Cassia Twig and Cypress Leaf Soup for Hair Loss

Cassia Twig and Cypress Leaf Soup (Guìzhī Bǎiyè Tāng) is a compact formula created by the Qing dynasty physician Huang Yuanyu. It is recorded in his classic work Four Sages’ Source of the Heart (Sì Shèng Xīnyuán) with the following composition:

Polygonum multiflorum (Heshouwu) — 3 qian (approx. 9 g)

Cassia Twig (Guizhi) — 3 qian

Moutan Bark (Danpi) — 3 qian

Raw Rehmannia Root (Shengdi) — 3 qian

Cypress Leaf (Baiye) — 3 qian

Fresh Ginger (Shengjiang) — 3 qian

Ginseng (Renshen) — 3 qian

Donkey-hide Gelatin (Ejiao) — 3 qian

Simmer in water down to roughly half a cup and serve warm.

The text states that this formula treats “beard falling out, hair scorched and withered, dry and lackluster.”

Huang also gives modifications: for hair that is yellowish and prematurely greying, add mulberries and black beans. For patients with yang decline and dampness in the earth (spleen), add dried ginger and Poria (Fuling). When lung qi is insufficient, increase the dose of Astragalus (Huangqi), since the lungs govern the skin and body hair.

Huang Yuanyu believed that the quality of hair is directly tied to the rise and fall of qi and blood. Because hair grows on the head, it is also closely related to the six yang meridians. Even if kidney essence is ample and qi and blood are abundant, if the yang meridians are blocked and qi and blood cannot surge upward to the head, the effort is in vain.

On this theoretical basis, he formulated Cassia Twig and Cypress Leaf Soup.

Setting aside the influence of later-era formulas on this prescription and analyzing it purely through Huang Yuanyu’s own framework, the overall strategy is to release wood stagnation and raise the blood, while astringing the metal (lung) and smoothing the flow of qi — a distinctive and rather elegant approach.

In recent years, I have used this compact formula to treat hair loss in a number of patients with good results. The therapeutic response is relatively rapid; after roughly two weeks, hair shedding is significantly reduced. I have observed over a dozen cases. This formula works best for thin, frail individuals with deficiency patterns. It is not well suited for middle-aged men with oily scalps experiencing hair loss. Some patients with dry, brittle hair and pulses clearly showing deficiency also experienced marked improvement in hair quality after taking this medicine.

Overall, among Huang Yuanyu’s original formulas, this one is relatively straightforward to master and apply clinically. Whenever one encounters hair loss or poor hair quality rooted in deficiency, this formula can generally be employed. However, its capacity for actually regenerating new hair remains to be verified — if there is an urgent need for regrowth, other formulas should be considered.

桂枝柏叶汤是黄元御先生创立的一个小方子，在四圣心源这本书中是这么描述的：

首乌 三钱

桂枝 三钱

丹皮 三钱

生地 三钱

柏叶 三钱

生姜 三钱

人参 三钱

阿胶 三钱

煎大半杯，温服。

治须落发焦，枯燥不荣。

黄涩早白，加桑椹、黑豆。阳衰土湿者，加干姜、茯苓。肺气不充，重用黄芪，肺主皮毛故也。

黄元御认为头发的好坏跟气血的盛衰直接相关，因为头发长在脑袋上，所以又跟六阳经息息相关，纵然肾精充足，气血充沛，如果阳经不通，气血涌动不到头上去，也白搭。

所以，根据这个理论，他创立了桂枝柏叶汤。

我们先不看这个方子受到时方的影响有多大，单纯从黄元御自身的理论去分析，总的来说就是开木郁而升血，敛庚金而畅气，别具一格，挺有意思。

这几年用这个小方治了几个人的脱发，效果不错，疗效比较迅速，吃上两个星期基本上能基本缓解掉头发的问题。我观察了十几个人，这个方子最适合瘦小的虚人服用，油性很大的中年男人脱发并不太适合。还有一些头发干枯的，脉象确实有虚损的病人，吃了这个药之后都能明显改善发质。

总的来说，这个方子是黄元御自创方剂中比较容易掌握使用的，临床中凡是遇到虚症的脱发、头发不好，基本上都可以用此方。不过，这个方子的生发能力仍有待考证，如有迫切生发需要的还应另择良方。