Tokugawa Ieshige was the eldest son of Tokugawa Yoshimune and Osuma no Kata, the daughter of the Daimyo of Odawara, Okubo Tadanao. Unfortunately, his mother passed away when Ieshige was only two years old. Initially raised by his father's concubine, Okon no Kata, he later moved to the care of another concubine, Okume no Kata, after she gave birth to Ieshige's stepbrother, Tokugawa Munetake.

The appointment of Ieshige as heir to the 8th Shogun Yoshimune stirred controversy due to his chronic health issues, including a severe speech defect caused by malformed teeth and other ailments. Some scholars have speculated that he may have also faced cognitive challenges, as he seemed incapable of making decisions, relying heavily on his capable minister, Ooka Tadamitsu, for governance. Despite suggestions of more suitable candidates among his younger, healthier brothers, Yoshimune adhered to Confucian principles and insisted on Ieshige inheriting the position, which occurred in 1745. Even after his retirement, Yoshimune continued to exert influence in his son's name until his own passing in 1751.

In 1760, Ieshige relinquished the title of Shogun in favor of his son, Ieharu, a year before his death at the age of 49, likely due to a urinary tract infection. Throughout his 15-year rule as Shogun, his failure to tackle corruption within the Tokugawa administration, coupled with famine and natural calamities, eroded the strength of the Bakufu.

In 1958, Ieshige's tomb at Zojo-Ji temple in Tokyo was unearthed as part of the relocation of numerous Tokugawa family graves to make room for the construction of Tokyo Tower. Forensic analysis confirmed historical accounts of his deformed teeth, suggesting he may have suffered from a form of cerebral palsy. He was estimated to be 156.3cm tall and had type A blood. 


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