Couching for Cataract in China

Couching for cataract is one of the most ancient surgical procedures. Maharshi Sushruta, an ancient Indian surgeon, first described the procedure around 600 BCE in Sushruta Samhita. The procedure, also known as jin pi shu in Mandarin, was introduced to China via the Silk Road during the late West Han Dynasty (206 BCE-9 CE), and it spread throughout China during the Tang Dynasty (618-907 CE). As the procedure was combined with the Chinese concept of acupuncture, jin pi shu was integrated into Chinese medical practice until the founding of the Republic of China in 1911. The government of the Republic of China considered jin pi shu to be unscientific. In 1949, the Communists established the People's Republic of China. Jin pi shu was revitalized by Chairman Mao Zedong (1893-1976), who thought that traditional Chinese medicine, including jin pi shu, was a great treasure. After his death and the opening of China to the external world, many Chinese ophthalmologists pointed out that jin pi shu had relatively high complications and a low success rate, compared to various modern techniques for cataract surgery. This procedure is gradually fading away in China. The use of jin pi shu reflects the history, culture, and political transformation of China.