The period of the Three Kingdoms: division, conflict, and medical innovation

After the fall of the Han dynasty, one of the most turbulent periods in Chinese history began: the period of the Three Kingdoms (220-280 AD). The empire split into three rival states that fought one another for decades without any of them gaining definitive supremacy. Yet this was also a period of remarkable cultural and medical development — proof that creative minds continued their work even in times of division and war.

Collapse of the Han

The seeds of division had already been sown in the late Han period. Central power had been weakened by palace intrigues, eunuch influence, and the rise of powerful local warlords. Child emperors — placed on the throne as puppets for generations — were unable to rule effectively. When major peasant uprisings further undermined imperial authority, the end of Han unity became inevitable.

Out of the resulting power vacuum emerged three realms. Wei, in the north — the strongest and most populous — claimed succession to the Han. Wu, in the south, controlled the rich Yangtze delta and coastal regions. Shu-Han, in the west — the region of present-day Sichuan — legitimated its existence as the true heir of the Han imperial line. None of the three was strong enough to defeat the others, which led to a long period of stalemate.

Hua Tuo: China's first surgeon

Despite the political chaos, the period of the Three Kingdoms produced one of the most legendary figures in the history of TCM: Hua Tuo. This brilliant physician is regarded as the first surgeon in Chinese history. He is said to have been the first to use an anesthetic technique — a drink called mafeisan, probably a mixture of cannabis and other narcotic plants — to render patients unconscious during operations.

Hua Tuo also developed the Wu Qin Xi — the "Exercises of the Five Animals" — a series of movement exercises based on the motions of the tiger, the deer, the bear, the monkey, and the crane. This is one of the earliest forms of therapeutic movement in the Chinese tradition, a precursor of modern Qi Gong. Hua Tuo died in captivity after refusing to become the exclusive personal physician of the powerful warlord Cao Cao — a tragic end for one of the greatest medical minds of his time.

Medical knowledge in times of war

The continuous warfare of the Three Kingdoms era had paradoxical consequences for medicine. On the one hand, the constant fighting cost countless lives and destroyed the infrastructure that made the transmission of knowledge possible. On the other hand, war stimulated the development of trauma medicine, wound care, and the treatment of febrile diseases — practical knowledge that would have been less urgent in times of peace.

The period of the Three Kingdoms ended when the Jin dynasty unified the three realms. Yet the stories, figures, and medical innovations of this era remained alive in Chinese cultural memory — to this day, the period of the Three Kingdoms is one of the most widely read and discussed eras in Chinese history.