An Unexpected Operation in Mao’s Study

On the night of July 23, 1975, history quietly unfolded in Chairman Mao Zedong’s private study. At 11:30 PM, under the dim glow of medical lamps, 49-year-old Tang Youzhi—an ophthalmologist from Beijing’s Guang’anmen Hospital specializing in traditional Chinese surgical techniques—performed a delicate cataract extraction on Mao’s left eye. The atmosphere was tense; nurses recorded Tang’s heart rate at 120 beats per minute, and one attending physician accidentally knocked over a water pitcher. Yet Mao remained remarkably calm, listening to the patriotic anthem Man Jiang Hong on a wire recorder as Tang completed the procedure in just four to five minutes.

The surgery succeeded brilliantly. When Mao regained vision days later, he spontaneously penned a line from Lu Xun’s poetry—”How could my passion remain as before? Flowers bloom and fade, all left to nature”—and gifted it to Tang. This moment symbolized more than medical triumph; it represented the enduring legacy of an ancient surgical tradition that had traveled across the Silk Road over a millennium earlier.

The Silk Road Origins of “Golden Needle” Surgery

Tang Youzhi’s technique, known as couching or jinbi shu (金篦术), traced its lineage to Sushruta, an Ayurvedic physician from 4th-century BCE India. The method involved using a gold needle to depress the clouded lens into the vitreous humor, clearing the optical pathway. Historical records reveal its transmission route:

– Buddhist Medical Transmission: The Mahaparinirvana Sutra (translated during the Northern Liang dynasty, 397–460 CE) contains the earliest Chinese reference: “The skilled physician used a golden pi [needle] to remove the eye membrane.”
– Early Adopters: By the 6th century, the Book of Liang documented a monk restoring vision to a prince using this technique, described as “the instant the needle entered, light flooded in.”

Literary giants like Du Fu and Liu Yuxi later immortalized the procedure in Tang dynasty poetry, comparing its precision to “scraping a mirror clear” or “lifting a veil from the sun.”

Poet-Patient: Bai Juyi’s Battle With Cataracts

The Tang dynasty poet Bai Juyi (772–846) left perhaps the most vivid patient account. His poem Two Poems on Eye Disease reveals a man grappling with failing sight:

> “Scattered snowflakes in the air, a gauze curtain over everything—
> Even sunny days seem foggy, flowers bloom out of season…”

Modern scholars identify classic cataract symptoms in his descriptions: blurred vision, light sensitivity, and frustrating treatments. Bai consulted Buddhist monks (who blamed “dust of worldly attachments”), Daoists (who advised retirement), and physicians diagnosing fengxuan—a liver-related disorder in traditional Chinese medicine (TCM). His desperate self-study of the Nagarjuna’s Treatise on Eyes (an Indian-influenced medical text) ultimately led him to consider surgery, lamenting:

> “Herbs and pills lie useless on my desk—
> Perhaps the golden needle can pierce this darkness.”

Though historical evidence suggests mixed results—Bai continued complaining of eye strain—he lived actively into his seventies, proving the procedure’s relative safety.

Cultural Crossroads: How Indian Ophthalmology Shaped Chinese Medicine

Three key factors facilitated this medical transfer:

1. Climate and Demand: India’s tropical climate fostered advanced ophthalmology to address prevalent eye diseases.
2. Buddhist Networks: Monk-physicians like the Brahmin treated elites, including Emperor Taizong of Tang.
3. Exotic Materia Medica: Indian-influenced treatments used:
– Carnelian stones (ground for topical application)
– Huyan salt (Central Asian mineral salts for eye pain)

Yet failures occurred. The blind monk Jianzhen—key to transmitting Buddhism to Japan—lost his vision after a botched treatment by an Indian doctor in 748 CE. Similarly, poet Du Mu recorded his brother’s tragic case where vascular complications made surgery impossible.

From Esoteric Art to Standard Practice

By the Song dynasty (960–1279), the technique had fully Sinicized:

– Medical Texts: The Longmu Lun (龙木论, evolved from Nagarjuna’s work) became a imperial medical school textbook, classifying cataracts by etiology (age, trauma, etc.).
– Famous Practitioners: Su Shi’s poem For Eye Doctor Wang Yanshuo captures a surgery’s drama:
> “Your needle moves like an axe splitting wood—
> Peeling away the veil as if dismantling a house!”

Physicians guarded secrets fiercely. A Song dynasty anecdote tells of a “200-Herb Flower Paste” that was actually just honeyed goat bile—the exaggerated name meant to deter copycats.

Political Eyes: A Royal Procedure With Consequences

A chilling episode from 1142 reveals the surgery’s cultural weight. When Emperor Gaozong’s mother, Empress Wei, returned from Jurchen captivity, she vowed to retrieve her other son (the deposed Emperor Qinzong)—swearing blindness otherwise. After reneging, legend claims a Taoist surgeon restored vision in one eye only, leaving the other “to remember broken oaths.” Whether fact or political parable, the tale underscores the procedure’s symbolic power.

Tang Youzhi’s Modern Renaissance

Building on classical methods, Tang’s 20th-century innovations included:
– Refined needle designs
– Sterilization protocols
– Lens extraction rather than displacement

Though modern phacoemulsification has largely replaced couching, Tang’s work—like the ancient jinbi shu—remains a testament to cross-cultural medical exchange. As his mentor once said: “This light traveled a thousand years to reach us—how could we let it fade?”

The golden needle’s journey, from Sushruta’s India to Mao’s Beijing study, embodies medicine’s timeless quest to restore one of humanity’s most precious gifts: sight.