小儿缘何囟下陷，泻久脾亏虚弱见，面目青黄四肢凉，六脉沉缓神惨淡。补中益气汤最宜，固真
汤进有奇验，外用乌附膏摊贴，温中理脾功无限。
【注】小儿脏腑有热，渴饮水浆，致成泻痢，久则脾气虚寒，不能上充脑髓，故囟陷
成坑，名曰囟陷。现证面目青黄，四肢逆冷，六脉沉缓，神气惨淡。先以补中益气汤升提
其气，再以固真汤温补其脾，外用乌附膏摊贴于陷处极效。
补中益气汤（方见飧泻）
固真汤（方见慢脾风）
乌附膏
雄黄（二钱） 川乌 附子（生，各五钱）
上为细末，用生葱和根叶细切，杵烂入前药末，同煎作成膏，每早空心贴陷处。
囟门肿起气上冲，其间虚实要分明，毛发憔悴频频汗，胸高气促口唇红。肝盛泻青丸最效，里热
连翘饮堪行，因表防风升麻剂，硬冷属阴用理中。
【注】囟填者，谓囟门肿起也。盖因乳哺无度，或寒或热，乘于脾经，致使脏腑不调，
其气上冲，为之填胀肿突。现证毛发憔悴，频频出汗，胸高气促，口唇色红，须分虚实治
之。肝气盛者，泻青丸主之；里热盛者，大连翘饮主之；因表者，防风升麻汤主之；坚
硬不热者属阴，理中汤主之。
泻青丸（方见急惊风）
大连翘饮
柴胡 荆芥 连翘（去心） 木通 滑石（水飞） 栀子 蝉蜕（去足翅） 瞿麦 当归（酒洗） 赤
芍药 黄芩 甘草（生） 防风
水煎服。
【方歌】连翘饮治热上冲，柴胡荆芥翘木通，滑石栀子蝉瞿麦，归芍黄芩草防风。
防风升麻汤
麦冬（去心） 木通 甘草节 山栀 升麻 防风
引用淡竹叶，水煎服。
【方歌】防风升麻汤，囟填效非常，麦冬木通草，山栀升麻防。
理中汤（方见不乳）
Why does the fontanelle of infants sink? This occurs due to prolonged diarrhea leading to Spleen Qi deficiency and physical weakness, manifesting as a greenish-yellow complexion, cold limbs, deep and slow pulse in all six positions, and listless spirit. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is most suitable; Gu Zhen Tang (Secure the True Decoction) also yields miraculous results when administered. Externally applying Wu Fu Gao (Aconite Plaster) offers boundless efficacy in warming the middle and regulating the Spleen.
[Note] When the internal organs of infants have heat, thirst leads to drinking fluids, resulting in diarrhea and dysentery. Over time, the Spleen Qi becomes deficient and cold, failing to ascend and nourish the brain marrow, causing the fontanelle to sink into a pit, termed "Fontanelle Depression" (Xian). Present symptoms include a greenish-yellow complexion, cold extremities, deep and slow pulse, and listless spirit. First, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to raise the Qi; then use Gu Zhen Tang (Secure the True Decoction) to warm and tonify the Spleen. Applying Wu Fu Gao (Aconite Plaster) externally to the depressed area is extremely effective.
Bu Zhong Yi Qi Tang (Formula see Sun Xie / Loose Stool with Undigested Food)
Gu Zhen Tang (Formula see Man Pi Feng / Slow Spleen Wind)
Wu Fu Gao (Aconite Plaster)
Xiong Huang (Realgar, two qian) Chuan Wu (Sichuan Aconite Root) Fu Zi (Raw Aconite Lateral Root, five qian each)
Grind the above into fine powder. Use raw scallions with roots and leaves, finely chopped, pounded until mushy, mixed with the aforementioned powder, and decocted together to form a plaster. Apply to the depressed area every morning on an empty stomach.
The fontanelle swells upward with a sensation of Qi rushing up; one must clearly distinguish between excess and deficiency. Symptoms include withered hair, frequent sweating, a distended chest, rapid breathing, and red lips. For Liver excess, Xie Qing Wan (Drain the Green Pill) is most effective; for interior heat, Da Lian Qiao Yin (Large Forsythia Decoction) is appropriate; for exterior causes, Fang Feng Sheng Ma Ji (Saposhnikovia and Cimicifuga Preparation) is used; for hard and cold conditions belonging to Yin, Li Zhong Tang (Regulate the Middle Decoction) is indicated.
[Note] "Fontanelle Fullness" (Xian Tian) refers to the swelling of the fontanelle. This is generally caused by unregulated nursing, or invasion by cold or heat pathogens affecting the Spleen Meridian, leading to disharmony of the internal organs and upward rushing of Qi, causing fullness and protrusion. Present symptoms include withered hair, frequent sweating, chest distension, rapid breathing, and red lips. Treatment must differentiate between excess and deficiency. For Liver Qi excess, Xie Qing Wan (Drain the Green Pill) is the primary formula; for severe interior heat, Da Lian Qiao Yin (Large Forsythia Decoction) is the primary formula; for exterior-related cases, Fang Feng Sheng Ma Tang (Saposhnikovia and Cimicifuga Decoction) is the primary formula; for hard and non-hot conditions belonging to Yin, Li Zhong Tang (Regulate the Middle Decoction) is the primary formula.
Xie Qing Wan (Formula see Ji Jing Feng / Acute Convulsive Wind)
Da Lian Qiao Yin (Large Forsythia Decoction)
Chai Hu (Bupleuri Radix) Jing Jie (Schizonepetae Spica) Lian Qiao (Forsythiae Fructus, remove heart) Mu Tong (Akebiae Caulis) Hua Shi (Talcum, water-floated) Zhi Zi (Gardeniae Fructus) Chan Tui (Cicadae Periostracum, remove feet and wings) Qu Mai (Dianthi Herba) Dang Gui (Angelicae Sinensis Radix, wine-washed) Chi Shao Yao (Paeoniae Radix Rubra) Huang Qin (Scutellariae Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma, raw) Fang Feng (Saposhnikoviae Radix)
Decoct in water and take orally.
[Prescription Verse] Lian Qiao Yin treats heat rushing upward, Chai Hu, Jing Jie, Lian Qiao, and Mu Tong; Hua Shi, Zhi Zi, Chan Tui, and Qu Mai; Dang Gui, Shao Yao, Huang Qin, Gan Cao, and Fang Feng.
Fang Feng Sheng Ma Tang (Saposhnikovia and Cimicifuga Decoction)
Mai Dong (Ophiopogonis Radix, remove heart) Mu Tong (Akebiae Caulis) Gan Cao Jie (Glycyrrhizae Radix et Rhizoma, knotted) Shan Zhi (Gardeniae Fructus) Sheng Ma (Cimicifugae Rhizoma) Fang Feng (Saposhnikoviae Radix)
Use Dan Zhu Ye (Lophatheri Herba) as a guide, decoct in water and take orally.
[Prescription Verse] Fang Feng Sheng Ma Tang, highly effective for Fontanelle Fullness; Mai Dong, Mu Tong, Gan Cao, Shan Zhi, Sheng Ma, and Fang Feng.
Li Zhong Tang (Regulate the Middle Decoction) (Formula see Bu Ru / Refusal to Nurse)