颅门肿起，谓之颅填。因乳哺失常，或寒热乘脾，其气上冲，则颅高而突。又有肝盛风热交攻，亦致颅填突起，
汗出，毛发黄而短是也。若寒气上冲则牢硬，热气上冲则柔软。然寒肿者十之一，热肿者十之九。古法用泻青丸
（如羌活、川芎、黑栀仁、龙胆草、当归、防风、锦庄黄，研末蜜丸，青黛为衣，如大豆大），每服一二丸，清
茶化下。寒肿，古法用参苏丸，或煎汤剂（如人参、茯苓、枳壳、半夏、前胡、桔梗、苏叶、葛根、陈皮、甘草，
引用生姜、葱白等味）。
〔真按〕颅门肿起，除寒气热气外，更有因包裹严密、盖覆过浓，阳气不得外出，亦现赤肿之形。只要衣被
寒暖，适合中度，即可痊愈。若寒肿者，但用吴茱萸末和水，调贴两足心。热肿者，但用黄柏末调涂两足心。即愈。
囟陷者，因脏腑有热，渴饮水浆，致成泄泻，则气血虚弱，不能上交脑髓，故囟陷成坑也。古法用参苓白术
散（如人参、白术、茯苓，山药、桔梗、薏苡、莲肉、炙甘草，引用姜、枣），或八味地黄丸（如六味地黄丸加
附子、肉桂），外用黄狗头骨炙黄为末，以鸡子清调敷，渐渐自平。
〔真按〕囟陷乃胃虚脾弱之见证。若与枕骨同陷，则尤甚于囟陷。有因禀受父精不足，母血虚羸而陷者；有
因久病而陷者，肾元不固，急宜培补气血。必使气血充足，方能上交脑髓，而陷自平。但用补气生血之法，以参
与远志二味，药虽简单，久服有益。参品不一。须视小儿之寒体热体为取裁耳。外敷之药，与解颅相同。
Fontanelle swelling, known as "cranial filling" (Lutan, 颅填). This is caused by irregular feeding or cold-heat pathogens invading the spleen and stomach, leading to upward rushing of Qi, resulting in a protruding fontanelle. It may also be caused by liver wind-heat attacking together, which similarly leads to fontanelle protrusion, accompanied by sweating and yellow, short hair. If cold Qi rushes upward, the fontanelle feels hard; if heat Qi rushes upward, it feels soft. However, cold-type swelling accounts for one-tenth, while heat-type swelling accounts for nine-tenths. Ancient methods used Xieqing Wan (Draining Green Pill) [containing Qianghuo (Notopterygii Rhizoma et Radix), Chuanxiong (Chuanxiong Rhizoma), Hei Zhiren (Gardeniae Fructus), Longdancao (Gentianae Radix), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Jin Zhuanghuang (Rhei Radix et Rhizoma), ground into powder and made into pills with honey, coated with Qingdai (Indigo Naturalis), size like soybeans], taking one or two pills per dose, dissolved and taken with clear tea. For cold-type swelling, ancient methods used Shen Su Wan (Ginseng and Perilla Pill) or decoctions [containing Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Zhiqiao (Aurantii Fructus), Banxia (Pinelliae Rhizoma), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Suye (Perillae Folium), Gegen (Puerariae Lobatae Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), with Shengjiang (Zingiberis Rhizoma Recens) and Congbai (Allii Fistulosi Bulbus) as guides].
[Chen Shouzhen's Note:] Fontanelle swelling, besides being caused by cold and heat, can also result from tight wrapping or thick covering, preventing Yang Qi from dispersing outward, thus presenting as red and swollen. As long as the temperature of clothing and bedding is moderate and suitable, recovery will occur. For cold-type swelling, simply mix Wuzhuyu (Evodiae Fructus) powder with water and apply to both soles. For heat-type swelling, simply apply Huangbai (Phellodendri Cortex) powder mixed with water to both soles. This will lead to cure.
Fontanelle depression occurs because internal organs have heat, causing excessive thirst and drinking, leading to diarrhea. This results in deficiency of Qi and Blood, which cannot ascend to nourish the brain marrow, causing the fontanelle to sink into a pit. Ancient methods used Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) [containing Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), Jiegeng (Platycodonis Radix), Yiyi (Coicis Semen), Lianrou (Nelumbinis Semen), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), with Shengjiang (Zingiberis Rhizoma Recens) and Zao (Jujubae Fructus) as guides], or Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) [which is Liudihuang Wan (Six-Ingredient Rehmannia Pill) plus Fuzi (Aconiti Lateralis Radix Praeparata) and Rougui (Cinnamomi Cortex)], externally applying roasted yellow dog skull bone powder mixed with egg white to the affected area, which will gradually flatten.
[Chen Shouzhen's Note:] Fontanelle depression is a manifestation of stomach deficiency and spleen weakness. If it sinks together with the occipital bone, it is more severe than simple fontanelle depression. Some cases arise from insufficient paternal essence or maternal blood deficiency and emaciation; others result from prolonged illness causing kidney Yuan instability, requiring urgent tonification of Qi and Blood. Only when Qi and Blood are sufficient can they ascend to nourish the brain marrow, and the depression will naturally flatten. Simply use methods to tonify Qi and generate Blood, using Renshen (Ginseng Radix et Rhizoma) and Yuanzhi (Polygalae Radix). Although the prescription is simple, long-term use is beneficial. There are various types of Renshen (Ginseng Radix et Rhizoma); selection must be based on whether the child has a cold or hot constitution. External applications are the same as those for Jielu (Delayed Closure of Fontanelle).