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The *Wanquan Fang* (Ten Thousand Complete Prescriptions) states: Infants may present with the syndrome of Jie Lu (splayed cranial sutures), the syndrome of fontanelle non-closure, and the syndrome of fontanelle depression. These three conditions are largely similar but differ slightly in specifics.

Jie Lu refers to a condition where, as the infant grows older, the fontanelle fails to close when it should, resulting in the splitting open of the cranial sutures. The Kidney governs bone marrow, and the brain is the sea of marrow. If Kidney Qi is insufficient, the sea of marrow will be deficient, thereby causing the cranial sutures to split open. Regarding fontanelle non-closure and fontanelle depression, although they arise from heat in the Zang-Fu organs with hot qi rushing upward—leading to either non-closure or depression—the root cause remains an insufficiency of Kidney Qi. [Xue Ji] stated that the Kidney governs bones; when bone Qi is substantial, brain marrow is abundant and the fontanelle closes early, while robust bone meridians lead to early tooth eruption. Conversely, if Kidney Qi is timid/weak, brain marrow becomes deficient and the fontanelle fails to close. This is often due to insufficiency of the parents' essence and blood, and it is appropriate to tonify using Dihuang Wan (Rehmannia Pill). If the child is still nursing, the mother should also be tonified concurrently. Additionally, the head should be tightly bound with soft cloth to facilitate closure. All these scenarios involve defluxion of deficiency fire, making the regulation and tonification of the Spleen and Kidney the best approach. Fontanelle filling (protrusion) and fontanelle depression also result from congenital insufficiency of Kidney Qi and improper feeding practices leading to Spleen-Stomach damage. The Spleen governs muscles; when Qi rebels and rushes upward, it causes filling and distension; when Yuan Qi sinks downward, it causes depression. Both conditions can be treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Dihuang Wan, along with applying powder made from roasted dog skull bone mixed with egg white to the fontanelle. In cases where diarrhea leads to Qi and Blood deficiency, preventing the Spleen-Stomach from nourishing upwards, the aforementioned methods are also applicable. If the hands and feet are cold and the previous decoctions fail to produce results, indicating severe deficiency-cold, Fuzi (Aconite Root) must be added urgently; otherwise, delay will likely lead to untreatable outcomes.

[Zhang Huan] noted that infantile Jie Lu, fontanelle non-closure, fontanelle filling, and uneven fontanelle depression are all caused by deficiency-heat in the Kidney meridian. It is appropriate to use the Fengxin San (Fontanelle Sealing Powder): Shed snake skin (1 liang, burned to ash, finely ground), Fangfeng (Saposhnikovia Root), Chuan Dahuang (Rhubarb Root wrapped in wet paper, stir-fried and baked to retain its properties), Baiji (Bletilla Rhizome) (each 0.5 liang). Grind the above ingredients into a fine powder, add Qingdai (Indigo Naturalis, 0.5 liang), and mix thoroughly. Use half a qian each time, blend with pig bile, spread onto a piece of paper, leaving a small white border on all sides. Apply to the fontanelle using dilute raw vinegar and wheat paste. Keep moistening with warm water continuously, and change once every fu period (approximately two hours).