The Characteristics and Treatment Patterns of “Liver-Based Treatment” for Qing Imperial Court Women: Based on Medical Records of Empress Longyu and Others

The archival historical materials of the medical records of the Qing imperial court possess significant medical value, containing numerous detailed medical records concerning women. These records are valuable resources for the treatment of female patients with traditional Chinese medicine (TCM). Based on their preservation types, they can be categorized into three groups: original prescriptions, complete registers compiled by year or for specific individuals, and materials transcribed among the populace. Some materials have not yet been incorporated into existing scholarly works but are nonetheless valuable primary sources. By analyzing the symptoms, pathogenesis, and prescriptions recorded in the original registers of five Qing imperial court women of different ranks—Empress Longyu (隆裕皇后), Noble Consort Qi (琪贵妃), Noble Consort Wan (婉贵妃), Consort Qing (庆妃), and Palace Maid Su’an (宫女素安)—this study reveals that liver qi stagnation (肝气郁结) permeated the entire course of various diseases among Qing imperial court women. Consequently, imperial physicians emphasized the holistic view of “ the liver as the source of diseases among the five organs (肝为五脏之贼)” and developed multiple methods for treating the liver, including soothing the liver, nourishing the liver, clearing the liver, and softening the liver. The liver disease treatment model embodied in these practices encompasses two aspects. First, the “integration of property (体) and function (用)” approach to pattern differentiation and treatment, wherein imperial physicians often combined regulating qi flow and balancing the internal organs with methods to clear the liver and nourish blood during treatment. Second, the preventive care philosophy of “harmonizing body and mind”. Recognizing the profound influence of emotional factors on women in the Qing imperial court, imperial physicians sought to regulate the “body” to harmonize the “mind”, thereby addressing the root cause and achieving treatment from the foundation. This model offers significant insights for the prevention and treatment of diseases affecting modern women.