On 8 April 1881, while attending an imperial court session, Empress Dowager Ci'an became ill and was escorted to her private quarters, where she died within a few hours. Her sudden death was a shock to many people. Although she was in good health, Ci'an had fallen seriously ill at least three times according to Weng Tonghe, who tutored the Guangxu Emperor. She had a history of what appeared to be strokes. In his diary, Weng Tonghe recorded the first stroke in March 1863, when Ci'an suddenly fainted and lost her ability to speak for nearly a month. Her reputation for 'speaking slowly and with difficulty' during audiences may have been a consequence of her stroke. A second stroke was recorded in January 1870. The official cause of her death between 2100 and 2300 hours was a sudden stroke. Physicians who studied her medical records are almost certain that she died of a massive brain haemorrhage.