初虞世云∶父精不足，则解颅眼白多。〔钱〕解颅，生下而囟不合，肾气不成
故也，长必少笑，更有目白睛多， 白色瘦者，多愁少喜也，余见肾虚。〔汤〕
解颅者，囟大，头缝不合如开解，故曰解颅，此由肾气不成故也。（云云见前总论）凡得此者，
不过千日，其间亦有数岁者，乃废人也。人之无脑髓，如木无根，古人虽有良方，
吾所以不录者，劳而无功也，亦不可束手待毙，宜根据钱氏补肾，万一有可生之理。
（钱氏补肾，如地黄丸加鹿茸之类是。）〔曾〕凡得此候，不及千日之内，间有数岁者，偶因他
疾攻激，遂成废人，若气色精明，能饮食者，多服调元散、补肾地黄丸，旬月内颇见效
者，次第调理，或有可治，若投药后如故，亦难疗矣。〔田〕解颅治法，宜用生地
散。〔丹〕小儿解颅，乃是母气血虚与热多耳，用四君子、四物，有热加酒炒黄连、
生甘草煎服，外以绵束紧，用白蔹末敷之。
钱氏地黄丸（见前并鹤节条）
天南星散 治囟开不合，鼻塞不通，天南星大者，微泡，去皮为细末，米醋涂调绯
帛上，贴囟上，炙手，频熨之，立效。
调元散 主禀受元气不足，颅囟开解，肌肉消瘦，腹大如肿，致语迟行迟，手足如
筒，神色昏慢，齿生迟，服之效。
干山药（去黑皮，五钱） 人参（去芦） 白茯苓（去皮） 茯神（去皮、木） 白术 白芍药 熟地黄（酒
洗） 当归（酒洗） 黄 （蜜水炙。各二钱半） 川芎 甘草（炙。二味各三钱） 石菖蒲（二钱）
上碎。每服二钱，水一盏，姜二片，枣一枚，煎七分，无时温服。如婴儿幼嫩，
与乳母同服。
〔张涣〕玉乳丹 治婴儿头骨应合而不合，头缝开解。
钟乳粉（根据古法制炼者） 柏子仁（别研） 熟干地黄（根据法蒸焙者） 当归（洗，焙干。各半两） 防风（锉） 补
骨脂（净拣，微炒。各一分） 或加黄 、茯苓
上件，除别研者，碾为细末，次入钟乳粉等拌匀，炼蜜和如黍米大。每服十粒，
煎茴香汤下，乳食前。
《婴孺方》狗脑丸 治小儿脑长喜摇头，解颅。
狗脑（一个） 漆（即五加皮） 甘草（炙） 白术 防风 钟乳石 干地黄（各一分） 牛黄（二分）
上，以狗脑丸小豆大。一岁饮下二丸，日再。未知、加之。又云∶儿囟常令暖，冷即病死。
小儿锢囟药
芍药粉
上取黄雌鸡临儿囟上，刺其冠，以血滴囟上，血止，以芍药粉敷之，使血不见，
一日，立瘥。
治小儿解颅虎骨方
虎骨 败龟板 不灰木 乳香（各半两）
上为末，用生猪血于手心内调，涂在头缝开处，以旧绵子包裹七日，第八日
以葱汤水洗去前药，再用此药涂之，经年者已减一分，又歇三日，方再用药涂之。
又服参苓散。
人参 茯苓 白附子（炮） 羌活 甘草（炙） 芍药 白术（水煮。各一分） 犀角屑 京芎
藿香（后三味减半）
上为末。每服半钱，水一盏，用少金银同薄荷三叶，煎至三分，温服，通惊气。
《千金》治小儿囟开不合方
防风（一两半） 柏子仁 白芨（各一两）
上三味，末之，以乳和敷囟上。十日知，二十日愈，日一。
《庄氏家传方》治脑缝不合。
山茵陈（一两） 车前子 百合（各半两）
上为末，用乌牛乳汁调涂脚及脑缝上，用帛子裹头。三日一换，五上必效。
〔王氏〕
封囟散 治囟开不合，头缝开张，囟开崎陷，咳嗽鼻塞。
柏子仁 防风 天南星（各四两）
上为细末，每用一钱，以猪胆汁调匀，稀稠得所，摊在绯绢帛上，看囟子大小
剪贴。一日一换，不得令干，时时以汤润动。
三辛散（三因） 治小儿骨应合而不合，头骨开也，名曰解颅。
细辛 桂心（各半两） 干姜（七钱半）
上为末，以姜汁和敷颅上贴之。儿面赤，即愈。
又方用蛇蜕炒焦为末，用猪颊车中髓调敷顶上，日三四度。曾有人作头巾裹遮护之，
久而自合，亦良法也。
灸法 脐上脐下各五分，各灸三壮，灸疮未发，先合。
Chu Yushi stated: Insufficiency of the father's essence leads to Jie Lu (delayed closure of fontanelles) and excessive exposure of the whites of the eyes. [Qian Yi] Jie Lu refers to the condition where the fontanelle fails to close after birth, caused by the failure of Kidney Qi to mature. Such children will likely smile less as they grow up; if accompanied by excessive whites of the eyes, pale complexion, and emaciation, they tend to be melancholic and rarely joyful. The remaining symptoms are all related to Kidney Deficiency. [Tang] Jie Lu is named so because the fontanelle is large and the cranial sutures appear split open, unable to close, which is also due to immature Kidney Qi. (See previous general discussion for details.) Those who contract this disease generally do not survive beyond a thousand days; some may live for several years but become disabled. A person without brain marrow is like a tree without roots. Although ancients had effective prescriptions, I do not record them here because treatment is laborious yet often ineffective. However, one should not wait passively for death; it is advisable to follow Qian's method of tonifying the Kidney, in case there is a chance of survival. (Qian's method of tonifying the Kidney includes Dihuang Wan with added Ruxi, i.e., Deer Antler.) [Zeng] For those presenting this syndrome, if within a thousand days, or occasionally surviving several years, and becoming disabled due to stimulation from other illnesses: if the complexion is bright and clear, and appetite is normal, frequent administration of Tiaoyuan San and Bushen Dihuang Wan may show significant results within ten days to a month; subsequent step-by-step regulation might lead to a cure. If the condition remains unchanged after medication, it is difficult to treat. [Tian] The treatment for Jie Lu should utilize Shengdi San. [Dan] Pediatric Jie Lu is caused by the mother's Qi and Blood deficiency combined with excess Heat. Use Sijunzi Tang and Siwu Tang; if Heat is present, add Jiuhuanglian (Wine-fried Coptidis Rhizoma) and Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), decoct and administer. Externally, bind tightly with cotton cloth and apply Bailian powder.
Qianshi Dihuang Wan (See previous section and Hejie article)
Tiannanxing San treats unclosed fontanelles and nasal congestion. Take large Tiannanxin (Arisaematis Rhizoma), soak slightly, remove skin, and grind into fine powder. Mix with rice vinegar, spread on crimson silk, apply to the fontanelle, warm with hands, and frequently moxa/iron over it for immediate effect.
Tiaoyuan San governs congenital insufficiency of Yuan Qi, resulting in unclosed cranial fontanelles, emaciated muscles, distended abdomen resembling swelling, delayed speech and walking, stiff limbs like tubes, dull spirit, and delayed tooth eruption. It is effective when taken.
Gan Shanyao (Dioscoreae Rhizoma, black skin removed, 5 qian)
Renshen (Panacis Ginseng Radix, radix removed)
Baifuling (Poria, skin removed)
Fushen (Poria with wood and skin removed)
Baizhu (Atractylodis Macrocephalae Rhizoma)
Baishaoyao (Paeoniae Radix Alba)
Shu Dihuang (Rehmanniae Radix Praeparata, wine-washed)
Danggui (Angelicae Sinensis Radix, wine-washed)
Huangqi (Astragali Radix, honey-fried. Each 2.5 qian)
Chuanxiong (Ligustici Chuanxiong Rhizoma)
Gancao (Glycyrrhizae Radix et Rhizoma, roasted. Two ingredients each 3 qian)
Shichangpu (Acori Tatarinowii Rhizoma, 2 qian)
Crush the above. Take 2 qian per dose, with one cup of water, two slices of ginger, and one jujube. Decoct to 70%, take warm at any time. For tender infants, the wet nurse may take it together.
[Zhang Huan] Yuru Dan treats infants whose skull bones should have closed but did not, with open cranial sutures.
Zhongru Fen (Stalactitum, prepared according to ancient methods)
Baizi Ren (Platycladi Semen, ground separately)
Shu Ganhuidi (Prepared Rehmanniae Radix, steamed and baked according to method)
Danggui (Angelicae Sinensis Radix, washed and dried. Each half liang)
Fangfeng (Saposhnikoviae Radix, sliced)
Buguzhi (Psoraleae Fructus, cleaned, lightly fried. Each 1 fen)
Optionally add Huangqi and Fuling.
Grind all except those ground separately into fine powder. Mix in Zhongru Fen evenly. Blend with refined honey to form pills the size of millet seeds. Take 10 pills per dose, down with anise seed soup before milk or food.
*Yinglu Fang* Gounao Wan treats children with elongated brain structures prone to head shaking and Jie Lu.
Gounao (Dog Brain, one)
Qi (Five-leaf Acanthopanacis Cortex, i.e., Wujia Pi)
Gancao (Glycyrrhizae Radix et Rhizoma, roasted)
Baizhu (Atractylodis Macrocephalae Rhizoma)
Fangfeng (Saposhnikoviae Radix)
Zhonglushi (Stalactitum)
Gan Dihuang (Dry Rehmanniae Radix. Each 1 fen)
Niuhuang (Bovis Calculus, 2 fen)
Form pills the size of adzuki beans. One-year-old infants take 2 pills with drink, twice daily. Increase dosage if no improvement. Also stated: Keep the infant's fontanelle warm; cold exposure leads to death.
Pediatric Fontanelle Binding Medicine
Shaoyao Fen (Paeoniae Radix Powder)
Take a yellow hen, prick its comb above the infant's fontanelle, let blood drip onto the fontanelle. Once bleeding stops, apply Shaoyao powder to cover the blood. Cure occurs in one day.
Hu Gu Fang for Treating Pediatric Jie Lu
Hu Gu (Tigris Ossis)
Baiguiban (Testudinis Carapax et Plastrum, aged)
Bu Huimu (Asbestos Fibra)
Ruxiang (Olibanum. Each half liang)
Grind into powder. Mix with raw pig blood in the palm. Apply to the open cranial suture. Wrap with old cotton for seven days. On the eighth day, wash off previous medicine with scallion water, then reapply this medicine. For chronic cases lasting a year, reduce severity by one degree. Rest for three days, then reapply.
Also administer Shenling San.
Renshen (Panacis Ginseng Radix)
Fuling (Poria)
Baifuzi (Typhonii Rhizoma, processed)
Qianghuo (Notopterygii Rhizoma et Radix)
Gancao (Glycyrrhizae Radix et Rhizoma, roasted)
Shaoyao (Paeoniae Radix)
Baizhu (Atractylodis Macrocephalae Rhizoma, boiled in water. Each 1 fen)
Xijiao Xie (Rhinocerotis Cornu, shaved)
Jingxiong (Ligustici Chuanxiong Rhizoma)
Huoxiang (Agastaches Herba. Last three ingredients halved)
Grind into powder. Take half qian per dose, with one cup of water, a small amount of gold/silver foil, and three mint leaves. Decoct to 30%, take warm to dispel wind-stroke qi.
*Qianjin* Formula for Treating Unclosed Infant Fontanelles
Fangfeng (Saposhnikoviae Radix, 1.5 liang)
Baizi Ren (Platycladi Semen)
Baiji (Bletillae Rhizoma. Each 1 liang)
Grind the three ingredients into powder. Mix with milk and apply to the fontanelle. Effective in ten days, cured in twenty days. Apply once daily.
*Zhuang Family Prescribed Formula* for Treating Unclosed Cranial Sutures.
Shanyinyinchen (Artemisiae Scopariae Herba, 1 liang)
Cheqianzi (Plantaginis Semen)
Baihe (Lilii Bulbus. Each half liang)
Grind into powder. Mix with black ox milk and apply to feet and cranial sutures. Wrap head with cloth. Change every three days. Five applications guarantee efficacy.
[Wang Shi]
Fengxin San treats unclosed fontanelles, open cranial sutures, depressed fontanelles, cough, and nasal congestion.
Baizi Ren (Platycladi Semen)
Fangfeng (Saposhnikoviae Radix)
Tiannanxing (Arisaematis Rhizoma. Each 4 liang)
Grind into fine powder. Use 1 qian per application. Mix with pig bile until consistency is appropriate. Spread on crimson silk. Cut to fit fontanelle size. Change once daily. Do not let it dry; moisten with water frequently.
Sanxin San (from *Sanyin Fang*) treats pediatric skeletal immaturity where bones fail to close, specifically open cranial bones, named Jie Lu.
Xixin (Asari Radix et Rhizoma)
Guixin (Cinnamomi Cortex. Each half liang)
Ganjiang (Zingiberis Rhizoma, dried, 7.5 qian)
Grind into powder. Mix with ginger juice and apply to the cranium. When the child's face turns red, it indicates recovery.
Another method: Char snake shed skin, grind to powder. Mix with pig masseter medulla. Apply to the vertex, 3-4 times daily. Someone made a cap to cover and protect it; over time, it closed naturally, which is also a good method.
Moxibustion Method: Moxa 3 cones at 0.5 cun above and below the umbilicus. The fontanelle closes before the moxa sore appears.