《巢氏病源》小儿囟填候∶小儿囟填，由乳哺不时，饥饱不节，或热或寒，乘于脾胃，致腑脏不调，其气上
冲所为也。其状囟张如物填其上，汗出，毛发黄而短者是也。若寒气上冲即牢HT （
音昴，履头也，肿硬如履头叠起。）热气上
冲即柔软。又小儿胁下有积，又气满而体热，热气乘于脏，脏气上冲于脑囟，亦致囟填。又咳且啼，而气乘脏
上冲，亦病之。啼甚久，其气未定，因而乳之，亦令囟填。所以然者，方啼之时，阴阳气逆上冲故也。
《石壁经》三十六种积热囟虚肿候歌∶
积聚脾中热不通，致令面赤口唇红。胸高夜嗽多 胀，休使流传肺有风。喉里作声涎上壅，囟门肿起热来
冲。但教凉膈安灵府，能使三朝速有功。
积有冷热皆能作肿。冷则粪白，或酸臭气冲人。亦有虫出，其食物皆不能化，腹胀满而多困，喉中亦鸣也。
热则使多渴，其粪赤色，面亦黄赤，口内臭气，亦虫出。各看其证候调治，且须分水谷去积，并调气。冷则温
脾胃，热则去其热，化涎止渴。囟隐则冷也，肿则热也。（《凤髓经》此候歌括一同。有注云∶宜与金华散。）
《石壁经》三十六种积热囟虚肿候云∶此候宜将时气门中。三十六种除湿散，浓煎，桑白皮汤下。
《小儿形证论》四十八候∶积热囟虚肿歌一同。后云∶此候肺热生风，涎鸣囟肿，将白丁香膏一、二服，或南
星丸一、二服便退。
《秘要指迷论方》∶凡小儿生下一月，日内或囟门肿，此乃受胎热气，即用黄柏膏涂于足心涌泉穴。如陷即
用半夏膏涂手心。此乃婴儿肾流受冷气。邪干心，致令病生。（黄柏、半夏皆为末，皆冷水调贴）
The *Nan Shi Bing Yuan* (Chao Yuanfang's Treatise on the Pathogenesis and Symptoms of All Diseases) discusses the syndrome of fontanelle bulging in infants: Infantile fontanelle bulging is caused by irregular breastfeeding, inconsistent hunger and satiety, or exposure to heat or cold pathogens invading the spleen and stomach. This leads to dysfunction of the zang-fu organs and upward rushing of qi. The presentation includes a bulging fontanelle that appears filled with an object, accompanied by sweating, yellowish short hair. If cold qi rushes upward, the fontanelle becomes firm (the character "Lao" sounds like "Mao", referring to the toe cap of a shoe, describing swelling that is hard and stacked like a shoe toe); if hot qi rushes upward, it remains soft. Additionally, if an infant has accumulations under the ribs, along with abdominal fullness and body heat, hot qi invades the zang organs, and the zang qi rushes upward to the brain and fontanelle, also causing fontanelle bulging. Coughing combined with crying, where qi invades the zang organs and rushes upward, can also cause this disease. Prolonged crying without allowing the qi to settle, followed immediately by feeding, can also lead to fontanelle bulging. The reason for this is that during crying, the yin and yang qi become rebellious and rush upward.
The song from the *Shi Bi Jing* (Book of Stone Walls) regarding the thirty-six types of accumulated heat causing hollow and swollen fontanelles:
Accumulated heat in the spleen fails to circulate smoothly, leading to a red face and bright red lips. The chest is elevated, night coughs are frequent with phlegm and abdominal distension; do not let the pathogen spread to the lungs causing wind. Sounds arise in the throat as saliva obstructs upward; the fontanelle swells as hot qi rushes up. By cooling the diaphragm to calm the spirit, efficacy can be achieved rapidly within three days.
Both cold and hot accumulations can cause swelling. Cold accumulation results in white stool or sour, foul-smelling breath. Parasites may also be expelled; food cannot be digested, leading to abdominal distension, lethargy, and borborygmus in the throat. Hot accumulation causes excessive thirst, reddish stool, a yellow-red complexion, foul breath, and expulsion of parasites. Treatment must be tailored to the specific symptoms, prioritizing the separation of water and grain accumulations, removal of stagnation, and regulation of qi. For cold, warm the spleen and stomach; for heat, clear the heat, transform saliva, and quench thirst. A sunken fontanelle indicates cold; a swollen fontanelle indicates heat. (The song in the *Feng Sui Jing* is identical. A note states: Jin Hua San is suitable.)
The *Shi Bi Jing* further states regarding the thirty-six types of accumulated heat causing hollow and swollen fontanelles: This syndrome is suitable for treatment using the Shi Qi Men formula. For the San Shi Liu Zhong Chu Shi San (Thirty-Six Types Dampness-Removing Powder), decoct it strongly and administer with Mulberry Root Bark Decoction (Sang Bai Pi Tang).
The *Xiao Er Xing Zheng Lun* (Treatise on Infant Forms and Syndromes) records forty-eight syndromes: The song for accumulated heat causing hollow and swollen fontanelles is the same as above. It adds: This syndrome is due to lung heat generating wind, with salivary rales and fontanelle swelling. Administer one or two doses of Bai Ding Xiang Gao (White Sparrow Dung Ointment) or Nan Xing Wan (Arisaema Pill) to resolve the condition.
The *Mi Yao Zhi Mi Lun Fang* (Secret Essentials Guide to Formulas) records: Whenever an infant within one month of birth presents with a swollen fontanelle, this is due to receiving heat from the fetal stage. Apply Huang Bo Gao (Phellodendron Bark Ointment) to the Yongquan acupoint (KI1, Sole of the Foot) on the sole of the foot. If the fontanelle is sunken, apply Ban Xia Gao (Pinellia Tuber Ointment) to the palm. This indicates loss of kidney qi in the infant due to cold invasion. Pathogenic factors interfere with the heart, causing illness. (Huang Bo and Ban Xia are both ground into powder and applied with cold water mixture.)