Chapter 355: The Female Physician

"Your symptoms have improved greatly since your last visit. I have made some slight adjustments to the previous prescription. After you return home, simply decoct this dose of herbal medicine in water, take it twice daily for three consecutive days, and this ailment should be resolved. During this period, avoid meat, fish, and spicy foods. If any discomfort persists afterward, feel free to come back and see me."

In the consultation room of the newly established Jing'an Hall in the capital, Fang Li-shi gave these gentle instructions.

"I thank you, elder sister, for your treatment. I have suffered from this condition for several years now. Whenever it flares up, I can only endure the pain for days on end. Sometimes it is truly unbearable, but due to the differences between men and women, I have no choice but to bear it forcefully. Ever since you took my pulse and prescribed medicine earlier this month, my old ailment has flared up again after taking the medicine, but the pain has been much lighter. Your medicine has truly been of great help!"

The speaker was a woman past thirty, dressed in a variegated patterned jacket and skirt. Her husband was a clerk in the Revenue Section of Shuntian Prefecture, and she had come for a follow-up visit to Jing'an Hall, which had been open for several months.

The physician treating her, Fang Li-shi, was an old woman past fifty. Her features were not particularly distinguished, but the scholarly air about her, along with her kind and composed demeanor, was something ordinary women could rarely possess.

Fang Li-shi came from a distinguished family of traditional Chinese medicine in the capital. Having been immersed in it since childhood, she had learned a fine medical craft by following her family elders.

After growing up and marrying into the Fang family, thanks to her reputation of coming from a medical lineage, she would sometimes be invited to the homes of wealthy and influential families to treat gynecological ailments of their wives and daughters. Over time, she had earned no small reputation within the capital.

"Chun'e, have you noted down everything I just said?"

"Yes, mistress, I have recorded it all. Please review it!"

After the woman had expressed her profuse thanks and gone to the front hall to pay the consultation and medicine fees before leaving, a maidservant in her teens, who had been sitting behind a desk at the side of the consultation room, set down her wolf-hair brush on the brush rest, picked up a sheet of gold-flecked white paper from the desk, and came before Fang Li-shi, placing it with both hands on the consultation table. Fang Li-shi picked it up and examined it carefully.

Chun'e was a maidservant of the Fang household, having served at Fang Li-shi's side since she was eight or nine years old.

Because she was clever and sensible, Fang Li-shi treated her like her own granddaughter, teaching her to read and study medical texts. Over four or five years, Chun'e had gained considerable knowledge of medicine.

Keeping files for patients was also a regulation established by the Bureau of Health.

For every patient who came for treatment — their name, place of origin, the nature of their illness, and how the medical officer diagnosed and prescribed — all of this had to be recorded and archived, to facilitate the handling of the patient's subsequent condition.

This was naturally a suggestion put forward by Zhu Youjian. Wu Youxing, the Director of the Bureau of Health, greatly admired the Emperor's idea and took the lead in implementing it within the Imperial Academy of Medicine.

Jing'an Hall, located in the southern part of the capital, was built at Zhu Youjian's behest. It belonged to the Bureau of Health, and its target clientele was all women within the capital.

Zhu Youjian's idea had been inspired by the Nei'an Hall within the palace.

Previously, when Empress Zhou and the others contracted gynecological ailments, because of the differences between men and women, they would not summon physicians from the Imperial Academy of Medicine. Instead, they would invite women from renowned traditional Chinese medicine families in the capital to come and treat them. Fang Li-shi of Jing'an Hall had entered the palace more than once to treat and prescribe for the noble ladies, and both her medical skill and personal character were highly praised.

After having the Embroidered Uniform Guard conduct an investigation, Zhu Youjian learned that there were quite a number of female physicians similar to Fang Li-shi within the capital. However, constrained by considerations of reputation and status, they all remained at home tending to their husbands and raising their children. Only the great households who knew of them would send people specifically to hire them to come and treat the women of their own families.

In ancient times, the difficulty of women obtaining medical treatment when ill had always been an unsolvable problem.

The wealthy and powerful families still had more channels and connections to resolve such problems, but for women of modest households, because they concealed their illnesses and avoided doctors, it was not uncommon for them to die in depression amid suffering and torment.

As for ordinary farming households, there was no need to even mention it — even their male laborers would die from illness for lack of money to treat it, so if a woman contracted a gynecological ailment, that was even more hopeless.

Regarding the problem of gender differences in medical treatment, Zhu Youjian could understand it quite easily.

Not to mention this era — even in the much more open-minded later generations, many women suffering from embarrassing ailments would turn around and leave upon seeing that the doctor at the hospital was male. Regardless of the size of the hospital, how many male doctors are there in gynecology and obstetrics?

But what was even more severe now was that women were not only ashamed to be examined by male physicians for gynecological conditions — even when suffering from ordinary illnesses, they likewise would not seek treatment from men.

Moved by this, in order to enable the vast number of women to receive treatment and assistance when ill, Zhu Youjian resolved to establish Jing'an Hall in the capital, to solve this stubborn problem of women's difficulty in accessing medical care.

But how to get these female physicians to be willing to show their faces in public and sit in consultation before the eyes of all became the problem.

From the perspective of the physicians themselves — especially given that the patients they faced were all women — female physicians like Fang Li-shi had no objection to sitting in consultation or making house calls. But the greatest resistance came from their families.

In a social system that emphasized the strict separation between men and women, the social status of women was extremely low.

Apart from women of small households or farming families who had to come out to engage in productive labor to make a living, women of families with any property or standing rarely had opportunities to communicate with the outside world, let alone engage in some profession outside the home year after year.

Although Zhu Youjian could forcibly issue an edict of conscription, or have the court use statutes to require female physicians to come out and practice, the result of doing so would likely be the rupture of these female physicians' family relationships, affecting their family happiness and harmony — a result Zhu Youjian did not wish to see.

Zhu Youjian was a perfectionist who always hoped to achieve a situation where everyone was satisfied.

What he always hoped was that, no matter what was done, so long as it did not violate human ethics and morality or contravene the laws of the court, following the other party's subjective wishes should be of paramount importance.

Coercion or compulsion did not seem to be the best methods, while conditional exchange should be the most practical and feasible strategy, and also the choice most in keeping with human nature.

After thinking it over again and again, Zhu Youjian decided to adopt his old method: tempt them with profit.

If they still did not accept, then awe them with authority.

Of course, the carrot he was offering this time was itself no small matter. It had stirred up no little controversy several months earlier, but he had forcibly suppressed it all.

Zhu Youjian's method was this: to conscript female physicians in the name of the Bureau of Health, granting them treatment and rank comparable to that of titled noblewomen.

In other words, it meant recruiting women to be officials — except that, to avoid provoking even greater opposition, the official posts were bestowed in the name of honorary titles upon the conscripted women's households, rather than being treated according to the ranks of court officials.

Although this move was not unprecedented in history, for the vast majority of court officials, it was still very difficult to accept.

Zhu Youjian specifically explained the great significance of this matter to both Empress Dowager Yi'an and Empress Zhou. The two women, being deeply reasonable, immediately expressed their firm support.

In order to silence the clamoring voices of the senior ministers, Empress Dowager Yi'an and Empress Zhou, at Zhu Youjian's direction, specially summoned the wives of all officials of the third rank and above into the palace under the pretext of escaping the summer heat and sightseeing. While feasting and strolling in the rear palace gardens, they explained the matter to them.

Women understand women after all. After Empress Dowager Yi'an and Empress Zhou had laid the matter out clearly, they immediately won unanimous approval from all the ladies.

Many of them, before their husbands had risen to prominence, had themselves suffered greatly from concealing illnesses and avoiding doctors due to their constrained circumstances. Thus they had a more direct understanding and appreciation of the matter. Added to the imperial authority standing right there, the vast majority expressed that upon returning home, they would do their utmost to persuade their own lords to support this cause.

The power of pillow talk was indeed not to be underestimated.

On the third day after the ladies returned home, the court's decree conscripting female medical officers was issued. Although it still stirred up considerable discussion, the court was strangely silent.

The senior ministers raised no objections whatsoever to the matter, which left the mid- and low-ranking officials puzzled and bewildered.

Zhu Youjian privately could not help but preen over his clever stratagem for quite a while, which set Empress Zhou and Noble Consort Tian giggling without end.

But merely getting female physicians to come out and practice was not Zhu Youjian's fundamental purpose. He also wanted to take this opportunity to do more things beneficial to women's physical and mental health.