Hair Falling Out in Clumps, Even Eyebrows Gone? Ming Dynasty Imperial Physician Doctor Xue Lizhai’s Hair Loss Cases (Bu Zhong Yi Qi Tang + Liuwei Dihuang Wan — Hair Restored in No Time)
Patient search words: hair falling out / hair falling out in clumps / eyebrows falling out / thinning hair / completely bald on top / bald patches / going bald young
Corresponding medical terms: hair loss · alopecia areata · early baldness · yin deficiency with dry blood · overwork injuring the essence-blood · liver-kidney yin deficiency
Opening scene: when this illness strikes, the eyebrows and hair all disappear
The illness we are looking at today is an unusual one — loss of body hair (mao fa tuo luo). Not the few strands you lose in the shower — this is the real thing: “all gone.” The eyebrows go. The hair goes. In severe cases even the armpit hair, the body hair, and the eyelashes fall out completely, leaving the person smooth and hairless all over, looking strange and unsettling.
💬 Note from Doctor Luo: Ordinary people rarely see a case like this, but we doctors do. Some people lose hair by the handful — wash your hair and a whole layer floats on the surface of the basin — that is still the mild kind. The severe kind is when suddenly both eyebrows and hair fall out completely, and even the eyelashes do not survive. Whoever meets such a patient finds it a headache — it is extraordinarily hard to treat.
In the book of Doctor Xue Lizhai (Xue Ji), director of the Imperial Academy of Medicine in the Ming dynasty, there are records of two such patients, treated in two quite different ways. Today we finish both in one sitting.
Who was the patient? A scholar — bad diet, overwork and anger, all three at once
The first patient was a ru zhe — a scholar. The moment you hear “scholar” you know the story: day after day memorizing the classics and writing essays, exhausting the mind and spirit, thinking and worrying without end.
Doctor Xue Lizhai recorded the cause of his illness in just eight characters: “yin shi lao yi ji nao nu” — because of diet, fatigue, and anger.
💬 Note from Doctor Luo: Let’s unpack it. Diet — skipping meals, eating poorly, wounding the spleen and stomach. Fatigue (lao juan) — busy every day, thoroughly worn out, draining the yuan qi (original qi), the upright qi. Anger (nao nu) — the work does not go smoothly, liver qi becomes constrained, wounding the liver. You see, all three at once: the spleen and stomach are injured, the qi is depleted, and liver fire flares up. Liver fire on the one hand consumes the yin blood, and on the other hand wood overacts on earth (mu ke tu) — it comes around and wounds the spleen and stomach again. This is the classic “overwork injury” (lao shang) patient.
And what was the result? The illness was strange indeed — mei fa tuo luo: both the eyebrows and the hair fell out completely.
Doctor Xue Lizhai’s diagnosis: overwork injuring the essence-blood, deficient fire flaring upward — a tree with no water under it
When Doctor Xue Lizhai examined him, his verdict came down to four characters: lao shang jing xue — overwork has injured the essence-blood.
He had worn himself out. The yuan qi was depleted, and next to be consumed was the essence-blood (jing xue) — and essence-blood belongs to yin; it is the most fundamental nourishment in the body. When overwork injures the essence-blood, yin huo shang yan follows: deficient fire and deficient heat attack upward. And since the yin blood is now insufficient, the hair and eyebrows receive no nourishment — so of course they fall out.
💬 Note from Doctor Luo: Think of it with an analogy and it becomes obvious. Imagine a tree: if you never water the ground beneath it, the soil dries out completely, the tree withers, and at the first gust of wind it topples over. Human hair is that tree — the essence-blood is the water that waters the tree. When the water is gone, the hair falls. That is why Chinese medicine says “fa wei xue zhi yu” — hair is the surplus energy of the blood. When the blood is insufficient, the hair is the first to suffer.
The prescription: Bu Zhong Yi Qi Tang with mai dong and wu wei zi, matched with Liuwei Dihuang Wan — one lifts the qi, the other nourishes yin
How was it treated? Doctor Xue Lizhai gave two formulas, taken alternately, morning and evening:
Formula one: Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction), with mai dong (ophiopogon) and wu wei zi (schisandra) added. Bu Zhong Yi Qi Tang lifts the upright qi — his diet had injured the spleen, his thinking had injured the spleen, and his anger had injured the liver, which then overacted on the spleen; the qi of the spleen and stomach had to be propped up. Mai dong and wu wei zi were added because he was yin deficient — his lung yin needed replenishing.
Formula two: Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), with wu wei zi added. Liuwei Dihuang Wan tonifies the liver and kidney and nourishes yin; among its ingredients shu di huang (prepared rehmannia) supplements the essence, and the whole direction is to nourish yin and build up the essence-blood.
💬 Note from Doctor Luo: The beauty of these two formulas working together is this: Bu Zhong Yi Qi Tang lifts the qi upward — like water vapor rising from the earth to form clouds; Liuwei Dihuang Wan supplements the yin below — like the clouds turning to rain, watering the lung yin and kidney yin thoroughly. One rises, one descends; the qi mechanism circulates; and the hair and eyebrows receive nourishment once again. Remember this pattern — two formulas taken at different times of day, in parallel — it is a signature move of Doctor Xue Lizhai’s, and I have spoken of it many times.
The masterstroke: a single herb, wu wei zi — gathering the lung metal to generate kidney water
The most instructive detail here is the use of wu wei zi (schisandra berry).
💬 Note from Doctor Luo: Schisandra is intensely sour. When you use it, you should crush it so the seeds inside split open and the sourness comes out. It is sour and astringent (suan shou), and it can supplement the essence of all five organs — above all the lungs and kidneys: nourishing kidney yin, nourishing kidney water, and moistening lung yin extremely well. The ancients used it in small amounts — the idea is to use it to gather the lung qi, and then, along the path of “tonifying the lung metal to generate kidney water,” build up the water. So adding a little wu wei zi to formulas that nourish yin, tonify the kidney and moisten the lung — the effect on both the lungs and the kidney water is outstanding. That is Doctor Xue Lizhai’s refined touch.
The result: eyebrows and hair grew back as before — why is this better than the usual approach?
What happened? Mei fa dun sheng ru gu — the eyebrows and hair grew back all at once, exactly as they had been before.
The commentary after Doctor Xue Lizhai’s case record puts it very well: ordinary doctors treating hair loss all use herbs to scatter wind and clear fire, or to nourish blood and moisten dryness — but Doctor Xue Lizhai used Bu Zhong Yi Qi Tang and Liuwei Dihuang Wan alternately, which is far more ingenious.
💬 Note from Doctor Luo: Why is it more ingenious? Because this “scholar-type” patient was genuinely injured — the qi was injured, the yuan qi was injured. Simply nourishing yin is not enough. Bu Zhong Yi Qi Tang has an extra benefit: it tonifies the lungs — when lung qi is full, kidney water is even fuller — that is a complete cycle of ascending and descending qi. Look at this prescription: a few strokes on paper, extremely economical — the two formulas together only added two herbs (mai dong and wu wei zi), and yet the effect was immediate. This kind of illness is in fact very hard to treat, because the depletion runs so deep and the essence-blood loss is so severe. That he could cure it this fast shows real skill.
The second patient: a twenty-year-old young man whose hair on the crown fell out completely
The second case is a younger patient — “yi nan zi nian er shi sui, dian fa tuo jin”: a man of twenty whose hair on the crown of his head fell out completely. Going bald at twenty — far too young.
Doctor Xue Lizhai gave him Liuwei Wan — the Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). “Bu shu ri, fa sheng” — within a few days, hair grew back about one cun (roughly 3 cm); “liang yue fu jiu” — within two months the hair had grown long again, long enough to tie up in a topknot.
💬 Note from Doctor Luo: This one I have personal experience with. Once when I was traveling to lecture, a young man from the event staff stopped me: “Doctor Luo, what do I do about my hair loss?” He was young, and his hair was already so thin you could see the scalp. I took one look at his tongue — yin deficiency — and said: “Take Liuwei Dihuang Wan.” Later he left me a message: “Doctor Luo, I used your magic formula, and my hair has grown back!” What magic formula? Liuwei Dihuang Wan, which you can buy at any pharmacy. This is the classic pattern: yin deficiency with dry blood, essence-blood insufficiency.
Why can Liuwei Dihuang Wan grow hair? The six ingredients each have their job
Doctor Luo Dalun unpacked Liuwei Dihuang Wan ingredient by ingredient — six herbs, each with its own task:
- Shu di huang (prepared rehmannia) — tonifies kidney essence, supplying the body’s most fundamental “water”;
- Shan zhu yu (cornus fruit) — tonifies the essence of liver and kidney;
- Shan yao (Chinese yam / huai shan yao) — tonifies the lung, spleen and kidney, supplementing yin and essence at the same time;
- Fu ling (poria) and ze xie (alisma) — drain dampness, clearing out the excess water-damp in the body;
- Mu dan pi (moutan bark) — drains liver fire.
💬 Note from Doctor Luo: See how thoroughly the ancients thought it through: on one side tonify kidney essence and nourish yin blood; on the other side clear deficient heat and drain dampness — one single Liuwei Dihuang Wan covers it all. So if your tongue is red, the coating is thin or absent, the pulse beats fast, and you have a few symptoms of deficient heat — use this approach and the hair will slowly grow back, just as grass and trees grow naturally once the earth has water. The earlier you treat it, the better — simple hair loss is far easier to fix than losing the eyebrows along with it. One more fascinating point: in the severe cases where the body hair falls out completely, treatment is slow — you must nourish bit by bit — and the left and right sides grow back unevenly, one side first, the other later. That shows the movement of qi and blood in the body really does follow rules — exactly as the ancients described.
Doctor Luo Dalun teaches you to tell your type apart: which kind of hair loss do you have?
Hair loss has many causes. Doctor Luo Dalun sorts them into categories:
First, hereditary. If the father went bald, the son is prone to baldness too.
Second, “ghost shaving” (gui ti tou) — alopecia areata. Overnight, patches of hair simply disappear. This is most closely tied to emotion — it typically appears after major stress or a major emotional blow. At such times you should soothe the liver and regulate qi (shu gan li qi), then nourish yin and blood (because liver fire damages the yin blood).
Third, hair that falls slowly at first and then faster and faster. Look at the tongue — red tongue, thin or absent coating, fast pulse — and match it with the yin-deficiency signals: dry mouth, dry eyes, sore and weak lower back and knees, hot palms and soles. That is the classic yin deficiency with dry blood, essence-blood insufficiency, and the Liuwei Dihuang Wan route applies.
💬 Note from Doctor Luo: And one major taboo that must be said plainly: people with yang deficiency must never take Liuwei Dihuang Wan! If you are always cold, cold food sends you running to the toilet, your hands and feet are ice-cold, your complexion is sallow, and you get up several times at night to urinate — that is yang deficiency, and taking Liuwei Dihuang Wan would be taking it backwards — the more you take, the worse it gets. Yin deficiency calls for nourishing yin; yang deficiency calls for warming yang. When the direction is wrong, the medicine becomes poison.
Don’t forget the emotions: such patients usually carry something in their hearts
Finally, Doctor Xue Lizhai’s case records hide a deeper meaning — don’t just treat the hair; treat the heart.
💬 Note from Doctor Luo: Patients with this kind of hair loss very often carry a deep emotional root cause that is not visible on the surface. Whenever I meet such a case, I always ask more questions: has something happened in the family? Ask, and you will find something. Regulate the emotions, open up the constraint, smooth out the constrained liver qi — and only then supplement the essence-blood and upright qi. The effect will be far better. There is a lot of hair loss among modern people, and frankly it comes down to two big causes: one is overwork — the essence-blood is drained; the other is emotion — liver qi constrained, liver fire scorching the yin fluids. Graying and falling hair are rooted in exactly these two. Take care of both, and the hair will return on its own.
Doctor Luo Dalun’s closing note: before rushing to hair-growth remedies, first check whether you are yin deficient
When this case is done, the core message is one sentence: hair is the body’s “weathervane” — fa wei xue zhi yu; when the essence-blood runs short, the hair is the first to suffer.
Doctor Xue Lizhai did not treat hair loss with some exotic secret formula. He used Bu Zhong Yi Qi Tang with mai dong and wu wei zi, and Liuwei Dihuang Wan with wu wei zi — one lifts the qi, the other nourishes yin — and in that way poured the qi and blood back up onto the top of the head. If you have been running from doctor to doctor without curing your hair loss, first check yourself: is your tongue red? Is the coating thin? Does your pulse beat fast? Are your mouth and eyes dry? Are your lower back and knees sore? If you are yin deficient, the Liuwei Dihuang Wan approach is worth trying — but remember, if you are yang deficient, don’t take it backwards.
Compiled from Doctor Luo Dalun’s explanation of Doctor Xue Lizhai’s case records. Source: Xue Shi Yi An (Xue’s Case Records, Ming dynasty, by Xue Ji — Neike Zhaiyao, Essentials of Internal Medicine).