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Quansheng Decoction: Treats sudden swelling of the fontanelle due to pathogenic heat.
Ingredients: Radix Polygalae (Yuanzhi Rou), Periostracum Cicadae (Chantui), Rhizoma Gastrodiae (Miantianma), Radix Saposhnikoviae (Fangfeng), Rhizoma Notopterygii (Qianghuo) (each 5 fen), Rhizoma Chuanxiong (Chuanxiong), Fructus Platycodonis (Jiegeng) (each 4 fen), Semen Arctii (Niubangzi) (stir-fried, 3 fen), Radix Glycyrrhizae (Gancao) (1 fen). Decoct with Thunbergia Claytoniana stem and node (Dengxincao) water for oral administration.

Feng Luzhan stated: Depression of the fontanelle may be caused by heat accumulation in the zang-fu organs, thirst for drinking fluids leading to diarrhea and dysentery. Prolonged illness results in deficiency of blood and qi, which fails to ascend to nourish the marrow and brain, causing the fontanelle to sink like a pit. This indicates extreme deficiency of the stomach and spleen; it is urgent to support the primordial qi. If the occipital bone also sinks, there is little hope of recovery. Alternatively, damage to the father's essence or deficiency of the mother's blood can lead to insufficient endowment, resulting in emaciation and dual deficiency of yin and yang, presenting with intermittent warmth and sinking fontanelle without fixed timing. Another cause is persistent heat accumulation leading to wasting, hair loss, flexion of limbs, scorched skin resembling crane's knee, exhaustion of blood and tendons, and sinking fontanelle. Treatment should follow specific patterns. Sinking of the occipital bone is more critical than that of the anterior fontanelle, applicable not only to infants. The area one cun square behind the ear belongs to the Kidney; sinking here indicates failure of Kidney primordial qi. (from *Jinnang*)

Gu Shicheng stated: Sinking of the fontanelle results from weak primordial qi after illness. Internal administration of Yigong San to strengthen the spleen and preserve primordial qi is the best strategy.

Yingning Decoction: Treats sinking fontanelle following vomiting and diarrhea complicated by cold invasion.
Ingredients: Radix Ginseng (Renshen) (5 fen), Poria (Baifuling), Herba Akebiae (Mutong) (each 7 fen), Prepared Radix Glycyrrhizae (Zhigancao) (1 fen), Rhizoma Chuanxiong (Chuanxiong), Semen Ziziphi Spinosae (Suanzaoren) (stir-fried, each 4 fen), Rhizoma Cimicifugae (Shengma) (roasted), Prepared Radix Aconiti Lateralis Preparata (Zhi Fuzi) (each 3 fen). Use fresh ginger as an adjuvant.

Wufu Decoction: Treats sinking fontanelle.
Ingredients: Raw Radix Aconiti (Sheng Fuzi) (5 qian), Realgar (Xionghuang), Raw Rhizoma Aconiti Kusnezoffii (Mian Chuanwu) (each 2 qian).
Grind into powder. Mix with raw green onion (including root and leaves) pounded into a paste. Apply topically to the fontanelle on an empty stomach.

Feng Luzhan stated: Jiechu (split skull) refers to the separation of cranial sutures where the skull bones do not close. Texts state: maternal weakness and emaciation, paternal deficiency, lead to Jiechu. This arises from insufficient endowment and severe depletion of congenital Kidney primordial qi. Since the Kidney governs the brain and marrow, Kidney deficiency leads to insufficient brain qi, causing the skull to split. Without brain marrow, a person is like a tree without roots; within a thousand days, they become disabled. Some attribute Jiechu to paternal essence deficiency, characterized by excessive scleral exposure. Others attribute it to maternal blood deficiency and heat, presenting with melancholy, excessive scleral exposure, and pale complexion. Cases arising post-illness are particularly ominous. Long-term administration of Dihuang Wan combined with external fontanelle sealing methods is recommended. Also, fright from storms or thunder during the fifth month of pregnancy can cause cranial separation. If the sutures remain open into adulthood, symptoms include steaming heat in bones, dry flesh, blackened skin, emaciated limbs, exposed joints, and crane's knee deformity. Extensive tonification of Tianyuan (primordial origin) is necessary. (from *Jinnang*)

Lu Tingchuan stated: Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), originally a celestial elixir for nourishing the Liver and Kidney, is even more effective when used in newborns. For infants over one hundred days old, administer one pill dissolved in warm water every morning. At this stage, before cognitive development, it greatly benefits the congenital foundation. As the Liver governs tendons and the Kidney governs bones, early administration prevents Jiechu, strengthens tendons and bones, promotes knee fullness, and improves walking speed. This insight was previously unrecorded and is included here to aid infant care. However, milk feeding should be delayed for one hour after pill administration. If external wind-heat or internal food stagnation occurs, suspend use until recovery, then resume.

Gu Shicheng stated: Jiechu results from congenital deficiency, irregular nursing, and frequent illness from birth, leading to cranial separation. Compounding Liuhuang Dihuang Wan with Placenta Humana (Ziheche) and taking it orally will naturally promote closure and has proven highly effective in repeated use.