Library

Fontanelle depression may be caused by heat in the zang-fu organs, excessive drinking of water leading to diarrhea and dysentery. Over time, Qi and Blood become weak and fail to ascend to nourish the Marrow Sea and brain, causing the fontanelle to sink like a pit. This indicates extreme deficiency of Stomach Qi and Spleen Qi; it is urgent to support the Primordial Qi. If both the fontanelle and the occipital bone are depressed, one out of a hundred cases is difficult to save. There are also cases due to damage to the father's essence or deficiency and decline of the mother's blood, resulting in insufficient congenital endowment. The child appears withered and emaciated, with both Yin and Yang deficient, experiencing no periodic fever but having a depressed fontanelle. In other cases, accumulated heat remains unresolved, gradually leading to emaciation, hair loss, flexed legs and fists, scorched skin, "crane knee" deformity (swollen knees resembling a crane's knee), exhaustion of Blood, and decline of Sinews, resulting in a depressed fontanelle. Treatment should follow each specific syndrome. Depression of the occipital bone is more serious than that of the fontanelle and is not limited to children. The area two cun in diameter behind the ear belongs to the Kidney; depression here indicates failure of Kidney Primordial Qi.

For congenital insufficiency, open fontanelles, emaciated muscles, and delayed dentition, speech, and walking:
Shan Yao (Dioscoreae Rhizoma) (1 qian), Ren Shen (Ginseng Radix et Rhizoma), Bai Fu Ling (Poria), Fu Shen (Poria cum Pinellia), Bai Zhu (Atractylodis Rhizoma), Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix, honey-fried), Shu Di Huang (Rehmanniae Radix Praeparata) (each 5 fen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma, fried, each 6 fen), Shi Chang Pu (Acori Tatarinowii Rhizoma) (4 fen), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus). Decoct in water and take orally.

For infant open fontanelles. This is due to incomplete formation of Kidney Qi. The Kidney governs the Marrow, and the Brain is the Sea of Marrow. When Kidney Qi is not robust, the fluid of the Brain Marrow is insufficient, so the fontanelle fails to close.
Ren Shen (Ginseng Radix et Rhizoma) (2 qian), Shu Di Huang (Rehmanniae Radix Praeparata) (4 qian), Lu Rong Jiu (Deer Antler Wine), Shan Yao (Dioscoreae Rhizoma), Bai Fu Ling (Poria), Mu Dan Pi (Moutan Cortex), Shan Zhu Yu (Corni Fructus, pitted, each 3 qian). Grind into fine powder, make into pills with honey, size equivalent to Euryales Semen (Qian Shi). Take with Ginseng decoction after meals for miraculous effect.

For Jie Lu (delayed closure of fontanelles):
Shan Yin Chen (Artemisiae Scopariae Herba), Che Qian Zi (Plantaginis Semen), Bai He (Lilii Bulbus) (each 5 qian). Grind into fine powder, mix with milk from a black cow, apply to the center of the sole and the open cranial sutures, wrap with cloth, and change every three days.
Another prescription:
Donkey skull bone, any amount, burn to ash, grind finely, mix with clear sesame oil, and apply to the cranial sutures.
Another prescription:
Dog skull bone, roast until yellow, grind into powder, mix with egg white, and apply.

For sudden swelling of the fontanelle due to contracted Heat:
Tian Ma (Gastrodiae Rhizoma), Chan Tui (Cicadae Periostracum), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Yuan Zhi Rou (Polygalae Radix flesh, each 5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 fen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix) (each 4 fen), Niu Bang Zi (Arctii Fructus, stir-fried, 3 fen), Deng Xin Cao (Junci Medulla). Decoct in water and take orally.