🌿 Folk Prescriptions

One, Medical System
(1) Imperial Medical Academy
Before the Opium War, the Qing Dynasty's medical system largely followed the Ming Dynasty's old system. In the first year of Shunzhi (1644), the Imperial Medical Academy was established as an independent central medical institution. It provided medical treatment for emperors, empresses, and palace personnel, prepared medicines, and managed other medical affairs. Initially, it had one Director (Grade 5), two Deputy Directors (Grade 6), who jointly oversaw the academy’s operations. Under them were 10 physicians, 30 clerks, 40 medical officers, 20 doctors, and 20 preparation physicians, each responsible for their respective duties. Subsequent dynasties saw changes in official numbers; in the eighth year of Yongzheng (1730), 30 food allowance physicians were added. In the second year of Qianlong (1737), it was officially decreed that the food allowance physicians would be permanently established. From the Director downward, all officials were Han Chinese appointments. In the 58th year of Qianlong (1793), a Manchu official was specially appointed to manage the academy.
Appointment and promotion procedures. The Director was promoted from the left Deputy Director, the left Deputy Director from the right Deputy Director, and the right Deputy Director from a physician. Physicians, clerks, and medical officers were initially selected by provincial authorities based on their expertise in medical theory, then examined and appointed by the academy.
(2) Imperial Pharmacy
The Imperial Pharmacy was responsible for preparing medicinal materials and manufacturing various ready-made medicines for the imperial court. Established in the tenth year of Shunzhi (1653), it was managed by senior eunuchs. In the 30th year of Kangxi (1691), the senior eunuch manager was abolished and replaced by one inner supervisor and two deputy supervisors.
The Imperial Pharmacy was divided into East and West sections. Physicians from the Imperial Medical Academy rotated duty for the emperor. The West section was staffed by the Director, Deputy Directors, physicians, and clerks, known as "palace duty." The East section was staffed by physicians, clerks, and medical officers, known as "six-duty rotation."
The Yuanmingyuan Pharmacy and Xifan Shou Pharmacy also assigned physicians to serve within the inner court, with physicians rotating duty. During imperial tours, academy officials were either specially commissioned or rotated according to schedule to accompany the emperor.
(3) Medicine Warehouse
The medicine warehouse, also called the raw medicine warehouse, was managed by two medical officers selected from among the medical officers, serving two-year terms and promoted to clerk positions afterward. Each province producing medicinal herbs annually sent its harvests to the warehouse, where they were inspected and stored by designated warehouse managers. All herbs were delivered in raw form, inspected by the warehouse’s medical officer, then processed by "Sula doctors" (servants in the Imperial Pharmacy) or "civilian doctors" (recruited from the public) for cutting, processing, and preparation.
The Qing Dynasty implemented a royal exclusive collection and sale system for ginseng produced in Northeast China, making it a crucial economic source and guarantee for the imperial household. Consequently, ginseng use in the Imperial Pharmacy was strictly controlled through a request-and-approval system without fixed quotas. When supplies ran out, the quantity used and the required amount along with the official’s name were reported for further approval.
(4) Social Welfare Organizations
In early Qing times, following the Ming model, there were provisions for free medicine distribution. During the Shunzhi era, a pharmacy was built outside Jingshan Gate in Beijing, where physicians provided free medicine to Manchu and Han military and civilians. During the mid-Kangxi period, this was expanded to include dispensaries in five urban districts, but ceased in the 40th year (1701).
Qing rulers, landlords, and wealthy elites established welfare institutions such as the Benevolent Care Institute, Universal Aid Hall, Nurseries, and porridge kitchens to support the poor, orphaned, and helpless, demonstrating benevolence to the people.
The Benevolent Care Institute existed since the Ming Dynasty. During Emperor Yingzong’s Tianxian era, the Ministry of Household was ordered to establish one Benevolent Care Institute in Daxing and Wannan counties. The Qing Dynasty continued this practice, establishing such institutes nationwide to support widows, orphans, the disabled, and those without support, with government funding for silver and grain rations. Local gentry willing to contribute could do so freely. During the Qianlong era, elderly individuals over sixty or those suffering from severe illness, including convicts sentenced to exile, were admitted to these institutes and given grain allowances based on their names.
There were also Universal Relief Halls in Beijing and provincial areas, which cared for frail, elderly people without family support. In the early Qianlong era, adults received eight he of rice daily, half that for children.
China has long regarded "caring for infants" as a virtue. During the Chunyou era of the Song Dynasty, the Compassionate Infant Bureau was established to care for abandoned newborns. In the Qing Dynasty, Nurseries were founded to care for abandoned or unmanageable infants.
Two, Medical Education
Before the Opium War, medical education in the Qing Dynasty involved training medical officials through instructors, divided into internal and external instructors, each appointing two instructors selected from physicians and clerks for their outstanding character and scholarship. Internal instructors resided in the East Imperial Pharmacy, teaching eunuchs how to study medical texts. External instructors taught students at the Imperial Medical Academy’s training hall and the children of medical officials in medicine. Prospective students typically needed recommendations from officials of sixth rank or higher, or from Manchu commanders, and were vouched for by academy physicians. They had to demonstrate basic medical knowledge and proficiency in Beijing dialect to pass the entrance exam and become "doctors." After enrollment, they were known as trainees.
Medical specializations underwent three reorganizations: during the Shunzhi era, there were 11 divisions—General Internal Medicine, Minor Internal Medicine, Smallpox, Cold Damage, Women’s Medicine, Ulcer Surgery, Acupuncture, Ophthalmology, Dentistry, Throat Diseases, and Orthopedics. In the second year of Jiaqing (1797), the Smallpox division merged into Minor Internal Medicine, reducing it to nine divisions. In the sixth year of Jiaqing (1802), the Imperial Decree assigned Orthopedics to Mongolian physicians under the Upper Horse Stable, leaving eight divisions. In the second year of Daoguang (1822), the Imperial Decree declared acupuncture inappropriate for imperial service, permanently abolishing the acupuncture division, leaving seven divisions. In the fifth year of Tongzhi (1866), it was revised to five divisions: General Internal Medicine (incorporating Cold Damage and Women’s Medicine), Minor Internal Medicine, Surgery (formerly Ulcer Surgery), Ophthalmology, and Dentistry-Throat Diseases.
Teaching content primarily included The Inner Canon, Compendium of Materia Medica, Treatise on Cold Damage, Essential Prescriptions from Golden Cabinet, and specialized medical texts. Later, Medical Canon of the Golden Mirror was added and gradually became the main textbook. Trainees generally studied for three years; upon completion, the Ministry of Rites conducted examinations. Those passing were designated as medical officers; those failing continued studying for another attempt. Trainees who passed three quarterly exams with top rankings could be recommended to the Ministry of Rites for appointment when vacancies arose, bypassing further exams.
The Qing Dynasty established medical education at local levels with examination systems, though on a smaller scale. Prefectures had chief physicians, prefectures had head physicians, and counties had instructors, each with one position, none of which were ranked. In the first year of Yongzheng (1723), it was decreed that provincial governors thoroughly examine local physicians. Those proficient in commentaries on The Inner Canon, Compendium of Materia Medica, and Treatise on Cold Damage could be recommended as medical instructors, one per province, receiving salaries for three years. If they performed diligently and maintained good character, they could be promoted to the Imperial Medical Academy as physicians. Their vacancies were filled by selecting qualified candidates from within the province.
The Qing Dynasty’s medical education, while largely following systems from the Song and Ming Dynasties, declined in vitality compared to earlier periods. Traditional folk family transmission and master-apprentice teaching became the primary methods of medical instruction, producing many renowned medical figures.
Moral education in medicine has always been emphasized by Chinese physicians, especially in the Qing Dynasty. Their writings almost invariably discussed the ethical standards essential for physicians, guiding future generations. These moral principles can generally be summarized as: (1) not seeking fame or profit; (2) urgently addressing patients’ needs; (3) treating rich and poor equally; (4) cherishing human life; (5) being humble and cautious, learning from one another.