Surgical anaesthesia in Ming China: scientific analysis of aconitine residues on medical instruments
Published online by Cambridge University Press: 26 May 2026
Abstract
The analysis of archaeological trace residues is offering expanding insights into various aspects of human (pre)history, including developments in medical knowledge. Here, the authors present results from the analysis of two medical instruments (scissors and tweezers) found in a Ming Dynasty (c. 1368–1644 CE) tomb in Jiangyin, China. While the form and composition of the instruments themselves indicate developed understandings of tool production and use, novel application of stimulated Raman scattering microscopy reveals probable traces of aconitine, likely providing direct evidence for the use of this highly toxic substance, possibly administered as a topical anaesthetic, in ancient Chinese surgery.
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Introduction
Archaeological discoveries of organic residues on human remains, in containers or on medical instruments can attest to ancient pharmaceutical practices (Dai Reference Dai1983; Liang Reference Liang1988; Liu Reference Liu1989; Chen et al. Reference Chen2008; Salih et al. Reference Salih2009). Surgical procedures developed independently in multiple civilisations worldwide, with evidence for their performance found both on physical remains—for example, trepanned skulls from prehistoric Europe and the Americas (Verano. Reference Verano2016a; Verano. Reference Verano2016b)—and in ancient texts such as the Indian Ayurvedic compendium Suśruta Saṃhitā (Bhishagratna Reference Bhishagratna1907; Saraf & Parihar Reference Saraf and Parihar2006). The physical remains of individuals who underwent surgical procedures and the associated surgical implements, unearthed through archaeology (Jackson Reference Jackson1986; Jakielski & Notis Reference Jakielski and Notis2000), provide a valuable basis for evaluating and comparing the evolution of surgical techniques around the world.
In China, historical records documenting the materials and uses of ancient surgical tools are scarce, meaning relevant research is limited (Yi Reference Yi1977; Dai Reference Dai1983). Analysis of archaeological medical instruments and any surface residues, which may contain traces of medicinal chemicals, is therefore crucial for developing a medical archaeology. Residue analysis can help identify the components and characteristics of trace materials, employing techniques like stable isotope analysis, Fourier-transform infrared spectroscopy, desorption electrospray ionisation mass spectrometry and gas chromatography mass spectrometry (Barnard et al. Reference Barnard2007; Zhou & Zhang Reference Zhou and Zhang2011). Recent studies have revealed the presence of zinc oxide, pine resin and beeswax in small tablets found aboard the Pozzino shipwreck (c. 130 BCE, Italy), indicating a possible ophthalmic function (Giachi et al. Reference Giachi2013); identified beeswax triglycerides and lead white in a sixteenth-century ceramic jar from Bruges (Belgium), suggesting the jar contained a lead-based plaster ointment intended for application on the skin (Baeten et al. Reference Baeten2010); and confirmed the antibacterial properties of Pistacia resin and beeswax found in ceramic vessels from a Twenty-Sixth Dynasty (c. 664–525 BCE) embalming workshop at Saqqara (Egypt) (Rageot et al. Reference Rageot2023). However, early excavations in China paid little attention to residue analysis, leading to a scarcity of pertinent studies. Identified residues on instruments are often difficult to extract and fail to meet minimum sample requirements for identification through gas-chromatography spectrometry (Yang Reference Yang2008). Application of innovative, non-destructive analysis with low detection limits is therefore essential for the advancement of organic residue analysis.
Stimulated Raman scattering (SRS) is an advanced optical technique that integrates spectroscopy and Raman imaging (Julien Reference Julien2024). SRS can be used to accurately identify material compositions and map component distribution via diagnostic Raman peaks (Jonkman et al. Reference Jonkman2020), effectively overcoming the key challenges in residue research of minimal sample availability and the need to preserve archaeological material.
Jiangsu Province was a thriving centre for medical practice in China during the Ming (1368–1644 CE) and Qing (1644–1912 CE) dynasties; studying the medical instruments unearthed there can provide valuable insights into medical practices during these periods (Geng & Geng Reference Geng and Geng1979). This study analyses residue samples taken from Ming Dynasty medical instruments excavated from the Xia Quan (夏颧) tomb, now held at the Jiangyin Museum. The composition and use of the instruments are assessed through elemental analysis, with stimulated Raman scattering used to analyse herbal residues identified on the instrument surfaces. This study provides a detailed and reliable foundation for understanding the development of ancient Chinese surgical knowledge and technology.
Residue samples
The residue samples, obtained from the Jiangyin Museum, were taken from metal instruments unearthed in 1974 in a Ming Dynasty tomb in Jiangyin County, Jiangsu Province (Figure 1, Table 1). Identification of the occupant of the tomb, Xia Quan (夏颧) (1348–1411 CE), provides a secure early Ming Dynasty date for the associated artefacts (Yi Reference Yi1977). As one of the few archaeological instances where medical tools are associated with a specific individual, the analysis of surface residues can provide key physical evidence for medicinal practices.
The sampled instruments and the residues analysed on each one. See Table 1 for details (photographs by authors).
Sampled instruments (see Figure 1).
Residues can be found on surgical tools in areas that are difficult to clean, such as the back of overlapping tongs or blades. Bright red rust micro-residues were sampled from these areas on two typical Ming medical instruments: scissors and tweezers. Sampling procedures strictly adhered to Article 29 of the ‘Law of the People’s Republic of China on the Protection of Cultural Relics’ (2023 Revision). Thus, a minimally destructive micro-extraction was performed under a microscope, collecting only 2mg of residue from each instrument (evident as slight red traces in the collection tube) for analysis.
Elemental analysis
Working under the constraints of the Jiangyin Museum’s prohibitions on destructive sampling and the removal of artefacts from the museum premises, the use of portable x-ray fluorescence presented the most viable method for rapid, in situ, non-destructive analysis of the elemental composition of the artefacts.
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