丹溪治一女子。十七八岁。发尽脱。饮食起居如常。脉微弦而涩。轻重皆同。此浓味成
熟。湿痰在膈间。复因多食酸梅。以致湿热之痰。随上升之气至于头。熏蒸发根之血。渐成
枯槁。遂一时脱落。治须补血升散。乃用防风通圣散去硝。惟大黄酒炒三次。兼以四物。合
作小剂与之。月余。诊其脉。知湿热渐解。乃停药。淡味二年。发长如初。
立斋治一儒者。因饮食劳役及恼怒。发脱落。薛以为劳伤精血。阴火上炎所致。用补中
益气加麦冬、五味。及六味地黄丸加五味。眉发顿生如故。
震按发乃血之余。枯焦者血不足也。若忽然脱落。或头皮痒须眉亦落。乃血热生风。风
摇木
落之象。酒客膏粱多此。脉数者。用通圣散宣泄风热。次用六味地黄丸。如下条治法。又有
劳伤精血。及恼怒阴火上炎而致者。宜用此条治法。
又治一男子年二十。巅毛脱尽。亦先以通圣散宣其风热。次用六味地黄丸。不数日。发
生寸许。两月复旧。
江应宿见一男子。眉毛脱落。遇方士教服鹿角胶。每日清晨酒化一二钱。半年眉发长。
年余复旧。
震按发落补肾。宜兼补心。若眉落。宜兼补肝。以眉禀木气而侧生也。但肝为风脏。眉
落多是患风之征。防成疠风。至于须落。必系肾虚。以须禀水气而下生也。魏书李元护为齐
州刺史。姬外家十余。声色自纵。情欲既甚。肢骨消削。须长二尺。一时落尽。又北史载王颁
痛父僧辨为陈武帝所杀。至隋灭陈后。召父时壮士。潜发其陵。剖棺。见陈武帝须皆不落。
其本皆出自骨中。此虽赋形不同。亦可见肾气之独浓。故勇略殊常也。
朱丹溪治疗一名女子,十七八岁,头发全部脱落,饮食起居如常,脉象微弦而涩,轻取重取皆同。这是因过食肥甘厚味导致湿热内生,湿痰停留在膈间,又因多吃酸梅,致使湿热之痰随上升之气到达头部,熏蒸发根之血,逐渐干枯,于是突然脱落。治疗需要补血并升散郁火,于是用防风通圣散去掉芒硝,仅将大黄用酒炒三次,配合四物汤,合为小剂量给予患者。一个月后,诊察其脉象,知道湿热已逐渐解除,便停药。此后两年清淡饮食,头发长得和原来一样。
薛立斋治疗一名儒生,因饮食不节、过度劳累及恼怒,导致头发脱落。薛立斋认为是劳损伤精血,阴火上炎所致。使用补中益气汤加麦冬、五味子,以及六味地黄丸加五味子。眉毛和头发顿时像以前一样长出来。
俞震按语:头发是血的余气所化,干枯焦黄是因为血不足。如果忽然脱落,或者头皮痒且眉毛也脱落,这是血热生风,风摇动树木导致落叶的现象。嗜酒者和食用膏粱厚味的人多患此病。脉数者,用防风通圣散宣泄风热,随后用六味地黄丸,如下条所述的治疗方法。又有因劳伤精血,以及恼怒导致阴火上炎而致脱发者,适宜采用本条的治疗方法。
又治疗一名二十岁的男子,头顶毛发全部脱落,也是先用防风通圣散宣散风热,随后用六味地黄丸。没过几天,头发长出寸许,两个月后恢复如初。
江应宿见到一名男子,眉毛脱落,遇到方士教导服用鹿角胶,每天清晨用酒化开一二钱服用,半年后眉毛和头发长出来,一年多后完全恢复。
俞震按语:头发脱落宜补肾,应当兼补心;如果眉毛脱落,宜兼补肝,因为眉毛禀受木气而生于侧面。但肝为风脏,眉毛脱落多是患风病的征兆,要防止发展成疠风(麻风病)。至于胡须脱落,必定是肾虚,因为胡须禀受水气而生于下部。《魏书》记载李元护担任齐州刺史时,姬妾外家十余户,纵情声色,情欲过度,导致肢体骨骼消瘦,胡须长达二尺,一时全部脱落。又《北史》记载王颁痛恨父亲王僧辨被陈武帝杀害,到隋朝灭陈后,召集父亲时的壮士,暗中挖掘陵墓,剖开棺材,看到陈武帝的胡须都没有脱落,胡须根部都出自骨中。这虽然形体禀赋不同,但也可见肾气特别浓厚,所以勇略超出常人。
Zhu Danxi treated a young woman, aged seventeen or eighteen, whose hair had completely fallen out. Her diet and daily activities remained normal. Her pulse was slightly wiry and choppy, consistent in both light and heavy pressure. This condition resulted from excessive consumption of rich and greasy foods, leading to the accumulation of damp-heat and phlegm-dampness in the diaphragm. Additionally, her frequent intake of sour plums caused damp-heat phlegm to ascend with the rising Qi to the head, steaming the blood at the hair roots. This gradually led to dryness and withering, resulting in sudden hair loss. The treatment required nourishing blood and dispersing stagnation. Zhu prescribed Fangfeng Tongsheng San (Windproof Unblocking Supreme Powder) without Mangxiao (Natrii Sulfas), using only Dahuang (Rhei Radix et Rhizoma) stir-fried three times with wine, combined with Siwu Tang (Four Substances Decoction). These were prepared as a small dose and administered to the patient. After more than a month, upon re-examining the pulse, Zhu determined that the damp-heat had gradually resolved, so he discontinued the medication. The patient maintained a bland diet for two years, after which her hair grew back to its original state.
Xue Lizai treated a scholar who suffered from hair loss due to improper diet, overwork, and anger. Xue attributed this to injury of essence and blood from labor, causing ministerial fire to flare upward. He prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus), along with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) also supplemented with Wuweizi. Consequently, his eyebrows and hair regrew as before.
Yu Zhen commented: Hair is considered the surplus of blood; dryness and britleness indicate blood deficiency. Sudden hair loss, especially accompanied by scalp itching and eyebrow loss, signifies wind generated by blood heat, analogous to wind shaking trees and causing leaves to fall. This pattern is common among those who consume alcohol and rich, fatty foods. For patients with a rapid pulse, Fangfeng Tongsheng San should be used to vent wind-heat, followed by Liuwei Dihuang Wan, as described in the following case. Cases caused by labor injuring essence and blood, or anger causing ministerial fire to flare upward, should be treated according to the method in this section.
He also treated a twenty-year-old man whose crown hair had completely fallen out. He first used Fangfeng Tongsheng San to disperse wind-heat, followed by Liuwei Dihuang Wan. Within a few days, hair grew about one cun long, and within two months, it returned to normal.
Jiang Yingsu observed a man with eyebrow loss. A Daoist practitioner advised him to take Lujiao Jiao (Deer Antler Glue), dissolved in wine, taken early each morning in doses of one or two qian. After half a year, his eyebrows and hair grew back, and after more than a year, they fully recovered.
Yu Zhen commented: For hair loss, tonifying the Kidney is appropriate, but it should be combined with tonifying the Heart. For eyebrow loss, it is appropriate to combine tonification of the Liver, as eyebrows are associated with Wood energy and grow on the sides. However, the Liver is the organ of Wind; eyebrow loss is often a sign of wind pathology, warranting prevention of leprosy (Li Feng). Regarding beard loss, it must be related to Kidney deficiency, as beards are associated with Water energy and grow below. The Book of Wei records that Li Yuanhu, serving as Prefect of Qizhou, indulged in sexual pleasures with numerous concubines. His excessive desire led to emaciation of limbs and bones, while his beard grew to two chi long before suddenly falling out entirely. The History of the Northern Dynasties records Wang Ban, who sought revenge for his father Wang Sengbian’s death at the hands of Emperor Wu of Chen. After Sui conquered Chen, Wang Ban summoned veterans from his father’s time to secretly excavate the imperial tomb. Upon opening the coffin, they found that Emperor Wu’s beard had not fallen out, with the roots emerging from the bone. Although physical constitutions differ, this demonstrates that robust Kidney Qi can lead to extraordinary courage and strategic prowess.