidence of anaesthetic compounds found on ancient surgical instruments. While ancient medical texts have long described anaesthesia in Chinese medicine, physical proof has been difficult to obtain because residues rarely survive and are often too small for conventional testing methods.
The use of SRS microscopy allowed the team to overcome these problems by detecting molecular traces invisible to the naked eye.
“Six centuries ago, a Ming Dynasty surgeon performed an operation with a pair of iron scissors and tweezers, and today we have read the traces of anaesthetic medicine left on those instruments using a beam of laser light,” Professor Zhao notes. “This is the first time humanity has found direct chemical evidence of anaesthetics on ancient surgical tools, proving that our ancestors already knew how to safely alleviate patients’ pain with highly toxic herbs.”
The article, “Surgical anaesthesia in Ming China: scientific analysis of aconitine residues on medical instruments,” by Xue Ling, Jingyu Li, Ge Zhao, Xu Cao, Xuehua Weng, Hong Zhang, Zheng Li and Congcang Zhao, is published in Antiquity. Click here to read it.
Archaeologists in China have uncovered rare physical evidence that surgeons in the Ming Dynasty were using sophisticated anaesthetic compounds more than 600 years ago. By analysing microscopic residues left on iron surgical tools, researchers identified traces of aconitine — a highly toxic substance derived from monkshood plants that was carefully processed and applied to reduce pain during operations.
The discovery offers a remarkable glimpse into medieval Chinese medicine, revealing not only advanced surgical knowledge but also refined methods for handling dangerous drugs safely.
The study, published in the journal Antiquity, focused on a pair of iron scissors and tweezers excavated from the tomb of the physician Xia Quan (1348–1411), whose burial was uncovered in Jiangyin, Jiangsu Province, in 1974. The instruments are now held by the Jiangyin Museum.
Detecting ancient medicine
Researchers used an advanced technique known as Stimulated Raman Scattering (SRS) microscopy to study tiny red residues trapped on the tools. The method allowed them to identify chemical traces without significantly damaging the artefacts.
“Stimulated Raman scattering (SRS) microscopic imaging is an advanced optical technique that can be used to accurately identify material compositions and map component distribution, effectively overcoming the key challenges in residue research of minimal sample availability and the need to preserve archaeological material,” explained Congcang Zhao, a professor at Northwest University in China and one of the lead authors of the article.
The team removed just two milligrams of residue from each instrument under a microscope. Even with such tiny samples, the researchers identified chemical signatures associated with aconitine, an alkaloid found in Aconitum plants such as wolfsbane and monkshood.
These plants are notoriously poisonous. In sufficient doses, aconitine can affect the nervous system and heart, making careful preparation essential. Yet medieval Chinese physicians had already developed methods to reduce its toxicity.
By the Ming Dynasty, practitioners were processing aconite through techniques such as vinegar boiling, soaking in black soybean decoctions, detoxifying with mung beans, and removing the outer skin of the root. The resulting compound, often called Caowu San, functioned as an anaesthetic intended to make patients insensitive to pain during surgery.
Medieval surgical instruments in China
The study sheds new light on the sophistication of Ming-era surgery. Historical records indicate that physicians used a surprisingly diverse range of instruments, including scalpels, scissors, needles and tweezers.
The researchers note that the excavated scissors resemble modern straight operating scissors used for precise cutting, while the tweezers resemble modern tissue forceps designed for gripping soft tissue.
The tools themselves also reveal the technological capabilities of the period. Analysis showed that both instruments contained over 95 percent iron, reflecting the advanced iron-smelting industry of Ming China. During the fourteenth and fifteenth centuries, both state-run and private iron production flourished in China. This allowed craftsmen to produce durable surgical tools capable of handling difficult procedures.
A medieval topical anaesthetic
One of the most intriguing aspects of the study is the evidence that the anaesthetic was likely applied directly to the patient’s skin. The residue was concentrated in concealed functional areas near the handles of the instruments, suggesting medicinal liquid had splashed into difficult-to-clean spaces during surgery.
Historical medical texts from the Ming Dynasty support this interpretation. According to Standards for Diagnosis and Treatment: Ulcer Treatment, surgeons would “first apply a numbing agent to the area, then use the scissors to trim away the outer layer of skin.”
The same texts describe wound-sealing medicines used for horrific injuries including slit throats, severed ears, ruptured abdomens, broken scrotums, and missing lips.
The article also catalogues numerous anaesthetic recipes preserved in medieval Chinese medical literature. These included ingredients such as datura, rhododendron, pepper, scorpion, mugwort, and even toad venom. Aconitum species appear repeatedly throughout these formulae.
“Combined with records of anaesthetic prescriptions in Ming Dynasty medical texts, the study confirms that Aconitum was employed as a topical anaesthetic, safely and precisely applied during surgical procedures,” Zhao said. “Ming physicians used iron surgical instruments and controlled the toxicity of aconitine through topical application, compound prescriptions and strict procedural controls, demonstrating a practical ability to balance drug potency with patient safety.”
Reading traces with lasers
The researchers argue that this is the first direct chemical evidence of anaesthetic compounds found on ancient surgical instruments. While ancient medical texts have long described anaesthesia in Chinese medicine, physical proof has been difficult to obtain because residues rarely survive and are often too small for conventional testing methods.
The use of SRS microscopy allowed the team to overcome these problems by detecting molecular traces invisible to the naked eye.
“Six centuries ago, a Ming Dynasty surgeon performed an operation with a pair of iron scissors and tweezers, and today we have read the traces of anaesthetic medicine left on those instruments using a beam of laser light,” Professor Zhao notes. “This is the first time humanity has found direct chemical evidence of anaesthetics on ancient surgical tools, proving that our ancestors already knew how to safely alleviate patients’ pain with highly toxic herbs.”
The article, “Surgical anaesthesia in Ming China: scientific analysis of aconitine residues on medical instruments,” by Xue Ling, Jingyu Li, Ge Zhao, Xu Cao, Xuehua Weng, Hong Zhang, Zheng Li and Congcang Zhao, is published in Antiquity. Click here to read it.
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